JMIR Publications

JMIR Diabetes

Emerging Technologies, Medical Devices, Apps, Sensors, and Informatics to Help People with Diabetes.


Journal Description

JMIR Diabetes (JD) is a new sister journal of JMIR (the leading open-access journal in health informatics with a 2015 impact factor of 4.532) 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.


Recent Articles:

  • Source: Qatar is booming.; URL:;

    Situation of Diabetes and Related Factors Among Qatari Adults: Findings From a Community-Based Survey


    Background: Diabetes mellitus (DM) is a prominent public health problem in Qatar with one of the highest prevalence in the Gulf Cooperation Council region. Obesity continues to be a challenging public health problem in Qatar along with other social determinants contributing to the high DM prevalence. Objective: This paper examines the data from Qatar National STEPS survey (2012) to determine diabetes prevalence among Qatari adults and identify the effect of both generalized and central obesity on it. The article also describes the contribution of selected social and demographic factors on diabetes prevalence in Qatar. Methods: Secondary data analysis of 1471 Qatari adults (18-64 years) from STEP 3 component of the 2012 STEPS Survey was executed. Multivariate binary logistic regression analysis was carried out to assess the role of social and biomedical factors in the prevalence of DM. Results: Among participants, 18.97% (279/1471) of the study population had DM. Both generalized (OR 1.8, P=.005) and central obesity (OR 1.9, P<.001) were significantly associated with DM when adjusted for various respondent characteristics. Older age (P<.001), marital status of ever married (P<.001), and lower educational status (P=.01) were associated with DM. Hypertension (OR 1.5, P=.003 total cholesterol level ≥190 mg/dL (OR 2.2, P<.001) and triglyceride level ≥150 mg/dL (OR 3.6, P<.001) were significantly associated with DM among the study participants. Although family history of DM was significantly associated with development of DM (OR 1.7, P=.01), parental consanguinity was not associated with DM (OR 0.96, P=.80). Conclusions: The DM prevalence in Qatar seems to be highly associated with obesity; however, various additional population characteristics and comorbidity factors should also require attention and should be incorporated while developing intervention strategies.

  • Opening page of the "How is your sugar" website, collage on mockup. Copyright: JMIR Publications; License: Creative Commons Attribution (CC-BY).

    How’s Your Sugar? Evaluation of a Website for Aboriginal People With Diabetes


    Background: Australia’s Aboriginal and Torres Strait Islander peoples (hereafter referred to as “Aboriginal people”) have the longest continuing culture in the world, living sustainably for at least 65,000 years on the Australian continent. In relatively recent times, colonization processes have resulted in Aboriginal people experiencing unacceptable health inequalities compared with other Australians. One disease introduced due to colonization is diabetes, the second leading cause of death for Aboriginal peoples. Objectives: The objective of this study was to describe the construction and utilization of the website “How’s Your Sugar, ” a website for Aboriginal people with type 2 diabetes (herein after referred to as diabetes). The questions for the evaluation were as follows: how was the website constructed; did target groups utilize the website; and did engagement with the website improve diabetes management. Methods: A mixed-method study design was employed. A content analysis of project documents provided information about the website construction. Data from Google analytics provided information about website utilization. To describe patterns of website sessions, percentages and numbers were calculated. A voluntary survey provided more information on website utilization and diabetes self-management. Percentage, numbers, and 95% CIs were calculated for each variable. A chi-square test was performed for Aboriginal status, age, gender, and Aboriginal diabetic status using Australian population estimates and Aboriginal diabetes rates. Results: The website development drew on Aboriginal health, social marketing, interactive health promotion frameworks, as well as evidence for diabetes self-management. The website build involved a multidisciplinary team and participation of Aboriginal diabetics, Aboriginal diabetic family members, and Aboriginal health workers. This participation allowed for inclusion of Aboriginal ways of knowing and being. The highest number of website sessions came from Australia, 98.15% (47,717/48,617) and within Australia, Victoria 50.97% (24,323/47,717). There were 129 survey respondents, and the distribution had more female, 82.9% (107/129, 95% CI 76-88), Aboriginal, 21.7% (28/129, 95% CI 16-30), and Aboriginal diabetic, 48% (13/27, 95% CI 31-66) respondents than expected with P<.001 for these three groups. Most common reasons for visits were university assignment research, 40.6% (41/101), and health workers looking for information, 20.8% (21/101). The sample size was too small to calculate diabetes self-management change. Conclusions: Inclusion of Aboriginal ways of knowing and being alongside other theoretical and evidence models in Web design is possible. Aboriginal people do utilize Web-based health promotion, and further understanding about reaching to this population would be of use. Provision of an education resource would likely have enhanced educational engagement. Web-based technologies are rapidly evolving, and these can potentially measure behavior change in engaging ways that also have benefits for the participant. A challenge for designers is inclusivity of cultural diversity for self-determination.

