Department of Internal Medicine, Diabetes and Endocrinology Center, University of Nebraska Medical Center, Omaha, NE, USA.
University of Utah College of Nursing, Salt Lake City, UT, USA.
J Diabetes Sci Technol. 2022 Jul;16(4):874-886. doi: 10.1177/19322968211069409. Epub 2022 Feb 5.
This purpose of this study was to conduct a rapid review and environmental scan of diabetes online communities (DOCs) to highlight the clinical impact of DOC engagement and provide guidance to health care providers for navigating and prescribing DOCs.
This two-phase review included a rapid review of clinical outcomes and an assessment of DOC content. We conducted a literature search for studies evaluating DOC use and glucometric (glycated hemoglobin [A1C], time-in-range, hypoglycemia), behavioral, and psychosocial outcomes. The environmental scan of current DOC sites established key features, including available platforms, target population, content areas, and reach.
Twelve papers were included-eight reported DOC use within a context of do-it-yourself (DIY) noncommercial, opensource hybrid closed loop systems community and four were non-DYI related. In latter, all studies were cross-sectional, describing patient-reported outcomes. Two studies reported A1C lowering with DOC use, two DOC use was associated with high self-efficacy, one showed association with higher self-care levels, and one showed higher quality of life scores when compared with population norms. All DIY studies showed improvement in glucometrics after initiation of sensor augmented pump technology with DOC support. Of 54 DOC sites reviewed in the environmental scan, 29 were included. Diabetes online community sites were heterogenous in social media platform and type of diabetes targeted.
Diabetes online communities have the potential to improve clinical, behavioral, and psychosocial outcomes. Randomized control trials and/or longitudinal prospective studies evaluating outcomes are needed to further examine the potential benefits of DOC use. Diabetes online communities are diverse and span a variety of social media platforms, providing clinicians opportunities to individualize recommendations for DOC use.
本研究旨在对糖尿病在线社区(DOC)进行快速回顾和环境扫描,重点介绍参与 DOC 的临床影响,并为医疗保健提供者提供指导,以帮助他们了解和开具 DOC 处方。
本研究分为两个阶段,包括对临床结果的快速回顾和对 DOC 内容的评估。我们对评估 DOC 使用情况以及血糖(糖化血红蛋白 [A1C]、时间在范围内、低血糖)、行为和心理社会结果的研究进行了文献检索。对当前 DOC 网站的环境扫描确定了关键特征,包括可用平台、目标人群、内容领域和覆盖范围。
共纳入 12 篇论文——8 篇报告了在 DIY(非商业、开源混合闭环系统)社区中使用 DOC 的情况,4 篇与 DIY 无关。在后 4 篇中,所有研究均为横断面研究,描述了患者报告的结果。两项研究报告了使用 DOC 可降低 A1C,两项研究表明使用 DOC 与高自我效能相关,一项研究表明与更高的自我护理水平相关,一项研究表明与人群正常水平相比,生活质量评分更高。所有 DIY 研究均显示,在使用带有 DOC 支持的传感器增强型泵技术后,血糖控制得到改善。在环境扫描中审查的 54 个 DOC 网站中,有 29 个被纳入。糖尿病在线社区在社交媒体平台和针对的糖尿病类型方面存在差异。
糖尿病在线社区有可能改善临床、行为和心理社会结果。需要进行随机对照试验和/或纵向前瞻性研究来进一步评估使用 DOC 的潜在益处。糖尿病在线社区种类繁多,涵盖各种社交媒体平台,为临床医生提供了根据个人情况为患者推荐使用 DOC 的机会。