scholarly journals Transmitting Insulin: The Design and Look of Insulin Delivery Devices as Technologies of Communication

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Carrie Rentschler ◽  
Benjamin Nothwehr
Keyword(s):  
Diabetes Education ◽  
Communication Technologies ◽  
Insulin Delivery ◽  
Self Management ◽  
Medical Surveillance ◽  
Anabolic Hormone ◽  
Technological Artifacts ◽  
Marketing Materials ◽  
Insulin Pens

In this article, we examine how insulin pens and pumps – two major devices for delivering insulin, the anabolic hormone used to treat Type 1 diabetes – are designed to conceal and fashion insulin delivery around their appearance as key communication technologies. Insulin pens and insulin pumps transform the aesthetics of insulin delivery away from the medicalized appearance of syringes toward that of beautiful technological artifacts. They both hide and draw attention to their status as technological artifacts and their medical use through a set of desirable, though sometimes incongruous, device aesthetics. Deliberately marketed around their resemblance to pens or pagers, insulin delivery devices are examples of skeuomorphs that “materialize the metaphor” of writing instruments and telecommunication tools into their design. We analyze how diabetes education and marketing materials present insulin delivery devices through skeuomorphic performances of use that uphold norms of concealment in diabetes self-management in conditions of social and medical surveillance. Drawing on patents, educational and marketing materials, and our own experiences with these devices, we argue that the skeuomorphic design of these devices morally regulates the embodied performance of diabetes.  

scholarly journals A qualitative study of users’ experiences after 3 months: the first Rwandan diabetes self-management Smartphone application “Kir’App”

2020 ◽  
Vol 11 ◽  
pp. 204201882091451
Author(s):  
Claudine B. Kabeza ◽  
Lorenz Harst ◽  
Peter E.H. Schwarz ◽  
Patrick Timpel
Keyword(s):  
Qualitative Content Analysis ◽  
Diabetes Education ◽  
Information Provision ◽  
Smartphone Application ◽  
Self Management ◽  
Diabetes Knowledge ◽  
Face To Face ◽  
Management Application

Background: Owing to the increasing popularity of smartphones in Rwanda, almost 75% of the entire population currently has access to the internet. Although it has been shown that smartphone applications can support diabetes self-management, there was no diabetes self-management application available in Rwanda until April 2019. Based on the findings of a prior study assessing the needs and expectations of potential users, ‘Kir’App’ was developed to fill that void. The aim of this study was to evaluate users’ experiences after 3 months of use of the first Kir’App prototype. Methods: The participants of the previous study were recruited to take part in the current study. Semi-structured, in-depth, face-to-face interviews were conducted. Findings were analysed thematically using Mayring’s method of qualitative content analysis. Both deductive and inductive approaches were used to analyse transcripts according to the original categories and subcategories of the previous study. Results: A total of 14 people with either type 1 or type 2 diabetes participated in the study. Age of participants ranged from 19 to 70 years, with a mean age of 34.4 years. Seven of the eight original themes and one additional theme were subjoined: diabetes education and desired information provision; increased diabetes knowledge and awareness; monitoring and reminder functions; nutrition; physical activity; coping with burden of disease; app features; use behaviour and usability. Overall, participants stated that the app increased their diabetes knowledge and assisted them with their diabetes self-management. Conclusions: We found that the first prototype of Kir’App meets the overall needs and expectations of participating Rwandan diabetics. Having followed a strict user-centred design process, their qualitative insights will help to further improve the app.

Wireless and Mobile Technologies Improving Diabetes Self-Management

2011 ◽  
pp. 136-156 ◽  
Author(s):  
Eirik Årsand ◽  
Naoe Tatara ◽  
Gunnar Hartvigsen
Keyword(s):  
Information And Communication Technologies ◽  
Communication Technologies ◽  
Mobile Technologies ◽  
Self Management ◽  
Future Research ◽  
Management Tools ◽  
Information And Communication ◽  
Future Research Directions

The technological revolution that has created a vast health problem due to a drastic change in lifestyle also holds great potential for individuals to take better care of their own health. This is the focus of the presented overview of current applications, and prospects for future research and innovations. The presented overview and the main goals of the systems included are to utilize information and communication technologies (ICT) as aids in self-management of individual health challenges, for the disease Diabetes, both for Type 1 and Type 2 diabetes. People with diabetes are generally as mobile as the rest of the population, and should have access to mobile technologies for managing their disease. Forty-seven relevant studies and prototypes of mobile, diabetes-specific self-management tools meeting our inclusion criteria have been identified; 27 publicly available products and services, nine relevant patent applications, and 31 examples of other disease-related mobile self-management systems are included to provide a broader overview of the state of the art. Finally, the reviewed systems are compared, and future research directions are suggested.