  • Image Source: Copyright sturti, via iStockPhoto. License purchased by author.
Stock file ID:516185934.

    A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes


    Background: Type 2 diabetes (T2D) is typically managed with a reduced fat diet plus glucose-lowering medications, the latter often promoting weight gain. Objective: We evaluated whether individuals with T2D could be taught by either on-site group or remote means to sustain adequate carbohydrate restriction to achieve nutritional ketosis as part of a comprehensive intervention, thereby improving glycemic control, decreasing medication use, and allowing clinically relevant weight loss. Methods: This study was a nonrandomized, parallel arm, outpatient intervention. Adults with T2D (N=262; mean age 54, SD 8, years; mean body mass index 41, SD 8, kg·m−2; 66.8% (175/262) women) were enrolled in an outpatient protocol providing intensive nutrition and behavioral counseling, digital coaching and education platform, and physician-guided medication management. A total of 238 participants completed the first 10 weeks. Body weight, capillary blood glucose, and beta-hydroxybutyrate (BOHB) levels were recorded daily using a mobile interface. Hemoglobin A1c (HbA1c) and related biomarkers of T2D were evaluated at baseline and 10-week follow-up. Results: Baseline HbA1c level was 7.6% (SD 1.5%) and only 52/262 (19.8%) participants had an HbA1c level of <6.5%. After 10 weeks, HbA1c level was reduced by 1.0% (SD 1.1%; 95% CI 0.9% to 1.1%, P<.001), and the percentage of individuals with an HbA1c level of <6.5% increased to 56.1% (147/262). The majority of participants (234/262, 89.3%) were taking at least one diabetes medication at baseline. By 10 weeks, 133/234 (56.8%) individuals had one or more diabetes medications reduced or eliminated. At follow-up, 47.7% of participants (125/262) achieved an HbA1c level of <6.5% while taking metformin only (n=86) or no diabetes medications (n=39). Mean body mass reduction was 7.2% (SD 3.7%; 95% CI 5.8% to 7.7%, P<.001) from baseline (117, SD 26, kg). Mean BOHB over 10 weeks was 0.6 (SD 0.6) mmol·L−1 indicating consistent carbohydrate restriction. Post hoc comparison of the remote versus on-site means of education revealed no effect of delivery method on change in HbA1c (F1,260=1.503, P=.22). Conclusions: These initial results indicate that an individualized program delivered and supported remotely that incorporates nutritional ketosis can be highly effective in improving glycemic control and weight loss in adults with T2D while significantly decreasing medication use.

  • Image Source: (fair use).

    The Use of Mobile Health to Deliver Self-Management Support to Young People With Type 1 Diabetes: A Cross-Sectional Survey


    Background: Young people living with type 1 diabetes face not only the challenges typical of adolescence, but also the challenges of daily management of their health and evolving understanding of the impact of their diagnosis on their future. Adolescence is a critical time for diabetes self-management, with a typical decline in glycemic control increasing risk for microvascular diabetes complications. To improve glycemic control, there is a need for evidence-based self-management support interventions that address the issues pertinent to this population, utilizing platforms that engage them. Increasingly, mobile health (mHealth) interventions are being developed and evaluated for this purpose with some evidence supporting improved glycemic control. A necessary step to enhance effectiveness of such approaches is to understand young people’s preferences for this mode of delivery. Objective: A cross-sectional survey was conducted to investigate the current and perceived roles of mHealth in supporting young people to manage their diabetes. Methods: Young adults (16-24 years) with type 1 diabetes in Auckland, New Zealand, were invited to take part in a survey via letter from their diabetes specialist. Results: A total of 115 young adults completed the survey (mean age 19.5 years; male 52/115, 45%; European 89/115, 77%), with all reporting they owned a mobile phone and 96% (110/115) of those were smartphones. However, smartphone apps for diabetes management had been used by only 33% (38/115) of respondents. The most commonly reported reason for not using apps was a lack of awareness that they existed. Although the majority felt they managed their diabetes well, 63% (72/115) reported wanting to learn more about diabetes and how to manage it. A total of 64% (74/115) respondents reported that they would be interested in receiving diabetes self-management support via text message (short message service, SMS). Conclusions: Current engagement with mHealth in this population appears low, although the findings from this study provide support for the use of mHealth in this group because of the ubiquity and convenience of mobile devices. mHealth has potential to provide information and support to this population, utilizing mediums commonplace for this group and with greater reach than traditional methods.

