816-P: Pediatric Preferences for an Ideal Artificial Pancreas (AP): Unique Features to Reduce Self-Care Burdens of Type 1 Diabetes (T1D)
Authors: COMMISSARIAT PERSIS V. , ROETHKE LINDSAY , VOLKENING LISA K. , BUTLER DEBORAH A. , FINNEGAN JENNIFER L. , DASSAU EYAL , WEINZIMER STUART A. , LAFFEL LORI M. 
Published: June 2019

Aim: With advancing diabetes technologies, patient hopes for an ideal system go beyond glycemia. We interviewed children, teens, and young adults with T1D experienced with diabetes technologies to explore their desired features for future ideal AP systems.
Methods: Semi-structured qualitative interviews were conducted in 39 youth, ages 10-25, with T1D for ≥1 year. Interview transcripts were coded and underwent thematic analysis. Participants (28% male, 82% white) had M±SD age 17.0±4.7 years, T1D duration 9.4±4.9 years, and A1c 8.4±1.1%; 79% were pump users and 82% CGM users.
Results: Participants described a variety of unique features related to user interface, ways to reduce mental and physical burdens of T1D care, and novel design ideas. Nearly all participants endorsed the need for a small, sleek, user-friendly system with customizable appearance (colors, applique, etc.), multiple alarm profiles (school, home, etc.), various alert sounds, and dynamic share settings (conditional, temporary, etc.) to facilitate willingness to wear the system. Many endorsed a desire for complete system automation for meals and exercise to reduce burden of self-care, limit sense of self-care failure, and avoid conflict with parents. Lastly, participants provided creative ideas for easier, more convenient self-care, including barcode scanners for carbohydrate counting, auto-prebolusing with detection of food aromas, heart rate monitor to detect exercise, songs as alerts to reduce negative emotional responses, and GPS tracking (for EMS, local food options, restrooms, etc.).
Conclusion: Participant preferences for an ideal AP system focused on ease of use, reducing burdens of T1D self-care, and innovative solutions. While participants acknowledged the current improbability of some features, AP designers must understand patients’ desire to reduce care burdens in future design efforts in order to maximize AP uptake and ongoing use by young persons with T1D.

Disclosure
P.V. Commissariat: None. L. Roethke: None. L.K. Volkening: None. D.A. Butler: None. J.L. Finnegan: None. E. Dassau: Consultant; Self; Eli Lilly and Company, Insulet Corporation. Research Support; Self; Dexcom, Inc., DreaMed Diabetes, Ltd., Insulet Corporation, Roche Diabetes Care, Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Speaker's Bureau; Self; Roche Diabetes Care. Other Relationship; Self; ModAGC. S.A. Weinzimer: Consultant; Self; Eli Lilly and Company, Sanofi. Consultant; Spouse/Partner; Tandem Diabetes Care. Consultant; Self; Zealand Pharma A/S. Speaker's Bureau; Self; Insulet Corporation, Medtronic MiniMed, Inc., Tandem Diabetes Care. Stock/Shareholder; Self; InsuLine Medical Ltd. L.M. Laffel: Advisory Panel; Self; Lilly Diabetes, Novo Nordisk A/S, Roche Diabetes Care, Sanofi. Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Dexcom, Inc., Janssen Pharmaceuticals, Inc., UpToDate.

Funding
National Institutes of Health (DP3DK113511, DP3DK104057, T32DK007260, P30DK036836, K12DK094721)