The United States faces a shortage of both primary care physicians (PCPs) and endocrinologists—the two groups of clinicians who provide the majority of care to people with diabetes. Patients treated with intensive insulin therapy, including all of those with type 1 diabetes and many with type 2 diabetes, face numerous daily self-management decisions. These decisions include factoring insulin dosing, glucose management, diet, activity, and other behavioral factors into their decision-making. These patients stand to gain from using the treatment and monitoring technologies that are rapidly advancing and accumulating evidence in support of their benefits. Despite this situation, the actual use of such technologies, including continuous glucose monitoring (CGM) and closed-loop artificial pancreas systems, remains relatively low.
Diabetes is a chronic disease that, regardless of type, requires intensive, ongoing self-management. As a result, people with diabetes (PWD) often have complex environmental, social, behavioral, and informational needs, many of which are unmet in healthcare settings and systems. To help meet these needs, many PWD interact with diabetes online communities (DOCs), including platforms such as Facebook, Twitter, and blogs, to share real-life support, problems, and concerns with other PWD, offering a rich source of data on patient-reported outcomes. This article reviews recent psychosocial needs and outcomes identified by studies of DOCs and/or their users.
Diabetes affects approximately 34 million Americans and many do not achieve glycemic targets. Continuous glucose monitoring (CGM) is associated with improved health outcomes for patients with diabetes. Most adults with diabetes receive care for their diabetes in primary care practices, where uptake of CGM is unclear. [...]
Self-management support (SMS) for patients with diabetes can improve adherence to treatment, mitigate disease-related distress, and improve health outcomes. Translating this evidence into real-world practice is needed, as it is not clear which SMS models are acceptable to patients, and feasible and sustainable for primary care practices.
Advanced diabetes technologies have produced increasingly favorable outcomes compared to older treatments. Disparities in practice resources have led to a treatment disparity by clinical setting, where endocrinologists typically prescribe far more such technologies than primary care providers (PCPs). Fully automated artificial pancreas systems (APS), which combine technologies to deliver and adjust insulin dosing continuously in response to automatic and continuous glucose monitoring, may be more straightforward for PCPs to prescribe and manage, therefore extending their benefit to more patients. [...]
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 using insulin pumps and continuous glucose monitors (CGMs) to help manage their T1D.[...]
Self-management of type 1 diabetes (T1D) requires numerous decisions and actions by people with T1D and their caregivers and poses many daily challenges. For those with T1D and a developmental disorder such as autism spectrum disorder (ASD), more complex challenges arise, though these remain largely unstudied.
With rising incidence of type 1 diabetes (T1D) diagnoses among children and the high levels of distress experienced by the caregivers of these children, caregiver support is becoming increasingly important. Historically, relatively few support resources have existed. Increasing use of the Internet, and blogs in particular, has seen a growth of peer support between caregivers of children with T1D. [...]
“What doctors overlook is how important it is to simply have emotional support, to know they aren't alone, which inspires people to take care of themselves.” As medical professionals, we may be experts in certain realms of diabetes, but our patients are the experts in living with diabetes. Unless we live with diabetes ourselves, we cannot truly appreciate what it is like to manage the many aspects of diabetes 24/7/365. And every person’s experience is not the same.[...]