Continuous Glucose Monitoring Plus an Online Peer Support Community Reinforces Healthy Behaviors in Hispanic Adults With Type 2 Diabetes

Abstract

Background Previous research has suggested beneficial glycemic outcomes for people with type 2 diabetes with the use of continuous glucose monitoring (CGM); yet, there is a dearth of data examining CGM in diverse populations. Additionally, the use of online peer support communities (OPSCs) can further support the application of CGM information to improve health behaviors. The purpose of this qualitative study was to assess participant experiences with an CGM+OPSC intervention. Methods Semi-structured interviews were conducted after a 12-week combined CGM and OPSC intervention with Hispanic, Spanish-speaking people with type 2 diabetes not using insulin. The OPSC was managed by five trained bilingual peer facilitators. Interviews were conducted in Spanish. Audio recordings were translated and transcribed and then reviewed by the interviewer for accuracy. Emergent themes were identified through inductive thematic analysis. Results Twenty-six participants completed interviews. Three main themes emerged from the data: 1) CGM supports participants’ understanding of the relationship between glucose levels and health behaviors such as healthy eating, being active, taking medication, stress reduction, and improving sleep; 2) the OPSC reinforced how to make healthy choices through personal experiments, collective learning, and social support, and 3) CGM+OPSC supports behavior change and increases confidence. Conclusion When combined, CGM+OPSC appear to create a positive feedback loop to reinforce and optimize healthy behaviors for diabetes self-management in individuals with type 2 diabetes who are not on insulin. The provision of such an intervention tailored to Hispanic, Spanish-speaking individuals has the potential to address the health care disparity seen in this population.

Use of Online Communities among People with Type 2 Diabetes: A Scoping Review

“…They completed a semi-structured post-intervention interview to document their experiences and provide feedback. Litchman et al (2022); United States [ 26 ] To assess participants' experiences with continuous glucose monitoring and the use of online peer support communities. Qualitative descriptive interpretative study Original table created by the authors …”

“…Online diabetes communities can be set up on specific platforms or use available social networks. Related to this issue, both studies by Litchman et al [ 25 •, 26 ] and Herrero et al [ 21 •] used a diabetes-specific online community created on a web domain, while the other authors studied communities created on broader social networks such as Facebook [ 21 •, 24 ]; Never Cafe [ 23 •] or Second Life [ 22 ]. All of them still active.…”

“…Once we analyzed in more detail the characteristics of online communities, we found that the studies led by Litchman [ 25 •, 26 ] used Beyond Type 2 [ https://community.beyondtype2.org/ ), an online community created in 2009 by the non-profit organization Beyond Type 1. This community requires pre-registration for people with T2D to share their stories, connect with each other, and find resources on topics ranging from daily management to mental health management.…”

“…In addition, an email with new posts or news is sent monthly. Litchman et al (2022) [ 26 ] Herrero et al (2021) [ 21 •] Online communities to which the participants belonged included: Facebook groups, diabetes-related forums, health-related forums, and other online forums. Verma et al (2019) [ 24 ] Diabetes support: a Facebook group with approximately 27,000 members Diabetes contact group- a diabetic support group: Facebook group of about 7,000 members.…”

“…In both Litchman studies [ 25 •, 26 ], although they were encouraged to participate 3 times a week, they did not specify if they complied or not. Herrero et al [ 21 •] only asked if they were members or not and since when, and did not measure the degree of participation.…”