Perspectives on Continuous Glucose Monitoring Among Adults with Type 2 Diabetes in the United Kingdom: Cross-Sectional Survey

<strong>Background:</strong> 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. <strong>Objective:</strong> This study aims to explore how adults with T2D perceive the benefits and challenges of using CGM, including both current users and nonusers. <strong>Methods:</strong> 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. <strong>Results:</strong> 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. <strong>Conclusions:</strong> 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.

Smartphone-based Intervention for Young Adults With ADHD

Conditions: Attention Deficit/Hyperactivity Disorder(ADHD); Alcohol Use

Interventions: Device: Ecological Momentary Assessment for ADHD and Substance Use – Intervention Group; Device: Ecological Momentary Assessment for ADHD & Substance Use – Control Group

Sponsors: Traci Kennedy; National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Recruiting

Tracking the longitudinal course of physiologic and mental health functioning among individuals in substance use disorder treatment

IntroductionMental health monitoring is crucial to long-term recovery in substance use disorder (SUD) treatment; however, little is known about how changes in physiological indicators align with changes in self-reported mental health over time.MethodsWe examined longitudinal associations of resting heart rate (RHR) and heart rate variability (HRV) collected via a WHOOP® photoplethysmography device with self-reported stress, anxiety, and depressive symptoms among individuals in SUD treatment. Participants (N = 59) continuously wore the device and completed at least two mental health and stress assessments during the first month of residential treatment. ResultsLinear regression results indicated favorable changes in mental health and/or physiologic metrics, with notable heterogeneity in concurrent subject-level trends. Among participants with decreased RHR (better physiological functioning), 39% (N=23) also endorsed decreased stress, 42% (N=25) decreased anxiety, and 39% (N=23) improved depressive symptoms. Of those with increased HRV (greater stress adaptability), 39% (N=23) endorsed decreased stress, 39% (N=23) improved anxiety, and 41% (N=24) reduced depressive symptoms.DiscussionConcurrent changes in physiologic and mental health metrics during the first month of treatment varied across participants. These findings highlight the importance of integrating subjective mental health measures with physiological indicators to capture clinically relevant change during early SUD treatment.

Personalized Pharmaco-Lifestyle Interventions for Severe Mental Illnesses (LIFETRAIN)

Conditions: Severe Mental Illness; Depression / Major Depressive Disorder; Bipolar Disorder (BD); Schizophrenia

Interventions: Drug: Semaglutide (SEMA); Behavioral: Exercise module; Behavioral: Anti-inflammatory diet module; Behavioral: Sleep intervention module; Behavioral: Social prescribing module; Device: Closed-loop transcranial alternating current stimulation (CL-tACS); Behavioral: Structured lifestyle psychoeducation; Device: Sham CL-tACS

Sponsors: Ludwig-Maximilians – University of Munich

Not yet recruiting

Factors Influencing the Initiation and Continued Engagement of Digital Mental Health Tools Among Adults: Theory of Planned Behavior–Informed Systematic Review

Background: Digital mental health tools (DMHTs) offer scalable support, but engagement varies. Understanding the shapes of initiation and ongoing use is essential for effective design and implementation. Objective: This study aims to synthesize determinants of adults’ initiation and engagement with DMHTs, organized through two lenses: (1) psychological factors aligned with the theory of planned behavior (TPB) and (2) design and access features. Methods: A systematic search of 9 databases (June 2025) identified qualitative and mixed methods primary studies reporting end-users’ experiences with DMHTs. Studies were screened and reported in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Quality appraisal used quality assessment with diverse studies (QuADS). Data were synthesized using a framework-guided thematic approach, mapping findings to TPB constructs and complementary design and access domains. Results: A total of 22 studies met inclusion criteria. Findings clustered into 2 interdependent domains. TPB constructs explained how beliefs, social expectations, and perceived control shaped decisions to start and persist with DMHTs. Design and access features frequently acted through these same pathways, especially by altering perceived behavioral control (PBC), with cost, connectivity, device constraints, and time flexibility affecting feasibility, with content design and privacy shaping perceived value and trust. Perceived fit (goals, cultural or linguistic relevance, and routine alignment) consistently influenced both initiation and continuation. Several features operated bidirectionally; depending on context, the same feature could facilitate or hinder engagement. Conclusions: Engagement with DMHTs is jointly determined by users’ beliefs and the design and access conditions within which tools are offered. Implementation should pursue a dual strategy, strengthening willingness to seek support (addressing attitudes, norms, and perceived control) while engineering low-effort, trustworthy, and context-appropriate experiences. Priorities include equity-focused policies (data costs, devices, and connectivity), transparent data practices, co-design with diverse communities, and consistent, theory-informed outcome measures.
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Wireless Stress Detector Offers Multiple Medical Uses

A next-generation device that detects signs of stress could have wide-ranging applications, from investigating sleep disorders to detecting signs of sepsis.

The polygraph detector, described in Science Advances, is worn on the chest and can even sense when a person is lying.

It allows psychophysiological states to be continuously monitored through a combination of multimodal sensing and wireless data transmission.

The gadget offers an alternative to current approaches such as such as polygraphy and polysomnography (PSG), which involve cumbersome wired sensors that limit their practicality.

“By uncovering mechanistic links between autonomic imbalance, stress reactivity, and health outcomes, these devices have the potential to transform diagnostic workflows, optimize educational programs, and enable personalized therapeutic monitoring across stress medicine, pediatrics, and behavioral health,” reported Sun Hong Kim, PhD, from the University of Seoul in South Korea, and co-workers.

Subtle physiological variations in cardiac, respiratory, electrodermal, and thermal activity often serve as indicators of compromised health or heightened stress responses.

These can be reflected in many scenarios, from pediatric sleep disorders that disrupt neurodevelopment to the psychological strain experienced in high-stakes clinical settings or during polygraph examinations.

Accurate monitoring of psychophysiological states is therefore essential for understanding how stress and autonomic dysfunction manifest across a wide spectrum of medical conditions.

However, most existing devices monitor only one or two parameters or rely on electrochemical sensors that detect sweat biomarkers, thereby failing to reflect the complex and dynamic interplay between multiple physiological systems.

Wearable polygraph device in the palm of a hand for scale. [John A. Rogers/Northwestern University]

Kim and co-workers therefore designed a single platform to enable comprehensive assessment of autonomic and stress-related physiology in real time.

The device continuously measures changes in heartbeat, skin temperature, and breathing, which are then converted using machine learning into measures of psychological strain.

The device had high fidelity with gold standard systems in quantifying the complex psychological stress induced by polygraph interviews and complex cognitive load tasks as well as the physical stress caused by repeatedly putting a hand in an iced water.

During overnight monitoring of children, it reliably identified arousals, hypopnea, and apnea while revealing disease-specific autonomic signatures among infants with Down syndrome.

Real-world deployment during emergency simulation training showed that multimodal stress signatures correlate inversely with performance, reflecting its value for medical education.

Machine learning analyses across all studies confirmed that multimodal features outperformed single-signal approaches in detecting stress and clinical events with high sensitivity and specificity.

“A particularly notable contribution lies in pediatric sleep medicine,” the authors noted.

“Simultaneous comparison with PSG confirms the ability to detect arousals, hypopnea, and apnea while also providing mechanistic insights into autonomic regulation.

“In infants with Down syndrome, multimodal analysis reveals attenuated sympathetic responsiveness and parasympathetic dominance, consistent with known vulnerabilities in airway patency and autonomic control.

“Such disease-specific autonomic signatures may serve as valuable biomarkers for risk stratification, early diagnosis, and targeted intervention in neurodevelopmental disorders.”

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