Wearable health monitors generate data, create challenges for diabetic patients

Devices to monitor health in patients can be helpful if the technology is easy to use and patients use them.

A new study examined wearability and ease of use – and found both caused challenges for older adult diabetic patients and caregivers.

Among the findings: Diabetic participants “were very interested in understanding their numbers,” such as glucose levels, and what those meant for their health. But the devices were tricky to use, “suggesting a need for device manufacturers to improve wearability and usability of the devices,” according to a news release about the study.

“This is a whole area of health technology that needs study,” study leader Michael Weiner, MD, MPH, said in the news release. “There's hardware involved, which is the device itself. There's software involved, which is reading, organizing, interpreting, and communicating the data from the device.

“Knowing how the technology works in the real world and the impact of the technology on usability and ultimately on health outcomes is important,” said Weiner, a research scientist at Regenstrief Institute, chief of health services research at the Richard L. Roudebush Veterans Affairs Medical Center, and a professor of medicine at Indiana University School of Medicine.

Challenges with technology

In an initial trial of continuous glucometer use, devices had a faulty adhesive that created a challenge for 10 patients aged 50 to 85 years. They also had difficulty interpreting graphs produced by the device.

In a subsequent study, 70 older adults with diabetes wore glucometers and activity monitors, and used smartphones and electronic medication bottles, to manage their blood sugar levels over a two-week period.

Nearly one in four said before that study, they had not checked blood sugar. Researchers found 73% of 70 participants had low blood sugar levels “often serious in magnitude.” That finding was “extremely concerning because hypoglycemia should always be addressed,” Weiner said.

“When we looked for hypoglycemia in an urban population of older adults who receive care in a safety-net health care institution, we found that it’s extremely common, more common than anybody knew previously, because no one had actually looked,” Weiner said.

Having tech handy

Weiner noted smartphones commonly are used with continuous glucometers. But participants who received them did not always carry them, so they missed or ignored one-third of daytime prompts about medications, behaviors, and symptoms.

Electronic medication bottles have potential to help, but study participants didn’t use them correctly or didn’t appropriately transfer pills to the bottles, Weiner said.

The study, “Continuous Glucose Monitoring and Other Wearable Devices to Assess Hypoglycemia among Older Adult Outpatients with Diabetes Mellitus,” was published Jan. 18 in the journal Applied Clinical Informatics. The study had support by the U.S. Agency for Healthcare Research and Quality.