scholarly journals Insulin-delivery methods for children and adolescents with type 1 diabetes

2020 ◽  
Vol 11 ◽  
pp. 204201882090601
Author(s):  
Zavuga Zuberi ◽  
Elingarami Sauli ◽  
Liu Cun ◽  
Jing Deng ◽  
Wen-Jun Li ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Artificial Pancreas ◽  
Insulin Delivery ◽  
Insulin Administration ◽  
Delivery Methods ◽  
Minimal Invasiveness ◽  
Insulin Pens ◽  
Alternative Routes

Efforts directed toward restoring normal metabolic levels by mimicking the physiological insulin secretion, thereby ensuring safety, efficacy, minimal invasiveness and conveniences, are of great significance in the management of type 1 diabetes among children and adolescents. Regardless of the various technologies being discovered in addressing invasiveness and enhancing medication adherence in the management of type 1 diabetes, yet limited success had been observed among children and adolescents. The multiple daily subcutaneous insulin injections route using vial and syringe, and occasionally insulin pens, remain the most predictable route for insulin administration among children and adolescents. However, this route has been associated with compromised patient compliance, fear of injections and unacceptability, resulting in poor glycemic control, which promote the demand for alternative routes of insulin administration. Alternative routes for delivering insulin are being investigated in children and adolescents with type 1 diabetes; these include the hybrid closed-loop ‘artificial pancreas’ system, oral, inhalation, intranasal routes, and others. This review article explores the current advances in insulin-delivery methods that address the needs of children and adolescents in the treatment of type 1 diabetes.

scholarly journals Hybrid Closed-Loop Insulin Delivery Systems for People With Type 1 Diabetes

2021 ◽  
Vol 1 (3) ◽  
Author(s):  
CADTH Health Technology Assessment Service
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Closed Loop ◽  
Insulin Pump ◽  
Insulin Delivery ◽  
Blood Glucose Monitoring ◽  
Self Management ◽  
Publicly Funded ◽  
Delivery Methods

Blood glucose monitoring and insulin delivery are essential parts of the management of type 1 diabetes. Hybrid closed-loop insulin delivery (HCL) systems are a treatment option for people with type 1 diabetes and consist of an insulin pump, a continuous glucose monitor (CGM), and a computer program (algorithm) that allows the devices to communicate with each other and calculates insulin needs. CADTH conducted a Health Technology Assessment (HTA) of the use of HCL systems compared to other insulin delivery methods in people with type 1 diabetes to inform decisions regarding whether HCL systems have a place in the management of type 1 diabetes. HCL therapy generally improved the amount of time a person spent in target blood glucose ranges. Additionally, people who used HCL systems had improved average blood glucose levels (glycated hemoglobin [A1C]) over the preceding 2 or 3 months. However, the effectiveness or safety of HCL systems based on age, sex, race, glucose management, or other clinical features (e.g., those who are pregnant or planning pregnancy, or who have hypoglycemia unawareness or a history of severe hypoglycemia) is unknown. HCL systems were generally as safe as other insulin delivery methods. Additional studies with longer follow-up periods and more participants are needed to confirm the clinical effectiveness and safety of HCL systems. From a pan-Canadian, publicly funded health care system perspective, the cost of covering HCL systems for individuals with type 1 diabetes who are eligible for insulin pumps in their jurisdictions was estimated to be an additional $822,635,045 over 3 years compared with diabetes supplies that are currently covered. If HCL systems are covered for all individuals with type 1 diabetes, regardless of their current insulin-pump eligibility, the budget impact will be higher. HCL systems can help provide distance from demanding self-management and monitoring tasks for people living with type 1 diabetes; however, in order to do this, people using these systems must navigate complex relationships built on trust and collaboration. Given that type 1 diabetes self-management to date has required considerable attention to blood glucose numbers and technical tasks, developing these relationships of trust and collaboration will require a shift in understanding what it means to care for someone who has — or to self-manage — type 1 diabetes. It is not possible to conclude whether HCL systems will improve overall population health over the longer-term because the data for this are not available. It is also unclear which people with type 1 diabetes would benefit most from HCL systems. Eligibility criteria for the existing public insulin-pump program may be useful in making coverage decisions; trial periods may be considered to ensure HCL systems are working well for new users. Education and support are needed for people living with type 1 diabetes when they start to use HCL systems. Clinicians noted the need for interactions between diabetes educators and HCL system pump users. User-friendly devices and understandable reports are key to effective use. Eligibility for access through any publicly funded program for HCL systems should be based on evidence. The criteria for coverage should be consistent with broader public health goals and should not contribute to existing inequities in diabetes management.

