Dear my Very Problematic Blood Glucose Meter: Adolescents' Experiences Self-Managing Type 1 Diabetes and their Psychosocial User Requirements Of Medical Technologies
Authors:   , McCarthy Gillian 
Published: November 2021

<p>“Dear insulin pump. I love that you came into my life! You give me flexibility, confidence, and happiness.”  “Dear my very problematic blood glucose meter. I wish I could let you go. I don't ask much from you, just correct readings and that you stop deciding to pack it in. You make me second guess myself and my health.”  The difference between a loved and a despised medical device is stark. Adolescents with type 1 diabetes require medical devices that facilitate their self-management throughout every aspect of their lives, from school, to the sports field, to managing hypoglycaemia in the middle of the night. This research aims to describe adolescents’ experiences self-managing type 1 diabetes, and identify their psychosocial user requirements of medical technologies.  Following a constructivist research paradigm, a range of predominantly qualitative and participatory design methods were employed with 16 adolescent and young adult participants with type 1 diabetes and nine health professionals. Methods included semi-structured interviews and a card-sort task to understand the psychosocial impacts of current medical devices. Cultural probes elicited: adolescents’ metaphors for managing diabetes, how they would like to manage their diabetes, the best and worst features of their devices, and the relationships they have with them. Undergraduate design students used secondary research and emergent psychosocial user requirements of medical devices to design blood glucose meters, lancets, storage solutions, and insulin pumps that resembled watches, jewellery, and smartphones, could be attached to a bike, or could glow at night. I used these designs to provide additional support for adolescents’ user requirements, demonstrate how they were of use to designers, and stimulate discussion with the adolescents. The adolescents with type 1 diabetes completed a participatory design workshop, designing blood glucose meters that challenged the ways in which medical devices currently draw attention. Findings were analysed using a constructivist approach to grounded theory, and psychosocial user requirements were developed.  On average, current medical devices have positive psychosocial impacts on adolescents, with large positive impacts on users’ feelings of competence, followed by increased feelings of adaptability and self-esteem. However, some adolescent requirements remain unmet. Issues include the transition of responsibility for diabetes management from parent to adolescent, managing blood glucose while participating in everyday activities such as sports, managing attention, and developing acceptance of a long-term condition. Other issues stem from devices’ features, usability, reliability, and context of use. As research has indicated, the traditional health approach is about curing illness, but with diabetes, managing wellness is key. The person learns to fit diabetes around the rest-of-life. While it is pertinent that diabetes technologies are clinically effective, they should also be designed in alignment with adolescent psychosocial user requirements, taking into account not only their physical health, but also the ways and contexts in which adolescents go about their daily lives.</p>