What Are Diabetes Patients Versus Health Care Personnel Discussing on Social Media?

Could Online Education Replace Face-to-Face Education in Diabetes? A Systematic Review

OBJECTIVE

Diabetes Self-Management Education and Support (DSMES) is a critical component of diabetes care. This study aims to examine the effect of online-based educational interventions on diabetes management compared to face-to-face interventions.

METHODS

A systematic review was conducted by searching three databases for studies in English or Spanish between December 2023 and March 2024. The inclusion criteria were studies that compared face-to-face DSMES with online interventions.

RESULTS

The follow-up duration of the trials ranged from 1 to 12 months. Multidisciplinary teams delivered online DSMES through various means, including Short Message Service (SMS), telephone calls, video calls, websites, and applications. Online DSMES was found to be comparable to face-to-face interventions in terms of glycated hemoglobin (HbA1c) levels in people with type 1 diabetes (T1D). In contrast, online interventions that focus on weight management in people with type 2 diabetes (T2D) have shown a significant reduction in HbA1c compared to face-to-face interventions. Online DSMES was found to be superior in terms of quality of life and cost-effectiveness in both T1D and T2D. None of the analyzed studies explored the differences between individual and group methodologies.

CONCLUSIONS

The current evidence indicates that online DSMES services provide at least comparable biomedical benefits to face-to-face interventions, suggesting that online interventions could be incorporated into clinical practice as a complement or reinforcement. However, further research is needed to explore the potential benefits and effectiveness of online group sessions in DSMES.

Reporting of Ethical Considerations in Qualitative Research Utilizing Social Media Data on Public Health Care: Scoping Review

BACKGROUND

The internet community has become a significant source for researchers to conduct qualitative studies analyzing users' views, attitudes, and experiences about public health. However, few studies have assessed the ethical issues in qualitative research using social media data.

OBJECTIVE

This study aims to review the reportage of ethical considerations in qualitative research utilizing social media data on public health care.

METHODS

We performed a scoping review of studies mining text from internet communities and published in peer-reviewed journals from 2010 to May 31, 2023. These studies, limited to the English language, were retrieved to evaluate the rates of reporting ethical approval, informed consent, and privacy issues. We searched 5 databases, that is, PubMed, Web of Science, CINAHL, Cochrane, and Embase. Gray literature was supplemented from Google Scholar and OpenGrey websites. Studies using qualitative methods mining text from the internet community focusing on health care topics were deemed eligible. Data extraction was performed using a standardized data extraction spreadsheet. Findings were reported using PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines.

RESULTS

After 4674 titles, abstracts, and full texts were screened, 108 studies on mining text from the internet community were included. Nearly half of the studies were published in the United States, with more studies from 2019 to 2022. Only 59.3% (64/108) of the studies sought ethical approval, 45.3% (49/108) mentioned informed consent, and only 12.9% (14/108) of the studies explicitly obtained informed consent. Approximately 86% (12/14) of the studies that reported informed consent obtained digital informed consent from participants/administrators, while 14% (2/14) did not describe the method used to obtain informed consent. Notably, 70.3% (76/108) of the studies contained users' written content or posts: 68% (52/76) contained verbatim quotes, while 32% (24/76) paraphrased the quotes to prevent traceability. However, 16% (4/24) of the studies that paraphrased the quotes did not report the paraphrasing methods. Moreover, 18.5% (20/108) of the studies used aggregated data analysis to protect users' privacy. Furthermore, the rates of reporting ethical approval were different between different countries (P=.02) and between papers that contained users' written content (both direct and paraphrased quotes) and papers that did not contain users' written content (P<.001).

CONCLUSIONS

Our scoping review demonstrates that the reporting of ethical considerations is widely neglected in qualitative research studies using social media data; such studies should be more cautious in citing user quotes to maintain user privacy. Further, our review reveals the need for detailed information on the precautions of obtaining informed consent and paraphrasing to reduce the potential bias. A national consensus of ethical considerations such as ethical approval, informed consent, and privacy issues is needed for qualitative research of health care using social media data of internet communities.

Supporting and Incentivizing Peer Leaders for an Internet-Based Private Peer Community for Youths With Type 1 Diabetes: Social Network and Directed Content Analysis

BACKGROUND

Youths with type 1 diabetes (T1D) frequently experience stigma. Internet-based peer communities can mitigate this through social support but require leaders to catalyze exchange. Whether nurturing potential leaders translates into a central role has not been well studied. Another issue understudied in such communities is lurking, the viewing of exchanges without commenting or posting.

