title: Real-World Use and Self-Reported Health Outcomes of a Patient-Designed Do-it-Yourself Mobile Technology System for Diabetes: Lessons for Mobile Health.
abstract: The aim of this study is to compare demographic/disease characteristics of users versus nonusers of a do-it-yourself (DIY) mobile technology system for diabetes (Nightscout), to describe its uses and personalization, and to evaluate associated changes in health behaviors and outcomes.
  
  
  
  A cross-sectional, household-level online survey was used. Of 1268 household respondents who were members of the CGM in the Cloud Facebook group, there were 1157 individuals with diabetes who provided information about Nightscout use.
  
  
  
  The majority of individuals with diabetes in the household sample were 6-12 years old (followed by 18 years and above, and 13-17 years), non-Hispanic whites (90.2%), with type 1 diabetes (99.4%). The majority used an insulin pump (85.6%) and CGM (97.0%) and had private health insurance (83.8%). Nightscout use was more prevalent among children compared with adolescents and adults. Children used Nightscout for nighttime, school, sporting events, and travel; adults used it for nighttime, work, travel, and sporting events. Whereas the majority of adults viewed their own data without assistance from others, among pediatric users, a median of three individuals (range: 0-8) viewed Nightscout, with a median of three devices per viewer (range: 0-7). Individuals reported that after Nightscout adoption, they checked blood glucose values with a meter less often; bolused more frequently; gave more boluses without checking first with a blood glucose meter; and experienced significant improvements in HbA1c and quality of life.
  
  
  
  The Nightscout Project is a patient-driven mobile technology for health and may have beneficial effects on glycemic control and quality of life.
authors.affiliation: 1 Pediatric Endocrinology, University of Michigan , Ann Arbor, Michigan.|2 Child Health Evaluation and Research Center, University of Michigan , Ann Arbor, Michigan.
authors.forename: Joyce M
authors.initials: JM
authors.lastname: Lee
authors.affiliation: 3 School of Information, University of Michigan , Ann Arbor, Michigan.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Newman
authors.affiliation: 2 Child Health Evaluation and Research Center, University of Michigan , Ann Arbor, Michigan.
authors.forename: Achamyeleh
authors.initials: A
authors.lastname: Gebremariam
authors.affiliation: 2 Child Health Evaluation and Research Center, University of Michigan , Ann Arbor, Michigan.
authors.forename: Preciosa
authors.initials: P
authors.lastname: Choi
authors.affiliation: 4 #OpenAPS , Seattle, Washington.
authors.forename: Dana
authors.initials: D
authors.lastname: Lewis
authors.affiliation: 5 The Nightscout Foundation , McKinney, Texas.
authors.forename: Weston
authors.initials: W
authors.lastname: Nordgren
authors.affiliation: 6 Center for Clinical Innovation, University of Rochester , Rochester, New York.
authors.forename: John
authors.initials: J
authors.lastname: Costik
authors.affiliation: 5 The Nightscout Foundation , McKinney, Texas.
authors.forename: James
authors.initials: J
authors.lastname: Wedding
authors.affiliation: 7 Nightscout Community , San Francisco, California.
authors.forename: Benjamin
authors.initials: B
authors.lastname: West
authors.affiliation: 3 School of Information, University of Michigan , Ann Arbor, Michigan.
authors.forename: Nancy Benovich
authors.initials: NB
authors.lastname: Gilby
authors.affiliation: 7 Nightscout Community , San Francisco, California.
authors.forename: Christopher
authors.initials: C
authors.lastname: Hannemann
authors.affiliation: 8 Communication Studies and Center for Political Studies, Institute for Social Research, University of Michigan , Ann Arbor, Michigan.
authors.forename: Josh
authors.initials: J
authors.lastname: Pasek
authors.affiliation: 2 Child Health Evaluation and Research Center, University of Michigan , Ann Arbor, Michigan.
authors.forename: Ashley
authors.initials: A
authors.lastname: Garrity
authors.affiliation: 2 Child Health Evaluation and Research Center, University of Michigan , Ann Arbor, Michigan.
authors.forename: Emily
authors.initials: E
authors.lastname: Hirschfeld
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation*; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D015438:Health Behavior; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D057566:Self Report; D061108:Social Media; D017216:Telemedicine; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Mobile technology; Online community; Social media; Type 1 diabetes