Albandari Alharbi

Digital health literacy (DHL), the ability to seek, understand, and apply digital health information, is increasingly important in the United Kingdom, with a focus on digital transformation within the health service. While digital tools offer potential to improve access and equity, they may exacerbate existing health inequities if segments of the population are unable to engage with them effectively. Understanding the sociodemographic, economic, and social factors associated with DHL is essential to designing inclusive digital health services. This study aimed to measure DHL among UK adults and identify its sociodemographic, economic, and social associates. A cross-sectional online survey was disseminated to a nationally representative sample of UK adult internet users from November to December 2024. DHL was self-reported using the validated eHealth Literacy Scale (eHEALS), which ranges from 8 to 40. eHEALS score was dichotomized into high and low DHL based on a cutoff of 26. Multivariable logistic regression was used to identify associates of DHL, with missing data handled using multiple imputation by chained equations. The median eHEALS score was 31 (IQR 27-32); 21% (320/1525) of the participants had low DHL, while 79% (1205/1525) had high DHL. Those aged 65 years and older, compared with those in the age group of 18-44 years, had higher odds of low DHL (odds ratio [OR] 1.43, 95% CI 1.02-2.01; P=.04). Those belonging to a lower social grade also had higher odds of low DHL, compared with those belonging to the higher social grade (OR 1.37, 95% CI 1.05-1.80; P=.02). Females had lower odds of low DHL (OR 0.60, 95% CI 0.46-0.77; P<.001), as did those with an undergraduate or postgraduate degree or higher, compared with those educated to below degree level (undergraduate degree OR 0.52, 95% CI 0.37-0.74, P<.001; postgraduate degree or higher OR 0.58, 95% CI 0.40-0.82, P=.002). Those who socialized daily, compared to those who did this never or rarely, had marginally lower odds of low DHL (OR 0.64, 95% CI 0.42-1.00; P=.05). In subgroup analysis among participants with chronic health conditions, age and social grade were not significant associates of DHL. Among UK internet users, male sex, lower educational attainment, lower social grade, less frequent socializing, and older age were statistically significant associates of low DHL. The model's modest explanatory power suggests that additional factors beyond those examined play an important role. As findings are based on internet users, the prevalence of low DHL in the general population is likely higher than reported. This study provides a partial basis for identifying groups who may benefit from additional support, but intervention design should not rely solely on factors identified here. Inclusive interventions accounting for a broader range of factors are needed to ensure that digital transformation in health care narrows rather than widens health inequities.

Background: Type 2 diabetes (T2D) is one of the most common noncommunicable diseases, requiring ongoing lifestyle changes and continuous glucose management through medication, diet, and physical activity. Traditional self-monitoring of blood glucose can be burdensome, especially with frequent finger pricks. As continuous glucose monitoring (CGM) becomes more affordable and accessible, it offers benefits such as increased glucose awareness, behavioral modifications, and reduced anxiety. However, challenges remain, including cost, discomfort, skin reactions, and privacy concerns. In the United Kingdom, perceptions of CGM among people with T2D, including both users and nonusers, are not well understood, limiting insight into factors influencing adoption and sustained use. Objective: This study aims to explore how adults with T2D perceive the benefits and challenges of using CGM, including both current users and nonusers. Methods: This study used a cross-sectional, online survey using YouGov’s nationally representative panel to explore experiences of CGM among adults with T2D in the United Kingdom. A total of 531 participants were recruited from November to December 2024. Thematic analysis of responses to 2 open-ended questions identified key perceived benefits and challenges associated with CGM use. Results: A total of 531 adults with T2D completed the YouGov online survey. Over half were male (297/531, 55.9%) and aged 65 years and older (281/531, 52.9%). Two-thirds (347/531, 65.3%) had lived with T2D for more than 5 years, and 9.6% (51/531) use or had previously used a CGM. Overall, 50.8% (270/531) responded to at least one free-text question, with 49% (260/531) commenting on benefits and 33.1% (176/531) on challenges. Thematic analysis identified five key benefit themes: (1) reduced monitoring burden, described as eliminating frequent finger prick testing and simplifying daily routines; (2) lifestyle feedback, enabling participants to better understand how diet and physical activity influence glucose levels; (3) greater control, by supporting more informed decision-making and increasing confidence in self-management; (4) feeling safer, through alerts for hypo- and hyperglycemia; and (5) sharing data with clinicians, which facilitated communication and more collaborative care. The main challenges were (1) access barriers, including restrictive eligibility criteria and the high cost of self-funding; (2) device issues, such as discomfort, inconvenience, and practical difficulties wearing the sensor; (3) technology reliance, with concerns about depending on devices rather than listening to bodily cues; (4) emotional strain, including anxiety, over-monitoring, and increased preoccupation with glucose levels; and (5) data concerns, particularly regarding accuracy, interpretation, and privacy. Conclusions: Adults with T2D, including both users and nonusers, described CGM as a practical and empowering tool that improves understanding, safety, and collaboration with health care providers. Nevertheless, access barriers, usability issues, and emotional and data-related burdens remain major obstacles to equitable adoption. Addressing these through improved affordability, digital literacy support, and customized clinical guidance may support ongoing and inclusive CGM use in routine care.

