Self-Monitoring Technologies for Type 2 Diabetes and the Prevention of Cardiovascular Complications: Perspectives from End Users (original) (raw)
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BMJ Open, 2021
IntroductionStudies suggest that continuous glucose monitors (CGMs) play an important role in the management of diabetes. Although general acceptance has been reported by patients with type 2 diabetes towards the use of CGMs, potential barriers exist like pain due to sensor insertion, accidental removal of the device or adhesive strip, impacts of daily activities, skin reactions to sensor adhesive, etc. This systematic review of qualitative studies aims to explore the perspectives, experiences and narratives of patients and caregivers about CGM use, and its barriers and facilitators.Methods and analysisThis review will include qualitative studies and cross-sectional and longitudinal cohort studies using open-ended questions, published in English by 30 October 2021. The following electronic databases will be searched: Cochrane Library, PubMed, EMBASE, CINAHL, PsycINFO and Scopus. A search of grey literature will be conducted via an online search of Google Scholar, WorldCat, ClinicalT...
Patient Preference and Adherence, 2014
Background: Self-monitoring of blood glucose (SMBG) helps to improve glycemic control and empowerment of people with diabetes. It is particularly useful for people with diabetes who are using insulin as it facilitates insulin titration and detection of hypoglycemia. Despite this, the uptake of SMBG remains low in many countries, including Malaysia. Purpose: This study aimed to explore the barriers and facilitators to SMBG, in people with type 2 diabetes using insulin. Patients and methods: Qualitative methodology was employed to explore participants' experience with SMBG. Semistructured, individual in-depth interviews were conducted on people with type 2 diabetes using insulin who had practiced SMBG, in the primary care clinic of a teaching hospital in Malaysia. Participants were purposively sampled from different age groups, ethnicity, education level, and level of glycemic control (as reflected by the glycated hemoglobin [HbA(1c)]), to achieve maximum variation in sampling. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked, and analyzed using a thematic approach. Results: A total of 15 participants were interviewed, and thematic saturation was reached. The factors that influenced SMBG were mainly related to cost, participants' emotion, and the SMBG process. The barriers identified included: frustration related to high blood glucose reading; perception that SMBG was only for insulin titration; stigma; fear of needles and pain; cost of test strips and needles; inconvenience; unconducive workplace; and lack of motivation, knowledge, and self-efficacy. The facilitators were: experiencing hypoglycemic symptoms; desire to see the effects of dietary changes; desire to please the physician; and family motivation. Conclusion: Participants' perceptions of the purpose of SMBG, the emotions associated with SMBG, and the complexity, pain, and cost related to SMBG as well as personal and family motivation are the key factors that health care providers must consider when advising people with diabetes on SMBG.
SUMMARY Background: Self-monitoring of blood glucose is controversial in the management of type 2 diabetes. Some research suggests that self-monitoring improves glycaemic control, whereas other research is sceptical about its value for people with type 2 diabetes who are not on insulin. Although blood glucose meters are widely available and used by this group, patients' own views are absent from the debate. Aim: To explore the pros and cons of glucose monitoring from the patients' perspectives. Design of study: Qualitative repeat-interview study. Setting: Patients were recruited from 16 general practices and three hospital clinics within four local healthcare cooperatives in Lothian, Scotland. Method: Interview data from 40 patients diagnosed with type 2 diabetes within the previous 6 months were analysed using thematic analysis informed by grounded theory. We report findings from round 1 and round 2 interviews. Results: Glucose monitoring can heighten patients' awarenes...
Journal of Physical Activity Research, 2020
Abstract Objective: To evaluate the prevalence, patterns, and sociodemographic predictors of wearable device use among individuals with self-reported diabetes mellitus. Methods: Data for our analysis was drawn from cycle 3 (2019) of the 5th edition of the Health Information National Trends Survey (HINTS 5). Descriptive statistics were used to evaluate the demographic characteristics, prevalence, and frequency of wearable device use among individuals with diabetes mellitus. Multivariable logistic regression was used to identify the sociodemographic predictors of wearable device use. Results: We identified 1149 individuals who self-reported diabetes mellitus. Of these, 51.2% were females, 59.3% were white, and 51.6% had less than a college education. The prevalence of wearable device use was 20%. Further, a sizable proportion (86.1%) of the wearable device users were willing to share information from their wearable devices with their healthcare provider, and almost half of them (43.4%) reported daily use of these devices in the past 1-month. Significant sociodemographic predictors of wearable device use include age, income, and level of education. Conclusion: Our results highlight the feasibility and acceptability of using wearable devices to deliver evidence-based health care to individuals with diabetes. Future interventions should consider the scalability of these tools and how to reach those subgroups of individuals with diabetes mellitus to whom current technologies may be unavailable. Keywords: wearable device, diabetes mellitus, weight loss, physical activity tracking, health behaviors
Journal of diabetes and metabolic disorders, 2015
Patient-centered perspectives on self-monitoring of blood glucose (SBMG) were assessed in adults with type 2 diabetes using a self-regulation conceptual framework. Participants (N = 589; 53 % female) were adults with type 2 diabetes who were recruited during routine appointments at a diabetes outpatient clinic in the Southeastern/lower Midwestern region of the United States. Participant's had varying perceptions regarding provider recommendations for SMBG (responder n = 380). Personal blood glucose testing patterns were also varied and reports frequently omitted (responder n = 296). Respondent's most frequent personal pattern was to test "occasionally, as needed," which did not differ by insulin use status, gender or age. In those not prescribed insulin, HbA1c reflected better control in those testing at least once per week (p = .040) or with a blood glucose goal (p = .018). 30.9 % endorsed at least monthly perceived encounters with SMBG barriers, with higher repor...
