Emerging Technologies, Medical Devices, Apps, Sensors, and Informatics to Help People with Diabetes.
JMIR Diabetes (JD) is a new sister journal of JMIR (the leading open-access journal in health informatics (Impact Factor 2016: 5.175), focusing on technologies, medical devices, apps, engineering, informatics and patient education for diabetes prevention, self-management, care, and cure, to help people with diabetes. As open access journal we are read by clinicians and patients alike and have (as all JMIR journals) a focus on readable and applied science reporting the design and evaluation of health innovations and emerging technologies, as well as on diabetes epidemiology. We publish original research, viewpoints, and reviews (both literature reviews and medical device/technology/app reviews) covering for example wearable devices and trackers, mobile apps, glucose monitoring (including emerging technologies such as Google contact lens), medical devices for insulin and metabolic peptide delivery, closed loop systems and artificial pancreas, telemedicine, web-based diabetes education and elearning, innovations for patient self-management and "quantified self", diabetes-specific EHR improvements, clinical or consumer-focused software, diabetes epidemiology and surveillance, crowdsourcing and quantified self-based research data, new sensors and actuators to be applied to diabetes.
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Engagement in the Diabetes Online Community Is Associated with Better Glycemic Control, Self-Care and Quality of Life
Date Submitted: Jul 29, 2017
Open Peer Review Period: Jul 29, 2017 - Sep 23, 2017
Background: Successful diabetes management, usually measured by glycosalyted hemoglobin (A1c) levels, requires ongoing lifelong self-care, and can reqire that individuals with diabetes become experts...
Background: Successful diabetes management, usually measured by glycosalyted hemoglobin (A1c) levels, requires ongoing lifelong self-care, and can reqire that individuals with diabetes become experts in translating care recommendations into real-life day-to-day diabetes management strategies. The diabetes online community (DOC) comprises multiple websites that include social media sites, blogs, and discussion groups for people with diabetes to chat and exchange information. Online communities can provide disease-specific practical advice, emotional support, allow users to share experiences, and encourage self-advocacy and patient empowerment. However, there has been little research about whether DOC use is associated with better diabetes self-management. Objective: This study surveyed adults with diabetes who participated in a DOC to better understand and describe who is using the DOC, how they are using it, and whether use of a DOC was associated with health indicators. Methods: We recruited, over a 7-month period, adults diagnosed with diabetes who used at least one of four different diabetes-related online communities to complete an online cross-sectional survey. Participants demographics, reported glycosylated hemoglobin (A1c), health-related quality of life (SF-12v2), level of diabetes self-care (Self-Care Inventory Revised), and DOC use (level of intensity and engagement) were collected. We examined the relationships between demographics, DOC use engagement and health indicators (HRQOL, self-care, and A1c levels).We used binary logistic regression to determine the extent to which DOC use predicted an A1C < 7% or ≥ 7% after controlling statistically for other variables in the model. Results: A total of 183 adults participated in this study. Participants were mostly female (71.6%; N=131/183) with a mean age of 44.7 years (SD=14) and diabetes duration of 18.2 years (SD=14.6). Participants had higher diabetes self-care (p<.001, M=72.4, SD=12.1) and better health-related quality of life (physical component summary p<.001, M= 64.8, SD=19; mental component summary p<.001, M= 66.6, SD=21.6) when compared to norms for diabetes. DOC engagement was a strong predictor of A1c, reducing the odds of having an A1c ≥7% by 33.8% for every point increase in DOC engagement (0-5). Our data also indicated that study participants are oftentimes (67.2%; N=123/183) not informing their healthcare providers about their DOC use even though most (91.2%; N=169/183) are seeing their healthcare provider on a regular basis. Conclusions: Our results suggest that individuals highly engaged with the DOC are more likely to have better glycemic control than those with lower engagement. Furthermore, DOC users have high health-related quality of life and diabetes self-care levels. Supplementing usual healthcare activities with DOC use may encourage knowledge and support among a population who need to optimize their diabetes self-management. Further studies are needed to determine how DOC use may affect health outcomes.
Behavioral and medical mechanisms that link diabetes to disability depend on the intersection of place and gender
Date Submitted: Jun 23, 2017
Open Peer Review Period: Jun 25, 2017 - Aug 20, 2017
Background: The mechanisms that link diabetes to disability may vary across populations. Objective: This study investigated gender by place differences in the behavioral and medical mechanisms behind...
Background: The mechanisms that link diabetes to disability may vary across populations. Objective: This study investigated gender by place differences in the behavioral and medical mechanisms behind the link between diabetes (DM) and disability in eight countries. Methods: We borrowed data from Research on Early Life and Aging Trends and Effects (RELATE). This analysis included adults from eight countries including Barbados, Brazil, Costa Rica, Chile, Cuba, Puerto Rico, Mexico, and Uruguay. Diabetes was the independent variable, disability (activities of daily living) was the dependent variable, socioeconomics, obesity, health behaviors, and comorbidities were covariates, and gender was the moderator. We used country by gender specific- logistic regressions to test the effect of DM on disability after adjusting for socioeconomics (Model 1), socioeconomics, health behaviors, and obesity (Model 2), and socioeconomics, obesity, health behaviors, and medical comorbid conditions (Model 3). Results: Gender by country specific patterns of association between DM and disability were observed in Puerto Rico, Mexico, Brazil, Chile, and Cuba. In Puerto Rico, in men, DM – ADL could be explained by health behaviors and obesity, for women, however, the impact of DM on ADL was above all confounders for women. In Mexico, for men, DM was not associated with disability, however, for women, there was a link which could be explained by health behaviors and obesity. In Brazil, for men, DM – ADL limitation link could be fully explained by health behaviors and obesity, for women, however, DM was not associated with ADL at all. In Chile, for men, DM was not associated with ADL limitation, for women, however, there was an association between DM and ADL limitation which could not be explained by health behaviors, obesity, or comorbid medical conditions. In Cuba, for men, health behaviors and obesity fully mediated the effect of DM on ADL, for women, however, this link was mediated by comorbid medical conditions. Conclusions: Gender by place differences exist in the link between DM and disability, as well as behavioral and medical mechanisms behind such link. These findings advocate for the intersectionality approach in studying burden of illnesses such as DM.