# Accelerating care, capacity and equity in automated insulin delivery systems for New Zealanders with type 1 diabetes: the ACCESS-AID study protocol

## TL;DR

The ACCESS-AID study aims to improve access to automated insulin delivery systems for people with type 1 diabetes in New Zealand by implementing a remote support model focused on equity and scalability.

## Contribution

The study introduces a novel, equity-focused model of care using a remote Hub to deliver training and support for diabetes technology.

## Key findings

- The model prioritizes participants based on need to address inequities in access to AID systems.
- Implementation effectiveness and clinical outcomes will be assessed through CGM metrics and HbA1c levels.
- Qualitative insights and workforce training outcomes will inform future service delivery for chronic conditions.

## Abstract

Automated insulin delivery (AID) systems are the gold standard for managing type 1 diabetes (T1D), yet access remains inequitable due to funding disparities, workforce limitations, bias, and geographic barriers. The ACCESS-AID study aims to implement a new model of care by using a remote ‘Hub’ to deliver prioritised training and support to those most in need and to improve workforce capacity by working in partnership with New Zealand’s National Public Health service.

Eligible participants include all individuals with T1D and eligible people with pancreatogenic/Type 3c diabetes). Enrolment will use a prioritisation score. After informed consent and baseline assessments, participants receive one-day AID training (in-person or remote) by certified, industry provided trainers, followed by 12-weeks of structured support from Hub staff. The primary outcome is implementation effectiveness. Secondary outcomes: clinical and psychosocial impacts, safety, nutrition education effectiveness, and qualitative insights. CGM metrics and HbA1c will be assessed at baseline and 12-weeks, and CGM again at 24-weeks. Hub staff will receive training in AID management, complete self-efficacy assessments, and participate in interviews.

This model offers a novel, scalable and equity-focused approach to diabetes technology care, which will enhance outcomes for people with diabetes and inform future service delivery for other long-term conditions.