Patient-experience themes

Last curated: 2026-08-30

Continuous vigilance and cognitive workload

Insulin, food, activity, glucose trends, supplies, and emergencies require continuous anticipation. Parent synthesis documents vigilance and altered family routines; fully closed-loop qualitative work describes relief from decisions alongside trust and adaptation work (Whittemore 2012, PMID 22581804; Lakshman 2024, PMID 38426909).

Fear, sleep, and acute-risk anticipation

Fear of hypoglycemia affects behavior and quality of life; parents describe nocturnal monitoring and worry. Technology can reduce distress on average but does not erase severe-event memory (Zhang 2020, PMID 33091198; Whittemore 2012, PMID 22581804; Canha 2025, PMID 39726162).

Stigma, visibility, and disclosure

Insulin delivery and sensors make disease visible; concealment and intrusive assumptions add workload. Systematic stigma evidence and diabetes-distress literature support this theme (Embick 2024, PMID 38361327; Fisher 2016, PMID 27118163).

Technology as relief and burden

AID can reduce distress and decision load, but alarms, wear, trust, data sharing, and device dependence remain. Evidence comes from meta-analysis and qualitative fully closed-loop study (Canha 2025, PMID 39726162; Lakshman 2024, PMID 38426909).

Access and unequal futures

Global pediatric service availability is uneven, and modeled remaining life expectancy differs by 52 years between low- and high-income settings for a child diagnosed at age 10. Within the US, racial disparities persist in technology uptake (Pulungan 2023, PMID 37362165; Gregory 2022, PMID 36113507; Agarwal 2021, PMID 33155826).

Transition and changing responsibility

Young adults face care-transfer gaps while families renegotiate responsibility. Adult clinician perspectives and the transition-intervention review show structural inconsistency and a limited evidence base (Garvey 2016, PMID 26681724; Campbell 2016, PMID 27128768).