Dr Michelle Litchman Describes Benefits of Online Diabetes Peer Support Groups
There are health disparities when it comes to prescribing technology, said Michelle Litchman, PHD, FNP-BC, FAANP, FADCES, assistant professor in the College of Nursing at the University of Utah. As part of her study, community health workers in Utah recruited Spanish-speaking patients with type 2 diabetes who were not yet using insulin. Patients used both continuous glucose monitoring (CGM) technology and participated in online peer support groups.
How do your research results compare to those of in-person peer support groups?
This is an excellent question. Online peer support is available 24/7. So just because you’re awake at 2 a.m., that doesn’t mean someone else might not see it. You can also scroll through the history of what other people have posted, which is different than in person. There is that kind of historical information that you can scroll through. Then you are not limited in time to a specific place, geographic location, or time of day. It offers a little more flexibility. Of course, people need to have access to the Internet, and everyone in our study did.
One of the things we also found interesting is that not only did people take to the online community, but the online community, as many do, created this email digest. Individuals were also browsing their email summary to scroll through information that was also shared in the online community.
What are the next steps in this research?
The next step is to apply for funding to expand the sample size to determine if we can see some effects beyond self-efficacy. We had A1C [glycated hemoglobin] trend in a direction we expected, which is downward, but we didn’t quite have the power to be statistically significant. It is something that we are exploring. Also, since we did this study, a new feature of CGM has come out that allows you to scan on a mobile phone, which was different from when we did the study. This means that you can scan the CGM glucose level on a phone and the data can be cloud based. To keep up with new trends in CGM, we will certainly need to update the study protocols to reflect this.
Why is it important to study the use of diabetes technology in Spanish speaking patients?
We know there are health disparities when it comes to prescribing technology. It was a low income, uninsured population, and yet they really wanted to use this device. They wanted to continue the device after we stopped the study. There are specific things that need to be explored beyond this study. Part is the cost associated with CGM. We know that online peer support is something that can be sustainable at a relatively reasonable cost. But definitely, this research is starting to ask questions about CGM, its cost, and whether it’s really accessible to everyone.