Dear my Very Problematic Blood Glucose Meter: Adolescents' Experiences Self-Managing Type 1 Diabetes and their Psychosocial User Requirements Of Medical Technologies

<p>“Dear insulin pump. I love that you came into my life! You give me flexibility, confidence, and happiness.” “Dear my very problematic blood glucose meter. I wish I could let you go. I don't ask much from you, just correct readings and that you stop deciding to pack it in. You make me second guess myself and my health.” The difference between a loved and a despised medical device is stark. Adolescents with type 1 diabetes require medical devices that facilitate their self-management throughout every aspect of their lives, from school, to the sports field, to managing hypoglycaemia in the middle of the night. This research aims to describe adolescents’ experiences self-managing type 1 diabetes, and identify their psychosocial user requirements of medical technologies. Following a constructivist research paradigm, a range of predominantly qualitative and participatory design methods were employed with 16 adolescent and young adult participants with type 1 diabetes and nine health professionals. Methods included semi-structured interviews and a card-sort task to understand the psychosocial impacts of current medical devices. Cultural probes elicited: adolescents’ metaphors for managing diabetes, how they would like to manage their diabetes, the best and worst features of their devices, and the relationships they have with them. Undergraduate design students used secondary research and emergent psychosocial user requirements of medical devices to design blood glucose meters, lancets, storage solutions, and insulin pumps that resembled watches, jewellery, and smartphones, could be attached to a bike, or could glow at night. I used these designs to provide additional support for adolescents’ user requirements, demonstrate how they were of use to designers, and stimulate discussion with the adolescents. The adolescents with type 1 diabetes completed a participatory design workshop, designing blood glucose meters that challenged the ways in which medical devices currently draw attention. Findings were analysed using a constructivist approach to grounded theory, and psychosocial user requirements were developed. On average, current medical devices have positive psychosocial impacts on adolescents, with large positive impacts on users’ feelings of competence, followed by increased feelings of adaptability and self-esteem. However, some adolescent requirements remain unmet. Issues include the transition of responsibility for diabetes management from parent to adolescent, managing blood glucose while participating in everyday activities such as sports, managing attention, and developing acceptance of a long-term condition. Other issues stem from devices’ features, usability, reliability, and context of use. As research has indicated, the traditional health approach is about curing illness, but with diabetes, managing wellness is key. The person learns to fit diabetes around the rest-of-life. While it is pertinent that diabetes technologies are clinically effective, they should also be designed in alignment with adolescent psychosocial user requirements, taking into account not only their physical health, but also the ways and contexts in which adolescents go about their daily lives.</p>

Dear my Very Problematic Blood Glucose Meter: Adolescents' Experiences Self-Managing Type 1 Diabetes and their Psychosocial User Requirements Of Medical Technologies

<p>“Dear insulin pump. I love that you came into my life! You give me flexibility, confidence, and happiness.” “Dear my very problematic blood glucose meter. I wish I could let you go. I don't ask much from you, just correct readings and that you stop deciding to pack it in. You make me second guess myself and my health.” The difference between a loved and a despised medical device is stark. Adolescents with type 1 diabetes require medical devices that facilitate their self-management throughout every aspect of their lives, from school, to the sports field, to managing hypoglycaemia in the middle of the night. This research aims to describe adolescents’ experiences self-managing type 1 diabetes, and identify their psychosocial user requirements of medical technologies. Following a constructivist research paradigm, a range of predominantly qualitative and participatory design methods were employed with 16 adolescent and young adult participants with type 1 diabetes and nine health professionals. Methods included semi-structured interviews and a card-sort task to understand the psychosocial impacts of current medical devices. Cultural probes elicited: adolescents’ metaphors for managing diabetes, how they would like to manage their diabetes, the best and worst features of their devices, and the relationships they have with them. Undergraduate design students used secondary research and emergent psychosocial user requirements of medical devices to design blood glucose meters, lancets, storage solutions, and insulin pumps that resembled watches, jewellery, and smartphones, could be attached to a bike, or could glow at night. I used these designs to provide additional support for adolescents’ user requirements, demonstrate how they were of use to designers, and stimulate discussion with the adolescents. The adolescents with type 1 diabetes completed a participatory design workshop, designing blood glucose meters that challenged the ways in which medical devices currently draw attention. Findings were analysed using a constructivist approach to grounded theory, and psychosocial user requirements were developed. On average, current medical devices have positive psychosocial impacts on adolescents, with large positive impacts on users’ feelings of competence, followed by increased feelings of adaptability and self-esteem. However, some adolescent requirements remain unmet. Issues include the transition of responsibility for diabetes management from parent to adolescent, managing blood glucose while participating in everyday activities such as sports, managing attention, and developing acceptance of a long-term condition. Other issues stem from devices’ features, usability, reliability, and context of use. As research has indicated, the traditional health approach is about curing illness, but with diabetes, managing wellness is key. The person learns to fit diabetes around the rest-of-life. While it is pertinent that diabetes technologies are clinically effective, they should also be designed in alignment with adolescent psychosocial user requirements, taking into account not only their physical health, but also the ways and contexts in which adolescents go about their daily lives.</p>

