Use of Telecommunication and Diabetes-Related Technologies in Older Adults With Type 1 Diabetes During a Time of Sudden Isolation: Mixed Methods Study.
COVID-19
continuous glucose monitoring
diabetes
diabetes technology
glucose monitoring
health technology
older adults
older population
telehealth
type 1 diabetes
Journal
JMIR diabetes
ISSN: 2371-4379
Titre abrégé: JMIR Diabetes
Pays: Canada
ID NLM: 101719410
Informations de publication
Date de publication:
18 Nov 2022
18 Nov 2022
Historique:
received:
19
04
2022
accepted:
15
10
2022
revised:
31
08
2022
pubmed:
19
10
2022
medline:
19
10
2022
entrez:
18
10
2022
Statut:
epublish
Résumé
The COVID-19 lockdown imposed a sudden change in lifestyle with self-isolation and a rapid shift to the use of technology to maintain clinical care and social connections. In this mixed methods study, we explored the impact of isolation during the lockdown on the use of technology in older adults with type 1 diabetes (T1D). Older adults (aged ≥65 years) with T1D using continuous glucose monitoring (CGM) participated in semistructured interviews during the COVID-19 lockdown. A multidisciplinary team coded the interviews. In addition, CGM metrics from a subgroup of participants were collected before and during the lockdown. We evaluated 34 participants (mean age 71, SD 5 years). Three themes related to technology use emerged from the thematic analysis regarding the impact of isolation on (1) insulin pump and CGM use to manage diabetes, including timely access to supplies, and changing Medicare eligibility regulations; (2) technology use for social interaction; and (3) telehealth use to maintain medical care. The CGM data from a subgroup (19/34, 56%; mean age 74, SD 5 years) showed an increase in time in range (mean 57%, SD 17% vs mean 63%, SD 15%; P=.001), a decrease in hyperglycemia (>180 mg/dL; mean 41%, SD 19% vs mean 35%, SD 17%; P<.001), and no change in hypoglycemia (<70 mg/dL; median 0.7%, IQR 0%-2% vs median 1.1%, IQR 0%-4%; P=.40) during the lockdown compared to before the lockdown. These findings show that our cohort of older adults successfully used technology during isolation. Participants provided the positive and negative perceptions of technology use. Clinicians can benefit from our findings by identifying barriers to technology use during times of isolation and developing strategies to overcome these barriers.
Sections du résumé
BACKGROUND
BACKGROUND
The COVID-19 lockdown imposed a sudden change in lifestyle with self-isolation and a rapid shift to the use of technology to maintain clinical care and social connections.
OBJECTIVE
OBJECTIVE
In this mixed methods study, we explored the impact of isolation during the lockdown on the use of technology in older adults with type 1 diabetes (T1D).
METHODS
METHODS
Older adults (aged ≥65 years) with T1D using continuous glucose monitoring (CGM) participated in semistructured interviews during the COVID-19 lockdown. A multidisciplinary team coded the interviews. In addition, CGM metrics from a subgroup of participants were collected before and during the lockdown.
RESULTS
RESULTS
We evaluated 34 participants (mean age 71, SD 5 years). Three themes related to technology use emerged from the thematic analysis regarding the impact of isolation on (1) insulin pump and CGM use to manage diabetes, including timely access to supplies, and changing Medicare eligibility regulations; (2) technology use for social interaction; and (3) telehealth use to maintain medical care. The CGM data from a subgroup (19/34, 56%; mean age 74, SD 5 years) showed an increase in time in range (mean 57%, SD 17% vs mean 63%, SD 15%; P=.001), a decrease in hyperglycemia (>180 mg/dL; mean 41%, SD 19% vs mean 35%, SD 17%; P<.001), and no change in hypoglycemia (<70 mg/dL; median 0.7%, IQR 0%-2% vs median 1.1%, IQR 0%-4%; P=.40) during the lockdown compared to before the lockdown.
CONCLUSIONS
CONCLUSIONS
These findings show that our cohort of older adults successfully used technology during isolation. Participants provided the positive and negative perceptions of technology use. Clinicians can benefit from our findings by identifying barriers to technology use during times of isolation and developing strategies to overcome these barriers.
Identifiants
pubmed: 36256804
pii: v7i4e38869
doi: 10.2196/38869
pmc: PMC9678329
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e38869Subventions
Organisme : NIDDK NIH HHS
ID : DP3 DK112214
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30 DK036836
Pays : United States
Informations de copyright
©Elena Toschi, Christine Slyne, Katie Weinger, Sarah Sy, Kayla Sifre, Amy Michals, DaiQuann Davis, Rachel Dewar, Astrid Atakov-Castillo, Saira Haque, Stirling Cummings, Stephen Brown, Medha Munshi. Originally published in JMIR Diabetes (https://diabetes.jmir.org), 18.11.2022.
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