Highlights
- •OS AID has been shown to improve clinical outcomes and quality of life.
- •This is the first study to identify the most common barriers to uptake of OS AID among those currently not using such a system.
Abstract
Aims
Social and technical trends are empowering people with diabetes to co-create or self-develop
medical devices and treatments to address their unmet healthcare needs, for example,
open-source automated insulin delivery (AID) systems. This study aims to investigate
the perceived barriers towards adoption and maintaining of open-source AID systems.
Methods
This is a multinational study based on a cross-sectional, retrospective web-based
survey of non-users of open-source AID. Participants (n=129) with type 1 diabetes
from 31 countries were recruited online to elicit their perceived barriers towards
the building and maintaining of an open-source AID system.
Results
Sourcing the necessary components, lack of confidence in one's own technology knowledge
and skills, perceived time and energy required to build a system and fear of losing
healthcare provider support appear to be major barriers towards the uptake of open-source
AID.
Conclusions
This study identified a range of structural and individual-level barriers to uptake
of open-source AID. Some of these individual-level barriers may be overcome over time
through the peer-support of the DIY online community as well as greater acceptance
of open-source innovation among healthcare professionals. The findings have important
implications for understanding the possible wider diffusion of open-source diabetes
technology solutions in the future.
Keywords
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References
- A Patient-Designed Do-It-Yourself Mobile Technology System for Diabetes.JAMA. 2016; : 1447https://doi.org/10.1001/jama.2016.1903
- Real-World Use of Do-It-Yourself Artificial Pancreas Systems in Children and Adolescents With Type 1 Diabetes: Online Survey and Analysis of Self-Reported Clinical Outcomes.JMIR Mhealth Uhealth. 2019; 7: e14087
- DIY artificial pancreas systems: here to stay?.Pract diabetes. 2019; 36: 63-68
- Open-source automated insulin delivery: international consensus statement and practical guidance for health-care professionals.The Lancet Diabetes & Endocrinology. 2022 Jan 1; 10: 58-74
- Open-Source Automated Insulin Delivery in Type 1 Diabetes.N Engl J Med. 2022; 387: 869-881
- Why #WeAreNotWaiting—Motivations and Self-Reported Outcomes Among Users of Open-source Automated Insulin Delivery Systems: Multinational Survey.J Med Internet Res. 2021; 23: e25409
- Open Source Closed-Loop Insulin Delivery Systems: A Clash of Cultures or Merging of Diverse Approaches?.J Diabetes Sci Technol. 2018; 12: 1223-1226
- Do-It-Yourself Automated Insulin Delivery: A Leading Example of the Democratization of Medicine.J Diabetes Sci Technol. 2020; 14: 878-882
- How Adults with Type 1 Diabetes Are Navigating the Challenges of Open-Source Artificial Pancreas Systems: A Qualitative Study.Diabetes Technol Ther. 2021; https://doi.org/10.1089/dia.2020.0652
- 78-LB: Detailing the Experiences of People with Diabetes Using Do-It-Yourself Artificial Pancreas Systems—Qualitative Analysis of Responses to Open-Ended Items in an International Survey.Diabetes. 2019; : 68https://doi.org/10.2337/db19-78-LB
- Learning to Close the Loop.Diabetes. 2018; : 67https://doi.org/10.2337/db18-983-P
Braune K, Gajewska KA, Thieffry A, Lewis DM, Froment T, O’Donnell S, et al. Why #WeAreNotWaiting - Motivations and Self-Reported Outcomes Among Users of Open-Source Automated Insulin Delivery Systems: A Multinational Survey. 2020. doi:10.2139/ssrn.3714627
