Usability of Medical Devices for Patients With Diabetes Who Are Visually Impaired or Blind

Abstract

The estimation is that every third to fourth patient with diabetes suffers from some degree of diabetic retinopathy. Medical products for insulin administration (such as insulin pens and pumps) or glucose monitoring not optimized to the needs of these patients’ represent a high barrier for optimal diabetes therapy in daily practice. To date, the number of devices suitable for visually impaired and blind patients with diabetes is scarce. This manuscript outlines the specific needs of this patient group with regard to systems for insulin administration, blood glucose measurement, and continuous glucose monitoring. We see the clear need for a policy requirement for manufacturers to provide accessible/user friendly technical aids for visually impaired and blind patients with diabetes. This would represent an important step toward improving the situation for this impressively large patient group.

Comparative characteristics of older people with type 1 diabetes treated with continuous subcutaneous insulin infusion or insulin injection therapy: data from the German/Austrian DPV registry

“…Hence older age in itself should not be seen as an exclusion criterion for the use of CSII. An individual's diabetes self‐management skills and possible impairments have to be taken into account . Although many older individuals with type 1 diabetes remain highly functional and demand intensive therapy options such as new diabetes technologies for optimized glycaemic control, other older people may potentially benefit from CSII but are affected by geriatric syndromes, which can complicate intensive therapy approaches and increase the risk of adverse outcomes .…”

“…It is conceivable that despite suboptimal glycaemic control, physicians might opt to continue insulin injection therapy or discontinue CSII due to age‐related barriers that complicate CSII initiation, and a lack of elderly‐friendly insulin pumps and reliable data on CSII usage in older people . Although there is a strong need for customizable options , such as adaptable displays, voice output or simplified menus, the design of current devices still does not offer enough personalized solutions to be most usable and thus effective and safe for the elderly . Actions targeted at healthcare professionals and the diabetes technology market that aim at the usability of devices and raise awareness for the needs of older people using CSII are essential.…”

Elderly Patients With Diabetes: Special Aspects to Consider

“…While a given patient with T1D may easily preserve his or her selfmanagement skills and successfully use DT even with increasing age, other patients with diabetes may experience substantial visual impairments or memory decline that are significant-and possibly dangerous-barriers to DT use. 1 Individually tailored regimens and DT options are called for that take into account possible age-associated impairments.…”

Wünsche, Sorgen und Bedürfnisse bezüglich der Insulinpumpentherapie im Alter: Ergebnisse einer Befragung bei Menschen mit Typ-1-Diabetes mellitus im höheren Lebensalter und von Diabetesfachkräften

“…B. Anpassung des Displays; unterschiedliche Anzeigegrößen, Voiceover-Funktionen) im Sinne einer Personal User Experience [12]. Bisher stehen jedoch leider nur wenige Insulinpumpen mit Akustikmodus zur Verfügung und zumeist sind wichtige Funktionen für sehbehinderte/blinde Menschen nicht nutzbar, sodass Patientinnen und Patienten im schlimmsten Fall für ihre tägliche Diabetestherapie dauerhaft auf die Hilfe anderer angewiesen sind [29,30]. Seit 2014 setzt sich das Bündnis "Diabetes und Auge", bestehend aus dem Deutschen Blinden-und Sehbehindertenverband (DBSV) und der Deutschen Diabetes Hilfe -Menschen mit Diabetes (DDH-M) dafür ein, Medizinproduktehersteller für die Notwendigkeit barrierefrei bedienbarer Diabetestechnologie zu sensibilisieren.…”