Cambridge Hybrid Closed Loop in Very Young Children with Type 1 Diabetes (KidsAP Study): Positive Expectancies of Parents Over 18 Months.

Background and Aims: Type 1 diabetes (T1D) management in young children is challenging, with variable glycemic control carrying risks for development and family well-being. Automated insulin delivery (AID) systems have shown metabolic benefits across age groups. Positive effects on caregiver burden and parental well-being
have also been described. However, less is known about parents’ long-term satisfaction and trust in these systems. This study examined parental expectancies during an extended period of hybrid closed-loop (HCL) insulin delivery in the home setting.
Methods: Data was collected for 65 parents of young children with T1D who participated in a multinational crossover trial. We compared assessments at baseline, post HCL trial phase and after 18-month HCL extension in home setting. Glycemic outcomes (HbA1c) were recorded and parental expectancies were assessed using the
INSPIRE questionnaire, which evaluates parents’ expectancies of AID systems. Linear mixed models compared outcomes across time.
Results: Initial CL use improved HbA1c (baseline: 55.97 – 7.25 mmol/mol vs. trial: 50.52 – 6.93; p < .001), with benefits maintained over the 18-month extension (49.04 – 5.48; p = .24). Parental expectancies did not change during trial (baseline: 44.11 – 34.38 vs.
trial: 42.10 – 38.11; p = .71, d = 0.05) but increased after 18 months of home use (89.83 – 9.35; p < .001, d = 1.14).
Conclusions: Prolonged HCL use in young children supports stable glycemic benefits while fostering greater parental trust in AID. Findings suggest that while initial adaptation may be required, continued experience with improved metabolic control
enhances parental confidence in system safety and reliability.