scholarly journals Evaluating a Glucose-Sensor-Based Tool to Help Clinicians and Adults With Type 1 Diabetes Improve Self-Management Skills

2018 ◽  
Vol 12 (6) ◽  
pp. 1143-1151 ◽  
Author(s):  
Elena Toschi ◽  
Lawrence Fisher ◽  
Howard Wolpert ◽  
Michael Love ◽  
Timothy Dunn ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Rating Scales ◽  
Glucose Sensor ◽  
Self Care ◽  
Mobile App ◽  
Self Management ◽  
Management Skills ◽  
Motivation To Change ◽  
Freestyle Libre

Background: The goal of this uncontrolled pilot study was to assess the feasibility of a self-care management mobile app, called Sugar Sleuth, which incorporates the FreeStyle Libre™ glucose sensor, to help clinicians and people with type 1 diabetes (PWD) identify and mitigate self-care behaviors that contribute to glucose variability. Methods: PWDs with a baseline A1c between 7.5 and 9.0% used the mobile app for 14 weeks. The app prompted the PWD to enter the suspected cause of detected glycemic excursions, and to record food and insulin information. PWDs met with clinicians to collaboratively review data, identify challenges, and devise a specific self-care plan. Outcome measures included a single glycemic outcome score (SGOS) and attitude rating scales to better understand how participant attitudes could affect glycemic outcome. Results: Thirty enrolled PWDs had a mean age of 55 ± 2.6 years, and a mean diabetes duration of 32 ± 2.9 years. A significant average reduction in A1c of 0.5 ± 0.07% ( P < .01) and in mean daily carbohydrate intake of 43 ± 21 grams ( P = .05) was found. No statistically significant change in glycemic metrics, body weight, or total daily insulin dose was found. A significant negative association occurred between SGOS and “hypoglycemia tolerance” ( P = .04), and a positive correlation occurred that approached significance with “motivation to change behavior” ( P = .06). Conclusions: These findings suggest that this mobile app system, in conjunction with CGM, provides a useful platform for helping clinicians and adults with T1D improve self-management skills to improve glycemic control.

scholarly journals Experiences of Adults With Type 1 Diabetes Using Glucose Sensor–Based Mobile Technology for Glycemic Variability: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Marilyn D Ritholz ◽  
Owen Henn ◽  
Astrid Atakov Castillo ◽  
Howard Wolpert ◽  
Stephanie Edwards ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Qualitative Study ◽  
Mobile Technology ◽  
Glucose Sensor ◽  
Self Care ◽  
Glycemic Variability ◽  
Mobile App ◽  
Self Management ◽  
Freestyle Libre

BACKGROUND Adults with type 1 diabetes (PWDs) face challenging self-management regimens including monitoring their glucose values multiple times a day to assist with achieving glycemic targets and reduce the risk of long-term diabetes complications. Recent advances in diabetes technology have reportedly improved glycemia, but little is known about how PWDs utilize mobile technology to make positive changes in their diabetes self-management. OBJECTIVE The aim of this qualitative study was to explore PWDs’ experiences using Sugar Sleuth, a glucose sensor–based mobile app and Web-based reporting system, integrated with the FreeStyle Libre glucose monitor that provides feedback about glycemic variability. METHODS We used a qualitative descriptive research design and conducted semistructured interviews with 10 PWDs (baseline mean glycated hemoglobin, HbA1c) 8.0%, (SD 0.45); 6 males and 4 females, aged 52 years (SD 15), type 1 diabetes (T1D) duration 31 years (SD 13), 40% (4/10, insulin pump) following a 14-week intervention during which they received clinical support and used Sugar Sleuth to evaluate and understand their glucose data. Audio-recorded interviews were transcribed, coded, and analyzed using thematic analysis and NVivo 11 (QSR International Pty Ltd). RESULTS A total of 4 main themes emerged from the data. Participants perceived Sugar Sleuth as an Empowering Tool that served to inform lifestyle choices and diabetes self-management tasks, promoted preemptive self-care actions, and improved discussions with clinicians. They also described Sugar Sleuth as providing a Source of Psychosocial Support and offering relief from worry, reducing glycemic uncertainty, and supporting positive feelings about everyday life with diabetes. Participants varied in their Approaches to Glycemic Data: 40% (4/10) described using Sugar Sleuth to review data, understand glycemic cause and effect, and plan for future self-care. On the contrary, 60% (6/10) were reluctant to review past data; they described receiving benefits from the immediate numbers and trend arrows, but the app still prompted them to enter in the suspected causes of glucose excursions within hours of their occurrence. Finally, only 2 participants voiced Concerns About Use of Sugar Sleuth; they perceived the app as sometimes too demanding of information or as not attuned to the socioeconomic backgrounds of PWDs from diverse populations. CONCLUSIONS Results suggest that Sugar Sleuth can be an effective educational tool to enhance both patient-clinician collaboration and diabetes self-management. Findings also highlight the importance of exploring psychosocial and socioeconomic factors that may advance the understanding of PWDs’ individual differences when using glycemic technology and may promote the development of customized mobile tools to improve diabetes self-management.

