TikTok as a Health Information Source: Assessment of the Quality of Information in Diabetes-Related Videos

Kong, W., Song, S., Zhao, Y.C., Zhu, Q. & Sha, L. | 2021 |
TikTok as a Health Information Source: Assessment of the Quality of Information in Diabetes-Related Videos|
J Med Internet Res| 23| 9| e30409 | doi: 10.2196/30409| PMID: 34468327

Published in the Journal of Medical Internet Research this paper looks at the quality of information in diabetes-related videos on the TikTok social media platform. The study assessed almost 200 diabetes video on TikTok, the overall quality of the diabetes videos was found to be acceptable on average, although it varied significantly, depending on the type of source. The authors conclude that the health information needs of patients with diabetes might not be fully met by watching TikTok videos, and patients should exercise caution when using TikTok for diabetes-related information.


Background: Diabetes has become one of the most prevalent chronic diseases, and many people living with diabetes use social media to seek health information. Recently, an emerging social media app, TikTok, has received much interest owing to its popularity among general health consumers. We notice that there are many videos about diabetes on TikTok. However, it remains unclear whether the information in these videos is of satisfactory quality.

Objective: This study aimed to assess the quality of the information in diabetes-related videos on TikTok.

Methods: We collected a sample of 199 diabetes-related videos in Chinese. The basic information presented in the videos was coded and analyzed. First, we identified the source of each video. Next, 2 independent raters assessed each video in terms of the completeness of six types of content (the definition of the disease, symptoms, risk factors, evaluation, management, and outcomes). Then, the 2 raters independently assessed the quality of information in the videos, using the DISCERN instrument.

Results: In regard to the sources of the videos, we found 6 distinct types of uploaders; these included 3 kinds of individual users (ie, health professionals, general users, and science communicators) and 3 types of organizational users (ie, news agencies, nonprofit organizations, and for-profit organizations). Regarding content, our results show that the videos were primarily about diabetes management and contained limited information on the definition of the disease, symptoms, risk factors, evaluation, and outcomes. The overall quality of the videos was acceptable, on average, although the quality of the information varied, depending on the sources. The videos created by nonprofit organizations had the highest information quality, while the videos contributed by for-profit organizations had the lowest information quality.

Conclusions: Although the overall quality of the information in the diabetes videos on TikTok is acceptable, TikTok might not fully meet the health information needs of patients with diabetes, and they should exercise caution when using TikTok as a source of diabetes-related information.

TikTok as a Health Information Source: Assessment of the Quality of Information in Diabetes-Related Videos [primary paper]

Digital diabetes prevention rolled out as part of NHS Long Term Plan

NHS England | August 2019| Digital diabetes prevention rolled out as part of NHS Long Term Plan

Pilot schemes, offering convenient, 24/7 access to online advice significantly boosted the numbers taking up the flagship Diabetes Prevention Programme (DPP). More than two-thirds of people (68%) referred to the digital schemes participated compared with face-to-face support. 



Those at risk of developing Type 2 but who cannot make face-to-face support sessions will be the first to benefit from the expansion which starts this month.

They will receive:

  • Wearable tech that monitors levels of exercise;
    • Apps which allow users to access health coaches and educational content
  • Online peer support groups;
    • The ability to set and monitor goals electronically

Dr Jennifer Smith Diabetes Programme Director Public Health England, said: “The success of the pilot’s early findings shows we are breaking new ground to help those most at risk of type 2 diabetes to literally take their health into their own hands at their own time and pace. Many of us use on-the-go digital technology every day and this is a fabulous next step in diabetes prevention.” (Source: NHS England)

Full details are available from NHS England

In the news:

Diabetes.co.uk  NHS England to offer wearable tech to help people reduce type 2 diabetes risk

The Guardian Thousands at risk of type 2 diabetes to be offered wearable tech

Breakthrough technology for people with diabetes available in York

Vale of York Clinical Commissioning Group | July 2019| Breakthrough technology for people with diabetes available in York 

NHS Vale of York Clinical Commissioning group has announced that it will be offering FreeStyle Libre– a handheld device which scans over a sensor applied to the skin to measure interstitial glucose levels – as an alternative to routine finger-prick blood glucose testing. This results in a quick and painless glucose reading, a near-continuous record of measurement and an indication of level trends over time. 

