Experiences of Adults With Type 1 Diabetes Using Digital Health Technology for Diabetes Self-Care: Qualitative Study.

Background: Type 1 diabetes is a constraining disease due to the burden of its management, and diabetes outcome largely depends on the effectiveness of diabetes self-care. Digital health technology (DHT), which includes continuous glucose monitoring, insulin delivery devices, and related mobile health apps, can support diabetes self-care and thereby improve diabetes outcomes. In literature, experiences with the use of DHT vary widely among people with diabetes and are a less studied area among adults with type 1 diabetes. Objective: The study aimed to explore experiences of using DHT for diabetes self-care among adults with type 1 diabetes. Methods: A qualitative design with an inductive approach was used. Adults with type 1 diabetes who are users of DHT and could understand Swedish were included in the study. Participants were recruited primarily via digital advertisements through social media. A convenient sampling method was used. Data were collected through open-ended questions in a web-based survey (autumn 2022) and 2 digital group interviews (autumn 2024). The survey questionnaire and interview guide attempted to capture positive and negative experiences of using DHTs for diabetes self-care through personally relevant incidents and behavioral details. Data from a total of 161 participants (n=156 survey participants and n=5 interview participants), using 1 or more forms of DHTs, were included in the study. Data were analyzed using qualitative content analysis with an inductive approach as per Graneheim and Lundman. The data in this study generated 324 meaning units relevant to the aim. Results: The participants experienced using DHTs in diabetes self-care as a balancing act between feeling empowered and feeling exasperated. This is described under 5 categories: promoting autonomy in daily life, self-awareness through collaborative learning, feeling secure, tackling technical challenges and the need for support, and navigating the burden of psychosocial challenges. DHTs were experienced as empowering when they supported autonomy in daily life, enhanced self-awareness through collaborative learning, and fostered a sense of security. However, having to tackle technical challenges and the need for support, and navigating the burden of psychosocial challenges, led to feelings of exasperation. The exasperating experiences hindered participants from experiencing a full sense of empowerment with DHT use. Conclusions: This study sheds light on both positive and negative experiences of using DHTs for diabetes self-care in a real-life setting. The exasperating experiences may widen the digital health inequities and therefore are important to address. Improving technological literacy and ongoing support from health care or device manufacturers may help users to address exasperating experiences. Further studies are needed to validate our findings.