{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:17:37Z","timestamp":1785802657838,"version":"3.56.0"},"reference-count":48,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["DIGITAL HEALTH"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Current glucose monitoring user interfaces (UIs) are problematic for people with Type 1 Diabetes Mellitus (T1DM) in maintaining recommended blood glucose levels effectively. However, there is a lack of in-depth investigation into this problem when these individuals interpret and make real-time decisions based on the glucose monitoring devices they use daily.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aim to investigate problems associated with glucose monitoring UIs by observing users\u2019 interpretation and decision-making while reading their Continuous Glucose Monitoring (CGM), Flash Glucose Monitoring (Flash) or Self-monitoring of Blood Glucose (SMBG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A mixed-method study was conducted. The Think Aloud protocol was used to capture participants\u2019 decision-making process while reading various device UIs. Their responses were evaluated using standard clinical guidance to assess their accuracy. Additionally, a survey was distributed to gather their perceptions of self-management practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-seven participants (17 patients and 10 carers) were recruited. Interpretation accuracy averaged 38\n                      <jats:italic>.<\/jats:italic>\n                      0%\u2009\n                      <jats:italic>\u00b1\u2009<\/jats:italic>\n                      11\n                      <jats:italic>.<\/jats:italic>\n                      1% for CGM, 39\n                      <jats:italic>.<\/jats:italic>\n                      5%\u2009\n                      <jats:italic>\u00b1\u2009<\/jats:italic>\n                      8\n                      <jats:italic>.<\/jats:italic>\n                      8% for Flash, and 33\n                      <jats:italic>.<\/jats:italic>\n                      3%\u2009\n                      <jats:italic>\u00b1\u2009<\/jats:italic>\n                      7\n                      <jats:italic>.<\/jats:italic>\n                      8% for SMBG group. Treatment action accuracy was 21\n                      <jats:italic>.<\/jats:italic>\n                      5%\u2009\n                      <jats:italic>\u00b1\u2009<\/jats:italic>\n                      15\n                      <jats:italic>.<\/jats:italic>\n                      6% for CGM, 21\n                      <jats:italic>.<\/jats:italic>\n                      2%\u2009\n                      <jats:italic>\u00b1\u2009<\/jats:italic>\n                      14\n                      <jats:italic>.<\/jats:italic>\n                      0% for Flash, and 18\n                      <jats:italic>.<\/jats:italic>\n                      0%\u2009\n                      <jats:italic>\u00b1\u2009<\/jats:italic>\n                      13\n                      <jats:italic>.<\/jats:italic>\n                      2% for SMBG group. Despite this, 75\n                      <jats:italic>.<\/jats:italic>\n                      0% of all participants expressed very high confidence in their self-management.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Interpreting and making decisions using glucose monitoring UIs remains significantly challenging for people with T1DM despite their self-perceived performance. Improving such UIs is crucial to reduce misinterpretation and help these individuals make better treatment decisions without relying on their potentially inaccurate interpretations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552076251332580","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T01:59:59Z","timestamp":1746583199000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Glucose interpretation meaning and action (GIMA): Insights to blood glucose user interface interpretation in type 1 diabetes"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0375-2833","authenticated-orcid":false,"given":"Rujiravee","family":"Kongdee","sequence":"first","affiliation":[{"name":"Department of Computer Science, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3222-7571","authenticated-orcid":false,"given":"Bijan","family":"Parsia","sequence":"additional","affiliation":[{"name":"Department of Computer Science, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6076-6997","authenticated-orcid":false,"given":"Hood","family":"Thabit","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Harper","sequence":"additional","affiliation":[{"name":"Department of Computer Science, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-0112"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2005.07.006"},{"key":"e_1_3_4_4_2","unstructured":"Digitale E. New research keeps diabetics safer during sleep 2014. http:\/\/scopeblog.stanford.edu\/2014\/05\/08\/new-research-keeps-diabetics-safer-during-sleep\/."