  • Diabetes Management via Mobile Health Technologies. Image source: Copyright: CC0 Public Domain.

    Mixed-Methods Research in Diabetes Management via Mobile Health Technologies: A Scoping Review


    Background: Considering the increasing incidence and prevalence of diabetes worldwide and the high level of patient involvement it requires, diabetes self-management is a serious issue. The use of mobile health (mHealth) in diabetes self-management has increased, but so far research has not provided sufficient information about the uses and effectiveness of mHealth-based interventions. Alternative study designs and more rigorous methodologies are needed. Mixed-methods designs may be particularly useful because both diabetes self-management and mHealth studies require integrating theoretical and methodological approaches. Objective: This scoping review aimed to examine the extent of the use of mixed-methods research in mHealth-based diabetes management studies. The methodological approaches used to conduct mixed-methods studies were analyzed, and implications for future research are provided. Methods: Guided by Arksey and O’Malley’s framework, this scoping review implemented a comprehensive search strategy including reviewing electronic databases, key journal searches, Web-based research and knowledge centers, websites, and handsearching reference lists of the studies. The studies focusing on mHealth technologies and diabetes management were included in the review if they were primary research papers published in academic journals and reported using a combination of qualitative and quantitative methods. The key data extracted from the reviewed studies include purpose of mixing, design type, stage of integration, methods of legitimation, and data collection techniques. Results: The final sample (N=14) included studies focused on the feasibility and usability of mHealth diabetes apps (n=7), behavioral measures related to the mHealth apps (n=6), and challenges of intervention delivery in the mHealth context (n=1). Reviewed studies used advanced forms of mixed-methods designs where integration occurred at multiple points and data were collected using multiple techniques. However, the majority of studies did not identify a specific mixed-methods design or use accepted terminology; nor did they justify using this approach. Conclusions: This review provided important insights into the use of mixed methods in studies focused on diabetes management via mHealth technologies. The prominent role of qualitative methods and tailored measures in diabetes self-management studies was confirmed, and the importance of using multiple techniques and approaches in this field was emphasized. This review suggests defining specific mixed-methods questions, using specific legitimation methods, and developing research designs that overcome sampling and other methodological problems in future studies.

  • Smartphone app for diabetes management. Image source: Image purchased by authors.

    Smartphone App Use for Diabetes Management: Evaluating Patient Perspectives


    Background: Finding novel ways to engage patients in chronic disease management has led to increased interest in the potential of mobile health technologies for the management of diabetes. There is currently a wealth of smartphone apps for diabetes management that are available for free download or purchase. However, the usability and desirability of these apps has not been extensively studied. These are important considerations, as these apps must be accepted by the patient population at a practical level if they are to be utilized. Objective: The purpose of this study was to gain insight into patient experiences related to the use of smartphone apps for the management of type 1 diabetes. Methods: Adults with type 1 diabetes who had previously (or currently) used apps to manage their diabetes were eligible to participate. Participants (n=12) completed a questionnaire in which they were required to list the names of preferred apps and indicate which app functions they had used. Participants were given the opportunity to comment on app functions that they perceived to be missing from the current technology. Participants were also asked whether they had previously paid for an app and whether they would be willing to do so. Results: MyFitnessPal and iBGStar were the apps most commonly listed as the best available on the market. Blood glucose tracking, carbohydrate counting, and activity tracking were the most commonly used features. Ten participants fulfilled all eligibility criteria, and indicated that they had not encountered any one app that included all of the functions that they had used. The ability to synchronize an app with a glucometer or insulin pump was the most common function that participants stated was missing from current app technology. One participant had previously paid for a diabetes-related app and the other 9 participants indicated that they would be willing to pay. Conclusions: Despite dissatisfaction with the currently available apps, there is interest in using these tools for diabetes management. Adapting existing technology to better meet the needs of this patient population may allow these apps to become more widely utilized.

