Directly engaging patients with glucose management: integrated visualization of personal device data for use between traditional visits

Keeping glucose below a threshold, as well as minimizing variation, is critical for individuals living with type 2 diabetes to avoid harm to organs and increase length and quality of life. Wearable devices provide patients with the opportunity to gain insight into how their physical activity and sleep quality relate to glucose levels monitored on a continuous basis. With integrated displays combining data from multiple wearable devices as well as self-reported data and assessment, there is an opportunity to see how related choices interact together to affect glucose levels on a continuous basis and averaged over the day, including documenting more information about diet, sleep, mood, and other activity choices. We conducted interviews with patients to assess their understanding of and anticipated strategies to use a personalized integrated display in-between traditional visits without the synchronous support of a clinician. We aimed to: 1) Reveal what information and uses for an integrated report are valuable for patients and 2) Elicit formative suggestions for improvement of the design of the report. An interview protocol was employed to investigate the reactions of patients to an integrated report ( N = 11). The results underscore that integrated visualizations primarily support patients in making sense of their own data obtained from multiple, independent wearable devices. With an integrated report, they can link their health behaviors to glucose variation, motivating self-reflection and behavioral change, and enhancing self-efficacy. Further, participants valued access to their own data and made recommendations to improve the usability of diet and mood information display. We discuss how integrated visualizations can enhance supervisory control and shared decision-making by empowering patients to act as informed partners in shared decision making with clinicians and diabetes self-management between visits.