No abstract

Our findings suggest that patients with diabetes and their caregivers use social media for many health-related purposes including medical recommendations and technical support for medical devices and systems as well as emotional support.

Background: Caregivers and individuals living with type 1 diabetes (T1D) who are members of CGM in the Cloud, a Facebook group associated with the Nightscout Project, were interviewed to assess how the online community impacted peer support. Methods: Semistructured qualitative interviews were conducted with caregivers and patients who are part of CGM in the Cloud Facebook group. Interview transcripts were analyzed to identify various themes related to peer support in the online group. Results: Members of the CGM in the Cloud Facebook group identified peer support through giving and receiving technical, emotional, and medical support, as well as giving back to the larger community by paying it forward. Peer support also extended beyond the online forum, connecting people in person, whether they were local or across the country. Conclusions: An online community can provide many avenues for peer support through emotional and technical support, as well as serve as a tool of empowerment. The community as a whole also had a spirit of altruism that bolstered confidence in others as well as those who paid it forward.

The Nightscout Project is a patient-driven mobile technology for health and may have beneficial effects on glycemic control and quality of life.

IMPORTANCE A low-burden electronic health record (EHR) workflow has been devised to systematize the collection and validation of 6 key diabetes self-management habits: (1) checks glucose at least 4 times/day or uses continuous glucose monitor (CGM); (2) gives at least 3 rapidacting insulin boluses per day; (3) uses insulin pump; (4) delivers boluses before meals; (5) reviewed glucose data since last clinic visit, and (6) has changed insulin doses since the last clinic visit. OBJECTIVE To describe the performance of these habits and examine their association with hemoglobin A 1c (HbA 1c ) levels and time in range (TIR). DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study included individuals with known type 1 diabetes who were seen in a US pediatric diabetes clinic in 2019. MAIN OUTCOMES AND MEASURESHabit performance, total habit score (sum of 6 habits per person), HbA 1c levels, and TIR. RESULTS Of 1344 patients, 1212 (609 [50.2%] males; 66 [5.4%] non-Hispanic Black; 1030 [85.0%] non-Hispanic White; mean [SD] age, 15.5 [4.5] years) were included, of whom 654 (54.0%) were using CGM and had a TIR. Only 105 patients (8.7%) performed all 6 habits. Habit performance was lower among older vs younger patients (age Ն18 years vs Յ12 years: 17 of 411 [4.1%] vs 57 of 330 [17.3%]; P < .001), Black vs White patients (3 [4.5%] vs 95 [9.2%]; P < .001), those with public vs private insurance (14 of 271 [5.2%] vs 91 of 941 [9.7%]; P < .001), and those with lower vs higher parental education levels (