{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:05:40Z","timestamp":1782846340519,"version":"3.54.5"},"reference-count":50,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Diabetes"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Type 1 diabetes is a constraining disease due to the burden of its management, and diabetes outcome largely depends on the effectiveness of diabetes self-care. Digital health technology (DHT), which includes continuous glucose monitoring, insulin delivery devices, and related mobile health apps, can support diabetes self-care and thereby improve diabetes outcomes. In literature, experiences with the use of DHT vary widely among people with diabetes and are a less studied area among adults with type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study aimed to explore experiences of using DHT for diabetes self-care among adults with type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative design with an inductive approach was used. Adults with type 1 diabetes who are users of DHT and could understand Swedish were included in the study. Participants were recruited primarily via digital advertisements through social media. A convenient sampling method was used. Data were collected through open-ended questions in a web-based survey (autumn 2022) and 2 digital group interviews (autumn 2024). The survey questionnaire and interview guide attempted to capture positive and negative experiences of using DHTs for diabetes self-care through personally relevant incidents and behavioral details. Data from a total of 161 participants (n=156 survey participants and n=5 interview participants), using 1 or more forms of DHTs, were included in the study. Data were analyzed using qualitative content analysis with an inductive approach as per Graneheim and Lundman. The data in this study generated 324 meaning units relevant to the aim.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The participants experienced using DHTs in diabetes self-care as a balancing act between feeling empowered and feeling exasperated. This is described under 5 categories: promoting autonomy in daily life, self-awareness through collaborative learning, feeling secure, tackling technical challenges and the need for support, and navigating the burden of psychosocial challenges. DHTs were experienced as empowering when they supported autonomy in daily life, enhanced self-awareness through collaborative learning, and fostered a sense of security. However, having to tackle technical challenges and the need for support, and navigating the burden of psychosocial challenges, led to feelings of exasperation. The exasperating experiences hindered participants from experiencing a full sense of empowerment with DHT use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study sheds light on both positive and negative experiences of using DHTs for diabetes self-care in a real-life setting. The exasperating experiences may widen the digital health inequities and therefore are important to address. Improving technological literacy and ongoing support from health care or device manufacturers may help users to address exasperating experiences. Further studies are needed to validate our findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/79704","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T20:41:41Z","timestamp":1774557701000},"page":"e79704-e79704","source":"Crossref","is-referenced-by-count":0,"title":["Experiences of Adults With Type 1 Diabetes Using Digital Health Technology for Diabetes Self-Care: Qualitative Study"],"prefix":"10.2196","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6116-3848","authenticated-orcid":false,"given":"Divya Anna","family":"Stephen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6245-1788","authenticated-orcid":false,"given":"Jan","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3309-136X","authenticated-orcid":false,"given":"Unn-Britt","family":"Johansson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8709-342X","authenticated-orcid":false,"given":"Anna","family":"Nordin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"issue":"11","key":"R1","doi-asserted-by":"publisher","first-page":"2589","DOI":"10.2337\/dci21-0043","article-title":"The management of type 1 diabetes in adults. a consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)","volume":"44","author":"Holt","journal-title":"Diabetes Care"},{"issue":"10","key":"R2","doi-asserted-by":"publisher","first-page":"1673","DOI":"10.1007\/s13300-023-01443-z","article-title":"Living with type 1 diabetes as experienced by adults with prolonged elevated HbA: a qualitative study","volume":"14","author":"Wijk","journal-title":"Diabetes