BACKGROUND Continuous glucose monitoring (CGM) offers clinical and behavioural benefits for people with type 2 diabetes (T2D), including improved glycaemic control and enhanced self-management. However, important evidence gaps remain regarding whether CGM use is equitably distributed across patient groups and whether OBJECTIVE To examine the relationship between CGM use among individuals with type 2 diabetes (T2D) and a range of patient characteristics, including socio-demographic factors linked to health inequities, digital health literacy, clinical characteristics, and service utilisation. METHODS A cross-sectional online survey was conducted in November 2024 among adults in the UK with self-reported type 2 diabetes (T2D), recruited via the YouGov panel. The primary outcome was self-reported CGM use. Predictor variables included PROGRESS-Plus characteristics (age, gender, ethnicity, religion, education, occupation, household income, disability, and social engagement), digital health literacy (eHEALS scale), clinical characteristics (disease duration, current treatment, and complications), overall health status (number of long-term conditions), and healthcare utilisation (frequency of visits). Descriptive statistics and multivariable logistic regression were used to examine associations between CGM use and patient characteristics. RESULTS Among 403 participants, 12.7% reported CGM use. Nearly half of participants were aged 65 years or older, and 56.80% were male. Most participants were White 83.90% and lived in urban areas. Higher odds of CGM use were observed among insulin users (OR=3.80, 95% CI: 1.6–9.22, p<0.001). No other demographic, clinical, or service utilisation variables were statistically significantly associated with CGM use. CONCLUSIONS CGM use was primarily driven by insulin therapy, consistent with established clinical pathways within the National Health Service that prioritise access for this group. No significant variation was observed across demographic, socioeconomic, or health literacy-related characteristics, suggesting no clear evidence of inequalities in this sample. These findings indicate potentially equitable access, although further research in larger and more diverse populations is needed to confirm these patterns.

BACKGROUND Type 2 diabetes (T2D) is one of the most common noncommunicable diseases, requiring ongoing lifestyle changes and continuous glucose management through medication, diet, and physical activity. Traditional self-monitoring of blood glucose can be burdensome, especially with frequent finger pricks. As continuous glucose monitoring (CGM) becomes more affordable and accessible, it offers benefits such as increased glucose awareness, behavioral modifications, and reduced anxiety. However, challenges remain, including cost, discomfort, skin reactions, and privacy concerns. In the United Kingdom, perceptions of CGM among people with T2D, including both users and nonusers, are not well understood, limiting insight into factors influencing adoption and sustained use. OBJECTIVE This study aims to explore how adults with T2D perceive the benefits and challenges of using CGM, including both current users and nonusers. METHODS This study used a cross-sectional, online survey using YouGov’s nationally representative panel to explore experiences of CGM among adults with T2D in the United Kingdom. A total of 531 participants were recruited from November to December 2024. Thematic analysis of responses to 2 open-ended questions identified key perceived benefits and challenges associated with CGM use. RESULTS A total of 531 adults with T2D completed the YouGov online survey. Over half were male (297/531, 55.9%) and aged 65 years and older (281/531, 52.9%). Two-thirds (347/531, 65.3%) had lived with T2D for more than 5 years, and 9.6% (51/531) use or had previously used a CGM. Overall, 50.8% (270/531) responded to at least one free-text question, with 49% (260/531) commenting on benefits and 33.1% (176/531) on challenges. Thematic analysis identified five key benefit themes: (1) reduced monitoring burden, described as eliminating frequent finger prick testing and simplifying daily routines; (2) lifestyle feedback, enabling participants to better understand how diet and physical activity influence glucose levels; (3) greater control, by supporting more informed decision-making and increasing confidence in self-management; (4) feeling safer, through alerts for hypo- and hyperglycemia; and (5) sharing data with clinicians, which facilitated communication and more collaborative care. The main challenges were (1) access barriers, including restrictive eligibility criteria and the high cost of self-funding; (2) device issues, such as discomfort, inconvenience, and practical difficulties wearing the sensor; (3) technology reliance, with concerns about depending on devices rather than listening to bodily cues; (4) emotional strain, including anxiety, over-monitoring, and increased preoccupation with glucose levels; and (5) data concerns, particularly regarding accuracy, interpretation, and privacy. CONCLUSIONS Adults with T2D, including both users and nonusers, described CGM as a practical and empowering tool that improves understanding, safety, and collaboration with health care providers. Nevertheless, access barriers, usability issues, and emotional and data-related burdens remain major obstacles to equitable adoption. Addressing these through improved affordability, digital literacy support, and customized clinical guidance may support ongoing and inclusive CGM use in routine care.

BACKGROUND Continuous glucose monitors (CGM) play an important role in type 2 diabetes management, offering benefits such as improved glucose awareness, behavioural adjustments, and reduced anxiety. While generally accepted by persons with T2D, challenges such as pain from sensor insertion and skin reactions to the adhesive may hinder their effectiveness. This qualitative study aims to examine how individuals with T2D perceive the clinical and personal benefits of CGM, as well as the challenges affecting its long-term use. By understanding patient experiences, this project seeks to inform clinical education, enhance patient support strategies, and promote CGM adoption and adherence. OBJECTIVE This qualitative study aims to explore T2D person’s perceived benefits and challenges associated with using CGM METHODS This study used an online questionnaire survey to explore the experiences of CGM of individuals with T2D in the UK. A total of 531 participants were recruited in October 2024. Thematic analysis identified key benefits and challenges associated with continuous glucose monitoring (CGM) use. RESULTS Participants identified several key benefits, which were categorised into five overarching themes, including (i) practicality, (ii) better understanding of lifestyle impacts on glucose levels, (iii) improved self-management, (iv) improved safety, and (v) enhanced data sharing with healthcare providers. The main challenges identified included (i) limited access, (ii) usability and technological issues, (iii) overreliance on passive monitoring, (iv) emotional burden, and (v) data-related issues. CONCLUSIONS Participants provided valuable insights into the experiences of individuals with T2D using CGM, particularly regarding its perceived benefits and challenges. Despite the benefits demonstrating that CGM is a valuable tool for T2D management, these findings emphasise the need for improved accessibility, user-friendly technology, and tailored education to enhance CGM adoption and long-term adherence.