Glucose interpretation meaning and action (GIMA): Insights to blood glucose user interface interpretation in type 1...

Current glucose monitoring user interfaces (UIs) are problematic for people with Type 1 Diabetes Mellitus (T1DM) in maintaining recommended blood glucose levels effectively. However, there is a lack of in-depth investigation into this problem when these individuals interpret and make real-time decisions based on the glucose monitoring devices they use daily.

We aim to investigate problems associated with glucose monitoring UIs by observing users' interpretation and decision-making while reading their Continuous Glucose Monitoring (CGM), Flash Glucose Monitoring (Flash) or Self-monitoring of Blood Glucose (SMBG).

A mixed-method study was conducted. The Think Aloud protocol was used to capture participants' decision-making process while reading various device UIs. Their responses were evaluated using standard clinical guidance to assess their accuracy. Additionally, a survey was distributed to gather their perceptions of self-management practices.

Twenty-seven participants (17 patients and 10 carers) were recruited. Interpretation accuracy averaged 38.0% ± 11.1% for CGM, 39.5% ± 8.8% for Flash, and 33.3% ± 7.8% for SMBG group. Treatment action accuracy was 21.5% ± 15.6% for CGM, 21.2% ± 14.0% for Flash, and 18.0% ± 13.2% for SMBG group. Despite this, 75.0% of all participants expressed very high confidence in their self-management.

Interpreting and making decisions using glucose monitoring UIs remains significantly challenging for people with T1DM despite their self-perceived performance. Improving such UIs is crucial to reduce misinterpretation and help these individuals make better treatment decisions without relying on their potentially inaccurate interpretations.