JMIR Publications

ABSTRACT

Background:

Individuals with diabetes are using social media as a method to share and gather information about their health via the diabetes online community. Infoveillance is one methodological approach to examine healthcare trends. Infoveillance, however, while very effective in identifying many real-world health trends, may miss opportunities which use photographs as primary sources for data. We propose a new methodology, photosurveillance, in which photographs are analyzed to examine real-world trends.

Objective:

The purpose of this research is to 1) assess the use of photosurveillance as a research method to examine real-world trends in diabetes, and 2) report on real-world use of continuous glucose monitoring on Instagram.

Methods:

This exploratory mixed method study examined all photographs posted on Instagram identified with the hashtag, #dexcom, over a 2-month period. Photographs were coded by CGM location on the body. Original posts and corresponding comments were textually coded for length of CGM wear and CGM failure and analyzed for emerging themes.

Results:

2923 photographs were manually screened, 12.1% (N=353) depicted a photograph with a CGM site location. The majority (64%, n=225) of the photographs showed a CGM site in an off-label location, while 26.2% where in an FDA approved location (abdomen), and 10.2% (n=36) were in unidentifiable locations There were no significant differences in the number of likes or comments based on FDA approval. Four themes emerged from the analysis of original posts (N-353) and corresponding comments (N=2364): 1) endorsement of CGM as providing a sense of wellbeing, 2) reciprocating encouragement and support, and 3) life hacks to optimize CGM use, and 4) sharing and learning about off-label CGM activity.

Conclusions:

Our results indicate that individuals successfully used CGM in off-label locations with greater frequency than the abdomen, with no indication of sensor failure, although these photographs only capture a snapshot in time. There were instances in which sensors were worn beyond the FDA-approved 7-days, however, they represented the minority in this study.