Ther"},{"issue":"2","key":"R3","doi-asserted-by":"publisher","first-page":"98","DOI":"10.34172\/hpp.2020.18","article-title":"Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis","volume":"10","author":"Mobasseri","journal-title":"Health Promot Perspect"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109083","article-title":"Global estimates of incidence of type 1 diabetes in children and adolescents: results from the International Diabetes Federation Atlas, 10th edition","volume":"183","author":"Ogle","journal-title":"Diabetes Res Clin Pract"},{"issue":"4","key":"R5","doi-asserted-by":"publisher","first-page":"994","DOI":"10.2337\/dc21-1752","article-title":"The incidence of adult-onset type 1 diabetes: a systematic review from 32 countries and regions","volume":"45","author":"Harding","journal-title":"Diabetes Care"},{"issue":"2","key":"R6","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1177\/0145721719894903","article-title":"An effective model of diabetes care and education: revising the AADE7 Self-Care Behaviors","volume":"46","author":"American Association of Diabetes Educators","journal-title":"Diabetes Educ"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/7278207","article-title":"Effect of the AADE7 Self-Care Behaviors Framework on diabetes education management in a shared care model","volume":"2024","author":"Liu","journal-title":"Int J Endocrinol"},{"issue":"1 Suppl 1","key":"R8","doi-asserted-by":"publisher","first-page":"S146","DOI":"10.2337\/dc25-S007","article-title":"Diabetes technology: standards of care in diabetes-2025","volume":"48","author":"American Diabetes Association Professional Practice Committee","journal-title":"Diabetes Care"},{"issue":"6","key":"R9","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1016\/j.eprac.2021.04.008","article-title":"American Association of Clinical Endocrinology clinical practice guideline: the use of advanced technology in the management of persons with diabetes mellitus","volume":"27","author":"Grunberger","journal-title":"Endocr Pract"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2020.108609","article-title":"Glycaemia and utilisation of technology across the lifespan of adults with type 1 diabetes: results of the Australian National Diabetes Audit (ANDA)","volume":"171","author":"Pease","journal-title":"Diabetes Res Clin Pract"},{"issue":"2","key":"R11","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1177\/19322968231208690","article-title":"European survey on adult people with type 1 diabetes and their caregivers: insights into perceptions of technology","volume":"19","author":"Penfornis","journal-title":"J Diabetes Sci Technol"},{"issue":"6","key":"R12","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1007\/s13300-020-00831-z","article-title":"Evolution of insulin delivery devices: from syringes, pens, and pumps to DIY artificial pancreas","volume":"11","author":"Kesavadev","journal-title":"Diabetes Ther"},{"issue":"3","key":"R13","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1177\/1932296819899394","article-title":"Continuous glucose monitoring devices: past, present, and future focus on the history and evolution of technological innovation","volume":"15","author":"Didyuk","journal-title":"J Diabetes Sci Technol"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14944","article-title":"Impact of glycaemic technologies on quality of life and related outcomes in adults with type 1 diabetes: a narrative review","volume":"40","author":"Speight","journal-title":"Diabet Med"},{"issue":"1","key":"R15","doi-asserted-by":"publisher","DOI":"10.1186\/s12962-019-0188-1","article-title":"Understanding and using patient experiences as evidence in healthcare priority setting","volume":"17","author":"Rand","journal-title":"Cost Eff Resour Alloc"},{"issue":"12","key":"R16","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1111\/1753-0407.13454","article-title":"Patient experiences of continuous glucose monitoring and sensor-augmented insulin pump therapy for diabetes: a systematic review of qualitative studies","volume":"15","author":"Natale","journal-title":"J Diabetes"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2023.110886","article-title":"The impact of real-time sensor technology on quality of life for adults with type 1 diabetes: a Dutch national survey","volume":"203","author":"Winterdijk","journal-title":"Diabetes Res Clin Pract"},{"issue":"3","key":"R18","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1177\/17423953211023962","article-title":"Values and control in type 1 diabetes beyond glycemic outcomes: a qualitative interview study of everyday life with an insulin