JMIR Diabetes

Participating in a Diabetes Self-Management Education and Support (DSMES) program improves self-care behaviors, quality of life, and health outcomes. However, language barriers and cultural differences can hinder participation, leaving many Vietnamese Americans with limited access to DSMES services.

Conventional clinical markers guide cardiovascular risk stratification; however, continuous glucose monitoring (CGM) data remain absent from prediction models. A synthesis of the current literature is needed to clarify the prognostic relevance of CGM data for cardiovascular outcomes in people with diabetes.

Globally, 537 million persons live with diabetes, and a lifetime risk of up to 34% of developing diabetic foot ulcers (DFUs) necessitates strengthened preventive initiatives.

Glycated hemoglobin (HbA) is a convenient tool to evaluate glycemic status but its ability to detect individuals at risk for type 2 diabetes is limited.

Many persons with type 2 diabetes (T2D) lack risk awareness or underestimate their cardiovascular risk. Although health care professionals in primary health care strive to implement risk-awareness strategies for cardiovascular risk, persons with T2D report a lack of meaningful dialogue with health care professionals. Co-creation is grounded in participatory action research and involves participants as equal partners across all stages of a project. This study describes the development of an intervention to increase cardiovascular risk awareness in people with T2D.

Recent decades have seen a dramatic proliferation of real-world data use and evidence generation from nonresearch settings. Data utilization is particularly revolutionizing the operations and impact of nongovernmental organizations worldwide, especially in low- and middle-income countries. Action4Diabetes, which has incrementally been providing sustainable diabetes care for children, adolescents, and young adults with type 1 diabetes (aged 0‐25 y) across Southeast Asia since 2015, is one such organization. Recognizing the importance of data, Action4Diabetes have collaborated with CorrelAid e.V. As part of this, Action4Diabetes has been exchanging patient data with the local program hospitals monthly. A preprocessing pipeline was implemented, extracting patient and medical product data in a standardized and unified manner. Data collected are anonymized and subsequently uploaded to secure public cloud storage, where they are processed and stored in a centralized database. The model used by Action4Diabetes shows that much can be achieved and can perhaps be utilized elsewhere.

Patients with type 2 diabetes mellitus (T2D) have a higher risk of cardiovascular disease, including heart failure (HF), leading to health care burden including hospitalization and mortality. Among multiple T2D therapies, there are inadequate head-to-head comparisons of their effects on HF in the real-world patient population.

Effective management of type 2 diabetes mellitus (T2DM) requires monitoring clinical parameters like blood glucose and medication, alongside lifestyle factors such as diet and physical activity. Decision support tools, including dashboards and shared decision-making tools, help with medication adjustments, glucose monitoring, and lifestyle. However, systems rarely integrate home-monitored lifestyle data with personalized guidance and rarely facilitate collaborative goal setting for behavior change. As a result, health care professionals (HCPs) are limited in their ability to support patients’ medical and lifestyle management. Blended care, combining in-person consultations with digital monitoring of patient data, can help bridge this gap by providing structured information and data-driven insights to support diabetes management.

Type 1 diabetes is a constraining disease due to the burden of its management, and diabetes outcome largely depends on the effectiveness of diabetes self-care. Digital health technology (DHT), which includes continuous glucose monitoring, insulin delivery devices, and related mobile health apps, can support diabetes self-care and thereby improve diabetes outcomes. In literature, experiences with the use of DHT vary widely among people with diabetes and are a less studied area among adults with type 1 diabetes.

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Type 2 diabetes affects 483 million adults worldwide, with rising prevalence and an estimated 6 million premature deaths annually. Low physical activity is a key risk factor, while increased activity can reduce disease onset and improve metabolic health. Consumer activity trackers, when paired with behavior change strategies, have shown potential to increase physical activity among adults with type 2 diabetes.

For adults living with type 1 diabetes (T1D), diabetes-specific mental health support is limited. Peer support and digital health platforms are promising strategies for delivering this support to this population, particularly those from geographically marginalized communities. Mobile apps, in particular, can enhance self-management and deliver support. This paper describes the iterative co-design and development process of a novel mobile app for use in a pilot trial, T1D REACHOUT (REACHOUT), that aims to reduce the diabetes distress, a core facet of diabetes-specific mental health, of adults with T1D. An initial think tank and 6 focus groups were conducted with adults with T1D to better understand their support needs and identify platform requirements. Following this, we partnered with adults living with T1D, the “end users,” to iteratively co-design the REACHOUT app, enhancing usability and ensuring relevance. Adapting the open-source Rocket.Chat platform to user-defined requirements, we deployed the app in a single cohort pilot study. A network analysis of messages exchanged during the pilot study was performed to explore trends and patterns and demonstrate implementation feasibility. Pilot study outcomes informed further refinement before implementation in a randomized controlled trial. The implementation of the REACHOUT app features 6 key components identified in 6 initial focus groups: a 24/7 chatroom (a customized group messaging function with threads), topic-specific discussion boards, a peer supporter library, peer supporter profiles for a user-driven matching process, small group virtual sessions, and direct (one-to-one) messaging. Forty-six participants were encouraged to use any or all of the features as frequently as desired over a 6-month period during the pilot study. During this time, 179 private small groups were created, and 10,410 messages were sent, including 1389 chat room messages and 7116 direct messages; among these were 3446 messages exchanged between participants and their self-selected peer supporters. Key factors for successful implementation included (1) the co-design process involving comprehensive user engagement and (2) the opportunities realized through hybrid development. These findings offer generalizable lessons for mobile health research teams developing similar app-based interventions.