  • Depression. Image source: Author: Wokandapix. Copyright: CCO License.

    The Case for Jointly Targeting Diabetes and Depression Among Vulnerable Patients Using Digital Technology


    It is well publicized that mobile and digital technologies hold great promise to improve health outcomes among patients with chronic illnesses such as diabetes. However, there is growing concern that digital health investments (both from federal research dollars and private venture investments) have not yet resulted in tangible health improvements. We see three major reasons for this limited real-world impact on health outcomes: (1) lack of solutions relevant for patients with multiple comorbidities or conditions, (2) lack of diverse patient populations involved in the design and early testing of products, and (3) inability to leverage existing clinical workflows to improve both patient enrollment and engagement in technology use. We discuss each of these in depth, followed by new research directions to increase effectiveness in this field.

  • An eye care professional prepares for laser surgery for diabetic retinopathy (leaking blood vessels). Image source: Author: National Eye Institute, National Institutes of Health. Copyright:

    Widely Viewed English Language YouTube Videos Relating to Diabetic Retinopathy: A Cross-Sectional Study


    Background: An emergent source of information on health issues is the Internet. One such platform with 1 billion users is YouTube, the global video-sharing service. Objective: The purpose of this study was to describe the content and characteristics of the most widely viewed YouTube videos related to diabetic retinopathy. Methods: Videos were sorted according to number of views using the key words “diabetic retinopathy.” For each video, general descriptive information was collected. This information included date and source of upload (news, professional, or consumer), length, and total number of views as of July 18, 2016. Content categories were largely informed by a National Eye Institute fact sheet. Each video was viewed to determine which, if any, of the given content categories were present. Results: Of the 98 most widely viewed videos related to diabetic retinopathy, 42 were generated by consumers, 40 were generated by professionals, and 16 were generated from news-based sources. The largest number of views were generated from professionals (624,770/994,494, 63.82%). Compared with professional videos, consumer videos were viewed less frequently (W=622, P=.04). The main purpose of the majority of videos was to provide information (59/98, 60%), and most of the videos showed or mentioned retinopathy in general (75/98, 77%). Smaller numbers offered information about specific types of retinopathy, namely proliferative (26/98, 27%) and nonproliferative (17/98, 17%). Compared with consumer-generated videos, professional videos were 5.57 times more likely to mention that diabetic retinopathy can go unnoticed (95% CI 1.59-26.15). More than 80% (80/98) of the most widely viewed videos did not address the asymptomatic nature of the disease, only about one-third (33/98) mentioned prevention, and only 58 of the 98 videos (59%) mentioned screening. Conclusion: Future research is needed to identify aspects of YouTube videos that attract viewer attention and best practices for using this medium to increase diabetic retinopathy screening among people with diabetes.

  • iPhone user. Image source: Author: MariusMB. Copyright: CC0 Public Domain.

    DiaFit: The Development of a Smart App for Patients with Type 2 Diabetes and Obesity


    Background: Optimal management of chronic diseases, such as type 2 diabetes (T2D) and obesity, requires patient-provider communication and proactive self-management from the patient. Mobile apps could be an effective strategy for improving patient-provider communication and provide resources for self-management to patients themselves. Objective: The objective of this paper is to describe the development of a mobile tool for patients with T2D and obesity that utilizes an integrative approach to facilitate patient-centered app development, with patient and physician interfaces. Our implementation strategy focused on the building of a multidisciplinary team to create a user-friendly and evidence-based app, to be used by patients in a home setting or at the point-of-care. Methods: We present the iterative design, development, and testing of DiaFit, an app designed to improve the self-management of T2D and obesity, using an adapted Agile approach to software implementation. The production team consisted of experts in mobile health, nutrition sciences, and obesity; software engineers; and clinicians. Additionally, the team included citizen scientists and clinicians who acted as the de facto software clients for DiaFit and therefore interacted with the production team throughout the entire app creation, from design to testing. Results: DiaFit (version 1.0) is an open-source, inclusive iOS app that incorporates nutrition data, physical activity data, and medication and glucose values, as well as patient-reported outcomes. DiaFit supports the uploading of data from sensory devices via Bluetooth for physical activity (iOS step counts, FitBit, Apple watch) and glucose monitoring (iHealth glucose meter). The app provides summary statistics and graphics for step counts, dietary information, and glucose values that can be used by patients and their providers to make informed health decisions. The DiaFit iOS app was developed in Swift (version 2.2) with a Web back-end deployed on the Health Insurance Portability and Accountability Act compliant-ready Amazon Web Services cloud computing platform. DiaFit is publicly available on GitHub to the diabetes community at large, under the GNU General Public License agreement. Conclusions: Given the proliferation of health-related apps available to health consumers, it is essential to ensure that apps are evidence-based and user-oriented, with specific health conditions in mind. To this end, we have used a software development approach focusing on community and clinical engagement to create DiaFit, an app that assists patients with T2D and obesity to better manage their health through active communication with their providers and proactive self-management of their diseases.

