Diabetic medicine : a journal of the British Diabetic Association · 2026
A qualitative enquiry into the lived experiences of women with type 1 diabetes using closed-loop insulin delivery in pregnancy in the CIRCUIT trial.
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Hirtle J, Goraya N, Dunlop A, Booth J, Feig D S, Yamamoto J, Donovan L E, Chaput K H, CIRCUIT Collaborative Group
Аннотация
AIMS: This qualitative inquiry aimed to explore the lived experiences of pregnant women with self-management of type 1 diabetes (T1D) using closed-loop insulin delivery in the CIRCUIT trial9 to provide a qualitative overview of its impacts and improve the understanding of T1D experiences in pregnancy.
METHODS: We used semi-structured, individual interviews with 18 CIRCUIT randomized trial participants. Two team members analysed verbatim transcripts using inductive thematic analysis.
RESULTS: Four major themes emerged: 1. Independence and isolation; 2. Support is key; 3. Closed-loop impacts; and 4. Control and autonomy. Diabetes management during pregnancy was an emotionally overwhelming experience that was managed largely independently. Closed-loop was noted as a gamechanger for diabetes management during and after pregnancy. Participants felt the transition to and use of this technology would not have been possible without their healthcare team's support. Permeating all themes was the importance of control to achieve the best possible glycaemic outcomes for the health of their babies and autonomy over personal treatment decisions. The perceptions of loss of personal autonomy were associated with high anxiety.
CONCLUSIONS: Managing T1D while pregnant is an independent and isolating endeavour, due to the 'invisible labour' involved and the lack of knowledge about T1D management in personal networks. Support from partners and care providers alleviated stress. Experiences with intrapartum care providers who had limited T1D understanding were perceived as a challenge by some for maintaining autonomy. The closed-loop system was seen as a 'gamechanger' in T1D pregnancy management, with unanimous perception of positive impacts that far outweigh any challenges. Use of this closed-loop system has potential to vastly improve pregnancy experiences among those with T1D.
METHODS: We used semi-structured, individual interviews with 18 CIRCUIT randomized trial participants. Two team members analysed verbatim transcripts using inductive thematic analysis.
RESULTS: Four major themes emerged: 1. Independence and isolation; 2. Support is key; 3. Closed-loop impacts; and 4. Control and autonomy. Diabetes management during pregnancy was an emotionally overwhelming experience that was managed largely independently. Closed-loop was noted as a gamechanger for diabetes management during and after pregnancy. Participants felt the transition to and use of this technology would not have been possible without their healthcare team's support. Permeating all themes was the importance of control to achieve the best possible glycaemic outcomes for the health of their babies and autonomy over personal treatment decisions. The perceptions of loss of personal autonomy were associated with high anxiety.
CONCLUSIONS: Managing T1D while pregnant is an independent and isolating endeavour, due to the 'invisible labour' involved and the lack of knowledge about T1D management in personal networks. Support from partners and care providers alleviated stress. Experiences with intrapartum care providers who had limited T1D understanding were perceived as a challenge by some for maintaining autonomy. The closed-loop system was seen as a 'gamechanger' in T1D pregnancy management, with unanimous perception of positive impacts that far outweigh any challenges. Use of this closed-loop system has potential to vastly improve pregnancy experiences among those with T1D.