OBJECTIVE

We aimed to assess the centrality of the peer leaders we selected, trained, and incentivized within the Canadian Virtual Peer Network (VPN)-T1D. This is a private Facebook (Meta Platforms, Inc) group that we created for persons aged 14 to 24 years with T1D. We specifically sought to (1) compare a quantitative estimate of network centrality between peer leaders and regular members, (2) assess the proportions of network exchanges that were social support oriented, and (3) assess proportions of high engagement (posts, comments, reactions, and votes) and low engagement (lurking) exchanges.

METHODS

We recruited peer leaders and members with T1D from prior study cohorts and clinics. We trained 10 leaders, provided them with a monthly stipend, and encouraged them to post on the private Facebook group we launched on June 21, 2017. We extracted all communications (posts, messages, reactions, polls, votes, and views) that occurred until March 20, 2020. We calculated each member's centrality (80% of higher engagement communications comprising posts, comments, and reactions plus 20% of members with whom they connected). We divided each member's centrality by the highest centrality to compute the relative centrality, and compared the mean values between leaders and members (linear regression). We calculated the proportions of communications that were posts, comments, reactions, and views without reaction. We performed content analysis with a social support framework (informational, emotional, esteem-related, network, and tangible support), applying a maximum of 3 codes per communication.

RESULTS

VPN-T1D gained 212 regular members and 10 peer leaders over 33 months; of these 222 members, 26 (11.7%) exited. Peer leaders had 10-fold higher relative centrality than regular members (mean 0.53, SD 0.26 vs mean 0.04, SD 0.05; 0.49 difference; 95% CI 0.44-0.53). Overall, 91.4% (203/222) of the members connected at least once through posts, comments, or reactions. Among the 75,051 communications, there were 5109 (6.81%) posts, comments, and polls, 6233 (8.31%) reactions, and 63,709 (84.9%) views (lurking). Moreover, 54.9% (3430/6253) of codes applied were social support related, 66.4% (2277/3430) of which were informational (eg, insurance and travel preparation), and 20.4% (699/3430) of which were esteem related (eg, relieving blame).

CONCLUSIONS

Designating, training, and incentivizing peer leaders may stimulate content exchange and creation. Social support was a key VPN-T1D deliverable. Although lurking accounted for a high proportion of the overall activity, even those demonstrating this type of passive participation likely derived benefits, given that the network exit rate was low.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/18714.

Methods for Analyzing the Contents of Social Media for Health Care: Scoping Review

BACKGROUND

Given the rapid development of social media, effective extraction and analysis of the contents of social media for health care have attracted widespread attention from health care providers. As far as we know, most of the reviews focus on the application of social media, and there is a lack of reviews that integrate the methods for analyzing social media information for health care.

OBJECTIVE

This scoping review aims to answer the following 4 questions: (1) What types of research have been used to investigate social media for health care, (2) what methods have been used to analyze the existing health information on social media, (3) what indicators should be applied to collect and evaluate the characteristics of methods for analyzing the contents of social media for health care, and (4) what are the current problems and development directions of methods used to analyze the contents of social media for health care?

METHODS

A scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. We searched PubMed, the Web of Science, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library for the period from 2010 to May 2023 for primary studies focusing on social media and health care. Two independent reviewers screened eligible studies against inclusion criteria. A narrative synthesis of the included studies was conducted.

RESULTS

Of 16,161 identified citations, 134 (0.8%) studies were included in this review. These included 67 (50.0%) qualitative designs, 43 (32.1%) quantitative designs, and 24 (17.9%) mixed methods designs. The applied research methods were classified based on the following aspects: (1) manual analysis methods (content analysis methodology, grounded theory, ethnography, classification analysis, thematic analysis, and scoring tables) and computer-aided analysis methods (latent Dirichlet allocation, support vector machine, probabilistic clustering, image analysis, topic modeling, sentiment analysis, and other natural language processing technologies), (2) categories of research contents, and (3) health care areas (health practice, health services, and health education).

CONCLUSIONS

Based on an extensive literature review, we investigated the methods for analyzing the contents of social media for health care to determine the main applications, differences, trends, and existing problems. We also discussed the implications for the future. Traditional content analysis is still the mainstream method for analyzing social media content, and future research may be combined with big data research. With the progress of computers, mobile phones, smartwatches, and other smart devices, social media information sources will become more diversified. Future research can combine new sources, such as pictures, videos, and physiological signals, with online social networking to adapt to the development trend of the internet. More medical information talents need to be trained in the future to better solve the problem of network information analysis. Overall, this scoping review can be useful for a large audience that includes researchers entering the field.

