# Exploring the Use of Hybrid Closed‐Loop Systems in People With Type 1 Diabetes and Their Partners: A Qualitative Evaluation From the NHS England Pilot

## TL;DR

This study explores how hybrid closed-loop insulin pumps affect the lives of people with Type 1 diabetes and their partners, highlighting both benefits and challenges.

## Contribution

The study provides new qualitative insights into the psychosocial and physiological impacts of hybrid closed-loop systems on users and their partners.

## Key findings

- Users and partners reported improved mental wellbeing and physical health from using HCL systems.
- Technical difficulties and learning hurdles were common but mitigated by prior experience and support.
- HCL systems were endorsed for their positive impact on diabetes management and lifestyle.

## Abstract

The NHS England hybrid closed‐loop (HCL) insulin pump pilot offered people living with Type 1 diabetes (PWT1Ds) access to HCL therapy. Outcomes demonstrated the glycaemic benefits of HCL. Our study explored the views, experiences and impact of HCL on users and their partners′ daily life.

A total of 14 PWT1Ds and 12 partners of PWT1Ds who participated in the NHS HCL pilot took part in semistructured interviews via telephone/video call. Topics explored included the effect of the HCL system on glucose levels, time spent managing diabetes, daily life and challenges with the systems. Interviews were audio‐recorded and transcribed. Data was analysed using inductive thematic analysis and then mapped onto an adapted Optimal Health Wheel (OHW) framework encompassing four relevant domains: (i) emotional, (ii) intellectual, (iii) social and (iv) physical.

Ten subthemes relating to the impact or experience of using HCL emerged—knowledge and previous experience, time/trial and error, building trust, impact on mental wellbeing, impact on physical health, impact on diabetes management, impact on lifestyle, impact on work, impact on relationships and need for support. PWT1Ds and partners reported multifaceted physiological and psychosocial benefits of using HCL systems. While technical difficulties and initial learning hurdles were acknowledged as barriers to HCL use, facilitators such as previous experience and trial and error helped overcome these issues.

PWT1Ds and their partners endorsed the use of HCL systems, despite challenges, due to the impactful benefits to their lives. To ensure future successful implementation of HCL, users should be offered appropriate training and access to support to help build trust. These findings underscore the potential of HCL systems in T1D treatment.