Evidence map›Paper›PMID 37250371›Full record

ArticleJournal of diabetes and metabolic disorders2023

Interviews with Indigenous Māori with type 1 diabetes using open-source automated insulin delivery in the CREATE randomised trial.

Mercedes Burnside, Tracy Haitana, Hamish Crocket, Dana Lewis, Renee Meier, Olivia Sanders, Craig Jefferies, Ann Faherty, Ryan Paul, Claire Lever and 8 more

Full text read
In one paragraph

Article in Journal of diabetes and metabolic disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Mercedes BurnsideChristchurch, New Zealand Department of Paediatrics, University of Otago.ORCID 0000-0002-8414-4479
Tracy HaitanaChristchurch, New Zealand Department of Māori Indigenous Health Innovation (MIHI), University of Otago.
Hamish CrocketHamilton, New Zealand Te Huataki Waiora School of Health, University of Waikato.
Dana LewisOpenAPS, Seattle, WA USA.
Renee MeierChristchurch, New Zealand Department of Paediatrics, University of Otago.
Olivia SandersChristchurch, New Zealand Department of Paediatrics, University of Otago.
Craig JefferiesAuckland, New Zealand Department of Paediatric Endocrinology, Starship Children's Health, Te Whatu Ora Te Toka Tumai.
Ann FahertyAuckland, New Zealand Department of Paediatric Endocrinology, Starship Children's Health, Te Whatu Ora Te Toka Tumai.
Ryan PaulHamilton, New Zealand Te Huataki Waiora School of Health, University of Waikato.
Claire LeverWaikato Regional Diabetes Service, Te Whatu Ora Health New Zealand Waikato, Hamilton, New Zealand.
Sarah PriceWaikato Regional Diabetes Service, Te Whatu Ora Health New Zealand Waikato, Hamilton, New Zealand.
Carla FrewenDunedin, New Zealand Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago.
Shirley JonesDunedin, New Zealand Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago.
Tim GunnNightscout New Zealand, Hamilton, New Zealand.
Benjamin J WheelerDunedin, New Zealand Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago.
Suzanne PitamaChristchurch, New Zealand Department of Māori Indigenous Health Innovation (MIHI), University of Otago.
Martin de BockChristchurch, New Zealand Department of Paediatrics, University of Otago.
Cameron LaceyChristchurch, New Zealand Department of Māori Indigenous Health Innovation (MIHI), University of Otago.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Open-source automated insulin delivery (AID) is used by thousands of people with type 1 diabetes (T1D), but has unknown generalisability to marginalised ethnic groups. This study explored experiences of Indigenous Māori participants in the CREATE trial with use of an open-source AID system to identify enablers/barriers to health equity. Methods: The CREATE randomised trial compared open-source AID (OpenAPS algorithm on an Android phone with a Bluetooth-connected pump) to sensor-augmented pump therapy. Kaupapa Māori Research methodology was used in this sub-study. Ten semi-structured interviews with Māori participants (5 children, 5 adults) and whānau (extended family) were completed. Interviews were recorded and transcribed, and data were analysed thematically. NVivo was used for descriptive and pattern coding. Results: Enablers/barriers to equity aligned with four themes: access (to diabetes technologies), training/support, operation (of open-source AID), and outcomes. Participants described a sense of empowerment, and improved quality of life, wellbeing, and glycaemia. Parents felt reassured by the system's ability to control glucose, and children were granted greater independence. Participants were able to use the open-source AID system with ease to suit whānau needs, and technical problems were manageable with healthcare professional support. All participants identified structures in the health system precluding equitable utilisation of diabetes technologies for Māori. Conclusion: Māori experienced open-source AID positively, and aspired to use this therapy; however, structural and socio-economic barriers to equity were identified. This research proposes strength-based solutions which should be considered in the redesign of diabetes services to improve health outcomes for Māori with T1D. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01215-3.

Indexed as

Automated Insulin DeliveryDiabetes Mellitus Type 1Health EquityIndigenous MāoriOpen-SourceQualitative Research

Identifiers

PMID37250371
PMCPMC10035484

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read38
table measurements read30
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.