Digital diabetes: Perspectives for diabetes prevention, management and research.

Background:Support groups play an important role in diabetes understanding and education. This study aims to find connections between participating in diabetes-related online communities (groups an...

Participation of Patients With Type 2 Diabetes in Online Support Groups is Correlated to Lower Levels of Diabetes Self-Management.

Introduction Little research has been done to systematically evaluate concerns of people living with diabetes through social media, which has been a powerful tool for social change and to better understand perceptions around health-related issues. This study aims to identify key diabetes-related concerns in the USA and primary emotions associated with those concerns using information shared on Twitter. Research Design and Methods A total of 11.7 million diabetes-related tweets in English were collected between April 2017 and July 2019. Machine learning methods were used to filter tweets with personal content, to geolocate (to the US) and to identify clusters of tweets with emotional elements. A sentiment analysis was then applied to each cluster. Results We identified 46,407 tweets with emotional elements in the USA from which 30 clusters were identified; five clusters (18% of tweets) were related to insulin pricing with both positive emotions (joy, love) referring to advocacy for affordable insulin and sadness emotions related to the frustration of insulin prices, five clusters (12% of tweets) to solidarity and support with a majority of joy and love emotions expressed. The most negative topics (10% of tweets) were related to diabetes distress (24% sadness, 27% anger, 21% fear elements), to diabetic and insulin shock (45% anger, 46% fear) and comorbidities (40% sadness). Conclusions Using social media data, we have been able to describe key diabetes-related concerns and their associated emotions. More specifically, we were able to highlight the real-world concerns of insulin pricing and its negative impact on mood. Using such data can be a useful addition to current measures that inform public decision making around topics of concern and burden among people with diabetes. Significance of Study What is already known about this subject? It is very challenging to collect representative data at a population level to understand what are the key concerns of people with diabetes in real life. Social media platforms, such as Twitter, may serve as a relevant source of information to supplement traditional population health studies. There are worldwide inequalities in access to insulin. What are the new findings? With 18% of the tweets related to insulin pricing, this is a major concern in the diabetes community in the USA. People regularly express fear, anger and sadness about potential diabetes-related complications and comorbidities. However, there is a lot of support and solidarity among the diabetes online community, with numerous posts related to positive emotions How might these results change the focus of research or clinical practice? Our work presents a reproducible approach to easily capture information about key diabetes-related concerns, that is usually not available in typical clinical or epidemiological studies. This information can supplement data from clinical or epidemiological studies to inform public health strategies to deal with diabetes-related prevention, management and treatment

/pdf/insulin-pricing-and-other-major-diabetes-related-concerns-in-hcbk9iyco1.pdf

Insulin pricing and other major diabetes-related concerns in the USA: A study of 46,407 Tweets between 2017 and 2019

Elexacaftor/Ivacaftor/tezacaftor

There is increasing recognition of the importance of realworld data to understand the effectiveness of treatments for type 1 diabetes (T1D). The T1D Exchange Glu online community (myglu.org) includes a diverse group of people with T1D and caregivers, and provides a platform for meaningful research to amplify the collective voice of those living with T1D. We present findings from a survey of the T1D Exchange Glu online community evaluating self-reported clinical outcomes and patient preferences impacting treatment choice in tubeless insulin pump users (Omnipod Insulin Management System, Insulet Corp., Acton, MA, United States) compared to their previous treatment. Eligibility criteria were age ≥18 years, T1D diagnosis ≥1 year, currently using Omnipod System for 0.5 to 2 years, and previously treated with multiple daily injections (MDI) or a tubed insulin pump. Outcomes included self-reported hemoglobin A1c (HbA1c) range and total daily dose (TDD) of insulin with prior and current therapy, treatment patterns on prior therapy, treatment preferences, and factors impacting treatment choice. Respondent characteristics (N = 147) were (mean ± SD, range): age 41.0 ± 13.8 years (18-73 years) and diabetes duration 17.8 ± 14.2 years (1-52 years). Prior treatment modality was 72% MDI and 28% insulin pump. Most respondents (71%) had been using the tubeless insulin pump system between one and two years. HbA1c results are summarized in Figure 1. Self-reported TDD of insulin decreased significantly post-tubeless pump for prior MDI users (53 ± 37 to 42 ± 25 U/day, P < .0001, N = 95) and prior pump users (43 ± 18 to 38 ± 15 U/day, P < .001, N = 40). Treatment patterns on prior therapy included bolus injections at least three times per day for 87% of prior MDI users. Forty-four percent of prior pump users reported disconnecting their tubed pump an average of at least two times per day. The most commonly reported duration of pump disconnection was 10 to 30 minutes (65% of respondents), with 22% reporting disconnecting for >30 minutes to one hour. The decision to initiate tubeless insulin pump therapy was made primarily by respondents (46%) or with some input from their healthcare provider (45%). Respondents’ three highest-ranked reasons for stopping prior therapy to initiate tubeless pump therapy included wanting better control of diabetes and wanting to lower HbA1c, as well as wanting more lifestyle flexibility for prior MDI users and not wanting to be connected to tubing for prior pump users. The most frequently reported benefits of the tubeless pump were lifestyle improvements (85%), improvement in glucose control (73%), lower HbA1c (60%), and ability to exercise more (50%). This survey study of the T1D Exchange Glu online community demonstrated that tubeless insulin pump therapy was associated with an improvement in self-reported HbA1c and a significant reduction in daily insulin use over up to two years compared to prior treatment with MDI or other insulin pumps. Perceived improvement in diabetes management and features of the tubeless insulin pump that supported lifestyle flexibility were significant factors in the adoption of this technology. The results of this study underscore the importance of access and choice of diabetes management technology to positively impact treatment satisfaction and outcomes. 868698 DSTXXX10.1177/1932296819868698Journal of Diabetes Science and TechnologyLayne et al. letter2019

