“Coach in your pocket”: Men’s digital self-management of type 2 diabetes

Abstract

Objective

To explore how adult men use digital technologies to support type 2 diabetes self-management and examine the perceived benefits, challenges, and meanings associated with technology use in everyday life.

Methods

A qualitative study was conducted with 41 adult men with type 2 diabetes recruited between September 2025 and May 2026 through Prolific, community-based outreach, social media, and participant referrals. Semi-structured interviews were conducted virtually via Zoom, lasted approximately 25–75 minutes, and were professionally transcribed. Both authors analyzed transcripts using an inductive thematic approach in MAXQDA. Data saturation was observed at approximately interviews 36–38, with the remaining scheduled interviews supporting the adequacy of the dataset.

Results

Six interrelated themes characterized participants’ experiences: real-time monitoring and awareness; technology as a reminder and organizational tool; learning and self-education; communication with healthcare providers; motivation and accountability; and barriers and frustrations with technology use. Across themes, participants described digital tools as helping them act independently on health information, maintain routines, make diabetes visible and actionable, and approach clinical encounters with organized personal data. Cost, usability, and trust in device accuracy remained important constraints.

Conclusions

Digital technologies were embedded in participants’ everyday diabetes self-management and often supported autonomy, practical problem-solving, accountability, and communication. Digital interventions for men with type 2 diabetes may be most useful when they provide actionable feedback, support self-directed management, integrate with clinical care, and minimize cost and usability burdens.

Introduction

Type 2 diabetes (T2D) requires sustained self-management, including glucose monitoring, medication adherence, dietary management, physical activity, and regular interaction with healthcare professionals. Digital health technologies—including continuous glucose monitors (CGMs), mobile health applications, wearable devices, patient portals, telehealth platforms, and online health resources—can extend diabetes self-management beyond the clinical encounter by providing immediate feedback, reminders, education, and mechanisms for sharing patient-generated data with clinicians.^1–6 Digital technologies may be particularly relevant to the everyday work of diabetes self-management because they can make health information continuously available and support self-directed decision-making. Prior qualitative research has shown that people with T2D use digital interventions to build self-care expertise, increase their sense of control, and negotiate illness-related identities.^7,8

At the same time, cost, digital literacy, usability, information quality, and access can shape who benefits from these tools and may reproduce existing inequities in chronic disease management.^9,10 A focus on men is warranted because gender can shape how people interpret illness, seek assistance, use healthcare services, and perform self-management. Research on men’s health has challenged simplistic assumptions that men uniformly avoid care, showing instead that help-seeking and self-management can be reframed as responsible action, problem-solving, and maintaining control.^11,12 Studies of T2D have also identified differences in how some men approach disclosure, glucose monitoring, social support, and engagement with healthcare professionals, while a recent scoping review concluded that men’s specific experiences of managing T2D remain underexamined and called for greater attention to the ways masculinities intersect with diabetes management.^13,14

Digital tools may therefore offer an important context for examining men’s diabetes self-management. Features such as private access to information, immediate personalized feedback, self-monitoring, and asynchronous communication may enable men to manage aspects of their health independently while still connecting with clinicians and other sources of support. However, little is known about how men themselves describe the role of these technologies in everyday T2D management or how they interpret technology in relation to autonomy, accountability, help-seeking, and control. The purpose of this qualitative study was to explore how adult men use digital technologies to support T2D self-management and to examine the perceived benefits and challenges associated with technology use. Rather than assuming that the experiences identified are unique to men, the study centers men’s accounts and considers how their descriptions of digital self-management may inform the design and delivery of digital health resources responsive to men’s needs.

Methods

Study design and setting

This study employed a qualitative descriptive design using semi-structured individual interviews to examine men’s experiences using digital technologies for T2D self-management. A qualitative descriptive approach was selected because it facilitates a comprehensive account of participants’ experiences while remaining close to their everyday language and perspectives. ¹⁵ The study was conducted in southeastern Texas between September 2025 and May 2026. Reporting was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ), a 32-item reporting guideline for qualitative interview and focus group studies. ¹⁶

Participants and recruitment

Participants were recruited using purposive sampling through multiple recruitment channels to obtain a diverse sample of adult men living with type 2 diabetes. Recruitment occurred between September 2025 and May 2026. The primary recruitment source was Prolific, an online research participant recruitment platform, through which 24 participants (58.5%) were recruited. Additional participants were recruited through community and clinic-based outreach (n = 10, 24.4%), social media (n = 5, 12.2%), and participant referral/snowball sampling (n = 2, 4.9%).