Ethical considerations and methodological uses of Facebook data in public health research: A systematic review

OBJECTIVE

Since 2016, around seven in 10 adults in the United States (U.S.) actively use Facebook. While much Facebook data is publicly available for research, many users may not understand how their data are being used. We sought to examine to what extent research ethical practices were employed and the research methods being used with Facebook data in public health research.

METHODS

We conducted a systematic review (PROSPERO registration CRD42020148170) of social media-based public health research focused on Facebook published in peer-reviewed journals in English between January 1, 2006 and October 31, 2019. We extracted data on ethical practices, methodology, and data analytic approaches. For studies that included verbatim user content, we attempted to locate users/posts within a timed 10-min period.

RESULTS

Sixty-one studies met eligibility criteria. Just under half (48%, n = 29) sought IRB approval and six (10%) sought and obtained informed consent from Facebook users. Users' written content appeared in 39 (64%) papers, of which 36 presented verbatim quotes. We were able to locate users/posts within 10 min for half (50%, n = 18) of the 36 studies containing verbatim content. Identifiable posts included content about sensitive health topics. We identified six categories of analytic approaches to using these data: network analysis, utility (i.e., usefulness of Facebook as a tool for surveillance, public health dissemination, or attitudes), associational studies of users' behavior and health outcomes, predictive model development, and two types of content analysis (thematic analysis and sentiment analysis). Associational studies were the most likely to seek IRB review (5/6, 83%), while those of utility (0/4, 0%) and prediction (1/4, 25%) were the least likely to do so.

CONCLUSIONS

Stronger guidance on research ethics for using Facebook data, especially the use of personal identifiers, is needed.

Use of virtual communities to support people with diabetes mellitus

Abstract Objective to analyze the support offered by virtual communities to people with diabetes mellitus. Method exploratory study with a qualitative approach, developed in three open virtual communities, focused on diabetes mellitus, with the largest number of members and posts in Portuguese. The content analysis was performed using word clouds to identify the nuclei of meaning. Results the most relevant results refer to virtual communities as sites of informational support to improve self-care; and as sites of emotional and spiritual support to encourage behavioral changes. Conclusion and implications for the practice virtual communities can contribute as scenarios of care for people with diabetes mellitus, providing greater approximation between professional practices and care needs. The understanding of the meanings of the shared information can contribute to the realization of holistic and effective care practices, without, however, being restricted to biological and technicist approaches. It can also constitute a strategy to help people with diabetes mellitus in self-care, highlighting the potential of social media for health as transformative tools for professionals and empowerment of patients.

Uso de comunidades virtuais no suporte às pessoas com diabetes mellitus

Resumo Objetivo analisar o suporte oferecido pelas comunidades virtuais às pessoas com diabetes mellitus. Métodos estudo exploratório com abordagem qualitativa, desenvolvido em três comunidades virtuais abertas, voltadas ao diabetes mellitus com o maior número de membros e postagens em português. A análise de conteúdo se deu por meio de nuvem de palavras como recurso para identificação dos núcleos de sentido. Resultados os resultados mais relevantes se referem às comunidades virtuais como locais de apoio informacional para melhorar o autocuidado; e como locais de suporte emocional e espiritual para encorajar mudanças comportamentais. Conclusão e implicações para a prática as comunidades virtuais podem contribuir como cenários de cuidado de pessoas com diabetes mellitus, proporcionando maior aproximação entre as práticas profissionais e as necessidades de cuidado. A compreensão dos significados das informações compartilhadas pode contribuir para a realização de práticas de cuidado integrais e efetivas, de forma holística, sem, porém, que essas estejam restritas a abordagens de caráter biológico e tecnicista. Pode, ainda, constituir-se em estratégia para auxiliar a pessoa com diabetes mellitus no cuidado de si, evidenciando o potencial das mídias sociais para a área da saúde como ferramentas transformadoras para os profissionais e empoderamento de pacientes.

The role of social networks in diabetes self‐care: A cross‐sectional study

Background

Patient involvement with diabetes self‐care is critical to reducing complications, morbidity, and mortality. Social media, as one of the most important forms of digital health, has always been available for diabetes self‐care, although the role of these media in supporting patient self‐care is unclear.

