Technological Ecological Momentary Assessment Tools to Study Type 1 Diabetes in Youth: Viewpoint of Methodologies

Abstract

Type 1 diabetes (T1D) is one of the most common chronic childhood diseases, and its prevalence is rapidly increasing. The management of glucose in T1D is challenging, as youth must consider a myriad of factors when making diabetes care decisions. This task often leads to significant hyperglycemia, hypoglycemia, and glucose variability throughout the day, which have been associated with short- and long-term medical complications. At present, most of what is known about each of these complications and the health behaviors that may lead to them have been uncovered in the clinical setting or in laboratory-based research. However, the tools often used in these settings are limited in their ability to capture the dynamic behaviors, feelings, and physiological changes associated with T1D that fluctuate from moment to moment throughout the day. A better understanding of T1D in daily life could potentially aid in the development of interventions to improve diabetes care and mitigate the negative medical consequences associated with it. Therefore, there is a need to measure repeated, real-time, and real-world features of this disease in youth. This approach is known as ecological momentary assessment (EMA), and it has considerable advantages to in-lab research. Thus, this viewpoint aims to describe EMA tools that have been used to collect data in the daily lives of youth with T1D and discuss studies that explored the nuances of T1D in daily life using these methods. This viewpoint focuses on the following EMA methods: continuous glucose monitoring, actigraphy, ambulatory blood pressure monitoring, personal digital assistants, smartphones, and phone-based systems. The viewpoint also discusses the benefits of using EMA methods to collect important data that might not otherwise be collected in the laboratory and the limitations of each tool, future directions of the field, and possible clinical implications for their use.

A Scoping Review of Children, Empowerment and Smartphone Technology Regarding Social Construction Theory with the Aim of Increasing Self-Direction in Democracies

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“…Unexpectedly, there are six reports assessed [75][76][77]82,90,92] that consider children in a manner equating them as part of the Advantaged. As such they are presented as legitimately entitled to the same rewards and burdens as middle class taxpaying adults.…”

“…As those who must learn to manage their self-care from the time they are very young, children with type 1 diabetes are viewed as prime candidates for making use of smartphone apps that help with all aspects of controling their disease [92]. Smartphones, in this regard, have greatly empowered children in the successful self-management of individual diabetic consequences in a manner similar to adults.…”

A Scoping Review of Children, Empowerment, and Smartphone Technology Regarding Social Construction Theory with the Aim of Increasing Self-Direction in Democracies

“…In the view of these authors, as smartphones are available to almost all children, they can and should be used to "reduce psychosocial consequences and improve self-management skills" (Abasi et al 2021). As those who must learn to manage their self-care from the time they are very young, children with type 1 diabetes are viewed as prime candidates for making use of smartphone apps that help with all aspects of controlling their disease (Ray et al 2021). Smartphones, in this regard, have greatly empowered children in the successful self-management of individual diabetic consequences in a manner similar to adults.…”