Community-based recruitment in southeastern Texas included recruitment flyers, outreach through community organizations and health-related events, and social-network connections of the research team and partnering organizations. Snowball sampling was also employed, whereby enrolled participants could share study information with other men who met the eligibility criteria. Eligibility criteria included being 18 years of age or older, identifying as a man, having type 2 diabetes, and having experience using digital technology for diabetes-related self-management.

Interview guide development

A semi-structured interview guide was developed specifically for this study based on the study purpose and research questions, relevant literature on digital health and T2D self-management, and the research team’s prior work in chronic disease self-management and qualitative health research. Questions explored participants’ daily use of digital technologies, monitoring and interpretation of health information, organization of self-management tasks, health information seeking, communication with healthcare providers, motivation and accountability, barriers and non-use, and preferences for future digital tools. The guide also explicitly asked participants whether they perceived being a man as influencing how they used—or chose not to use—technology for diabetes management, including probes related to independent management, comfort asking for help, and features that might appeal to men. Prior to formal data collection, the guide was pilot tested with four individuals. Several questions and probes were revised following pilot testing to improve clarity and elicit more thorough responses.

Interview procedures

Semi-structured interviews were conducted virtually via Zoom and lasted approximately 25–75 minutes, depending on the depth and elaboration of participants’ responses. Written informed consent was obtained electronically from all participants prior to the initiation of study procedures and before their Zoom interview. With participants’ permission, all interview sessions were audio-recorded and professionally transcribed by QualTranscribe, a professional transcription service, for verbatim transcription. Following transcription, personally identifiable information was removed from the transcripts and pseudonyms were assigned to protect participant confidentiality. Each participant received a $25 Amazon electronic gift card in appreciation of participation.

Sample size and data saturation

Sample size was guided by the qualitative design and the goal of obtaining sufficient depth and variation in men’s experiences with digital technologies for T2D self-management. Sample adequacy was also considered in relation to data saturation, understood as the point at which additional interviews were no longer generating substantively new information relevant to the study aims. ¹⁷ Data collection and preliminary analysis occurred iteratively. By approximately interviews 36–38, the research team observed that subsequent interviews were largely reinforcing previously identified patterns and were no longer generating substantively new information relevant to the study aims.

Data analysis

The interview transcripts were analyzed using MAXQDA (VERBI Software, Berlin, Germany) to facilitate data organization, coding, memoing, and thematic development. Both authors participated in coding and analysis. Analysis followed an inductive thematic approach. ¹⁸ The authors first read transcripts in their entirety to become familiar with participants’ accounts. Initial codes were generated from meaningful segments of data related to participants’ experiences with digital technologies, perceived benefits, challenges, and the role of technology in everyday diabetes management. Codes were iteratively reviewed and compared across transcripts, then organized into broader patterns of shared meaning. The authors met throughout analysis to compare interpretations, discuss coding discrepancies, consider alternative explanations, refine theme definitions, and agree on the final thematic structure. Analytic memos documented coding decisions, researcher reflections, and the evolution of themes. Theme development considered both recurrent patterns and accounts that differed from dominant patterns, with divergent perspectives retained when they provided important context or qualified the interpretation of a theme.

Research team, reflexivity, and trustworthiness

The lead author, a university faculty member with doctoral-level training and extensive experience conducting qualitative health research and qualitative interviews, conducted all participant interviews. Because qualitative data collection and interpretation are shaped by researcher-participant interactions, reflexivity was maintained throughout the study. Both authors discussed how their professional backgrounds, assumptions, and expectations could influence interpretation and used analytic memos and team discussions to document interpretive decisions and consider alternative explanations. Dependability and confirmability were supported through documentation of coding and thematic decisions and maintenance of an analytic audit trail. Both authors participated in theme review and refinement.

Member checking was not conducted and participants therefore did not review transcripts or comment on the final thematic interpretations. This study was reviewed and approved by the Texas A&M University Institutional Review Board (IRB Protocol #IRB2026-1327). Participation was voluntary, and participants could decline to answer any question or discontinue participation at any time. Interview recordings and transcripts were handled in accordance with approved confidentiality and data-security procedures, and personally identifiable information was removed from transcripts and replaced with pseudonyms.