scholarly journals Impact of COVID-19 lockdown on flash and real-time glucose sensor users with type 1 diabetes in England

2020 ◽  
Author(s):  
Joshi Prabhu Navis ◽  
Lalantha Leelarathna ◽  
Womba Mubita ◽  
Andrea Urwin ◽  
Martin K. Rutter ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Sensor ◽  
Management Strategies ◽  
Self Management ◽  
International Consensus ◽  
Diabetes Clinic ◽  
Period 2 ◽  
Freestyle Libre ◽  
The Uk

Abstract Aims People with type 1 diabetes (T1D) face the daily task of implementing self-management strategies to achieve their glycaemic goals. The UK COVID-19 lockdown has had an impact on day-to-day behaviour, which may affect diabetes self-management and outcomes. We assessed whether sensor-based outcomes pre- and during lockdown periods were different in a cohort of glucose sensor users with T1D. Methods Data were collected from Freestyle Libre (FSL) or Dexcom G6 sensor users who remotely shared their data with the diabetes clinic web platform. Sensor metrics according to international consensus were analysed and compared between pre-lockdown period and 2 and 3 weeks into lockdown (periods 1 and 2). Results Two hundred and sixty-nine T1D patients (baseline HbA1c 57 ± 14 mmol/mol) were identified as FSL (n = 190) or Dexcom G6 (n = 79) users. In patients with sensor use > 70% (N = 223), compared to pre-lockdown period percentage TIR 3.9–10 mM (TIR) significantly increased during period 1 (59.6 ± 18.2 vs. 57.5 ± 17.2%, p = 0.002) and period 2 (59.3 ± 18.3 vs. 57.5 ± 17.2%, p = 0.035). The proportion of patients achieving TIR ≥ 70% increased from 23.3% pre-lockdown to 27.8% in period 1 and 30.5% in period 2. A higher proportion also achieved the recommended time below and above range, and coefficient of variation in periods 1 and 2. Dexcom G6 users had significantly lower % time below range (< 3.9 mM) compared to FSL users during both lockdown periods (period 1: Dexcom G6 vs. FSL: 1.8% vs. 4%; period 2: 1.4% vs. 4%, p < 0.005 for both periods). Conclusion Sensor-based glycaemic outcomes in people with T1D in the current cohort improved during COVID-19 lockdown, which may be associated with positive changes in self-management strategies. Further work is required to evaluate long-term sustainability and support.

The second Moroccan mobile application for type 1 diabetes self-care : towards a new pedagogical dynamism in T1DM self-management

2021 ◽  
Author(s):  
Nada Derkaoui ◽  
Yakhlef Salma Ben ◽  
Rami Imane ◽  
Ouafae Elmehraoui ◽  
Messaoudi Najoua ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Mobile Application ◽  
Self Care ◽  
Self Management

scholarly journals Using an mHealth App to Transition Care of Type 1 Diabetes from Parents to Teens: Protocol for a Pilot Study (Preprint)