pump","volume":"18","author":"Cleal","journal-title":"Chronic Illn"},{"issue":"8","key":"R19","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1016\/j.jcjd.2021.02.006","article-title":"Real-world patient experience of long-term hybrid closed-loop insulin pump use","volume":"45","author":"Wang","journal-title":"Can J Diabetes"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1177\/19322968241274364","article-title":"Adult's lived experience using the insulin-only bionic pancreas","volume":"19","author":"Garza","journal-title":"J Diabetes Sci Technol"},{"issue":"10","key":"R21","doi-asserted-by":"publisher","DOI":"10.1530\/EC-23-0193","article-title":"Experience with burdens of diabetes device use that affect uptake and optimal use in people with type 1 diabetes","volume":"12","author":"Tanenbaum","journal-title":"Endocr Connect"},{"issue":"5","key":"R22","first-page":"1","volume":"14","author":"Anell","journal-title":"Health Syst Transit"},{"key":"R23","unstructured":"Socialdepartementet. H\u00e4lso- och sjukv\u00e5rdslag (2017:30) [Report in Swedish]. Sveriges Riksdag. 2017. URL: https:\/\/www.riksdagen.se\/sv\/dokument-lagar\/dokument\/svensk-forfattningssamling\/halso--och-sjukvardslag-201730_sfs-2017-30 [Accessed 08-12-2025]"},{"key":"R24","unstructured":"Nationella diabetesregistret: \u00e5rsrapport [Report in Swedish]. Nationella Diabetesregistret; 2024. URL: https:\/\/registercentrum.blob.core.windows.net\/ndr\/r\/NDR_-rsrapport-2024-nfsZyhug5.pdf [Accessed 08-12-2025]"},{"issue":"6","key":"R25","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.1007\/s13300-024-01581-y","article-title":"Psychosocial self-efficacy and its association with selected potential factors among adults with type 1 diabetes: a cross-sectional survey study","volume":"15","author":"Stephen","journal-title":"Diabetes Ther"},{"issue":"6","key":"R26","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","journal-title":"Int J Qual Health Care"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.2196\/66117","article-title":"eHealth literacy and its association with demographic factors, disease-specific factors, and well-being among adults with type 1 diabetes: cross-sectional survey study","volume":"10","author":"Stephen","journal-title":"JMIR Diabetes"},{"issue":"1","key":"R28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15226\/2471-6529\/3\/1\/00125","article-title":"Critical incident technique applied in nursing and healthcare sciences","volume":"3","author":"Fridlund","journal-title":"SOJ Nurs Health Care"},{"issue":"4","key":"R29","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1177\/1468794105056924","article-title":"Fifty years of the critical incident technique: 1954-2004 and beyond","volume":"5","author":"Butterfield","journal-title":"Qual Res"},{"issue":"5","key":"R30","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1046\/j.1365-2648.2000.01597.x","article-title":"The critical incident technique and nursing care quality research","volume":"32","author":"Kemppainen","journal-title":"J Adv Nurs"},{"issue":"2","key":"R31","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.nedt.2003.10.001","article-title":"Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness","volume":"24","author":"Graneheim","journal-title":"Nurse Educ Today"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2017.06.002","article-title":"Methodological challenges in qualitative content analysis: a discussion paper","volume":"56","author":"Graneheim","journal-title":"Nurse Educ Today"},{"issue":"1","key":"R33","doi-asserted-by":"publisher","first-page":"2158244014522633","DOI":"10.1177\/2158244014522633","article-title":"Qualitative content analysis: a focus on trustworthiness","volume":"4","author":"Elo","journal-title":"SAGE Open"},{"key":"R34","unstructured":"WMA Declaration of Helsinki \u2013 ethical principles for medical research involving human participants. World Medical Association. URL: https:\/\/www.wma.net\/policies-post\/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects\/ [Accessed 08-12-2025]"},{"issue":"8","key":"R35","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1016\/j.eprac.2023.04.007","article-title":"The evolution of diabetes technology - options toward personalized care","volume":"29","author":"Zahid","journal-title":"Endocr Pract"},{"issue":"4","key":"R36","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1111\/dme.13568","article-title":"Best friend or spy: a qualitative meta-synthesis on the impact of continuous glucose monitoring on life with type 1 diabetes","volume":"35","author":"Messer","journal-title":"Diabet