},{"key":"e_1_3_4_5_2","article-title":"Type 1 diabetes in adults: supporting self management","volume":"352","author":"Reddy M","year":"2016","unstructured":"Reddy M, Rilstone S, Cooper P, et al. Type 1 diabetes in adults: supporting self management. Br Med J 2016; 352: i998.","journal-title":"Br Med J"},{"key":"e_1_3_4_6_2","first-page":"82","article-title":"Current and emerging technology for continuous glucose monitoring","volume":"17","author":"Chen C","year":"2017","unstructured":"Chen C, Zhao XL, Li ZH, et al. Current and emerging technology for continuous glucose monitoring. Sensors 2017; 17: 82. http:\/\/www.mdpi.com\/1424-8220\/17\/1\/182","journal-title":"Sensors"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2015.0417"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2019.0121"},{"key":"e_1_3_4_9_2","first-page":"3S","article-title":"Reference guide for integrating continuous glucose monitoring into clinical practice","volume":"45","author":"Kruger DF","year":"2019","unstructured":"Kruger DF, Edelman SV, Hinnen DA, et al. Reference guide for integrating continuous glucose monitoring into clinical practice. Sci Diabetes Self Manag Care 2019; 45: 3S\u201320S. http:\/\/journals.sagepub.com\/doi\/10.1177\/0145721718818066","journal-title":"Sci Diabetes Self Manag Care"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/20552076221129712"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2019.0142"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1145\/3134723"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-1855"},{"key":"e_1_3_4_14_2","first-page":"503","article-title":"Data, data everywhere, and still too hard to link: insights from user interactions with diabetes apps","author":"Katz D","year":"2018","unstructured":"Katz D, Price BA, Holland S, et al. Data, data everywhere, and still too hard to link: insights from user interactions with diabetes apps. CHI 2018: 503. DOI:10.1145\/3173574.3174 077","journal-title":"CHI"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2016.0011"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-148-10-200805200-00006"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296816641433"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2022.109938"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/26350106231168859"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.4158\/EP14520.OR"},{"key":"e_1_3_4_21_2","first-page":"315","article-title":"Questioning the reflection paradigm for diabetes Mobile apps","volume":"360","author":"Katz D","year":"2016","unstructured":"Katz D, Dalton N, Holland S, et al. Questioning the reflection paradigm for diabetes Mobile apps. eHealth 2016; 360\u00b0: 315\u2013326.","journal-title":"eHealth"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1145\/3314409"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049732309354278"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1006\/ijhc.1994.1065"},{"key":"e_1_3_4_25_2","unstructured":"Flash glucose monitors (Freestyle Libre) and continuous glucose monitors (CGM) \u2014 diabetes.org.uk. https:\/\/www.diabetes.org.uk\/guide-to-diabetes\/diabetes-technology\/flash-glucose-monitors-and-continuous-glucose-monitors. [Accessed 18-07-2024]."},{"key":"e_1_3_4_26_2","unstructured":"Everyone with type 1 diabetes will be offered flash or CGM technology free on the NHS in England and Wales: new NICE guidelines published \u2014 JDRF \u2014 jdrf.org.uk. https:\/\/jdrf.org.uk\/news\/everyone-with-type-1-diabetes-will-be-offered-flash-or-cgm-technology-free-on-the-nhs-in-england-and-wales-new-nice-guidelines-published\/. [Accessed 18-07-2024]."},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.82.6.949"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12105"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/6271591"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S47577"},{"key":"e_1_3_4_31_2","unstructured":"tldvio. Transcript zoom calls 2024. https:\/\/tldv.io\/transcript-zoom-calls. Accessed: 2024-07-25."},{"key":"e_1_3_4_32_2","unstructured":"Qualtrics. Qualtrics 2020. URL. Version: current; Used: September 2024."},{"key":"e_1_3_4_33_2","unstructured":"National Institute for Health and Care Excellence. Type 1 diabetes in adults: diagnosis and management. NICE guideline [NG17] 2015. Published: 26 August 2015. Last updated: 17 August 2022."},{"key":"e_1_3_4_34_2","volume-title":"Measuring the user experience: collecting, analyzing, and presenting usability metrics.","author":"Tullis T","year":"2013","unstructured":"Tullis T, Albert B. Measuring the user experience: collecting, analyzing, and presenting usability metrics. Second edition ed. Interactive Technologies Ser. Amsterdam Boston Heidelberg: Elsevier\/MK, Morgan Kaufmann, 2013, ISBN 978-0-12-415792-7 978-1-299-62214-2 978-0-12-415781-1."},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-02806-9_1"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.9734\/BJAST\/2015\/14975"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17186464"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.2196\/19126"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2016.08.013"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14430"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-020-0165-1"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2019.0341"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1177\/193229681300700324"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968241236504"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10880-022-09895-4"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-1006.2004.00018.x"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1037\/a0020959"},{"key":"e_1_3_4_48_2","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.77.6.1121"},{"key":"e_1_3_4_49_2","doi-asserted-by":"publisher","DOI":"10.1108\/09654280710716860"}],"container-title":["DIGITAL HEALTH"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20552076251332580","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20552076251332580","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20552076251332580","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T17:51:45Z","timestamp":1777398705000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20552076251332580"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":48,"alternative-id":["10.1177\/20552076251332580"],"URL":"https:\/\/doi.org\/10.1177\/20552076251332580","relation":{},"ISSN":["2055-2076","2055-2076"],"issn-type":[{"value":"2055-2076","type":"print"},{"value":"2055-2076","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]},"article-number":"20552076251332580"}}