BACKGROUND
Young adults (YA) with type 1 diabetes (T1D) often struggle with self-management and achieving target glycemic control and, thus, may benefit from additional support during this challenging developmental life stage. They are also some of the highest utilizers of social media (SM), which may have some benefits to young people with T1D.
OBJECTIVE
Given the potential of online social media support for people with diabetes, we sought to use qualitative methods to explore the perceptions of diabetes social media posts to influence self-care and emotional state of YA with T1D.
METHODS
A series of Instagram posts were selected by a multidisciplinary team of T1D experts. YA aged 18-25 with T1D duration of 1 year or more were recruited from clinic to participate in a 60-minute semi-structured videoconferencing interview over HIPAA-compliant Microsoft Teams. First, they were queried about their social media use in general and specific to diabetes. Next, they reviewed 10 posts with the interviewer. For each post, their perceptions and reactions were queried. They were asked about each post’s impact on their emotional state and potential influence on diabetes self-care. Finally, they were asked to comment on what the post emphasized and how their feelings after viewing the posts. Interviews were transcribed and coded using thematic analysis. The participants’ diabetes management information was extracted from the electronic health record.
RESULTS
There were 26 YA who completed the study. Their mean (+/-standard deviation) age was 22.6+/-s2.0 years, T1D duration 12.6+/-s5.9 years, and HbA1c 7.6+/-s1.2%. In this sample, 65.3% were female and 84.6% white. All were using continuous glucose monitors (CGM) and 80.7% used insulin pumps, 71.4% of which were hybrid closed loop. All participants used SM at least once daily, but most only sometimes or rarely used SM to access diabetes content and rarely or never posted diabetes content themselves. Major themes arising from the interviews centered on the potential for the YA to connect emotionally through social media, which could be either positive or negative. Overall, for YA with T1D, social media served to: 1) highlight the existence of a community of people with T1D; 2) be a source of new diabetes information; 3) potentially influence diabetes self-management; 4) potentially influence emotional state; and 5) be appealing to the T1D community when the posts possessed certain characteristics (e.g. medical accuracy, aesthetically appealing presentation of content).
CONCLUSIONS
Social media has the potential to help YA with T1D feel a sense of community, seek and share objective and subjective thoughts and feelings about diabetes, motivate diabetes self-care, and positively affect emotional state. However, it may also have the potential to demotivate self-care and exacerbate negative emotional state with regards to diabetes.