Digital monitoring for diabetes: what's acceptable?

The use of digital technologies – for example, sensors that monitor glucose levels and apps that use artificial intelligence to adapt insulin treatment to food intake – are revolutionising diabetes management. But just how much digital and remote monitoring is acceptable, and who should your data be shared with?

In winter 2019, Diabetes NZ amplified a call for participants in an important international study. More than 1000 people living with type 1 and type 2 diabetes from 30 countries, including New Zealand, assessed the acceptability and perceived intrusiveness of 36 different digital monitoring scenarios. The study was led by researchers at the French National Health Institute Inserm (France) and Mayo Clinic (USA).

Now the results are out, in a study entitled “Evaluation of Patient Willingness to Adopt Remote Digital Monitoring for Diabetes Management”.

The study found that extra digital food monitoring and receiving real-time physician feedback were considered among the most intrusive scenarios by participants. People worried that digital food monitoring would attract unwanted attention in public, and expose them to criticism. They also wanted control over monitoring settings, such as limiting which data they share with their physician.

Additionally, participants were concerned about the use of their data for purposes other than health care, such as marketing by private-sector companies. Many considered private-sector handling of their data very intrusive.

However, participants were more likely to adopt technology they considered intrusive if it was much more effective at reducing hypoglycemic episodes than the systems they were currently using.

The researchers hope these findings and more will guide developers in designing minimally intrusive health technologies and incite physicians to use shared decisionmaking to prescribe digital tools that fit each patient’s life.

The researchers say, “Identifying patients’ views is the key to make digital health not only effective, but also effortless.”

The findings are reported in two articles published in Mayo Clinic Proceedings and JAMA Network Open. See doi:10.1001/ jamanetworkopen.2020.33115

For more information, contact: Theodora Oikonomidi, theodora. oikonomidi@inserm.fr

DIABETES YOUTH: GROWING UP

For many young people living with diabetes, the new year will be a time of transition: starting secondary or tertiary study, finding a first job, maybe moving to a hall of residence or going flatting for the first time. It’s important to have the right information and resources to negotiate these major life changes.

Diabetes NZ provides a comprehensive set of resources for young people with diabetes – on subjects including going out, driving, employment, puberty, sex, tattoos and bodypiercing, travel, exercise, and emotional wellbeing.

See www.diabetes.org.nz/resources-young-adults