Aims

The aim of this study was to investigate the role of social networks in diabetes self‐care. In this study, the most important social networks used to receive self‐care services, diabetes self‐care behaviors, diabetes self‐care educations and benefits of using various services provided through social networks were identified.

Methods

The present study is a cross‐sectional study that was conducted through an electronic researcher‐made questionnaire in 2021. Two hundred and eighteen patients were selected to participate in the study from centers of diabetes of Fasa city, south of Iran. Sampling was performed by convenience sampling and in accordance with inclusion and exclusion criteria. Data were analyzed by descriptive statistics and analytical tests.

Results

In the data analysis section on Diabetes self‐care behaviors, there was no significant relationship between gender (p = 0.292), age (p = 0.49), type of diabetes (p = 0.909) and duration of diabetes (p = 0.076) with the use of self‐care services provided through social networks. There was a significant relationship between education level and the use of self‐care services provided through social networks (p = 0.01). “Recognizing diabetes and its complications,” “observing personal hygiene,” and “the impact of physical activity on diabetes control” were the most important educations. “Increasing patient knowledge and understanding about diabetes and its complications,” “reducing the consumption of high‐calorie foods and sugars,” and “observing personal and public health” were the most important social network's benefits, respectively.

Conclusions

Various self‐care educations and services provided through social networks can increase the in‐depth knowledge of diabetic patients about self‐care techniques and their effective role in controlling and managing diabetes and performing more self‐care processes.

Social media analytics and reachability evaluation - #Diabetes

BACKGROUND AND AIMS

Diabetes as a lifestyle disorder could be effectively managed by creating awareness among people through social media. Understanding the content of Twitter messages will aid in strategizing health communication about diabetes to the community through Twitter. This study aimed to analyze the content, sentiment, and reachability of diabetes related tweets posted in India.

METHODS

Diabetes related messages from India were collected via Twitter's Application Programming Interface for April 2019. Themes and subthemes of tweet content were identified from randomly selected tweets. The tweets were coded as the source, themes, and subthemes manually. Sentiment analysis of the tweets was done by a lexicon-based approach. The reachability of tweets was assessed based on re-tweet and favorite counts.

RESULTS

Out of 1840 tweets, 57.28% were from organizations and 42.72% were from individuals. The largest proportion of tweet messages were informative (50.76%), followed by promotional tweets (21.52%). The largest proportion of tweets were positive (40.4%) followed by neutral (31.14%) tweets. Among the six major themes, the diabetes story had the highest reachability.

CONCLUSIONS

The outcome of this study would aid public health professionals in planning information dissemination and communication regarding diabetes on Twitter so that the right information reaches a wider population.

Information Patients With Melanoma Spontaneously Report About Health-Related Quality of Life on Web-Based Forums: Case Study

Background

There is a general agreement on the importance of health-related quality of life (HRQoL). This type of information is becoming increasingly important for the value assessment of health technology assessment agencies in evaluating the benefits of new health technologies, including medicines. However, HRQoL data are often limited, and additional sources that provide this type of information may be helpful.

Objective

We aim to identify the HRQoL topics important to patients with melanoma based on web-based discussions on public social media forums.

Methods

We identified 3 public web-based forums from the United States and the United Kingdom, namely the Melanoma Patient Information Page, the Melanoma International Forum, and MacMillan. Their posts were randomly selected and coded using qualitative methods until saturation was reached.

Results

Of the posts assessed, 36.7% (150/409) of posts on Melanoma International Forum, 45.1% (198/439) on MacMillan, and 35.4% (128/362) on Melanoma Patient Information Page focused on HRQoL. The 2 themes most frequently mentioned were mental health and (un)certainty. The themes were constructed based on underlying and more detailed codes. Codes related to fear, worry and anxiety, uncertainty, and unfavorable effects were the most-often discussed ones.

Conclusions

Web-based forums are a valuable source for identifying relevant HRQoL aspects in patients with a given disease. These aspects could be cross-referenced with existing tools and they might improve the content validity of patient-reported outcome measures, including HRQoL questionnaires. In addition, web-based forums may provide health technology assessment agencies with a more holistic understanding of the external aspects affecting patient HRQoL. These aspects might support the value assessment of new health technologies and could therefore help inform topic prioritization as well as the scoping phase before any value assessment.

Social Media Use for Health Purposes: Systematic Review

Background

Social media has been widely used for health-related purposes, especially during the COVID-19 pandemic. Previous reviews have summarized social media uses for a specific health purpose such as health interventions, health campaigns, medical education, and disease outbreak surveillance. The most recent comprehensive review of social media uses for health purposes, however, was conducted in 2013. A systematic review that covers various health purposes is needed to reveal the new usages and research gaps that emerge in recent years.

