Aims This study aimed to investigate the effectiveness and understand the process of a nurse‐led social media intervention for health behavior and glucose control for diabetes self‐management among patients with type 2 diabetes mellitus. Design This study had an explanatory sequential mixed methods design, with a randomized controlled trial and qualitative interviews. Methods A total of 89 patients diagnosed with type 2 diabetes mellitus were randomly assigned to an intervention or a control group. Patients in the intervention group were invited to join the closed nurse‐led social media platform that included diabetes information, action planning, unmoderated chat, and questions and answers. The outcomes of diabetes self‐care behavior, hemoglobin A1c (HbA1c) percentage, fasting blood sugar level (FBS), systolic and diastolic blood pressure, and triglyceride (TG) and total cholesterol levels were measured at baseline, 3 months, and 6 months. A linear mixed model was used to analyze the effectiveness of the intervention over time. Qualitative data were collected from interviews with seven patients engaged in the intervention and analyzed using qualitative content analysis. Findings After 6 months, insulin users who were provided with the social media intervention had significantly lower FBS and TG levels than those with usual care (135.80 ± 12.37 vs. 175.82 ± 15.34 mg/dL, p = 0.049; 206.85 ± 38.26 vs. 387.50 ± 56.19 mg/dL, p = 0.013; respectively). Although a similar rate of decrease in the HbA1c level over time was observed among insulin and noninsulin users after the social media intervention, this decrease was significantly greater among noninsulin users at 3 and 6 months compared with the control group (6.38 ± 0.34 vs. 7.25 ± 0.24, p = 0.040; 6.31 ± 0.37 vs. 7.28 ± 0.26, p = 0.036; respectively). Interview with seven patients who engaged in the intervention revealed that their engagement in the intervention was primarily determined by their acceptance of the role of managing their diabetes. Being engaged in the intervention, patients benefited from information sharing and interactive support to motivate their self‐care, nurses' professional advice to modify their behaviors, and action planning to make progress toward behavioral change. Conclusions The positive outcomes of the nurse‐led social media intervention indicate that the social media platform is an effective strategy to implement diabetes self‐management in clinical nursing practice. Clinical Relevance The social media intervention would be successfully implemented by nurses to facilitate patients accepting their role in diabetes management and employing key services for diabetes information, support, professional advice, and action planning.

In this scoping review of the literature, we identified the types and the parameters of objective measurements to assess sleep patterns among night-shift workers. We conducted a literature search using electronic databases for studies published from 1991 to 2020 and charted and summarized key information. We included 32 studies in the review. Polysomnography was used in 6 studies and wearable sleep detection devices were utilized in 26 studies. The duration of sleep assessment using the wearable devices ranged from 1 day to > 4 weeks, and more than half of the studies collected data for > 2 weeks. The majority of the studies used subjective questionnaires, such as the Karolinska Sleepiness Scale, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index, in addition to objective sleep measurements. Total sleep time was the most common parameter, followed by sleep efficiency, sleep onset latency, and time or frequency of being awake. As the utilization of wearable devices to assess the sleep patterns of night-shift workers is expected to increase, further evaluation of device accuracy and precision, optimal data collection period, and key parameters is warranted.

Background: Adherence to medications is vital for glycemic control in type 2 diabetes. It is unclear if insomnia is a barrier to medication adherence. The aim of this secondary analysis was to examine the association between insomnia and adherence to insulin therapy. Method: Using a cross-sectional design, baseline data from subjects (N=139) prescribed insulin from the Diabetes Sleep Treatment Trial were analyzed. Measures included demographics, A1C, BMI, the Insomnia Severity Index, and the Pittsburgh Sleep Quality Index. Self-reported adherence to insulin therapy was determined by response to the question: How many of the past 7 days did you take your recommended insulin injections and scored as 7 days for adherent (77.7%; n=107) and 0 to 6 days for non-adherent (23.0%; n=32). Data were analyzed using univariate and backward multivariate logistic regression. Results: The sample was diverse (55.4% white; 46.0% female; 41.7% married/partnered; 55.4% >2 years post high school with a mean age of 56.3±10.9 years, BMI of 35.2±6.6 kg/m2; and A1C of 8.3±1.7%). Individuals with insulin adherence had a lower A1C than those with non-adherence (8.0±1.6% vs. 9.5±1.7%, p<.001). Insomnia was negatively associated with insulin adherence in univariate and multivariate logistic regression. Conclusion: These results suggest insomnia severity and race are associated with deceased insulin adherence. The mechanisms for these potential associations need to be further explored. Disclosure Y. Zheng: None. M.T. Korytkowski: None. S.M. Sereika: None. L.E. Burke: None. C.W. Atwood: None. P.J. Strollo: Consultant; Self; Emmi, Inspire Medical Systems, Philips Respironics. Research Support; Self; Jazz Pharmaceuticals, ResMed. B. Jeon: None. E.R. Chasens: Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases, Philips Respironics, ResMed Inc. Funding National Institutes of Health (R01DK096028)