The British Journal of General Practice, 2004
BACKGROUND: Self-monitoring of blood glucose is controversial in the management of type 2 diabetes. Some research suggests that self-monitoring improves glycaemic control, whereas other research is sceptical about its value for people with type 2 diabetes who are not on insulin. Although blood glucose meters are widely available and used by this group, patients' own views are absent from the debate. AIM: To explore the pros and cons of glucose monitoring from the patients' perspectives. DESIGN OF STUDY: Qualitative repeat-interview study. SETTING: Patients were recruited from 16 general practices and three hospital clinics within four local healthcare cooperatives in Lothian, Scotland. METHOD: Interview data from 40 patients diagnosed with type 2 diabetes within the previous 6 months were analysed using thematic analysis informed by grounded theory. We report findings from round 1 and round 2 interviews. RESULTS: Glucose monitoring can heighten patients' awareness of the impact of lifestyle; for example, dietary choices, on blood glucose levels. Glucose monitoring amplifies a sense of 'success' or 'failure' about self-management, often resulting in anxiety and self-blame if glucose readings remain consistently high. Moreover, monitoring can negatively effect patients' self-management when readings are counter-intuitive. CONCLUSION: Our analysis highlights the importance of understanding the meanings that newly diagnosed patients attach to glucose self-monitoring. To maximise the positive effects of self-monitoring, health professionals should ensure that patients understand the purpose of monitoring and should clarify with patients how readings should be interpreted.
British Journal of General Practice
Self-monitoring of blood glucose is controversial in the management of type 2 diabetes. Some research suggests that self-monitoring improves glycaemic control, whereas other research is sceptical about its value for people with type 2 diabetes who are not on insulin. Although blood glucose meters are widely available and used by this group, patients' own views are absent from the debate. To explore the pros and cons of glucose monitoring from the patients' perspectives. Qualitative repeat-interview study. Patients were recruited from 16 general practices and three hospital clinics within four local healthcare cooperatives in Lothian, Scotland. Interview data from 40 patients diagnosed with type 2 diabetes within the previous 6 months were analysed using thematic analysis informed by grounded theory. We report findings from round 1 and round 2 interviews. Glucose monitoring can heighten patients' awareness of the impact of lifestyle; for example, dietary choices, on blood...
JMIR Diabetes, 2019
Background: Technology-embedded health care is a future trend. How middle-aged and older patients perceive the added technology intervention is not clear. Objective: The study aimed to understand the factors associated with the adoption of new technology in diabetes care, to understand the feelings and behaviors while using it, and to determine the changes in attitudes and behavior after completing the use of the new technology at the 3-month follow-up. Methods: Middle-aged and older type 2 diabetes patients who had received professional continuous glucose monitoring (CGM; iPro 2 [Medtronic]) were invited for semistructured in-depth interviews on the day of the CGM sensor removal and at 3 months after CGM-based counseling. A phenomenography approach was used to analyze the interview data. Results: A total of 20 type 2 diabetes patients (aged 53 to 72 years, 13 males and 7 females, 4 to 40 years duration of diabetes, mean glycated hemoglobin 8.54% [SD 0.71%]) completed 2 sections of semistructured in-depth interviews. Physician guidance and participant motivation toward problem solving were found to be factors associated with adoption of the device. Participants indicated that technology can be a reminder, a supervisor, and a visualizer of blood glucose, all of which are helpful for disease management. However, CGM is somewhat inconvenient, and some participants also reported that the provision of this new technology might be a hint of disease progression. There was a higher percentage of women compared with men who reported that CGM can be a reminder or a supervisor to help them with diet control. Conclusions: Physician guidance and participants' degree of motivation are keys to adopting new technology in the case of middle-aged and older adults. Although the CGM sensor may cause inconvenience to patients on their limited body movement when wearing the device, it is helpful for diet control and is an effective behavioral modification tool that offers support, especially in the case of women.
Journal of Clinical Nursing, 2009
Aims and Objectives-The aim of this study was to develop role model data for an intervention to motivate non-exercising individuals with type 2 diabetes mellitus to engage in regular physical activity. Toward that end, the study 1) described Continuous Glucose Monitoring System data and obtained role model CGMS graphs, 2) described a monitor to measure exercise amount and intensity and 3) explored participants' experiences of the monitors and perceptions of the glucose monitoring data. Background-Physical activity is a cornerstone of diabetes treatment yet the majority of individuals with diabetes are inactive. Thus, increasing physical activity in these individuals demands innovative interventions. Design-A two-phase, multi-method design was used. Methods-In phase 1, a descriptive design was used to describe physical activity patterns and glucose levels for 72 hours in nine exercising adults with type 2 diabetes. In phase 2, a focus group interview was used to collect data from seven phase-1 participants. Verbatim transcripts of the audio taped focus group were analyzed for themes and trends. Results-The glucose monitor data captured lower glucose levels after exercise. Compared to formal diabetes education, visual data from the glucose monitoring technology were perceived as more relevant to participants' particular, everyday experiences with exercise, diet and stress. Participants reported a reinforced commitment to their exercise and diet regimens after using Continuous Glucose Monitoring System. Technology issues were identified, e.g. discomfort wearing activity monitors and forgetting to enter calibration and event data in glucose monitors. Relevance to Clinical Practice-Participants found that visual glucose monitoring data reinforced self-management behaviors, such as exercise.