Objective

This study aimed to provide a systematic review of social media uses for health purposes that have been identified in previous studies.

Methods

The researchers searched for peer-reviewed journal articles published between 2006 and 2020 in 12 databases covering medicine, public health, and social science. After coding the articles in terms of publication year, journal area, country, method, social media platform, and social media use for health purposes, the researchers provided a review of social media use for health purposes identified in these articles.

Results

This study summarized 10 social media uses for various health purposes by health institutions, health researchers and practitioners, and the public.

Conclusions

Social media can be used for various health purposes. Several new usages have emerged since 2013 including advancing health research and practice, social mobilization, and facilitating offline health-related services and events. Research gaps exist regarding advancing strategic use of social media based on audience segmentation, evaluating the impact of social media in health interventions, understanding the impact of health identity development, and addressing privacy concerns.

Factors Engaging Users of Diabetes Social Media Channels on Facebook, Twitter, and Instagram: Observational Study

Background

Diabetes patient associations and diabetes-specific patient groups around the world are present on social media. Although active participation and engagement in these diabetes social media groups has been mostly linked to positive effects, very little is known about the content that is shared on these channels or the post features that engage their users the most.

Objective

The objective of this study was to analyze (1) the content and features of posts shared over a 3-year period on 3 diabetes social media channels (Facebook, Twitter, and Instagram) of a diabetes association, and (2) users’ engagement with these posts (likes, comments, and shares).

Methods

All social media posts published from the Norwegian Diabetes Association between January 1, 2017, and December 31, 2019, were extracted. Two independent reviewers classified the posts into 7 categories based on their content. The interrater reliability was calculated using Cohen kappa. Regression analyses were carried out to analyze the effects of content topic, social media channel, and post features on users’ engagement (likes, comments, and shares).

Results

A total of 1449 messages were posted. Posts of interviews and personal stories received 111% more likes, 106% more comments, and 112% more shares than miscellaneous posts (all P<.001). Messages posted about awareness days and other celebrations were 41% more likely to receive likes than miscellaneous posts (P<.001). Conversely, posts on research and innovation received 31% less likes (P<.001), 35% less comments (P=.02), and 25% less shares (P=.03) than miscellaneous posts. Health education posts received 38% less comments (P=.003) but were shared 39% more than miscellaneous posts (P=.007). With regard to social media channel, Facebook and Instagram posts were both 35 times more likely than Twitter posts to receive likes, and 60 times and almost 10 times more likely to receive comments, respectively (P<.001). Compared to text-only posts, those with videos had 3 times greater chance of receiving likes, almost 4 times greater chance of receiving comments, and 2.5 times greater chance of being shared (all P<.001). Including both videos and emoji in posts increased the chances of receiving likes by almost 7 times (P<.001). Adding an emoji to posts increased their chances of receiving likes and being shared by 71% and 144%, respectively (P<.001).

Conclusions

Diabetes social media users seem to be least engaged in posts with content topics that a priori could be linked to greater empowerment: research and innovation on diabetes, and health education. Diabetes social media groups, public health authorities, and other stakeholders interested in sharing research and innovation content and promoting health education on social media should consider including videos and emoji in their posts, and publish on popular and visual-based social media channels, such as Facebook and Instagram, to increase user engagement.

International Registered Report Identifier (IRRID)

RR2-10.1186/s12913-018-3178-7

Facebook as a Medium for the Support and Enhancement of Ambulatory Care for People With Diabetes: Qualitative Realist Evaluation of a Real-World Trial

BACKGROUND

There is a growing focus on the potential uses, benefits, and limitations of social media in the context of health care communication. In this study, we have sought to evaluate an initiative pioneered at a hospital in Denmark that uses Facebook to support and enhance patient-provider communication about diabetes.

OBJECTIVE

This paper aims to evaluate the success of the trial according to its initial objectives and to assess its potential scalability.

METHODS

The study was undertaken in a clinic for diabetes and hormonal diseases at a large regional hospital in Denmark. Using a realist evaluation approach, we identified 4 key components in the program theory of the initiative, which we formulated as context-mechanism-outcome configurations (eg, complex and iterative chains of causality). These configurations informed data gathering and analysis. Primary data sources were the activity and content in the Facebook group, in the form of posts, likes, and comments, and interviews with patients (n=26) and staff (n=6) at the clinic.