  • Heatmap of diabetes-related tweets with geolocation. Image sourced and copyright owned by authors.

    Use of Social Media in the Diabetes Community: An Exploratory Analysis of Diabetes-Related Tweets


    Background: Use of social media is becoming ubiquitous, and disease-related communities are forming online, including communities of interest around diabetes. Objective: Our objective was to examine diabetes-related participation on Twitter by describing the frequency and timing of diabetes-related tweets, the geography of tweets, and the types of participants over a 2-year sample of 10% of all tweets. Methods: We identified tweets with diabetes-related search terms and hashtags in a dataset of 29.6 billion tweets for the years 2013 and 2014 and extracted the text, time, location, retweet, and user information. We assessed the frequencies of tweets used across different search terms and hashtags by month and day of week and, for tweets that provided location information, by country. We also performed these analyses for a subset of tweets that used the hashtag #dsma, a social media advocacy community focused on diabetes. Random samples of user profiles in the 2 groups were also drawn and reviewed to understand the types of stakeholders participating online. Results: We found 1,368,575 diabetes-related tweets based on diabetes-related terms and hashtags. There was a seasonality to tweets; a higher proportion occurred during the month of November, which is when World Diabetes Day occurs. The subset of tweets with the #dsma were most frequent on Thursdays (coordinated universal time), which is consistent with the timing of a weekly chat organized by this online community. Approximately 2% of tweets carried geolocation information and were most prominent in the United States (on the east and west coasts), followed by Indonesia and the United Kingdom. For the user profiles randomly selected among overall tweets, we could not identify a relationship to diabetes for the majority of users; for the profiles using the #dsma hashtag, we found that patients with type 1 diabetes and their caregivers represented the largest proportion of individuals. Conclusions: Twitter is increasingly becoming a space for online conversations about diabetes. Further qualitative and quantitative content analysis is needed to understand the nature and purpose of these conversations.

  • image for table of contents.

    Evaluating the Accuracy of Google Translate for Diabetes Education Material


    Background: Approximately 21% of the US population speaks a language other than English at home; many of these individuals cannot effectively communicate in English. Hispanic and Chinese Americans, in particular, are the two largest minority groups having low health literacy in the United States. Fortunately, machine-generated translations represent a novel tool that non-English speakers can use to receive and relay health education information when human interpreters are not available. Objective: The purpose of this study was to evaluate the accuracy of the Google Translate website when translating health information from English to Spanish and English to Chinese. Methods: The pamphlet, “You are the heart of your family…take care of it,” is a health education sheet for diabetes patients that outlines six tips for behavior change. Two professional translators translated the original English sentences into Spanish and Chinese. We recruited 6 certified translators (3 Spanish and 3 Chinese) to conduct blinded evaluations of the following versions: (1) sentences translated by Google Translate, and (2) sentences translated by a professional human translator. Evaluators rated the sentences on four scales: fluency, adequacy, meaning, and severity. We performed descriptive analysis to examine differences between these two versions. Results: Cronbach's alpha values exhibited high degrees of agreement on the rating outcome of both evaluator groups: .919 for the Spanish evaluators and .972 for the Chinese evaluators. The readability of the sentences in this study ranged from 2.8 to 9.0 (mean 5.4, SD 2.7). The correlation coefficients between the grade level and translation accuracy for all sentences translated by Google were negative (eg, rMeaning=-.660), which indicates that Google provided accurate translation for simple sentences. However, the likelihood of incorrect translation increased when the original English sentences required higher grade levels to comprehend. The Chinese human translator provided more accurate translation compared to Google. The Spanish human translator, on the other hand, did not provide a significantly better translation compared to Google. Conclusion: Google produced a more accurate translation from English to Spanish than English to Chinese. Some sentences translated by Google from English to Chinese exhibit the potential to result in delayed patient care. We recommend continuous training and credential practice standards for professional medical translators to enhance patient safety as well as providing health education information in multiple languages.

