Improving patient self-care using diabetes technologies

Alcantara-Aragon, Valeria

doi:10.1177/2042018818824215

Cited by 42 publications

(35 citation statements)

References 76 publications

(117 reference statements)

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“…Because exercise leads to fluctuations in blood glucose level, it may be difficult for children and adolescents with T1D to undertake appropriate levels of physical activity in their everyday life [27]. An effective solution can be found in the use of new technologies such as continuous glucose monitoring (CGM), either from real-time use (rtCGM) or intermittently viewed (iCGM), which offer opportunities to improve self-management, allow observation of the trends in their glycemic control, as well as prevent hypoglycemia [28]. Fear of severe hypoglycemia is still the most important barrier for children and adolescents and it can be more troublesome for them than for adults with T1D [23,29].…”

Section: Discussionmentioning

confidence: 99%

Levels of Physical Activity in Children and Adolescents with Type 1 Diabetes in Relation to the Healthy Comparators and to the Method of Insulin Therapy Used

Czenczek‐Lewandowska

Leszczak

Baran

et al. 2019

IJERPH

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Given the fact that physical exertion leads to blood glucose fluctuations, type one diabetes mellitus (T1D) may potentially constitute a barrier for obtaining a sufficient amount of exercise. The main purpose of the study was to compare the level of physical activity between children with T1D (n = 215) and healthy controls (n = 115) and to assess the physical activity of the study group in relation to the applied method of insulin therapy, i.e., the use of insulin pen vs. insulin pump. The level of physical activity was assessed with a hip-worn tri-axial accelerometer (ActiGraph GT3X+) used by the subjects for an uninterrupted period of seven days. Children with T1D had significantly lower median values of total time of moderate (213.3 vs. 272.1 min), vigorous (135.3 vs. 19.6 min) and moderate-to-vigorous (347.4 vs. 467.4 min) physical activity compared to healthy peers respectively, (p < 0.001) in all cases. In addition, the total median number of steps was significantly lower (53,631 vs. 67,542 steps), (p < 0.001). The method of insulin therapy was not associated with significant differences in physical activity level (p > 0.001). The level of physical activity in children and adolescents with T1D is lower than in their healthy peers and does not depend on the insulin therapy method.

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Section: Discussionmentioning

confidence: 99%

Levels of Physical Activity in Children and Adolescents with Type 1 Diabetes in Relation to the Healthy Comparators and to the Method of Insulin Therapy Used

Czenczek‐Lewandowska

Leszczak

Baran

et al. 2019

IJERPH

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“…In this digital era of connected health consumers, the interplay between theory-driven models of diabetes management and observed communication in social media is currently poorly understood [ 50 ]. Previous studies have shown that those with DSM who participate in social media forums or platforms saw a decrease in their HbA 1c (glycated hemoglobin) [ 51 ]. In the future, physicians may “prescribe” a form of social media or platform to reinforce healthy lifestyle choices outside of the clinic.…”

Section: Discussionmentioning

confidence: 99%

Diabetes Self-Management in the Age of Social Media: Large-Scale Analysis of Peer Interactions Using Semiautomated Methods

Myneni¹,

Lewis²,

Singh³

et al. 2020

JMIR Med Inform

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Background Online communities have been gaining popularity as support venues for chronic disease management. User engagement, information exposure, and social influence mechanisms can play a significant role in the utility of these platforms. Objective In this paper, we characterize peer interactions in an online community for chronic disease management. Our objective is to identify key communications and study their prevalence in online social interactions. Methods The American Diabetes Association Online community is an online social network for diabetes self-management. We analyzed 80,481 randomly selected deidentified peer-to-peer messages from 1212 members, posted between June 1, 2012, and May 30, 2019. Our mixed methods approach comprised qualitative coding and automated text analysis to identify, visualize, and analyze content-specific communication patterns underlying diabetes self-management. Results Qualitative analysis revealed that “social support” was the most prevalent theme (84.9%), followed by “readiness to change” (18.8%), “teachable moments” (14.7%), “pharmacotherapy” (13.7%), and “progress” (13.3%). The support vector machine classifier resulted in reasonable accuracy with a recall of 0.76 and precision 0.78 and allowed us to extend our thematic codes to the entire data set. Conclusions Modeling health-related communication through high throughput methods can enable the identification of specific content related to sustainable chronic disease management, which facilitates targeted health promotion.

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“…The emergence of advanced and userfriendly technologies such as the new-generation glucose sensors and insulin pumps offers promising prospects to patient self-care through empowerment [6]. These technologies allow people with T1D and caregivers to precisely and constantly measure their blood glucose (BG) concentrations and regulate insulin infusion.…”

Section: Introductionmentioning

confidence: 99%

The Do-It-Yourself Artificial Pancreas: A Comprehensive Review

Kesavadev

Srinivasan

Saboo³

et al. 2020

Diabetes Ther

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Diabetes technology (DT) has accomplished tremendous progress in the past decades, aiming to convert these technologies as viable treatment options for the benefit of patients with diabetes (PWD). Despite the advances, PWD face multiple challenges with the efficient management of type 1 diabetes. Most of the promising and innovative technological developments are not accessible to a larger proportion of PWD. The slow pace of development and commercialization, overpricing, and lack of peer support are few such factors leading to inequitable access to the innovations in DT. Highly motivated and tech-savvy members of the diabetes community have therefore come up with the #WeAreNotWaiting movement and started developing their own do-it-yourself artificial pancreas systems (DIYAPS) integrating continuous glucose monitoring (CGM), insulin pumps, and smartphone technology to run openly shared algorithms to achieve appreciable glycemic control and quality of life (QoL). These systems use tailor-made interventions to achieve automated insulin delivery (AID) and are not commercialized or regulated. Online social network megatrends such as GitHub, CGM in the Cloud, and Twitter have been providing platforms to share these open source technologies and user experiences. Observational studies, anecdotal evidence, and realworld patient stories revealed significant improvements in time in range (TIR), time in hypoglycemia (TIHypo), HbA1c levels, and QoL after the initiation of DIYAPS. But this unregulated do-it-yourself (DIY) approach is perceived with great circumspection by healthcare professionals (HCP), regulatory bodies, and device manufacturers, making users the ultimate riskbearers. The use of the regularized CGM and insulin pump with unauthorized algorithms makes them off-label and has been a matter of great concern. Besides these, lack of safety data, funding or insurance coverage, ethical, and legal issues are roadblocks to the unanimous acceptance of these systems among patients with type 1 diabetes (T1D). A multi-agency approach is necessary to evaluate the risks, and to delineate the incumbency and liability of Digital Features To view digital features for this article go to

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Improving patient self-care using diabetes technologies

Cited by 42 publications

References 76 publications

Levels of Physical Activity in Children and Adolescents with Type 1 Diabetes in Relation to the Healthy Comparators and to the Method of Insulin Therapy Used

Levels of Physical Activity in Children and Adolescents with Type 1 Diabetes in Relation to the Healthy Comparators and to the Method of Insulin Therapy Used

Diabetes Self-Management in the Age of Social Media: Large-Scale Analysis of Peer Interactions Using Semiautomated Methods

The Do-It-Yourself Artificial Pancreas: A Comprehensive Review

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