Using a Cell Phone-Based Glucose Monitoring System for Adolescent Diabetes Management

Abstract

Introduction Mobile technology may be useful in addressing several issues in adolescent diabetes management. Purpose To assess the feasibility and acceptability of a cell phone glucose monitoring system for adolescents with type 1 diabetes and their parents. Methods The authors recruited patients with type 1 diabetes who had been diagnosed for at least 1 year. Each adolescent used the system for 6 months, filling out surveys every 3 months to measure their usability and satisfaction with the cell phone glucose monitoring system, as well as how use of the system might affect quality of family functioning and diabetes management. Results Adolescents reported positive feelings about the technology and the service, even though a concerning number of them had significant technical issues that affected continued use of the device. Nearly all thought that the clinic involvement in monitoring testing behavior was quite acceptable. The use of the Glucophone™ did not, however, significantly change the quality of life of the adolescents, their level of conflict with their parents, their reported self-management of diabetes, or their average glycemic control within the short time frame of the study. Conclusions As a feasibility study of the technology, this work was successful in demonstrating that cell phone glucose monitoring technology can be used in an adolescent population to track and assist in self-monitoring behavior. The authors speculate that explicitly attempting to change behavior, perhaps with the use of behavioral contracts, would enhance the technology’s ability to improve outcomes.

The role of digital communication in patient–clinician communication for NHS providers of specialist clinical services for young people [the Long-term conditions Young people Networked Communication (LYNC) study]: a mixed-methods study

“…250,276,282,284,286 Additionally, one study found that low-density lipoprotein cholesterol concentrations decreased significantly in the intervention arm and high-density lipoprotein cholesterol concentrations increased significantly in both the experimental and control groups. 285 Five studies reported positive impacts of DCC interventions on patients' physical health (BMI and weight stabilised, whereas they increased in the control group, 275 glucose testing increased, 277 DKA admission rates decreased 279 and the number of urgent clinic appointments decreased). 283 Findings were less clear regarding psychological outcomes, however.…”

“…Two studies reported no differences in quality of life between the intervention and control groups. 250,276,283 There were also mixed findings in relation to self-efficacy: two studies found that self-efficacy and self-management increased in the intervention group, 275,277 whereas one found no differences. 276 In the qualitative pilot study, patients reported benefits to the intervention.…”

Codesigned Shared Decision-Making Diabetes Management Plan Tool for Adolescents With Type 1 Diabetes Mellitus and Their Parents: Prototype Development and Pilot Test (Preprint)

“…HIT-enhanced SMBG has been shown to improve reactive and proactive blood glucose management, provide adherence support, and promote intensification of treatment. [2][3][4] However, adolescents and parents are often reluctant to adopt this technology, which may be related to parental nagging, family conflict, and additional burden placed on adolescents and parents. [5,6] We wanted to determine if shared decision making to identify self-care goals during the clinical encounter could improve diabetes self-care among adolescents with T1D using HITenhanced SMBG.…”

“…The intervention allowed us to study three strategies for improving SMBG and diabetes self-care in the short-term (6-months). These strategies were: (1) HIT-enhanced SMBG that both shared SMBG data among patients, their parents, and health care providers, and allowed for text messaging; (2) shared-decision making to construct a diabetes self-care "contract"; and (3) a combination of (1) and (2).…”

Diabetes Educators

“…20 Specialized program applications (apps) downloaded on smartphones and tablets support self-care through timely provision of information on blood glucose, diet, and exercise patterns; and this information can be shared electronically with health care providers. 19,21,22 Another communication modality is video conferencing (VC), which allows simultaneous audio and visual communication between 2 or more locations via the Internet. 6 This may involve commercial systems managed by health care organizations or personal communication software such as Skype.…”