scholarly journals Establishment of a type 1 diabetes structured education programme suitable for Chinese patients: Type 1 Diabetes Education in Lifestyle and Self Adjustment (TELSA)

2020 ◽  
Author(s):  
Yuting Xie ◽  
Fang Liu ◽  
Fansu Huang ◽  
Chunna Lan ◽  
Jia Guo ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Quality Assurance ◽  
Diabetes Education ◽  
Insulin Dose ◽  
Education Programme ◽  
Chinese Patients ◽  
Self Management ◽  
Structured Interviews ◽  
Structured Education

Abstract Background: Various guidelines recommend that all adults diagnosed with type 1 diabetes (T1D) should be offered an evidence based, structured education programme (SEP) to optimize self-management care. China has a 13,000 annual increase in newly diagnosed T1D cases and is now the fourth largest country in the number of new T1D cases per year. However, there is yet no validated SEP targeted to T1D patients in China. The purpose of this study is to establish a structured T1D self-management education programme—‘Type 1 Diabetes Education in Lifestyle and Self Adjustment’ (TELSA) that is adapted to medical and cultural practices in China. Methods: TELSA programme was developed based on the ADDIE model, following three steps: i) Semi-structured interviews were administered to 10 healthcare professionals (HCPs) and 13 T1D patients. Different topic guides, focusing on 4 dimensions including goals, contents, format of delivery, and quality assurance, were designed for either HCPs or patients. The interviews were recorded and analysed with thematic analysis. ii) Extracted themes were modified according to Delphi consultation. iii) Preliminary courses were conducted as pilot study to evaluate the effects of TELSA and optimization of the curriculum was finalized accordingly. Results: A total of 18 themes in 4 dimensions of the programme design were identified in the final version: i) goals: ‘behaviour modification’ and ‘outcome improvement’; ii) contents: ‘living with T1D’, ‘self-monitoring of blood glucose’, ‘knowing insulin’, ‘insulin dose adjustment’, ‘carbohydrates and carbohydrate counting’, ‘hypoglycaemia’, ‘complications’, ‘managing psychological issues’, ‘physical activities’, and ‘question-and-answer’; iii) format: ‘multidisciplinary team combined with peer support’, ‘face-to-face education followed with distal learning’, and ‘2-day programme held on weekends’; and iv) quality assurance: ‘after-class quiz’, ‘patients’ feedback’, and ‘long-term evaluation on effectiveness’. Conclusions: A type 1 diabetes structured education programme in China was set up and shown to be applicable under local medical, social, and cultural environment.

scholarly journals Establishment of a type 1 diabetes structured education programme suitable for Chinese patients: Type 1 Diabetes Education in Lifestyle and Self Adjustment (TELSA)

2020 ◽  
Author(s):  
Yuting Xie ◽  
Fang Liu ◽  
Fansu Huang ◽  
Chunna Lan ◽  
Jia Guo ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Quality Assurance ◽  
Diabetes Education ◽  
Insulin Dose ◽  
Education Programme ◽  
Chinese Patients ◽  
Self Management ◽  
Structured Interviews ◽  
Structured Education

Abstract Background: Various guidelines recommend that all adults diagnosed with type 1 diabetes (T1D) should be offered an evidence based, structured education programme (SEP) to optimize self-management care. China has a 13,000 annual increase in newly diagnosed T1D cases, of which 65% are adults. However, there is yet no validated SEP targeted to T1D patients in China. The purpose of this study is to establish a structured T1D self-management education programme—‘Type 1 Diabetes Education in Lifestyle and Self Adjustment’ (TELSA) that is adapted to medical and cultural practices in China. Methods: TELSA programme was developed based on the ADDIE model, following three steps: i) Semi-structured interviews were administered to 10 healthcare professionals (HCPs) and 13 T1D patients. Different topic guides, focusing on 4 dimensions including goals, contents, format of delivery, and quality assurance, were designed for either HCPs or patients. The interviews were recorded and analysed with thematic analysis. ii) Extracted themes were modified according to Delphi consultation. iii) Preliminary courses were conducted as pilot study to evaluate the effects of TELSA and optimization of the curriculum was finalized accordingly. Results: A total of 18 themes in 4 dimensions of the programme design were identified in the final version: i) goals: ‘behaviour modification’ and ‘outcome improvement’; ii) contents: ‘living with T1D’, ‘self-monitoring of blood glucose’, ‘knowing insulin’, ‘insulin dose adjustment’, ‘carbohydrates and carbohydrate counting’, ‘hypoglycaemia’, ‘complications of diabetes’, ‘managing psychological issues’, ‘physical activity’, and ‘question-and-answer’; iii) format: ‘multidisciplinary team combined with peer support’, ‘face-to-face education followed by remote learning’, and ‘2-day programme held on weekends’; and iv) quality assurance: ‘after-class quiz’, ‘patients’ feedback’, and ‘long-term evaluation on effectiveness’. Conclusions: A type 1 diabetes structured education programme in China was set up and shown to be applicable under local medical, social, and cultural environment.