Results

Participant characteristics

Forty-one men with T2D participated. Participants had a mean age of 60.0 years (SD = 6.0; range 48–72 years) and represented multiple racial and ethnic groups. Participants reported using a range of digital technologies to support diabetes self-management, including CGMs, smartphone health applications, wearable activity trackers, patient portals, telehealth platforms, and AI-enabled health tools. Because participants could use more than one technology, technology categories were not mutually exclusive (Table 1).

Table 1.

Participant characteristics (N = 41).

Characteristic	n (%) or M ± SD
Age (years)	60.0 ± 6.0 (48–72)
Race/Ethnicity
Black/African American	9 (22.0)
Hispanic/Latino	8 (19.5)
White	8 (19.5)
Asian	6 (14.6)
Biracial/Multiracial	6 (14.6)
Pacific Islander	4 (9.8)
Recruitment Source
Prolific	24 (58.5)
Community outreach	10 (24.4)
Social media	5 (12.2)
Referral/snowball sampling	2 (4.9)
Technology Used
Continuous glucose monitor (CGM)	31 (75.6
Smartphone health applications	26 (63.4)
Wearable activity trackers	18 (43.9)
Patient portals	14 (34.1)
Telehealth platforms	13 (31.7)
AI-enabled health tools	9 (22.0)

Participants could report more than one type of technology; therefore, percentages do not sum 100%.

Overview of themes

Six interrelated themes were identified: (1) real-time monitoring and awareness, (2) technology as a reminder and organizational tool, (3) learning and self-education, (4) communication with healthcare providers, (5) motivation and accountability, and (6) barriers and frustrations with technology use. Across these themes, a broader interpretive pattern was evident: technology often allowed participants to convert diabetes management into concrete, visible, and actionable tasks that could be handled with greater independence and control. In addition to these six themes, participants were explicitly asked to reflect on whether being a man influenced their technology use. Their responses revealed varied perspectives regarding independence, help-seeking, control, and the relevance of gender to digital self-management.

Real-time monitoring and awareness

Participants described CGMs and mobile tracking tools as reducing uncertainty by making glucose patterns immediately visible. Rather than waiting for symptoms or a clinical appointment, participants could interpret changes and respond in the moment. One participant explained, “The continuous monitor lets me know what’s going on without guessing. Before technology, I was just hoping I was doing okay.” Another said, “Seeing my numbers on my phone makes it real. I can’t ignore it when it pops up on the screen.” A third described the practical consequence of this feedback: “If I see that number high, I know right then I need to walk or drink water. It keeps me honest.” The significance of monitoring extended beyond access to numerical data. Participants described real-time feedback as increasing their ability to act independently and make immediate decisions about diet, physical activity, and other self-management behaviors. In this sense, digital monitoring shifted diabetes from an intermittently assessed condition to one that could be actively managed throughout the day.

Technology as a reminder and organizational tool

Participants used smartphone alerts, applications, and digital logs to create structure around medication, glucose checks, meals, and other self-management tasks. “The reminders on my phone help me take my medication. Without that, I might miss a dose if I get busy,” one participant explained. Another stated, “I log my meals and numbers in the app. It keeps everything organized in one place.” A participant summarized, “Technology keeps me on a schedule. My phone tells me when to check, when to eat, when to take insulin.”

These accounts suggest that participants did not view technology only as a source of health information; they also used it to externalize the cognitive work of diabetes management. Reminders and centralized records reduced reliance on memory and helped participants incorporate self-management into everyday routines.

Learning and self-education

Participants frequently used websites, search engines, applications, and other online resources to interpret glucose changes and learn about food, activity, and diabetes management. One participant said, “I Google everything. If my numbers change, I look up what could be causing it.” Another explained, “The apps explain what high or low readings mean. It helps me understand my body better.” As one participant stated, “Technology gave me information my doctor didn’t always have time to explain.” Self-directed information seeking gave participants a way to investigate questions when they arose rather than waiting for an appointment. This autonomy was valued, while participants’ accounts also underscored the importance of trustworthy and understandable information.

Communication with healthcare providers

Digital technologies changed how participants prepared for and communicated during clinical encounters. “I can send my numbers straight to my doctor through the portal. That makes visits easier,” one participant explained. Another said, “Instead of trying to remember everything, I just show them my phone.” A third noted, “My provider looks at my app data and tells me what to adjust.” These accounts complicate a simple distinction between independent self-management and professional support. Participants often used technology to manage diabetes on their own between visits while simultaneously creating a more organized connection to clinicians.

