Diabetes Management Among Women Using an AID System: a Mixed Method Study

Automated insulin delivery (AID) systems substantially improve diabetes management in people with type 1 diabetes but do not account for menstrual cycle related changes in insulin sensitivity. As a result, many menstruating individuals rely on manual adjustments, such as entering fake carbohydrates, modifying insulin settings, or changing basal rates, to maintain glycemic control. This study aims to systematically characterize these manual adjustment strategies, estimate how frequently they are used across the menstrual cycle, and explore their perceived burden, effectiveness, and implications for the development of future AID algorithms that better address menstrual cycle related insulin variability.

Inclusion Criteria: * At least 18 years old * Good knowledge of English or German * Type 1 diabetes since \>3 years * Regular menstrual cycle (24-35 days) since \>2 years * Using one of the following AID systems: Tandem t-slim:X2 with Control-IQ; Medtronic 780G; DBLG1 (Kaleido, AkkuChek Insight); CAMAPS FX (Ypsopump, Dana); Omnipod 5; AAPS DIY; IAPS DIY; Loop DIY