"You can hide it if you want to, you can let it be seen if you want to": A qualitative study of the lived experiences of Australian adults with type 1 diabetes using the Omnipod DASH® system

Amber Stocco; Steven Trawley; Yee Wen Kong; Cheng Yi Yuan; Katerina Kiburg; Cecilia Pham; Katrin Brown; Andi Partovi; Kerryn Roem; Natalie Harrison; Spiros Fourlanos; Elif I Ekinci; David N O'Neal

doi:10.1016/j.diabres.2024.111123

"You can hide it if you want to, you can let it be seen if you want to": A qualitative study of the lived experiences of Australian adults with type 1 diabetes using the Omnipod DASH® system

Diabetes Res Clin Pract. 2024 Feb:208:111123. doi: 10.1016/j.diabres.2024.111123. Epub 2024 Feb 2.

Authors

Affiliations

¹ Cairnmillar Institute, Camberwell, Victoria, Australia.
² Cairnmillar Institute, Camberwell, Victoria, Australia; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia. Electronic address: steven.trawley@unimelb.edu.au.
³ Diabetes Technology Research Group, The University of Melbourne, Melbourne, Victoria, Australia; Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
⁴ Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia; Department of Endocrinology, Austin Health, Melbourne, Victoria, Australia; The Australian Centre for Accelerating Diabetes Innovations (ACADI), The University of Melbourne, Melbourne, Victoria, Australia.
⁵ Keylead Health, Melbourne, Victoria, Australia.
⁶ Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
⁷ Geelong Endocrinology and Diabetes, Geelong, Victoria, Australia.
⁸ Department of Diabetes and Endocrinology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia; The Australian Centre for Accelerating Diabetes Innovations (ACADI), The University of Melbourne, Melbourne, Victoria, Australia.
⁹ Diabetes Technology Research Group, The University of Melbourne, Melbourne, Victoria, Australia; Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia; The Australian Centre for Accelerating Diabetes Innovations (ACADI), The University of Melbourne, Melbourne, Victoria, Australia.

PMID: 38309532
DOI: 10.1016/j.diabres.2024.111123

Abstract

Aims: Understanding the lived experience of using a tubeless insulin pump and how this differs compared to usual care (tubed insulin pump therapy (IPT) vs multiple daily injections (MDI)).

Methods: Interviews were conducted after 12-weeks of using the Omnipod DASH Insulin Management System (Insulet, Acton, MA) and analysed using thematic analysis.

Results: Fifty-eight adults (35 female; mean age 42;SD 13 years; 35 previous MDI) were interviewed. Most (84 %) wanted to continue using the device. Experiences fit two themes: 1. Taking back control of my diabetes: many previous MDI users perceived improved glycaemic control, explained by more "nuanced" control, with some reporting positive effects during exercise and sleep. Many previous MDI and IPT users endorsed positive experiences in concealing or disclosing their diabetes to others. However, some previous MDI users reported negative psychosocial experiences due to feeling continuously "attached" to their diabetes. 2. Barriers and facilitators of device acceptability: both MDI and IPT users cited wearability, alarms and the financial cost impacted their choice to continue device use. IPT users reported positive wearability experiences.

Conclusions: The tubeless pump improved diabetes management perceptions for both MDI and tubed pump users. However, participants' prior glucose management affected perceptions of its advantages and disadvantages.

Keywords: Insulin pump; Interviews; Type 1 diabetes.

MeSH terms

Adult
Australia
Blood Glucose
Diabetes Mellitus, Type 1* / drug therapy
Diabetes Mellitus, Type 1* / psychology
Female
Humans
Hypoglycemic Agents / therapeutic use
Injections
Insulin / therapeutic use
Insulin Infusion Systems

Substances

Hypoglycemic Agents
Insulin
Blood Glucose