Med"},{"issue":"1","key":"R37","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1007\/s40200-023-01215-3","article-title":"Interviews with Indigenous M\u0101ori with type 1 diabetes using open-source automated insulin delivery in the CREATE randomised trial","volume":"22","author":"Burnside","journal-title":"J Diabetes Metab Disord"},{"key":"R38","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2023.110830","article-title":"Empowering us\u201d: a community-led survey of real-world perspectives of adults with type 1 diabetes using insulin pumps and continuous glucose monitoring to manage their glucose levels","volume":"202","author":"Read","journal-title":"Diabetes Res Clin Pract"},{"issue":"4","key":"R39","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-057836","article-title":"'Striving for freedom or remaining with what is well-known': a focus-group study of self-management among people with type 1 diabetes who have suboptimal glycaemic control despite continuous subcutaneous insulin infusion","volume":"12","author":"Persson","journal-title":"BMJ Open"},{"issue":"17-18","key":"R40","doi-asserted-by":"publisher","first-page":"3318","DOI":"10.1111\/jocn.14911","article-title":"Continuous glucose monitoring in adults with type 1 diabetes: a balance between benefits and barriers: a critical incident study","volume":"28","author":"S\u00f8rg\u00e5rd","journal-title":"J Clin Nurs"},{"issue":"5","key":"R41","doi-asserted-by":"publisher","first-page":"1096","DOI":"10.1177\/19322968231156572","article-title":"Interruption of continuous glucose monitoring: frequency and adverse consequences","volume":"18","author":"Markov","journal-title":"J Diabetes Sci Technol"},{"issue":"3","key":"R42","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-080053","article-title":"Associations between use of diabetes technology and diabetes distress: a Danish cross-sectional survey of adults with type 1 diabetes","volume":"14","author":"Lorenzen","journal-title":"BMJ Open"},{"issue":"8","key":"R43","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15338","article-title":"Identifying the deficiencies of currently available CGM to improve uptake and benefit","volume":"41","author":"Barnard-Kelly","journal-title":"Diabet Med"},{"issue":"5","key":"R44","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0320702","article-title":"The experiences of high-risk young adults with type 1 diabetes transitioning to real-time continuous glucose monitoring - a thematic analysis","volume":"20","author":"McKechnie","journal-title":"PLoS ONE"},{"issue":"1","key":"R45","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1007\/s00592-024-02340-y","article-title":"A new approach in insulin pump education improves glycemic outcomes: a randomized controlled trial","volume":"62","author":"Rytter","journal-title":"Acta Diabetol"},{"issue":"10","key":"R46","doi-asserted-by":"publisher","first-page":"4293","DOI":"10.1111\/dom.15774","article-title":"Systematic review of disparities in continuous glucose monitoring and insulin pump utilization in the United States: key themes and evidentiary gaps","volume":"26","author":"Patel","journal-title":"Diabetes Obes Metab"},{"issue":"5","key":"R47","doi-asserted-by":"publisher","first-page":"266","DOI":"10.12968\/bjon.2013.22.5.266","article-title":"Focus group interviews part 3: analysis","volume":"22","author":"Doody","journal-title":"Br J Nurs"},{"issue":"4","key":"R48","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1037\/h0061470","article-title":"The critical incident technique","volume":"51","author":"Flanagan","journal-title":"Psychol Bull"},{"issue":"10","key":"R49","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14575","article-title":"Cost considerations for adoption of diabetes technology are pervasive: a qualitative study of persons living with type 1 diabetes and their families","volume":"38","author":"Addala","journal-title":"Diabet Med"},{"issue":"1","key":"R50","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvae210","article-title":"Disparities in diabetes technology uptake in youth and young adults with type 1 diabetes: a global perspective","volume":"9","author":"Conway","journal-title":"J Endocr Soc"}],"container-title":["JMIR Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetes.jmir.org\/2026\/1\/e79704","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:12:53Z","timestamp":1782843173000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetes.jmir.org\/2026\/1\/e79704"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":50,"URL":"https:\/\/doi.org\/10.2196\/79704","relation":{},"ISSN":["2371-4379"],"issn-type":[{"value":"2371-4379","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]},"article-number":"v11i11e79704"}}