%0 Journal Article %@ 1438-8871 %I JMIR Publications %V 25 %N %P e44002 %T Psychosocial Outcomes Among Users and Nonusers of Open-Source Automated Insulin Delivery Systems: Multinational Survey of Adults With Type 1 Diabetes %A Schipp,Jasmine %A Hendrieckx,Christel %A Braune,Katarina %A Knoll,Christine %A O’Donnell,Shane %A Ballhausen,Hanne %A Cleal,Bryan %A Wäldchen,Mandy %A Lewis,Dana M %A Gajewska,Katarzyna A %A Skinner,Timothy C %A Speight,Jane %+ The Australian Centre for Behavioural Research in Diabetes, Suite G01, 15-31 Pelham Street, Carlton, 3053, Australia, 61 03 9244 6448, schippj@deakin.edu.au %K artificial %K diabetes mellitus %K hypoglycaemia %K pancreas %K patient-reported outcome measures, surveys, and questionnaires %K quality of life %K sleep quality %K type 1 %D 2023 %7 14.12.2023 %9 Original Paper %J J Med Internet Res %G English %X Background: Emerging research suggests that open-source automated insulin delivery (AID) may reduce diabetes burden and improve sleep quality and quality of life (QoL). However, the evidence is mostly qualitative or uses unvalidated, study-specific, single items. Validated person-reported outcome measures (PROMs) have demonstrated the benefits of other diabetes technologies. The relative lack of research investigating open-source AID using PROMs has been considered a missed opportunity. Objective: This study aimed to examine the psychosocial outcomes of adults with type 1 diabetes using and not using open-source AID systems using a comprehensive set of validated PROMs in a real-world, multinational, cross-sectional study. Methods: Adults with type 1 diabetes completed 8 validated measures of general emotional well-being (5-item World Health Organization Well-Being Index), sleep quality (Pittsburgh Sleep Quality Index), diabetes-specific QoL (modified DAWN Impact of Diabetes Profile), diabetes-specific positive well-being (4-item subscale of the 28-item Well-Being Questionnaire), diabetes treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire), diabetes distress (20-item Problem Areas in Diabetes scale), fear of hypoglycemia (short form of the Hypoglycemia Fear Survey II), and a measure of the impact of COVID-19 on QoL. Independent groups 2-tailed t tests and Mann-Whitney U tests compared PROM scores between adults with type 1 diabetes using and not using open-source AID. An analysis of covariance was used to adjust for potentially confounding variables, including all sociodemographic and clinical characteristics that differed by use of open-source AID. Results: In total, 592 participants were eligible (attempting at least 1 questionnaire), including 451 using open-source AID (mean age 43, SD 13 years; n=189, 41.9% women) and 141 nonusers (mean age 40, SD 13 years; n=90, 63.8% women). Adults using open-source AID reported significantly better general emotional well-being and subjective sleep quality, as well as better diabetes-specific QoL, positive well-being, and treatment satisfaction. They also reported significantly less diabetes distress, fear of hypoglycemia, and perceived less impact of the COVID-19 pandemic on their QoL. All were medium-to-large effects (Cohen d=0.5-1.5). The differences between groups remained significant after adjusting for sociodemographic and clinical characteristics. Conclusions: Adults with type 1 diabetes using open-source AID report significantly better psychosocial outcomes than those not using these systems, after adjusting for sociodemographic and clinical characteristics. Using validated, quantitative measures, this real-world study corroborates the beneficial psychosocial outcomes described previously in qualitative studies or using unvalidated study-specific items. %M 38096018 %R 10.2196/44002 %U https://www.jmir.org/2023/1/e44002 %U https://doi.org/10.2196/44002 %U http://www.ncbi.nlm.nih.gov/pubmed/38096018