ESPE Abstracts

Introduction: Hybrid closed loop system (HCLS), also known as automated insulin delivery system, is available in NHS across the four nations of UK. The first commercial HCLS was made available in 2016. Over the last 8 years, successful research on acceptability and efficacy of HCLS has enabled its use widely available. NICE now recommends HCLS in management of children and young people (CYP) with type 1 diabetes (T1D). Paediatric Diabetes Specialist Nurses (PDSNs) are at the front line and most experienced in adopting HCLS.

Aim: This study aims to investigate the available commercial HCLSs across Wales and the opinions of PDSNs on clinical benefits, customer service and support of each company.

Method: A survey was distributed to all PDSNs across Wales through Children and Young People’s Wales Diabetes Network (CYPWDN). Data collected covers available HCLSs, customer service and pump start support, clinical efficacy, experience and satisfaction of PDSNs, CYP and families. NPDA data on percentage of CYP with T1D using HCLS from 2022-2023 audit year was also reviewed.

Results: NPDA (2022-2023) reported that 14% of CYP with T1D in Wales used HCLS whilst 55.7% on CGM, 47.8% on insulin pump and 51.7% on MDI regimen. 17 PDSNs responded to the survey, a response rate of 50%. Omnipod5 was found to be used in all health boards, Medtronic780G in 70%, Tandem T-slim control IQ in 53% and Cam APS FX Ypso pump in 29%. Omnipod5 was rated as very helpful in general customer service by 58.8% of respondents, very helpful with pump start by 88.2%, highest in overall experience of CYP and families by 47.1% and well-liked for data uploading and interpreting system by 76.5%. However, Medtronic was rated highest in reducing hypoglycaemia and keeping time in range. Choice of PDSNs’ personal favourite system was equally split between Omnipod5 and Medtronic780G. 58.8% of PDSNs had experience of CYP reverting from HCLS to non-HCLS regimen, especially in adolescents. The main reasons were alarm burden and constant attachment to glucose sensor and pump.

Conclusion: Real-world experience of PDSNs reflects the satisfaction rate of key stakeholders and reliability of each HCLS not only on its clinical efficacy, also the support from device representatives for patient care and education. Most used systems in Wales are Omnipod5 and Medtronic780G with Omnipod earning overall higher stakeholder satisfaction and Medtronic edging on clinical efficacy and safety based on perspective of PDSNs.