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This paper explores intensive self‐management of type 1 diabetes with insulin pump therapy as an enabling technology and reports barriers in the communication process with health professionals providing diabetes care who are unfamiliar with this treatment. Questionnaire responses and telephone interviews from a study conducted with 78 people using pump therapy in 2006 showed that individuals attending diabetes centres that were not pump‐trained suffered poor communication and a lack of support for intensive diabetes self‐management. As a result, some pump users did not visit their diabetes centre for care and management of the condition, preferring to communicate with the pump manufacturer and a national insulin pump therapy support organisation because they were familiar with the treatment. Nonetheless, all pump users had a strong sense of self‐efficacy concerning their mastery of the treatment technology to prevent, delay or stabilise the chronic complications of type 1 diabetes. Conclusions are linked to the Insulin Pump Services Report (Department of Health, 2007) and specific guidance on the use of pump therapy with patients by trained health professionals.

The purpose of this paper is to study insulin pump therapy and accurate monitoring of glucose levels in diabetic patients, which are current research trends in diabetology. Both problems have a wide margin for improvement and promising applications in the control of parameters and levels involved.

The authors have registered data for the levels of glucose in diabetic patients throughout a day with a temporal resolution of 5 minutes, the amount and time of insulin administered and time of ingestion. The estimated quantity of carbohydrates is also monitored. A mathematical model for Type 1 patients was fitted piecewise to these data and the evolution of the parameters was analyzed.

They have found that the parameters for the model change abruptly throughout a day for the same patient, but this set of parameters account with precision for the evolution of the glucose levels in the test patients. This fitting technique could be used to personalize treatments for specific patients and predict the glucose-level variations in terms of hours or even shorter periods of time. This way more effective insulin pump therapies could be developed.

The proposed model could allow for the development of improved schedules on insulin pump therapies.

The purpose of this paper is to examine how pregnant women with type 1 diabetes integrate new information technology (IT) into their health management activities, using activity theory as an analytical framework.

The research is a multiple case design, based on interviews with 15 women with type 1 diabetes who were pregnant, considering pregnancy, or had recently given birth. A thematic analysis, sensitised by activity theory, was used to analyse the data.

Health management in this setting involves negotiations and contradictions across boundaries of interacting activities. Participants play an active role in managing their health and using new IT tools in particular ways to support their health management. Using new technologies creates both opportunities and challenges. IT-enabled healthcare devices and other information systems open up new treatment possibilities, but also generate new contradictions between interacting activity systems.

The research was conducted with a small sample in a specific context of health management. Further research is needed to extend the findings to other contexts.

Healthcare providers need to accommodate a bottom-up approach to the adoption and use of new technologies in settings where empowered patients play an active role in managing their health.

The findings highlight opportunities to further develop activity theory to accommodate the central role that individuals play in resolving inherent contradictions and achieving alignment between multiple interacting activity systems when incorporating new IT tools into health management activities.

Telemedicine has been advancing for decades and is more indispensable than ever in this unprecedented time of the COVID-19 pandemic. As shown, eHealth appears to be effective for routine management of chronic conditions that require extensive and repeated interactions with healthcare professionals, as well as the monitoring of symptoms and diagnostics. Yet much needs to be done to alleviate digital inequalities that stand in the way of making the benefits of eHealth accessible to all. The purpose of this paper is to explore the recent shift in healthcare delivery in response to the COVID-19 pandemic towards telemedicine in healthcare delivery and show how this rapid shift is leaving behind those without digital resources and exacerbating inequalities along many axes.

Because the digitally disadvantaged are less likely to use eHealth services, they bear greater risks during the pandemic to meet ongoing medical care needs. This holds true for both medical conditions necessitating lifelong care and conditions of particular urgency such as pregnancy. For this reason, the authors examine two case studies that exemplify the implications of differential access to eHealth: the case of chronic care diseases such as diabetes requiring ongoing care and the case of time-sensitive health conditions such as pregnancy that may be compromised by gaps in continuous care.

Not only are the digitally disadvantaged more likely to belong to populations experiencing greater risk – including age and economic class – but they are less likely to use eHealth services and thereby bear greater risks during the pandemic to meet ongoing medical care needs during the pandemic.

At the time of writing, almost 20% of Americans have been unable to obtain medical prescriptions or needed medical care unrelated to the virus. In light of the potential of telemedicine, this does not need to be the case. These social inequalities take on particular significance in light of the COVID-19 pandemic.

