CoChat
Sign Up
Cited by 117Diabetes Management and ResearchDiabetes Management and EducationMobile Health and mHealth Applications

Optimal use of diabetes devices: clinician perspectives on barriers and adherence to device use

Open access
Tanenbaum, Molly L., Adams, Rebecca N., Hanes, Sarah J., Barley, Regan C., Miller, Kellee M., Mulvaney, Shelagh A., Hood, Korey K.·2017·Journal of Diabetes Science and Technology
DOI 10.1177/1932296816688010PMC PMC5505431
Open this paper in CoChat — free account

Abstract

BACKGROUND: Insulin pumps and continuous glucose monitors (CGM) can improve glycemic control for individuals with type 1 diabetes (T1D). Device uptake rates continue to show room for improvement, and consistent adherence is needed to achieve better outcomes. Diabetes health care providers have important roles to play in promoting device use and adherence. METHODS: We surveyed 209 clinicians who treat people with type 1 diabetes to examine perceptions of barriers to device uptake, attitudes toward diabetes technology, and resources needed for clinicians to improve device uptake. We compared findings with our survey of adults with T1D. RESULTS: Younger clinicians treated more patients using insulin pumps ( r = -.26, P < .001) and CGM ( r = -.14, P = .02), and had more positive attitudes about diabetes technology ( r = -.23, P = .001). The most frequently endorsed modifiable barriers were perceptions that patients dislike having the device on their body (73% pump; 63% CGM), dislike the alarms (61% CGM), and do not understand what to do with device information or features (40% pump; 46% CGM). Clinicians wanted lower cost and better insurance coverage for their patients, and they recommended counseling and education to help address barriers and improve adherence to devices. CONCLUSION: Clinicians perceive many barriers to their patients initiating and adhering to diabetes devices. Findings highlight opportunities for intervention to improve clinician-patient communication around device barriers to help address them.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1177/1932296816688010

Cites

30 of 30 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • For people with insulin-requiring diabetes, dosing instructions may be complex and confusing.

    “For people with insulin-requiring diabetes, dosing instructions may be complex and confusing (3-6).”

    From Observed Glycemic and Psychosocial Benefits in the Prospective Bigfoot Unity Real World Study: A 6-Month Analysis (2025) · cites this paper as [6]

    The Abstract (page unavailable) describes insulin-pump use as requiring complex tasks, including carbohydrate counting and administering boluses. The Results (page unavailable) report clinicians’ perceptions that some patients do not understand pump information or features. These passages support complexity and possible confusion in device use, but do not specifically say that dosing instructions are confusing for people with insulin-requiring diabetes generally. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • There is a clear need for intuitive, integrated systems to help MDI patients interpret CGM data into actionable management steps to reduce the burden of demanding self-care directives and support telemedicine.

    “As injection therapy is used by more than 80% of people with insulin-requiring diabetes, there is a clear need for intuitive, integrated systems to help multiple daily injection (MDI) patients interpret CGM data into actionable management steps to reduce the burden of demanding self-care directives and support telemedicine (3, 6, 10-13).”

    From Observed Glycemic and Psychosocial Benefits in the Prospective Bigfoot Unity Real World Study: A 6-Month Analysis (2025) · cites this paper as [6]

    The Results report that clinicians saw patients’ difficulty understanding device information as a barrier, and the Conclusions describe complex adherence tasks and suggest remote monitoring and practical support. The paper does not specifically call for intuitive, integrated systems for MDI patients that turn CGM data into management steps or support telemedicine. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • There is evidence that patients may not know how to interpret what to do with CGM data.

    “While recent guidelines call for continuous glucose monitoring (CGM) use for all who require insulin, regardless of diabetes type (7), there is also evidence that patients may not know how to interpret what to do with the CGM data (6, 8, 9).”

    From Observed Glycemic and Psychosocial Benefits in the Prospective Bigfoot Unity Real World Study: A 6-Month Analysis (2025) · cites this paper as [6]

  • Injection therapy is used by more than 80% of people with insulin-requiring diabetes.

    “As injection therapy is used by more than 80% of people with insulin-requiring diabetes, there is a clear need for intuitive, integrated systems to help multiple daily injection (MDI) patients interpret CGM data into actionable management steps to reduce the burden of demanding self-care directives and support telemedicine (3, 6, 10-13).”

    From Observed Glycemic and Psychosocial Benefits in the Prospective Bigfoot Unity Real World Study: A 6-Month Analysis (2025) · cites this paper as [6]

    The Results (Sample Characteristics; page unavailable) report clinicians’ estimates of insulin-pump use among their patients with type 1 diabetes, not the prevalence of injection therapy among all people with insulin-requiring diabetes. Searches for “more than 80%,” injection therapy, and related terms found no passage establishing the claimed figure. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [13]13. Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med. 2008;359:1464-1476. [DOI] [PubMed] [Google Scholar]

Cited by

Sorted by citations

Related

Authors
Tanenbaum, M. L., Adams, R. N., Hanes, S. J., Barley, R. C., Miller, K. M., Mulvaney, S. A., & Hood, K. K.
Affiliations
  • Stanford Medicine (US)
  • Jaeb Center for Health Research (US)
  • Vanderbilt University (US)
Corresponding author
Hood, Korey K.
ORCID
Venue
Journal of Diabetes Science and Technology
Publisher
SAGE Publications
Published
2017-01-10
Volume
11
Issue
3
Pages
484-492
ISSN
1932-2968 (ISSN-L)
DOI
10.1177/1932296816688010
PMC
PMC5505431
OpenAlex
W2572387108
Cited by
117
References
30
Citations by year
2026: 12 · 2025: 8 · 2024: 21 · 2023: 15 · 2022: 14 · 2021: 16 · 2020: 15 · 2019: 9 · 2018: 7
FWCI
6.70
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Journal of Diabetes Science and Technology (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Leona M. and Harry B. Helmsley Charitable Trust
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
type 1 diabetes, insulin pump, continuous glucose monitors, diabetes technology adoption, device adherence, clinician attitudes, clinician-patient communication, patient education, insurance coverage, device cost
MeSH terms
Adult, Diabetes Mellitus, Type 1, Female, Humans, Insulin Infusion Systems, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Monitoring, Physiologic, Patient Compliance, Practice Patterns, Physicians', Surveys and Questionnaires

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review