Experience of Using Wearable Devices for Dietary Management for Chinese Americans With Type 2 Diabetes: One-Group Prospective Cohort Study.

Abstract

Background: Chinese Americans with type 2 diabetes (T2D) face significant challenges in dietary management, which is crucial for glycemic control. Wearable sensors, such as the electronic button (eButton) and continuous glucose monitor (CGM), offer a promising solution.

Objective: We aimed to explore the experience of using the eButton and CGM for dietary management among Chinese Americans with T2D.

Methods: Chinese Americans with T2D (N=11) participated in a one-group prospective cohort study, recruited via convenience sampling from the electronic medical records of NYU Langone Health. Participants wore an eButton on their chest to record their 10-day meals and a CGM for the 2 weeks and kept a diary to track food intake, medication, and physical activity. Individual interviews were conducted after 2 weeks to discuss their experience, barriers, and facilitators of use. Interview transcripts were thematically analyzed using ATLAS.ti (Scientific Software Development GmbH) software.

Results: Facilitators of using an eButton included the device's ease of use, ability to make participants more mindful, and influence on increased sense of control. Greater awareness of food intake enabled participants to eat smaller portions. Reported barriers included privacy concerns, difficulty positioning the camera for pictures, and the lack of a meal photo record to track glucose trends. For the CGM, facilitators included its comfort and ease of use, its ability to increase mindfulness of meal choices, and its motivating changes in eating behaviors. The most common barriers included the sensor falling off, getting trapped in clothes, and causing skin sensitivity.

Conclusions: Our findings suggest that it is feasible for Chinese Americans with T2D to use eButton and CGM for dietary management. When paired, these tools offer a promising method to help patients visualize the relationship between food intake and glycemic response. For clinical implementation, structured support from health care providers-such as dietitians or diabetes educators-is essential to help patients interpret the data meaningfully. Clinicians should also consider cultural factors, privacy concerns, and individual preferences when introducing wearable technologies, ensuring a personalized and patient-centered approach to diabetes care. Future studies should apply these devices to a larger sample over a longer duration to better inform effective diabetes management strategies.