2018 ◽  
Author(s):  
Bree E Holtz ◽  
Katharine M Mitchell ◽  
Denise D Hershey ◽  
Shelia R Cotten ◽  
Amanda J Holmstrom ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
The United States ◽  
Mobile App ◽  
Self Management ◽  
Pilot Test ◽  
Pilot Testing ◽  
App Development ◽  
Difficult Time ◽  
Two Phases

BACKGROUND Type 1 diabetes mellitus (T1DM) afflicts approximately 154,000 people under the age of 20 in the United States. Most people with T1DM are diagnosed at a young age, and parents have to take on the responsibility of T1DM management. Eventually, the child must begin to transition to self-management. Adolescents often struggle to take on responsibility for all the necessary tasks to successfully self-manage their T1DM. In fact, approximately three-quarters of adolescents are not achieving American Diabetes Association–recommended glycated hemoglobin (HbA1c) targets. This lack of adherence can lead to negative health outcomes. OBJECTIVE The goals of this interdisciplinary proposal are as follows: (1) to develop a unique and theory-driven technology using a mobile phone app to promote self-management behaviors for adolescents aged 10-15 years with T1DM and their parents and (2) to explore the feasibility and impact of the self-management mobile app. METHODS This study has two phases: app development and pilot testing. In the app development phase, the app will be conceptualized and a prototype will be tested. In Phase 2, the mobile app will undergo pilot testing to determine its feasibility and impact on diabetes self-management. RESULTS The pilot test was launched in September 2017. Data collection for the final pilot test is underway, and results are forthcoming. CONCLUSIONS Adolescents with T1DM and their parents can have a difficult time managing the transition of diabetes care. It is hoped that this app can help. The focus groups and prototype testing have indicated promising outcomes of app use. CLINICALTRIAL ClinicalTrials.gov NCT03436628; https://clinicaltrials.gov/ct2/show/NCT03436628 (Archived by WebCite at http://www.webcitation.org/72tHXTE2Z) INTERNATIONAL REGISTERED REPOR RR1-10.2196/10803

scholarly journals A Mobile App for the Self-Management of Type 1 Diabetes Among Adolescents: A Randomized Controlled Trial

2017 ◽  
Vol 5 (6) ◽  
pp. e82 ◽  
Author(s):  
Shivani Goyal ◽  
Caitlin A Nunn ◽  
Michael Rotondi ◽  
Amy B Couperthwaite ◽  
Sally Reiser ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Type 1 Diabetes ◽  
Controlled Trial ◽  
Mobile App ◽  
The Self ◽  
Self Management ◽  
Randomized Controlled

scholarly journals Techno-social reconfigurations in diabetes (self-) care

2020 ◽  
Vol 50 (2) ◽  
pp. 198-220 ◽  
Author(s):  
Giada Danesi ◽  
Mélody Pralong ◽  
Francesco Panese ◽  
Bernard Burnand ◽  
Michèle Grossen
Keyword(s):  
Glucose Monitoring ◽  
Self Care ◽  
Self Management ◽  
Clinical Practices ◽  
Flash Glucose Monitoring ◽  
Freestyle Libre ◽  
Care Practices ◽  
Flash Glucose Monitoring System ◽  
Social Reconfigurations

This article focuses on the ways in which a flash glucose monitoring system, FreeStyle Libre®, is introduced and used by people living with type 1 diabetes, their relatives and healthcare professionals. It draws on a multi-sited ethnography in a variety of clinical and daily situations, and on interviews with caregivers and people living with diabetes. We explore how the users develop knowledge-in-practice, and consider the use of self-management technologies to be largely dependent on locally grounded and situated care acts, and resulting from the relational, pragmatic and creative maneuvering of technology-in-practice. Our findings show that adjustments between users, their bodies and the technology are required, and show the reflexive work and practices of patients and relatives who learn to use the device in a proper way. Moreover, we reveal that practitioners see this technology as a tool that not only improves self-care practices but also clinical practices, and that wearing and using this new medical device may become a moral injunction for self-improvement. Our results illustrate the techno-social reconfigurations at work and the development of new ways of feeling, thinking and acting in diabetes (self-) care.

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