- Barriers and facilitators to accessing insulin pump therapy by adults with type 1 diabetes mellitus: a qualitative study.Acta Diabetol. 2021; 58: 93-105
- Do-It-Yourself Artificial Pancreas Systems in Type 1 Diabetes: Perspectives of Two Adult Users, a Caregiver and Three Physicians.Diabetes Ther. 2019; 10: 1553-1564
- Do-It-Yourself (DIY) Closed Loop Systems: Perspectives of an Endocrinologist.J Diabetes Sci Technol. 2020; 14: 1104-1106
- Low uptake of continuous subcutaneous insulin infusion therapy in people with type 1 diabetes in Ireland: a retrospective cross-sectional study.BMC Endocr Disord. 2020; 20: 92
- A Real-World Prospective Study of the Safety and Effectiveness of the Loop Open Source Automated Insulin Delivery System.Diabetes Technol Ther. 2020; https://doi.org/10.1089/dia.2020.0535
- Pre-school and school-aged children benefit from the switch from a sensor-augmented pump to an AndroidAPS hybrid closed loop: A retrospective analysis.Pediatr Diabetes. 2021; https://doi.org/10.1111/pedi.13190
O’Donnell, S., Braune, K., Ballhausen, H., Lewis, D., Cleal, B., Skinner,T., Raille, K., Pfiester, E., Wolf S. ACCESS ISSUES IN DIABETES TECHNOLOGY: THE CASE OF DO‐IT‐YOURSELF ARTIFICIAL PANCREAS SYSTEMS. Diabetes Technol Ther. 2020;22. doi:10.1089/dia.2020.2525.abstracts
- “Your wealth is your health”: the fundamental causes of inequalities in diabetes management outcomes: a qualitative analysis.Sociol Health Illn. 2020; 42: 1626-1641
- Prescribing unapproved medical devices? The case of DIY artificial pancreas systems.Med Law Int. 2021; 21: 42-68
- The DIY artificial pancreas system: an ethical dilemma for doctors.Diabet Med. 2020; https://doi.org/10.1111/dme.14270
- Using a Do-It-Yourself Artificial Pancreas: Perspectives from Patients and Diabetes Providers.J Diabetes Sci Technol. 2020; 14: 860-867
- Barriers to Uptake of Open-Source Automated Insulin Delivery Systems: Analysis of Socioeconomic Factors and Perceived Challenges of Caregivers of Children and Adolescents With Type 1 Diabetes From the OPEN Survey.Frontiers in Clinical Diabetes and Healthcare. 2022;; : 3https://doi.org/10.3389/fcdhc.2022.876511
- HbA1c Levels in Type 1 Diabetes from Early Childhood to Older Adults: A Deeper Dive into the Influence of Technology and Socioeconomic Status on HbA1c in the T1D Exchange Clinic Registry Findings.Diabetes Technol Ther. 2020; 22: 645-650
- Barriers to Technology Use and Endocrinology Care for Underserved Communities With Type 1 Diabetes.Diabetes Care. 2021; https://doi.org/10.2337/dc20-2753
- Stratified users and technologies of empowerment: theorising social inequalities in the use and perception of diabetes self-management technologies.Sociol Health Illn. 2020; 42: 862-876
Weiss D, Sund ER, Freese J, Krokstad S. The diffusion of innovative diabetes technologies as a fundamental cause of social inequalities in health. The Nord-Trøndelag Health Study, Norway. Sociol Health Illn. 2020;42: 1548–1565.
- DIY artificial pancreas: A narrative of the first patient and the physicians’ experiences from India.Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2021; : 615-620https://doi.org/10.1016/j.dsx.2021.02.033
- Do-It-Yourself Artificial Pancreas Systems: A Review of the Emerging Evidence and Insights for Healthcare Professionals.J Diabetes Sci Technol. 2019; 1932296819894296
- User and Healthcare Professional Perspectives on Do-It-Yourself Artificial Pancreas Systems: A Need for Guidelines.J Diabetes Sci Technol. 2020; 1932296820957728
Mialet H. Bodies in Balance: Tracking Type 1 Diabetes. Body & Society. 2022; 1357034X221109140.
Article info
Publication history
Accepted:
December 21,
2022
Received in revised form:
December 13,
2022
Received:
November 9,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Published by Elsevier B.V.
