Experiences of Young People and Their Caregivers of Using Technology to Manage Type 1 Diabetes Mellitus: Systematic Literature Review and Narrative Synthesis

Nicola Brew-Sam; Madhur Chhabra; Anne Parkinson; Kristal Hannan; Ellen Brown; Lachlan Pedley; Karen Brown; Kristine Wright; Elizabeth Pedley; Christopher J Nolan; Christine Phillips; Hanna Suominen; Antonio Tricoli; Jane Desborough

doi:10.2196/20973

Experiences of Young People and Their Caregivers of Using Technology to Manage Type 1 Diabetes Mellitus: Systematic Literature Review and Narrative Synthesis

JMIR Diabetes. 2021 Feb 2;6(1):e20973. doi: 10.2196/20973.

Authors

Nicola Brew-Sam^#¹, Madhur Chhabra^#¹, Anne Parkinson¹, Kristal Hannan¹, Ellen Brown¹, Lachlan Pedley¹, Karen Brown^{1

2}, Kristine Wright^{1

2}, Elizabeth Pedley^{1

2}, Christopher J Nolan^{2

3

4}, Christine Phillips³, Hanna Suominen^{5

6

7}, Antonio Tricoli^{4

8}, Jane Desborough¹

Affiliations

¹ Department of Health Services Research and Policy, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia.
² Canberra Health Services, Canberra, Australia.
³ ANU Medical School, College of Health and Medicine, Australian National University, Canberra, Australia.
⁴ The John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, Australia.
⁵ School of Computing, College of Engineering and Computer Science, Australian National University, Canberra, Australia.
⁶ Department of Computing, University of Turku, Turku, Finland.
⁷ Data61, Commonwealth Scientific and Industrial Research Organisation, Canberra, Australia.
⁸ Nanotechnology Research Lab, Research School of Chemistry, College of Science, Australian National University, Canberra, Australia.

^# Contributed equally.

PMID: 33528374
PMCID: PMC7886614
DOI: 10.2196/20973

Abstract

Background: In the last decade, diabetes management has begun to transition to technology-based care, with young people being the focus of many technological advances. Yet, detailed insights into the experiences of young people and their caregivers of using technology to manage type 1 diabetes mellitus are lacking.

Objective: The objective of our study was to describe the breadth of experiences and perspectives on diabetes technology use among children and adolescents with type 1 diabetes mellitus and their caregivers.

Methods: This systematic literature review used integrated thematic analysis to guide a narrative synthesis of the included studies. We analyzed the perspectives and experiences of young people with type 1 diabetes mellitus and their caregivers reported in qualitative studies, quantitative descriptive studies, and studies with a mixed methods design.

Results: Seventeen articles met the inclusion criteria, and they included studies on insulin pump, glucose sensors, and remote monitoring systems. The following eight themes were derived from the analysis: (1) expectations of the technology prior to use, (2) perceived impact on sleep and overnight experiences, (3) experiences with alarms, (4) impact on independence and relationships, (5) perceived usage impact on blood glucose control, (6) device design and features, (7) financial cost, and (8) user satisfaction. While many advantages of using diabetes technology were reported, several challenges for its use were also reported, such as cost, the size and visibility of devices, and the intrusiveness of alarms, which drew attention to the fact that the user had type 1 diabetes mellitus. Continued use of diabetes technology was underpinned by its benefits outweighing its challenges, especially among younger people.

Conclusions: Diabetes technologies have improved the quality of life of many young people with type 1 diabetes mellitus and their caregivers. Future design needs to consider the impact of these technologies on relationships between young people and their caregivers, and the impact of device features and characteristics such as size, ease of use, and cost.

Keywords: adolescents; children; diabetes; experiences; perspectives; self-management; systematic review; technology; type 1 diabetes mellitus.

©Nicola Brew-Sam, Madhur Chhabra, Anne Parkinson, Kristal Hannan, Ellen Brown, Lachlan Pedley, Karen Brown, Kristine Wright, Elizabeth Pedley, Christopher J Nolan, Christine Phillips, Hanna Suominen, Antonio Tricoli, Jane Desborough. Originally published in JMIR Diabetes (http://diabetes.jmir.org), 02.02.2021.

Publication types

Review