CGM Linked to Low A1C Among Blog Readers With Type 1 Diabetes

The ability of people with type 1 diabetes (T1D) to find each other online, either through blog posts or social media, is recognized as a significant source of support among those living with the disease. But do these connections lead to better health?

A recent study that looked at this question found there is an association between reading blogs and improved glycated hemoglobin (A1C) levels among those with T1D, especially for those who also use continuous glucose monitoring (CGM).

The findings appeared earlier this month in JMIR Diabetes and were based on a survey of 282 people with T1D; 214 were blog readers and 68 were not. The average length of time participants had lived with T1D was 21.2 years; 77.7% were female, 81.2% used an insulin pump, and 66.3% used CGM.

Researchers from Penn State College of Medicine identified 3 distinct types of people in the T1D blogging community: (1) bloggers who journal their experiences for others, (2) commenters who engage with posts by others, and (3) “lurkers” who read without commenting “and are thought to comprise the largest” of the groups. The Penn State team was especially interested in learning how online activity from this third group translated into technology use and A1C outcomes. They recruited survey participants through a mailing to a diabetes registry and with help from 2 well-known bloggers in the T1D online community, Scott Johnson and Kerri Sparling.

Results from the survey found the following:

• Self-reported A1C was significantly lower for blog readers than for others (7.0% vs 7.5%; P = .006). After adjustment for covariates, this difference retained significance (P = .04).
• A1C was lower for those using insulin pumps than those using multiple daily injections (7.0% vs 7.7%; P = .001).
• A1C was lower for CGM users than for those not using CGM (7.0% vs 7.5%; P = .001).
• No other variables significantly affected A1C.

When evaluating the respondents based on 2 factors, the researchers found:

• A1C was lowest among those blog readers who also use CGM (6.9%) and highest among those who do not read blogs and do not use CGM (7.5%).
• Intermediate A1C levels were reported among those who use CGM but do not read blogs (7.4%), and blog readers who do not use a CGM (7.4%).

While the combination of reading blogs and using CGM was associated with the lowest A1C level, there was no significant association between reading blogs and CGM use (P = .24).

The researchers suggest the possibility that blog users may have greater ability to use technology, which would make them more likely to use insulin pumps or CGM. Future studies could look at adults with type 2 diabetes (T2D), they write; however, the T2D population is underrepresented in the diabetes online community (about 5% of the 30.3 million Americans with diabetes have T1D, but this group is more active on social media and blogs). Researchers also say other areas of study could include parents of children with T1D, “and examining how lurkers interact with blog content and the impact of these interactions on behaviors.”

Reference

Oser SM, Stuckey HL, Parascando JA, McGinley EL, Berg A, Oser TK. Glycated hemoglobin differences among blog-reading adults with type 1 diabetes compared with those who do not read blogs: cross-sectional study. JMIR Diabetes. 2019;4(2):e13634. doi: 10.2196/13634.