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

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Of the estimated 23.1 million individuals diagnosed with diabetes, approximately 5% have type 1 diabetes (T1D). It has been proposed that this number will triple by 2050. With increases in technology use and resources available, many individuals are utilizing insulin pumps and continuous glucose monitors (CGMs) to help manage their T1D. They are also using online resources such as social media to find more information and advice based on real-life experiences from peers. Blogs are a particular social media modality often used by people with T1D but have not been widely investigated. Objective: The purpose of this study was to assess glycated hemoglobin A1c (HbA1c) differences between blog readers and blog non-users in a population of adults with T1D. This study also looked at differences in technology use in these two groups, as well as HbA1c differences in blog use and technology subgroups. Methods: Participants were recruited both by mail and by online T1D-themed blog postings. Respondents completed a secure online eligibility assessment and were asked questions related to their T1D, blog and internet use, and insulin pump and CGM use. Demographics were also collected. Differences between blog readers and blog non-users were tested via chi-square and t tests. Mann-Whitney U tests, Fisher exact tests, and analysis of variance were used to test for differences in self-reported HbA1c between groups and subgroups. Results: A total of 282 eligible participants completed the survey (214 blog readers, 68 blog non-users). Average duration of diabetes was 21.2 years, 77.7% were female, 81.2% used an insulin pump, 66.3% used a CGM, and 95.7% were white. HbA1c was lower for blog readers (7.049) than blog non-readers (7.476), P = .006; for insulin pump users (7.039) than multiple daily injections (7.652), P = .001; and for CGM users (6.996) than CGM non-users (7.469), P = .001. After adjusting for significant covariates, the association between blog use and HbA1c remained significant (P = .04). ANOVA modeling also demonstrated significant differences in HbA1c between blog users and non-users among subgroups by pump use and CGM use (P < .001). Conclusions: These results suggest that reading blogs may contribute to lower HbA1c. Blog readers have the benefit of learning information from peers and having 24/7 access to a community of individuals with similar daily life struggles, where they are able to ask questions and seek advice.

Metaphor helps humans understand complex concepts by “mapping” them onto accessible concepts. The purpose of this study was to investigate the effects of using jazz as a metaphor to teach senior medical students improvisational communication skills, and to understand student learning experiences. The authors designed a month-long course that used jazz to teach improvisational communication. A sample of fourth-year medical students (N = 30) completed the course between 2011 and 2014. Evaluation consisted of quantitative and qualitative data collected pre- and post-course, with comparison to a concurrent control group on some measures. Measures included: (a) Student self-reports of knowledge and ability performing communicative tasks; (b) blinded standardized patient assessment of students’ adaptability and quality of listening; and (c) qualitative course evaluation data and open-ended interviews with course students. Compared to control students, course students demonstrated statistically significant and educationally meaningful gains in adaptability and listening behaviors. Students’ course experiences suggested that the jazz components led to high engagement and creativity, and provided a model to guide application of improvisational concepts to their own communication behaviors. Metaphor proved to be a powerful tool in this study, partly through enabling increased reflection and decreased resistance to behaviors that, on the surface, tended to run counter to generally accepted norms. The use of jazz as a metaphor to teach improvisational communication warrants further refinement and investigation.