scholarly journals Adolescents’ Experiences of Using a Smartphone Application Hosting a Closed-loop Algorithm to Manage Type 1 Diabetes in Everyday Life: Qualitative Study

2021 ◽  
pp. 193229682199420
Author(s):  
David Rankin ◽  
Barbara Kimbell ◽  
Janet M. Allen ◽  
Rachel E. J. Besser ◽  
Charlotte K. Boughton ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Management Practices ◽  
Closed Loop ◽  
Age Groups ◽  
Insulin Delivery ◽  
Smartphone Application ◽  
Self Management ◽  
Smartphone App ◽  
Medical App

Background: Closed-loop technology may help address health disparities experienced by adolescents, who are more likely to have suboptimal glycemic control than other age groups and, because of their age, find diabetes self-management particularly challenging. The CamAPS FX closed-loop has sought to address accessibility and usability issues reported by users of previous prototype systems. It comprises small components and a smartphone app used to: announce meal-time boluses, adjust (“boost” or “ease-off”) closed-loop insulin delivery, customize alarms, and review/share data. We explored how using the CamAPS FX platform influences adolescents’ self-management practices and everyday lives. Methods: Eighteen adolescents were interviewed after having ≥6 months experience using the closed-loop platform. Data were analyzed thematically. Results: Participants reported feeling less burdened and shackled by diabetes because closed-loop components were easier to carry/wear, finger-pricks were not required, the smartphone app provided a discreet and less stigmatizing way of managing diabetes in public, and they were able to customize alarms. Participants also reported checking and reviewing data more regularly, because they did so when using the smartphone for other reasons. Some reported challenges in school settings where use of personal phones was restricted. Participants highlighted how self-management practices were improved because they could easily review glucose data and adjust closed-loop insulin delivery using the “boost” and “ease-off” functions. Some described how using the system resulted in them forgetting about diabetes and neglecting certain tasks. Conclusions: A closed-loop system with small components and control algorithm on a smartphone app can enhance usability and acceptability for adolescents and may help address the health-related disparities experienced by this age group. However, challenges can arise from using a medical app on a device which doubles as a smartphone. Trial registration: Closed Loop From Onset in Type 1 Diabetes (CLOuD); NCT02871089; https://clinicaltrials.gov/ct2/show/NCT02871089

Development of a Web portal to assist in diabetes education and self-management

2007 ◽  
Vol 13 (1_suppl) ◽  
pp. 19-22 ◽  
Author(s):  
Steven Devlin ◽  
Roy Harper ◽  
Phyl Reynolds ◽  
Paul Mccullagh
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Diabetes Education ◽  
Learning Objects ◽  
Care Staff ◽  
Self Management ◽  
Health Care Staff ◽  
Web Portal

A Web portal was developed to assist in diabetes education and self-management. Access to reliable information is an essential component of effective self-care in diabetes. Education was provided as a series of learning objects, aimed at patients with either Type 1 or Type 2 diabetes. Where appropriate, material was also provided via multimedia learning tools, such as tutorials and interactive quizzes. Throughout the development of the Web portal, periodic assessment was carried out by an expert patient group. This comprised 10 individuals, four of whom had Type 1 diabetes and two with Type 2. The expert group provided feedback to the health-care professionals involved with content development. There were also regular discussion forums with both patients and health-care staff. The portal was designed to facilitate effective self-management, by providing ongoing support with regular feedback on progress.

scholarly journals Establishment of a type 1 diabetes structured education programme suitable for Chinese patients: Type 1 Diabetes Education in Lifestyle and Self Adjustment (TELSA)

2020 ◽  
Author(s):  
Yuting Xie ◽  
Fang Liu ◽  
Fansu Huang ◽  
Chunna Lan ◽  
Jia Guo ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Quality Assurance ◽  
Diabetes Education ◽  
Insulin Dose ◽  
Education Programme ◽  
Chinese Patients ◽  
Self Management ◽  
Structured Interviews ◽  
Structured Education

