The evolution of technology in managing Type 1 diabetes has brought about significant transformations for those living with this condition. While these technological advancements offer new tools for coping with diabetes, research suggests that their focus tends to be on disease management rather than considering their impact on individuals. Numerous studies delve into the potential improvements in the quality of life achievable through these technologies.

In 2007, Diabetic Medicine conducted a study exploring continuous subcutaneous insulin infusion (CSII) and its potential benefits for individuals with Type 1 diabetes. The outcomes were mixed, revealing varying impacts on the quality of life for participants. An editorial accompanying the study delved into the subjective nature of quality of life (QoL), stressing its individualized nature. The user’s expectations of QoL may not always align with those of healthcare professionals. While the primary focus is on enhancing overall diabetes control, the impact on various aspects of life and the rigorous monitoring requirements of the technology may affect the management outcome.

Living with diabetes necessitates a daily commitment to maintaining stable blood sugar levels. Any disruptions to this balance can result in metabolic and physical changes with severe consequences over time. Microvascular changes, including retinopathy, neuropathy, and nephropathy, may cause eye damage, and loss of sensation in the toes and feet, and affect kidney function. On a macrovascular level, atherosclerosis, the narrowing of arteries, increases the risk of cardiovascular diseases such as strokes. While diabetes technology has significantly improved diabetes management, recent research indicates that anxiety may still be associated with its use.

‘’As a closed-loop system user, I can attest to the constant monitoring and user input required for the system to function correctly. Despite the convenience of these technologies, there remains a degree of anxiety. There are times when I’ve seen my blood glucose level plummeting and freaked out as I have to remind myself not to interfere with the pump. To, ‘ sit on my hands’ so to speak and let the ‘shield’ setting on the pump handle the situation. This is extremely difficult because my first inclination is to intervene and suspend the pump’s ability to keep delivering the insulin. I sometimes feel that the reaction of the pump is too slow. I must honestly say, that I have intervened many times and I think confused the system. However, when I leave it to the pump shield setting, I realise that it is more than capable of making the adjustments needed. Patience is key as well as being able to trust that the pump will achieve the target range ‘you’ set up initially. I also feel as if this system has learnt my sporadic nature, of wanting to interfere and has made changes quicker and in turn this has put me at ease.” - SHSL

Research and personal experiences highlight the need for vigilant monitoring, with the user reporting occasional discrepancies between the closed-loop system’s readings and finger-prick test results. Such discrepancies can result in over or under-correction of blood glucose levels, leading to potentially dangerous situations. To address this, users may have to calibrate the system by inputting recent blood glucose readings through finger-pricking regularly.

”My journey with diabetes technology over the past twenty-nine years has seen a shift from the traditional injecting of insulin to embracing the use of insulin pumps. This shift has been a process and one that has taken some time for me to develop the ability required to navigate changes in my diabetes management and to trust the technology to guide me in the direction of being able to improve my overall diabetes blood glucose control. ” – SHSL

In recent studies, there has been a growing recognition of the need to include quality-of-life measures alongside traditional clinical endpoints. This reflects a broader understanding of the impact that diabetes technology has on individuals beyond its clinical efficacy. As these technologies continue to advance, the ongoing dialogue between users, healthcare professionals, and researchers becomes paramount in ensuring that advancements not only enhance diabetes control but also contribute positively to the overall quality of life for individuals living with Type 1 diabetes.

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Amina xx