Dr Andrew Lee, the CCG’s Executive Director of Primary Care and Population Health said: “The CCG are delighted to be able to offer FreeStyle Libre in the Vale of York. Over 1600 members of our population live with type 1 diabetes and this new technology offers a chance to revolutionise diabetes self-management and give people even more control over their health.

“Being able to monitor glucose readings digitally and access recordings on demand is an example of the brilliant digital resources we have in the NHS.”

Eligible people will be initiated on to FreeStyle Libre through the Diabetes Specialist Team at York Teaching Hospital NHS Foundation Trust. Local GPs will then issue their patients with a prescription for two Freestyle Libre sensors per month until a six month re-assessment (Source: The Vale of York).

Read the full news story from Vale of York CCG 

New online type II diabetes support

The NHS has announced that it will be offering online support for patients with type II diabetes to help them manage their condition, via a first of its kind service | via PharmaTimes online

A new online portal in partnership with Changing Health will offer people with type II diabetes evidence-based information and support, which will be available at the touch of a button, giving them convenient and quick help to deal with the physical and mental challenges of diabetes.


Patients have already made use of the online courses and information to help reduce their blood glucose levels, a crucial part of managing type II diabetes.

The collaboration with Changing Health will see the largest ever roll out of free digital support for people diagnosed with type II diabetes, which currently costs the NHS around £8.8 billion a year.

The company says that the partnership will allow the NHS to offer its patients highly personalised support to make positive lifestyle changes and crucially sustain them over the long term.

Full story at PharmaTimes online

Virtual reality system piloted to help spot diabetes-related emergencies

The NHS England diabetes team has partnered with virtual reality medical training company Oxford Medical Simulation to train doctors in a bid to improve care for patients with diabetes | via Med-Tech Innovation

The training will allow doctors to practice in virtual reality medical emergencies. Dr Partha Kar, NHS England clinical director of diabetes said: “Embracing technology is at the heart of the NHS Long Term Plan and training doctors using virtual reality is another example of modernising the NHS to help improve care for patients with diabetes.”

Combining clinical expertise from the NHS, volunteer patient input and world leading virtual reality software, doctors can now put on virtual reality headsets and practice taking care of patients as often as they want, without risking lives.

The system is being piloted through Health Education England in a multicentre trial in the South of England, with development funded by Novo Nordisk. If supported by evidence from the pilot there are plans for further roll-outs nationwide throughout 2019.

Full detail at Med-Tech Innovation

See also:  NHS pilots virtual reality system to help spot diabetes-related emergencies | Diabetes UK

NHS to provide life changing glucose monitors for Type 1 diabetes patients

NHS England | November 2018 | NHS to provide life changing glucose monitors for Type 1 diabetes patients

Simon Stevens Chief Executive of NHS England  has announced that thousands of people with diabetes will be able to access Freestyle Libre; a wearable sensor that means those with the condition no longer need to rely on inconvenient and sometimes painful finger prick blood tests, as the device works by relaying glucose levels to a smart phone or e-reader.  This announcement marks an end to the current variation  some people in different parts of the country were experiencing. 



The pioneering technology should ultimately help people with Type 1 diabetes achieve better health outcomes and benefits for patients include:

  • Easily noticing when sugar levels are starting to rise or drop, so action can be taken earlier
  • Giving patients more confidence in managing their own condition
  • Not having to do as many finger-prick checks (Source: NHS England)

Read the full announcement from NHS England

In the media:

BBC News Diabetes glucose monitors ‘available to thousands more’


AI app for gestational diabetes adopted by NHS

The NHS has adopted a software system to help manage gestational diabetes. The system from Sensyne Health comprises a smartphone application which connects to a wireless blood glucose monitor. 


