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Continuous Glucose Monitoring in the Real World Using Photosurveillance of #Dexcom on Instagram: Exploratory Mixed
Michelle L Litchman1, Sarah E Wawrzynski1,2, Whitney S Woodruff1
1College of Nursing, University of Utah, Salt Lake City, UT, United States.
JMIR Public Health and Surveillance
|May 26, 2019
Summary
Photosurveillance of Instagram reveals that people with diabetes frequently use continuous glucose monitoring (CGM) devices in off-label body locations. This social media data offers insights into real-world CGM trends and user experiences.
Area of Science:
- Digital Health
- Social Media Analytics
- Diabetes Management
Background:
- The diabetes online community utilizes social media for health information exchange.
- Infoveillance is a method for tracking health trends, but may overlook visual data.
- Photosurveillance is proposed as a novel method to analyze photographic data for health trends.
Purpose of the Study:
- To evaluate photosurveillance as a method for studying diabetes trends.
- To analyze the real-world usage of continuous glucose monitoring (CGM) on Instagram.
Main Methods:
- Exploratory mixed methods study analyzing Instagram photos with #dexcom hashtag (Dec 2016-Feb 2017).
- Photographs were coded for CGM location, device wear duration, and sensor failure.
- Textual analysis of posts and comments identified emerging themes.
Main Results:
- Over 12% of photos showed CGM site locations, with most in off-label areas (63.7%).
- No significant difference in engagement based on FDA-approved vs. off-label locations.
- Key themes included CGM endorsement, information sharing, frustrations, optimization hacks, and off-label use.
Conclusions:
- Individuals successfully use CGM in off-label locations more frequently than approved sites, without reported sensor failure.
- Photographic data from social media can inform healthcare providers and industry about real-world CGM trends.
- A minority of users reported wearing sensors beyond the FDA-approved 7-day period.
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