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News
Insulin pumps and CGMs have transformed type 1 diabetes care, but a new JAMA Network Open study reveals they also pile on unexpected burdens. Over 500 adults with T1D shared real-world frustrations — from device failures and insurance battles to sleep disruption and even guilt over plastic waste. Clinicians say many of these struggles go unrecognized because they simply aren't asking the right questions.
Diabetes technology — insulin pumps, continuous glucose monitors (CGMs), and automated insulin delivery (AID) systems — has been a major win for people living with type 1 diabetes (T1D). But a new qualitative study published in JAMA Network Open shows the flip side: these devices come with a whole new set of burdens that often fly under the radar in clinical settings.
Researchers at UCLA surveyed over 500 adults with T1D, asking them to share how diabetes technology affects their daily lives. The responses revealed four major themes: psychosocial and emotional impact, daily functioning and lifestyle, environmental concerns, and device performance. While some issues — like cost and insurance friction — are well known, others surprised even the researchers, including patient guilt over unrecyclable device waste and inconsistent TSA screening policies during travel.
Device failures were nearly as concerning as cost, with patients reporting that early failures can disrupt the entire AID "loop" and that getting replacements often involves lengthy customer service ordeals. Clinicians noted they frequently feel "powerless" to help, since insurers won't cover backup supplies.
Key Takeaways
Why it matters: As diabetes technology advances rapidly, the clinical conversation needs to keep pace. Recognizing and addressing these hidden burdens is essential to truly supporting patients — not just their glucose numbers.