Glucose measurements, free-text commentary and requests for a call-back are transmitted directly to a dashboard for the multi-disciplinary team at the hospital in charge. The care team can also communicate directly with the patient via the system. The app has now completed a two-year clinical evaluation and is available for implementation across the NHS.

Full detail at Med Tech Innovation

Text messages improve diabetes self-management and blood sugar control

NIHR | September 2018 | Text messages improve diabetes self-management and blood sugar control

A study from New Zealand underlines how a text message service was well-received by patients with diabetes, the participants who received the text message achieved a small reduction in blood sugar levels. 



The trial randomized 366 patients with  with poorly controlled type 1 or type 2 diabetes (HbA1c 65mmol/mol or more) to receive either text messages in addition to usual care or usual care alone. The texts were individually tailored to motivate participants to engage in behaviours relating to diabetes management.

What are the implications?

Text message support appears to be a safe, well received, and modestly effective adjunct to standard care for patients with poorly controlled diabetes. However, the HbA1c 4.2mmol/mol difference between the groups was small and did not reach the pre-set 5.5mmol/mol clinically meaningful difference by the researchers. Nevertheless, any improvement is likely to help reduce the risk of complications.

There is increasing interest and investment in UK programmes applying mobile technology to the prevention and management of diabetes and other chronic diseases.

Uncertainties remain around the long-term benefits of such interventions, their cost-effectiveness, their use in overcoming health care inequalities, and the optimal content and frequency of their messages.

For further information see the NIHR Signal

Published Abstract

Objective: To determine the effectiveness of a theoretically based and individually tailored, text message based, diabetes self management support intervention (SMS4BG) in adults with poorly controlled diabetes.

Design: Nine month, two arm, parallel randomised controlled trial. SETTING: Primary and secondary healthcare services in New Zealand.

Participants: 366 participants aged 16 years and over with poorly controlled type 1 or type 2 diabetes randomised between June 2015 and November 2016 (n=183 intervention, n=183 control).

Interventions: The intervention group received a tailored package of text messages for up to nine months in addition to usual care. Text messages provided information, support, motivation, and reminders related to diabetes self management and lifestyle behaviours. The control group received usual care. Messages were delivered by a specifically designed automated content management system.

Main outcome measures: Primary outcome measure was change in glycaemic control (HbA1c) from baseline to nine months. Secondary outcomes included change in HbA1c at three and six months, and self efficacy, diabetes self care behaviours, diabetes distress, perceptions and beliefs about diabetes, health related quality of life, perceived support for diabetes management, and intervention engagement and satisfaction at nine months. Regression models adjusted for baseline outcome, health district category, diabetes type, and ethnicity.

Results: The reduction in HbA1c at nine months was significantly greater in the intervention group. Of 21 secondary outcomes, only four showed statistically significant improvements in favour of the intervention group at nine months. Significant improvements were seen for foot care behaviour (adjusted mean difference 0.85, overall diabetes support, health status on the EQ-5D visual analogue scale, and perceptions of illness identity. High levels of satisfaction with SMS4BG were found, with 161 (95%) of 169 participants reporting it to be useful, and 164 (97%) willing to recommend the programme to other people with diabetes.

Conclusion: A tailored, text message based, self management support programme resulted in modest improvements in glycaemic control in adults with poorly controlled diabetes. Although the clinical significance of these results is unclear, the findings support further investigation into the use of SMS4BG and other text message based support for this patient population.

Full reference:

Dobson, R. et al.| 2018| Effectiveness of text message based, diabetes self management support programme (SMS4BG): two arm, parallel randomised controlled trial| BMJ|Vol. 361 | 2018 | doi: 10.3310/signal-000640

Diabetes foot ulcer service digital imaging in the community