  • Blood glucose testing.
Image By: David-i98
License: CC BY-SA 3.0 
Source URL:

    Information and Communication Technology-Powered Diabetes Self-Management Systems in China: A Study Evaluating the Features and Requirements of Apps and Patents


    Background: For patients with diabetes, the self-monitoring of blood glucose (SMBG) is a recommended way of controlling the blood glucose level. By leveraging the modern information and communication technology (ICT) and the corresponding infrastructure, engineers nowadays are able to merge the SMBG activities into daily life and to dramatically reduce patient’s burden. Such type of ICT-powered SMBG had already been marketed in the United States and the European Union for a decade, but was introduced into the Chinese market only in recent years. Although there is no doubt about the general need for such type of SMBG in the Chinese market, how it could be adapted to the local technical and operational environment is still an open question. Objective: Our overall goal is to understand the local requirements and the current status of deploying ICT-powered SMBG to the Chinese market. In particular, we aim to analyze existing domestic SMBG mobile apps and relevant domestic patents to identify their various aspects, including the common functionalities, innovative feature, defects, conformance to standards, prospects, etc. In the long run, we hope the outcome of this study could help the decision making on how to properly adapt ICT-powered SMBG to the Chinese market. Methods: We identified 289 apps. After exclusion of irrelevant apps, 78 apps remained. These were downloaded and analyzed. A total of 8070 patents related to glucose were identified from patent database. Irrelevant materials and duplicates were excluded, following which 39 patents were parsed to extract the important features. These apps and patents were further compared with the corresponding requirements derived from relevant clinical guidelines and data standards. Results: The most common features of studied apps were blood health data recording, notification, and decision supporting. The most common features of studied patents included mobile terminal, server, and decision supporting. The main difference between patents and apps is that the patents had 2 specific features, namely, interface to the hospital information system and recording personal information, which were not mentioned in the app. The other major finding is that, in general, in terms of the components of the features, although the features identified in both apps and patents conform to the requirements of the relevant clinical guidelines and data standards, upon looking into the details, gaps exist between the features of the identified apps and patents and the relevant clinical guidelines and data standards. In addition, the social media feature that the apps and patents have is not included in the standard requirements list. Conclusions: The development of Chinese SMBG mobile apps and relevant patents is still in the primitive stage. Although the functionalities of most apps and patents can meet the basic requirements of SMBG, gaps have been identified when comparing the functionalities provided by apps and patents with the requirements necessitated by the standards. One of the most important gaps is that only a small portion of the studied apps provides the automatic data transmission and exchange feature, which may hamper the overall performance. The clinical guidelines can thus be further developed to leverage new features provided by ICT-powered SMBG apps (eg, the social media feature, which may help to improve the social intervention of patients with diabetes).

Citing this Article

Right click to copy or hit: ctrl+c (cmd+c on mac)

Latest Submissions Open for Peer-Review:

View All Open Peer Review Articles
  • Using data cubes to construct a disease-gene-drug association network for diabetes mellitus

    Date Submitted: May 16, 2017

    Open Peer Review Period: May 19, 2017 - Jul 14, 2017

    Background: In this post-genomic big-data era, genomic approaches are increasingly used to search for potential new drugs and treatments for diseases. Large-scale data mining of biomedical literature...

    Background: In this post-genomic big-data era, genomic approaches are increasingly used to search for potential new drugs and treatments for diseases. Large-scale data mining of biomedical literature is an essential tool for investigating and predicting the relationships between causal genes and treatments of diabetes mellitus (DM). Objective: The objective of the study is to construct a disease-gene-drug association network for diabetes mellitus and predict some new associations. Methods: Based on textual data, we developed a novel, data cube–based approach for constructing a disease-gene-drug association network for DM. We used association rules to measure the associations between biological entities. Results: We obtained phenotypic, genotypic, and treatment drug data for DM from the PubMed database. After data preprocessing, we constructed the 0-D vertex cube, which we then filtered to construct three 1-D cubes consisting of 14 diseases, 23 genes, and 34 drugs. We found 194 associations between the 14 subclasses of DM and the 23 genes, 75 associations between 11 of the DM subclasses and 24 of the drugs, and 142 associations between 14 of the DM-related genes and 15 of the drugs. By applying association rules to quantify the correlation between the disease phenotypes, genes, and treatment drugs, we established three 2-D cubes and three relational networks. Finally, using the bottom-up computation algorithm, we constructed the 3-D disease-gene-drug network, which revealed 411 associations between 14 subclasses of DM, 23 genes, and 24 drugs. Based on this 3-D network, we constructed 8 optimal disease-gene-drug subnetworks of DM. Conclusions: We have implemented and validated a network-based approach to identifying and ranking the hidden associations between diseases, genes, and drugs. Our results provide new potential pathways in the search for DM treatment drugs.