Abstract Background: Various guidelines recommend that all adults diagnosed with type 1 diabetes (T1D) should be offered an evidence based, structured education programme (SEP) to optimize self-management care. China has a 13,000 annual increase in newly diagnosed T1D cases, of which 65% are adults. However, there is yet no validated SEP targeted to T1D patients in China. The purpose of this study is to establish a structured T1D self-management education programme—‘Type 1 Diabetes Education in Lifestyle and Self Adjustment’ (TELSA) that is adapted to medical and cultural practices in China. Methods: TELSA programme was developed based on the ADDIE model, following three steps: i) Semi-structured interviews were administered to 10 healthcare professionals (HCPs) and 13 T1D patients. Different topic guides, focusing on 4 dimensions including goals, contents, format of delivery, and quality assurance, were designed for either HCPs or patients. The interviews were recorded and analysed with thematic analysis. ii) Extracted themes were modified according to Delphi consultation. iii) Preliminary courses were conducted as pilot study to evaluate the effects of TELSA and optimization of the curriculum was finalized accordingly. Results: A total of 18 themes in 4 dimensions of the programme design were identified in the final version: i) goals: ‘behaviour modification’ and ‘outcome improvement’; ii) contents: ‘living with T1D’, ‘self-monitoring of blood glucose’, ‘knowing insulin’, ‘insulin dose adjustment’, ‘carbohydrates and carbohydrate counting’, ‘hypoglycaemia’, ‘complications of diabetes’, ‘managing psychological issues’, ‘physical activity’, and ‘question-and-answer’; iii) format: ‘multidisciplinary team combined with peer support’, ‘face-to-face education followed by remote learning’, and ‘2-day programme held on weekends’; and iv) quality assurance: ‘after-class quiz’, ‘patients’ feedback’, and ‘long-term evaluation on effectiveness’. Conclusions: A type 1 diabetes structured education programme in China was set up and shown to be applicable under local medical, social, and cultural environment.

scholarly journals Establishment of a type 1 diabetes structured education programme suitable for Chinese patients: Type 1 Diabetes Education in Lifestyle and Self Adjustment (TELSA)

2019 ◽  
Author(s):  
Yuting Xie ◽  
Fang Liu ◽  
Fansu Huang ◽  
Chunna Lan ◽  
Jia Guo ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Quality Assurance ◽  
Curriculum Design ◽  
Diabetes Education ◽  
Insulin Dose ◽  
Education Programme ◽  
Chinese Patients ◽  
Self Management ◽  
Structured Education

Abstract Background It is recommended by various guidelines that all adults diagnosed with type 1 diabetes (T1D) should be offered an evidence based, structured education programme (SEP) to optimize self-management care. China has a 13,000 annual increase of newly diagnosed T1D cases and is now the fourth largest country in the number of new T1D cases per year. However, there is yet no validated SEP targeted for T1D patients in China. The purpose of this paper is to establish a structured T1D self-management education programme—‘Type 1 Diabetes Education in Lifestyle and Self Adjustment’ (TELSA) which adapted to China’s medical and cultural background. Methods The process of developing the programme TELSA was based on the ADDIE model by three steps. Firstly, semi-structured interviews were conducted in 10 healthcare professionals (HCPs) and 13 T1D patients. Different topic guides, focusing on 4 dimensions including goals, contents, format of delivery, and quality assurance, were designed for either HCPs or patients. The interviews were recorded and analysed with thematic analysis. Secondly, extracted themes were modified according to Delphi consultation. Lastly, preliminary courses were conducted as pilot study to evaluate the effects of TELSA and optimization of the curriculum design was finalized accordingly. Results A total of 18 themes in 4 dimensions of the programme design were identified in the final version: i) goals: ‘behaviour modification’ and ‘outcome improvement’; ii) contents: ‘living with T1D’, ‘self-monitoring of blood glucose’, ‘knowing insulin’, ‘insulin dose adjustment’, ‘carbohydrates and carb-counting’, ‘hypoglycaemia’, ‘complications’, ‘managing psychological issues’, ‘physical activities’, and ‘question-and-answer’; iii) format: ‘multidisciplinary team combined with companion support’, ‘face-to-face education followed with distal learning’, and ‘2-day programme held on weekends’; and iv) quality assurance: ‘after-class quiz’, ‘patients’ feedbacks’, and ‘long-term evaluation on effectiveness’. Conclusions A type 1 diabetes structured education programme in China was set up and shown to be applicable under local medical, social, and cultural environment.

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