Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Sep 21;6(9):e11400.
doi: 10.2196/11400.

Exploration of Users' Perspectives and Needs and Design of a Type 1 Diabetes Management Mobile App: Mixed-Methods Study

Yiyu Zhang #  1   2   3 , Xia Li #  1   2   3 , Shuoming Luo  1   2   3 , Chaoyuan Liu  4 , Fang Liu  1 , Zhiguang Zhou  1   2   3
Affiliations

Exploration of Users' Perspectives and Needs and Design of a Type 1 Diabetes Management Mobile App: Mixed-Methods Study

Yiyu Zhang et al. JMIR Mhealth Uhealth. .

Abstract

Background: With the popularity of mobile phones, mobile apps have great potential for the management of diabetes, but the effectiveness of current diabetes apps for type 1 diabetes mellitus (T1DM) is poor. No study has explored the reasons for this deficiency from the users' perspective.

Objective: The aims of this study were to explore the perspectives and needs of T1DM patients and diabetes experts concerning a diabetes app and to design a new T1DM management mobile app.

Methods: A mixed-methods design combining quantitative surveys and qualitative interviews was used to explore users' needs and perspectives. Experts were surveyed at 2 diabetes conferences using paper questionnaires. T1DM patients were surveyed using Sojump (Changsha ran Xing InfoTech Ltd) on a network. We conducted semistructured, in-depth interviews with adult T1DM patients or parents of child patients who had ever used diabetes apps. The interviews were audio-recorded, transcribed, and coded for theme identification.

Results: The expert response rate was 63.5% (127/200). The respondents thought that the reasons for app invalidity were that patients did not continue using the app (76.4%, 97/127), little guidance was received from health care professionals (HCPs; 73.2%, 93/127), diabetes education knowledge was unsystematic (52.8%, 67/127), and the app functions were incomplete (44.1%, 56/127). A total of 245 T1DM patient questionnaires were collected, of which 21.2% (52/245) of the respondents had used diabetes apps. The reasons for their reluctance to use an app were limited time (39%, 20/52), complicated operations (25%, 13/52), uselessness (25%, 13/52), and cost (25%, 13/52). Both the experts and patients thought that the most important functions of the app were patient-doctor communication and the availability of a diabetes diary. Two themes that were useful for app design were identified from the interviews: (1) problems with patients' diabetes self-management and (2) problems with current apps. In addition, needs and suggestions for a diabetes app were obtained. Patient-doctor communication, diabetes diary, diabetes education, and peer support were all considered important by the patients, which informed the development of a prototype multifunctional app.

Conclusions: Patient-doctor communication is the most important function of a diabetes app. Apps should be integrated with HCPs rather than stand-alone. We advocate that doctors follow up with their patients using a diabetes app. Our user-centered method explored comprehensively and deeply why the effectiveness of current diabetes apps for T1DM was poor and what T1DM patients needed for a diabetes app and provided meaningful guidance for app design.

Keywords: diabetes mellitus, type 1; mobile applications; qualitative research; surveys and questionnaires.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Factors influencing experts’ recommendation of diabetes apps (n=127).
Figure 2
Figure 2
The biggest obstacles to experts’ use of apps to manage diabetes patients (n=118).
Figure 3
Figure 3
Proportions of different functions of patients’ diabetes apps (n=52). HCP: health care professional.
Figure 4
Figure 4
Usefulness of app functions reported as important by patients (n=245).
Figure 5
Figure 5
Homepage screenshot of the patient app. EMR: electronic medical record.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. You WP, Henneberg M. Type 1 diabetes prevalence increasing globally and regionally: the role of natural selection and life expectancy at birth. Br Med J Open Diabetes Res Care. 2016;4(1):e000161. doi: 10.1136/bmjdrc-2015-000161. http://europepmc.org/abstract/MED/26977306 bmjdrc-2015-000161 - DOI - PMC - PubMed
    1. Onkamo P, Väänänen S, Karvonen M, Tuomilehto J. Worldwide increase in incidence of Type I diabetes--the analysis of the data on published incidence trends. Diabetologia. 1999 Dec;42(12):1395–403. doi: 10.1007/s001250051309. - DOI - PubMed
    1. Weng J, Zhou Z, Guo L, Zhu D, Ji L, Luo X, Mu Y, Jia W, T1D China Study Group Incidence of type 1 diabetes in China, 2010-13: population based study. Br Med J. 2018 Dec 03;360:j5295. http://www.bmj.com/cgi/pmidlookup?view=long&pmid=29298776 - PMC - PubMed
    1. Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diabetes. Lancet. 2014 Jan 04;383(9911):69–82. doi: 10.1016/S0140-6736(13)60591-7. http://europepmc.org/abstract/MED/23890997 S0140-6736(13)60591-7 - DOI - PMC - PubMed
    1. Ryan EA, Holland J, Stroulia E, Bazelli B, Babwik SA, Li H, Senior P, Greiner R. Improved A1C levels in type 1 diabetes with smartphone app use. Can J Diabetes. 2017 Feb;41(1):33–40. doi: 10.1016/j.jcjd.2016.06.001.S1499-2671(16)30041-7 - DOI - PubMed