  • Smartphone Apps for Gestational Diabetes: A Scoping Review Examining Functionality, Implementation, Impact and the Role of Health Literacy

    Date Submitted: May 14, 2017

    Open Peer Review Period: May 17, 2017 - Jul 12, 2017

    Background: The increasing ownership of smartphones and advances in hardware and software position these devices as cost-effective personalized tools for health promotion and management among women wi...

    Background: The increasing ownership of smartphones and advances in hardware and software position these devices as cost-effective personalized tools for health promotion and management among women with gestational diabetes mellitus (GDM). Numerous smartphone apps are available online; however, no review has documented how these apps are developed and evaluated in relation to gestational diabetes. Objective: To answer the following two research questions: (1) What is known from the existing literature about the availability, functionality, and effectiveness of smartphone apps on GDM prevention and management? And (2) What is the role of health literacy in these apps? Methods: Seven relevant electronic databases were searched for original research documents using terms related to smartphone apps, GDM, and health literacy. Selected articles were thematically categorized using a framework adapted from Arksey & O'Malley. Results: Twelve articles related to seven app/systems were included in the final analysis. Articles were classified around two themes: (1) description of the development, feasibility or usability of the apps/systems, and (2) trial protocols. Varying degrees of personalization exist in the apps for GDM and decision support systems (DSSs) can be used to generate time-efficient personalized feedback for both patients and healthcare providers. Health literacy was considered during the development or measured as an outcome by some apps. Conclusions: There is a limited body of research on smartphone apps in relation to GDM prevention and management. Smartphone apps can provide time- and cost-efficient personalized interventions for GDM. Several randomized controlled trials (RCT) have been launched recently to evaluate the effectiveness of the apps. Consideration of health literacy should be improved when developing features of the apps.

  • Digital Health for Medication Adherence in Adult Diabetes or Hypertension: An Integrative Review

    Date Submitted: May 12, 2017

    Open Peer Review Period: May 13, 2017 - Jul 8, 2017

    Background: Optimal management of chronic diseases, such as type 2 diabetes (T2D) and hypertension (HTN) often include prescription medications. Medication adherence (MA)is one component of self-manag...

    Background: Optimal management of chronic diseases, such as type 2 diabetes (T2D) and hypertension (HTN) often include prescription medications. Medication adherence (MA)is one component of self-management. Optimization through digital health (eHealth and mHealth) could enhance patient awareness and/or communication between the patient and provider. Objective: Medication Adherence (MA) is a major issue that affects 50-60% of chronically ill adults. Digital health refers to eHealth and mHealth collectively [1] and as these technologies become more accessible, remote health delivery is increasingly available as an adjunct to improve medication adherence, communicate with patients and providers, and provide education to patients, families and communities. The objective of this integrative review was to examine the types of digital health technologies that targeted medication adherence in the adult population with diabetes or hypertension. Methods: An integrative review was conducted using databases within EbscoHost, PubMed, and Scopus. Eligible studies available as of September 2016 had to be written in English, and contain digital health interventions to improve medication adherence to prescription medications in adults (18 years or older), and focus on diabetes or hypertension. Results: Of the 337 located studies, 12 used a digital health intervention to promote medication adherence to prescribed medications for diabetes or hypertension and were assessed according to the Chronic Care Model. Conclusions: The twelve studies included in this review found no conclusive evidence of improved medication adherence using digital health interventions such as Interactive Voice Response (IVR), Short Message Service (SMS), telemonitoring, and interactive software technology. Among those are digital health interventions that foster medication adherence via one-way communication to the patient or two-way communication between the patient and healthcare provider for adjunct medication adherence strategies. More research is needed to determine which digital health interventions are most beneficial for individuals with diabetes or hypertension.