RESULTS

New developments in diabetes technology were the most popular posts in the forum, judged by number of likes and comments. Otherwise, information specific to the clinic received the most attention. All 4 components of the program theory were compromised to varying degrees, either as a result of failings in the anticipated mechanisms of change or contextual factors derived from the mode of implementation.

CONCLUSIONS

Social media serves well as a conduit for imagining positive change, but this can be a strength and weakness when attempting to enact change via concrete interventions, where stakeholder expectations may be unreasonably high or incompatible. Nonetheless, such initiatives may possess intangible benefits difficult to measure in terms of cost-effectiveness.

Perception of diabetes management and cardiovascular disease risk among men with type 2 diabetes: A qualitative study

Aim

The aim of this study was to explore the perception and understanding of men with type 2 diabetes about their illness control, risk for CVD and their adherence to healthcare management plans in Jordan.

Design

A qualitative descriptive design was used, recruiting a purposive sample of 13 men diagnosed with type 2 diabetes.

Methods

Data were collected between February and April 2019 through in-depth semi-structured interviews and analysed using content analysis.

Results

Data analysis revealed four themes: (a) Perception of diabetes control; (b) Perception of cardiovascular disease risk; (c) Coping with disease-imposed limitations; and (d) Information validation.

Conclusion

The study concludes that the perception of disease control does not necessarily coincide with actual disease control. Examining patients with diabetes perception and knowledge of their healthcare management and increased CVD risks is essential. An individualized culture and gender-sensitive health education and counselling involving spouses are recommended. Social media to disseminate scientific valid health instructions can enhance adherence.

Perspectiva de jovens com diabetes sobre intervenção educativa na rede social Facebook®

Resumo Objetivo Apreender a perspectiva de jovens com diabetes mellitus sobre a participação em um grupo de estimulo ao autocuidado na rede social Facebook®. Métodos Estudo descritivo e exploratório, junto a 35 jovens com diabetes mellitus tipo 1 que participaram de um grupo no Facebook®. Os dados foram coletados por meio de entrevista semi-esturuada e após submetidos à análise de conteúdo, modalidade temática. Resultados Foram identificadas três categorias: assistência convencional oferecida aos jovens com diabetes mellitus; vantagens da utilização do Facebook® para inovação da assistência à saúde, e espírito de comunidade e fortalecimento a partir do Facebook®, as quais mostram que, na perspectiva de jovens com diabetes, a participação no grupo favoreceu o desenvolvimento do espírito de comunidade e o fortalecimento de vínculo entre os pares, além de auxiliar no processo de aceitação da doença e na formação de uma rede de suporte. Além disso, observou-se avaliação positiva sobre a participação, uma vez que os jovens manifestaram o desejo de que outros grupos com características semelhantes fossem implementados. Conclusão Ações educativas na rede social Facebook® são bem aceitas por jovens e pode constituir uma estratégia importante para aproximá-los dos serviços de saúde e auxiliá-los nas ações de autocuidado.

Glycated Hemoglobin Differences Among Blog-Reading Adults With Type 1 Diabetes Compared With Those Who Do Not Read Blogs: Cross-Sectional Study

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 using 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 (HbA_1c) differences between blog readers and blog nonusers in a population of adults with T1D. This study also looked at differences in technology use in these two groups, as well as HbA_1c 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 nonusers were tested via chi-square and t tests. Mann-Whitney U tests, Fisher exact tests, and analyses of variance (ANOVA) were used to test for differences in self-reported HbA_1c between groups and subgroups.

RESULTS

A total of 282 eligible participants completed the survey (214 blog readers, 68 blog nonusers). Average duration of diabetes was 21.2 years, 77.7% (219/282) were female, 81.2% (229/282) used an insulin pump, 66.3% (187/282) used a CGM, and 95.7% (270/282) were white. HbA_1c was lower for blog readers (7.0%) than blog nonusers (7.5%), P=.006; for insulin pump users (7.0%) than multiple daily injections (7.7%), P=.001; and for CGM users (7.0%) than CGM nonusers (7.5%), P=.001. After adjusting for significant covariates, the association between blog use and HbA_1c remained significant (P=.04). ANOVA modeling also demonstrated significant differences in HbA_1c between blog users and nonusers among subgroups by pump use and CGM use (P<.001).

CONCLUSIONS

These results suggest that reading blogs is associated with lower HbA_1c values. While association does not prove causation, 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.