Are people with diabetes wearing their continuous glucose monitor as FDA approved? And should they be? An examination of #dexcom on Instagram.

1. COLLEGE OF NURSING
Photosurveillance of Non-FDA Approved Activity: Instagram and Diabetes
Whitney S. Woodruff, RN, BSN, DNP Student, Joseph Arrington, BS Student, & Michelle Litchman, PhD, FNP-BC, FAANP
Background
 Individuals with diabetes are using social media to share
information about their health
 Real-Time Continuous Glucose Monitor (RT-CGM) users post
about their experiences, including non-FDA approved activity
 The purpose of this research is to assess the use of
photosurveillance as a research method to examine real-
world trends in diabetes and analyze non-FDA approved
activity as it relates to RT-CGM use.
Methods
 Descriptive design; content analysis
 Photographs (N=2923) posted on Instagram, identified
by #dexcom, were examined over a 2-months
 Photographs depicting a RT-CGM site were included
Photographs were categorized by type of non-FDA approved
activity, abdomen only is FDA approved
N=147
Included
Abdomen
92 (26.1%)
Post. Arm
139 (39.4%)
Thigh
45 (12.7%)
Back
10 (2.8%)
Calf
7 (2%)
Ant. Arm
10 (2.8%)
Forearm
12 (3.4%)
Other
36 (10.2%)
Results
Conclusions
 Photosurveillance can be used to examine real-world
trends in diabetes.
 In this study, individuals used RT-CGM in non-FDA
approved locations with greater frequency than the
abdomen. Sensor failure was equal between non-FDA
and FDA sites.
 The risk for scar tissue and the need to rotate insulin
injection/pump sites increase the patient's need for
multiple areas to place RT-CGM with interstitial fluid, not
just the abdomen.
 The viral nature of social media will likely expose
individuals of all age groups to non-FDA approved
activity related to RT-CGM use.
Non-FDA Approved FDA Approved p-value
Likes 13,612 4,365 .851
Comments 1,395 357 .159
Figure 2. RT-CGM Site Locations with Corresponding Exemplars (N=353)
64% of RT-CGM placements are in Non-FDA approved locations
Table 2. Likes and Comments Based on FDA Approved Sites
Figure 3. Sensor Failure (N=32)
Comment Type Total (N=2364)
Affirmations 85
General Inquiries 127
Non-FDA Approved Non-Issue 133
FDA Approved Non-Issue 7
Comments on Sensor Failure 32
User Difficulties 20
Future Plans for Sensor Site 30
Other 1930
Figure 4. Comments Per
Photo
Table 1. Total Comments per Photo
353 Included
2923 Examined
Figure 1. Data Collection