User Experiences of a Bihormonal Fully Closed-Loop System Among Adults with Type 1 Diabetes in a Real-World Setting: A Qualitative Analysis
Authors' conclusion
FCL users experience improvements mostly in glycemic and often also person-reported outcomes, with continuation of use depending on reconcilability of technology hassles. To facilitate FCL adoption and long-term use, expectation management and continued support from the manufacturer and trained diabetes care teams seem key.
Study context
- Population
- Adults with T1D using a bihormonal fully closed-loop (fully closed loop (FCL)) system in a real-world setting, subsample of the FREE 1 trialinterviewed subsample
- Participants
- 12 adults
- Comparison
- Ongoing users vs Discontinued
- Ongoing usersn = 8
- Discontinuedn = 4
- Outcome
- User experiences of bihormonal FCL
Methodological detailsthematic and narrative analysis, interviews after a 12-month single-arm trial (FREE 1)
- Thematic and narrative analysis
- Interviews after a 12-month single-arm trial (FREE 1)
Main finding
As reported in the abstract
- Personal and altruistic considerations in the decision to start FCL
- Benefits (improved glycemic outcomes, feeling more like a person without diabetes) mostly outweighed burdens (glucagon replacement, multiple components, alarms)
- FCL a positive life changer for ongoing users, despite continued technology-management effort
- Finding a working relation with the system was challenging and took time; varied coping strategies
- Discontinuation reasons presented early, with accumulating negative experiences before stopping
Original publication
User Experiences of a Bihormonal Fully Closed-Loop System Among Adults with Type 1 Diabetes in a Real-World Setting: A Qualitative Analysis. Diabetes Technol Ther. Published 7 October 2025. doi:10.
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