Over the last couple of decades and especially the last few years, people with diabetes have seen a huge increase in options for monitoring their diabetes — from blood glucose meters than sync with their phones to continuous glucose monitoring (CGM) systems that record and transmit their glucose levels every few minutes. But with all these improvements in monitoring and connectivity, some people with diabetes may wonder if they’re justified by their health benefits — of if this is just another example of technology eating up a growing share of our lives, with no real purpose.
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Some people with diabetes — particularly those who experience frequent hypoglycemia (low blood glucose) — may experience immediate benefits from better monitoring and sharing, such as seeing when their blood glucose level is dropping so that they can take action before hypoglycemia occurs. Sharing this data with their doctor may also help inform their diabetes treatment plan, since adjustments to insulin or other medications may be needed if frequent action has to be taken to avoid low blood glucose.
But other people with diabetes may not be sold on the benefits of greater digital monitoring and sharing of their blood glucose levels. So in a recently published survey, researchers sought to find out what kinds of health benefits people with diabetes would need to experience in order to be open to different digital monitoring options.
More health benefits, more willingness to adopt monitoring
The survey results, published in the journal AMA Network Open, were based on responses from 1,010 adults with type 1 or type 2 diabetes living in 30 countries. Overall, there was a willingness to adopt digital monitoring strategies even if there weren’t clear health benefits from doing so, with 65% of respondents saying they would change to a different type of digital monitoring even if this offered only modest or no health improvements.
But when a remote digital monitoring system was perceived as being intrusive, respondents said it had to be justified by its health benefits. Options that people tended to view as intrusive included monitoring food choices, as well as real-time feedback from a healthcare professional.
The survey presented participants with three different scenarios for digital monitoring of their diabetes — randomly selected out of 36 possible scenarios — and asked them to indicate what level of health benefit would be required for them to willingly adopt each one. These scenarios included different kinds of digital monitoring tools — tracking glucose levels, physical activity or food consumption — as well as how and when feedback was given, such as only when participants asked for it, or automatically in real time. Other variables in these scenarios included how data was handled, such as whether it could be accessed by a private company or a public health agency or system.
Participants were asked to evaluate each scenario based on its potential effectiveness in two different areas: reducing episodes of hypoglycemia, and preventing long-term eye complications from diabetes.
Overall, 2,860 scenario assessments were collected in the survey (some people assessed only one or two scenarios). In 65% of these assessments, participants would adopt a scenario if it were only somewhat more effective at preventing hypoglycemia, while in 36% of assessments, participants said it would have to be much more effective at preventing hypoglycemia. The most important factors in participants saying a scenario would have to be “much more effective” in order to adopt it were that it included food monitoring or real-time feedback from a healthcare professional, or was otherwise viewed as intrusive.
There wasn’t widespread agreement among participants, though, about the level of effectiveness at preventing hypoglycemia that each scenario would require for them to adopt it. For 34 of the 36 possible scenarios, at least 25% of participants required no increase in effectiveness at all, while at the same time at least 25% required it to be much more effective. All of these patterns were similar when participants were asked about effectiveness at preventing long-term eye complications, rather than preventing hypoglycemia.
Varying willingness to adopt new technologies
The main lesson from this survey is that while some people are eager to adopt new kinds of digital tracking to help manage their diabetes, other will view the very same method as intrusive and annoying, saying that it would need large health benefits for them to adopt it. People seemed especially reluctant to have their food choices tracked, or to have real people — as opposed to a computer algorithm — give them feedback without asking for it.
This range in willingness to adopt digital monitoring, and the reasons why many people are hesitant to adopt certain kinds of monitoring, mean that it’s important for doctors and patients to discuss what kinds of benefits people with diabetes expect to get from a new form of monitoring — and what qualms or concerns they have about it — before adding it to a person’s diabetes self-management routine.