https://journals.sagepub.com/doi/pdf/10.1177/1932296819868698

Glycemic Control and Factors Impacting Treatment Choice in Tubeless Insulin Pump Users: A Survey of the T1D Exchange Glu Online Community.

T1D Exchange: An Online Community for People Touched by Type 1 Diabetes:

<h3>Introduction</h3> CFHealthHub is a digital platform and behaviour change programme for people with cystic fibrosis (CF). We present part of the CFHealthHub Easy Medicines for Burden Reduction and Care Enhancement (EMBRACE) study, which was to understand participant experiences of obtaining repeat supplies of nebulised medicines. <h3>Methods</h3> 1191 people who had consented to the CFHealthHub learning health system were emailed an online Qualtrics® survey containing both quantitative and qualitative questions. One reminder was sent after 2 weeks. Completed surveys were analysed using MS Excel® and themes were identified. <h3>Results</h3> 203 (17%) surveys were completed (28 were &lt;50% completed and excluded). 175 (14.7%) surveys were analysed. Participants were from 14 different adult centres, aged 16–75 y (mean 39.4 y) and 57.7% were female. Most people (58%) obtained medicines from a combination of routes (e.g., GP and/or hospital). 55% participants received 1+ nebulised medicines prescriptions from the GP. The hospital service differed by centre: dispensed in the hospital pharmacy then collected (49%)/delivered (83%); or a hospital prescription dispensed at a community pharmacy (39%). One third of people only received their nebulised medicines from homecare. Table 1 includes a summary of themes. <h3>Conclusion</h3> Many people use more than one route to obtain their medicines, creating a need to manage ordering in different ways depending on the drug. There was a desire for more automation and online or app based ordering, and for all medication to be available from the same place. There is room for improvement in medication ordering systems. CFHealthHub real-time data capture can be used to personalise repeat supplies. 

P64 Using the CFHealthHub learning health system to understand the experiences of adults with cystic fibrosis of obtaining repeat supplies of nebulised medicines: results of a national survey

P120 Adherence to elexacaftor/texacaftor/ivacaftor during the first 2 years of treatment in an adolescent population

ePS1.10 Easy Medicines for Burden Reduction And Care Enhancement (EMBRACE): exploring the views of adults with cystic fibrosis on the current nebulised medicines supply process using homecare deliveries in 2 UK centres

WS03.05 Percentage days covered: what does it tell us about adherence to Kaftrio and Kalydeco®?

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T1D Exchange: An Online Community for People Touched by Type 1 Diabetes:

P64 Using the CFHealthHub learning health system to understand the experiences of adults with cystic fibrosis of obtaining repeat supplies of nebulised medicines: results of a national survey

P120 Adherence to elexacaftor/texacaftor/ivacaftor during the first 2 years of treatment in an adolescent population

ePS1.10 Easy Medicines for Burden Reduction And Care Enhancement (EMBRACE): exploring the views of adults with cystic fibrosis on the current nebulised medicines supply process using homecare deliveries in 2 UK centres

WS03.05 Percentage days covered: what does it tell us about adherence to Kaftrio and Kalydeco®?