In light of the COVID-19 virus, ongoing medical care requires exposure to risks that can be successfully managed by digital communications and eHealth advances. However, the benefits of eHealth are far less likely to accrue to the digitally disadvantaged.

Background – Studies suggest text messaging is beneficial to health care; however, no one has synthesized the overall evidence on texting interventions. In response to this need, we conducted a systematic review of the impacts of text messaging in health care.

Methods – PubMed database searches and subsequent reference list reviews sought English-language, peer-reviewed studies involving text messaging in health care. Commentaries, conference proceedings, and feasibilities studies were excluded. Data was extracted using an article coding sheet and input into a database for analysis.

Results – Of the 61 papers reviewed, 50 articles (82%) found text messaging had a positive effect on the primary outcome. Average sample sizes in articles reporting positive findings (n=813) were significantly larger than those that did not find a positive impact (n=178) on outcomes (p=0.032). Articles were categorized into focal groups as follows: 27 articles (44.3%) investigated the impact of texting on disease management, 24 articles (39.3%) focused texting's impact to public health related outcomes, and 10 articles (16.4%) examined texting and its influence on administrative processes. Articles in focal groups differed by the purpose of the study, direction of the communication, and where they were published, but not in likelihood of reporting a positive impact from texting.

Conclusions – Current evidence indicates that text messaging health care interventions are largely beneficial clinically, in public health related uses, and in terms of administrative processes. However, despite the promise of these findings, literature gaps exist, especially in primary care settings, across geographic regions and with vulnerable populations.

Personal Health Record (PHR) systems make possible to integrate data from different sources and circulate them within the illness care and management network. The new arrangements prefigure a redefinition of the relations among healthcare practitioners, patients, and caregivers. The purpose of this paper is to consider the role and the meanings attributed to information when a technical artifact enables new forms of communication within the healthcare management network.

The authors adopted a qualitative research design, conducting a pre-post analysis on a theoretical sample of patients and of a paediatrics department. The authors selected 12 patients (six females and six males) aged between four and 20 years old.

The patients were willing to act as “stewards of their own information” (Halamka et al., 2008), but they interpreted this role in terms of restricting access to their information, rather than facilitating its dissemination. In fact, the PHR was symbolized as an instrument to support personal diabetes management but the patients want to preserve their own competence and independent management on the information regarding their “Personal” diseases.

This work highlights two connotation of “Personal” information. The first is the dimension of the right to the privacy of information when it is believed that it may be used to pass judgement on the patient. The second connotation of “Personal” is the assertion by patients of their competence and autonomy in interpreting the information on the basis of personal knowledge about their diabetes.

Continuous glucose monitoring (CGM) is a notable invention introduced in the biomedical industry. It provides valuable information about intermittent capillary blood glucose that is normally unattainable by regular clinical blood sample tests. CGM includes several progressive facilities such as instantaneous and real-time display of blood glucose level, “24/7” coverage, continuous motion of alerts for actual or impending hypo- and hyperglycemia and the ability to characterize glycemic variability. CGM allows users and physicians to visualize and diagnose more accurate and precise rate of change of glucose by capacitating small, comfortable, user-friendly sensor devices. Sometimes, this vital information is shared to the personal message box over Internet. In short, CGM is capable to inform, educate, motivate and alert (IEMA) people with diabetes. Despite the huge expectation with CGM, the available solutions have not attracted much attention among people. The huge potential of CGM in future diabetic study relies on the successful implication of the CGM. This paper aims at disseminating of state-of-the-art knowledge about existing work around the CGM.

This paper presents a comprehensive systematic review on the recent developments in CGM development techniques that have been reported in credible sources, namely PubMed, IEEE Xplore, Science Direct, Springer Link, Scopus and Google Scholar. Detailed analysis and systematic comparison are provided to highlight the achievement and future direction of CGM deployment.

Several key challenges are also portrayed for suitable opportunistic orientation. CGM solutions from four leading manufacturers such as Tandem, Dexcom, Abbott and Medtronic are compared based on the following factors including accuracy (% MARD); sensor lifetime, calibration requirement, smart device, compatibility and remote monitoring. Qualitative and quantitative analyses are performed.

This work can be a valuable source of reference and guidance for future research in this field.