650-P: Attitudes and Barriers to Implantable AID Solutions—Development of a New Assessment Tool

Major limitations of current automated insulin delivery (AID) systems are the subcutaneous insulin route and the need to wear devices on the body. The EU project “FORGETDIABETES” (supported by H2020-FETPROACT, n.951933) will develop a fully implantable AID systems to overcome these barriers. To assess attitudes and barriers to such an implantable solution, a new assessment tool was developed. A list of 19 items assessing different aspects of an implantable AID system were developed. In an online survey, 366 people with type 1 diabetes (27.0% insulin pen, 45.9% insulin pump, 27.0% AID) completed the item pool and answered questions about the expected reductions in diabetes distress and improvement in quality of life from such an implantable AID system. Factor analysis revealed 4 factors explaining 63.7% of the variance. Overall reliability was very high with Cronbach’s alpha (CR-a)=0.88. The factors were named “glycemic benefits” (e.g. protection from complications; 6 items, CR-a =0.85), “mental benefits” (e.g. less thinking about diabetes; 3 items, CR-a =0.81), “technical barriers” (e.g. complications during implantation; 3 items, CR-a =0.80), and “emotional barriers” (e.g. loss of control; 7 items, CR-a =0.86). Higher glycemic benefits and higher mental benefits were associated with higher expected reductions in diabetes distress (r=0.47, r=0.42) and quality of life (r=0.42, r=0.38) (all p<.01). Higher technical and emotional barriers were associated with lower expected reductions in diabetes distress (r=-0.35, r=-0.41) and quality of life (r=-0.34, r=-0.42) (all p<.01). There were no differences between therapy regimens, except for lower emotional barriers in AID users (p<.001). The new questionnaire is a reliable and valid tool to assess attitudes and barriers to implantable AID systems. It can be used to assess and consequently address human factors associated with use of implantable AID solutions.