GLUKOSA DARAH PASIEN DIABETES MELLITUS DAN TEKANAN DARAH SERTA RISIKO STROKE PADA LANSIA

Abstrak : Diabetes Mellitus (DM) tipe 2 merupakan suatu kondisi yang ditandai dengan adanya hiperglikemia, yang disebabkan adanya gangguan kerja dari hormone insulin ataupun adanya defek pada sekresi insulin. Tujuan dari penelitian ini adalah untuk mengetahui apakah ada hubungan kadar gula darah pasien DM tipe II dengan tekanan darah dan terjadinya risiko stroke pada lansia. Penelitian dilakukan terhadap pasien DM tipe 2 di poli penyakit dalam RS Ibnu Sina Bukittinggi dengan jenis penelitian yang digunakan cross sectional study. Jumlah sampel dalam penelitian ini sebanyak 96 responden. Pengumpulan data menggunakan Shygmomanometer, Glucose meter (Easy Touch) dan kuesioner resiko stroke. Analisa dilakukan secara komputerisasi dengan perangkat menggunakan uji spearmanrank. Hasil penelitian didapatkan bahwa terdapat hubungan kadar gula darah dengan tekanan darah dan resiko stroke dengan nilai pvalue = 0,000. Dari penelitian ini disimpulkan ada hubungan yang bermakna kadar glukoasa darah dengan tekanan darah dan risiko stroke pada lansia penderita DM tipe 2

The clinical effect of glucose meter selection upon the detection of neonatal hypoglycemia

Neonatal hypoglycemia is a common, transitional metabolic state that may lead to poor neurodevelopmental outcomes if unrecognized or managed inadequately. Given its frequency of presentation and immense clinical significance, a myriad of clinical practice guidelines have been published outlining appropriate screening, diagnosis, and treatment principles—many endorsing the use of glucose point-of-care testing (POCT). Unfortunately, the well-intended ‘march’ toward POCT, with bedside glucose meters as screening devices in the NICU, has resulted in unintended consequences with critical implications: a lack of international traceability to the ‘gold’ standard glucose method by POCT devices, under-recognition of POCT limitations, and a reliance upon a technology primarily driven to detect hyperglycemia in the adult population as opposed to neonatal hypoglycemia. As providers continue to advocate for improved POCT, there must be robust communication between providers and the clinical laboratory in the selection, standardization, and interpretation of glucose POCT to ensure optimal neonatal glucose detection.

A Pilot Trial to Evaluate the Accuracy of a Novel Non-Invasive Glucose Meter

The non-invasive self-monitoring of blood glucose (SMBG) has been the subject of intense investigation over recent decades. We conducted a pilot study designed to examine a novel non-invasive glucometer, the HGR GWave, utilizing radiofrequency (RF) sensing. Blood glucose levels assessed by this HGR prototype were compared to measurements performed by a hexokinase core laboratory assay during an oral glucose tolerance test (oGTT) for 5 subjects with type 2 diabetes. The HGR glucose meter readings were also compared to two Abbot Freestyle® glucose meters, which were also used for calibration. The accuracy of the results was evaluated through the calculation of relative absolute difference (RAD), specified percentage differences between 43 reference glucose measurements, and using comparator measurements. The median RAD was −4.787. We detected 79.04%, 92.99% and 97.64% of HGR readings within ±10%, ±15% and ±20% of the reference glucose measurements. The HGR readings had a high correlation with reference lab glucose measurements with R2 = 0.924 (95% CI 0.929–0.979; p < 0.0001). When compared to the Freestyle® glucose meters 94.3% and 100% of the readings were within ±5% and ±10%, with R2 = 0.975 (0.975–0.994; p < 0.0001). The HGR prototype glucose meter was found to be accurate in detecting real-time blood glucose during an oGTT in this small pilot study. A study with a broader range of blood glucose levels is needed to further assess its accuracy and its suitability for clinical use.

Mapping the Content Structure of Online Diabetes Support Group Activity on Facebook

Diabetes is one of the most prevalent chronic diseases and necessitates ongoing self-management to control symptoms. People with diabetes (PWD) express various needs, which are often met in online support groups. Our objectives were to examine related discourse in Hungarian Facebook groups in order to map the content and structure of information PWD are sharing. We aimed to juxtapose our findings with the functionality of eHealth tools available to Hungarian patients to understand what these tools may be lacking. We extracted a total of 200 threads from two public self-help groups. Codes were developed inductively and applied to the entire corpus with the Interface for the Reproducible Open Coding Kit. We used Epistemic Network Analysis to model our data. The mean network of the entire dataset indicates that discourse was chiefly centered on providing help regarding lifestyle-related issues, especially diet. Critical facets of discourse included the need by experienced PWD to provide guidance to the newly diagnosed, share "street-level" knowledge on diabetes, and ensure a sense of support and community. Existing eHealth tools could be supplemented with an app that automatically downloads blood glucose meter measurements, warns patients about predicted high glucose levels, enables location-based information exchange, and promotes social support in adhering to diet and exercise. Ideally, this app would connect patients with their physicians and/or dietitians.