# Hybrid closed‐loop systems in UK type 1 diabetes care: National survey of healthcare professional awareness, confidence, and training needs

## TL;DR

This study surveyed UK healthcare professionals about their awareness and confidence in using hybrid closed-loop diabetes systems, finding high awareness but gaps in training, especially for pregnancy-specific systems.

## Contribution

The study identifies training needs among UK healthcare professionals regarding hybrid closed-loop systems, particularly for pregnancy-specific systems.

## Key findings

- High overall awareness of HCL systems was reported, with endocrinologists and diabetes nurse specialists more familiar than residents.
- Confidence in pregnancy-specific CamAPSFx-based systems was notably low, with 41% of pregnancy care respondents reporting no confidence.
- 73.3% of respondents expressed interest in additional training, preferring remotely accessible modules.

## Abstract

Hybrid closed‐loop (HCL) systems significantly improve glycaemia and have become the standard of care for type 1 diabetes (T1D), leading to the recent widescale implementation programme in England and Wales. Limited data exist regarding UK healthcare professionals' (HCPs) confidence and experience with commercially available HCL systems. This survey aimed to evaluate UK HCPs' awareness, confidence, and training needs concerning commercial HCL systems.

A national survey, developed in collaboration with the Association of British Clinical Diabetologists' Diabetes Technology Network (ABCD‐DTN‐UK), was distributed to adult and paediatric diabetes care teams. Data were collected between July and November 2024 and analysed descriptively, stratified by professional roles and care settings.

Responses from 637 HCPs (42.4% diabetes specialist nurses, 24.5% endocrinologists, 16.6% dieticians, 12.7% endocrinology residents) across 135 healthcare organisations in the UK revealed high overall awareness regarding HCL initiation and safety. Awareness varied significantly by role, with endocrinologists and diabetes nurse specialists reporting greater familiarity than endocrinology residents (p < 0.001). Confidence in system‐specific use varied, with notably lower confidence in pregnancy‐specific CamAPSFx‐based systems. 41% of respondents involved in pregnancy care reported no confidence in advising on these systems, with 7% reporting no access to any CamAPSFx‐based system. A majority (73.3%) expressed interest in additional training, favouring remotely accessible modules (52.3%).

This survey highlights encouraging overall confidence and awareness of commercial HCL systems among UK HCPs, reflecting successful recent educational initiatives. However, significant gaps, particularly concerning pregnancy‐licensed systems and variable exposure to specific HCL systems, identify clear training needs. Addressing these will be crucial in ensuring equitable and effective HCL implementation of systems licensed for use across the lifespan of an individual with T1D and across diverse clinical settings.