Evaluation of a Web-Based Simulation Tool for Self-Management Support in Type 1 Diabetes: A Pilot Study

Objective:
To develop and evaluate a novel Web-based Simulation Tool (WST) that brings simulation technologies to people with Type 1 Diabetes (T1D), enabling unique patient-data interactions seamlessly on a daily basis.
Methods:
A pilot clinical trial was conducted to assess system usability. The study consisted of one week of observation (Phase 1) and four weeks of interaction with WST (Phase 2). Responses to Technology Acceptance (TA) and Diabetes Distress Scale (DDS) questionnaires were collected, and follow-up interviews were conducted after Phase 2.
Results:
Fifteen participants with T1D using Control-IQ technology (age: 36
$\pm$
13 years, HbA1c: 6.5%
$\pm$
0.7%) completed all study procedures. Generated simulation models achieved a median Mean Absolute Relative Difference (MARD) of 6.8% [interquartile range, IQR: 5.1%, 9.1%]. A decrease in expected benefits (likely explained by issues with the third-party data collection system) and an increase in expected burdens were observed. On a 1-5 scale, ease of use, trust, and usefulness scores were 3 [3,4], 4 [3,4], and 4 [3,4], respectively. Time below 70 mg/dL decreased between Phases 1 and 2 (1.6% [0.7%,3.7%] vs 0.8% [0.5%,3.0%]). A reduction in mean emotional burden was also observed (2.5
$\pm$
1.1 vs 2.1
$\pm$
0.8).
Conclusions:
Results indicate that there was a learning curve to WST, but also that most participants trusted the system and found it useful in their diabetes care.
Significance:
Simulation technologies like WST could be used by educators and patients to facilitate diabetes self-management, leading to better diabetes literacy and reducing associated distress.