Motivation and accountability

Participants described visual feedback, progress tracking, and alerts as mechanisms that reinforced responsibility for daily self-management. “When I see my progress on the app, it motivates me to keep going,” one participant said. Another stated, “The numbers don’t lie. Technology shows me if I’m doing right or wrong.” The phrase that became the title of this study captured this relationship particularly well: “It’s like having a coach in your pocket.”

The metaphor of a “coach” illustrates how technology could provide persistent guidance and accountability while remaining under the participant’s control. This combination of autonomy and accountability may be relevant when considering practical, action-oriented approaches to men’s health management; however, the study did not compare men with women and cannot establish a gender difference.

Barriers and frustrations with technology use

Participants’ enthusiasm for digital tools was tempered by concerns about affordability, complexity, and accuracy. One participant said, “Sometimes the technology is overwhelming. Too many apps and devices.” Another emphasized cost: “Not everybody can afford the newest monitor or sensors.” Trust could also be disrupted by technical problems, “If the device messes up, I don’t trust the readings.” These barriers demonstrate that digital self-management is constrained by resources and technology design. The benefits described by this digitally engaged sample should therefore not be generalized to men with limited access to digital technologies.

Gender, masculinity, and digital self-management

Participants expressed differing perspectives on whether being a man influenced their use of digital technologies for T2D self-management. For some, technology aligned with a preference for independence and self-reliance. These participants described digital tools as allowing them to monitor and respond to their diabetes without depending as heavily on family members or immediately seeking assistance from healthcare professionals. One participant explained, “I think being a man probably does affect it. I’m the type that wants to handle things myself. I don’t want my wife reminding me to check my sugar or asking me what I ate. If I can look at my phone and see where I’m at, I can take care of it myself.” Another similarly emphasized the control afforded by technology, “The biggest thing is control. Diabetes already makes you feel like there are things you can’t control. Being able to pull out my phone and see my information makes me feel like I’m doing something about it.”

Several participants also connected technology use with reluctance to seek help. Digital resources offered a private means of obtaining information or addressing concerns before involving others. As one participant explained, “I probably don’t ask for help as much as I should. I was raised where you figure things out yourself. So if there’s something on my phone that helps me track my diabetes or gives me information, I’ll probably try that first before I call somebody.” Another participant reflected on the influence of masculine expectations: “I think men are taught not to complain about things. You’re supposed to just deal with it. That can be a problem with diabetes because sometimes you need help. Technology makes it a little easier because you can get information without feeling like you’re bothering somebody.”

These accounts suggest that technology could provide a bridge between self-reliance and help-seeking by allowing participants to initially engage with health concerns privately while preserving the option of seeking professional assistance when needed.

Participants also identified characteristics they believed could make digital technologies more appealing to men, particularly simplicity, direct feedback, measurable progress, goals, and challenges. One participant stated, “If you want men to use it, make it simple. Show me my number, tell me if it’s good or bad, and tell me what I need to do. I don’t need a bunch of extra stuff.” Another compared progress monitoring to competition: “I like seeing progress. If I can see that my numbers are getting better or I’ve been doing what I’m supposed to do for the last two weeks, that motivates me. It’s almost like keeping score.” For these participants, the appeal of technology was tied to its capacity to translate diabetes management into concrete information and actionable tasks.

Other participants, however, explicitly rejected a gendered interpretation of their technology use. These men viewed digital technology primarily as a practical resource for managing diabetes rather than as something they used differently because they were men. One participant stated, “I don’t look at it as a man thing. It’s a diabetes thing. You have this disease and you have to manage it. Whether you’re male or female, you still have to check your numbers and watch what you eat.” Another emphasized individual rather than gender differences: “I think it depends more on the person than whether they’re a man. Some people like technology and some people don’t. Age probably has more to do with it for me than being male.”

Taken together, these accounts demonstrate that gender was salient to some participants but not others. Some men understood technology as supporting independence, privacy, control, and a practical approach to diabetes management, whereas others viewed technology use as unrelated to gender. This variation cautions against treating men as a homogeneous group and suggests that the relationship between gender and digital self-management is contingent on individual experiences and beliefs.

Analytic progression

Table 2 illustrates how selected descriptive codes were organized into broader thematic meanings. The examples demonstrate the analytic progression rather than reproduce the full codebook. Table 2. Illustrative progression from descriptive codes to themes and analytic interpretations.

Table 2.

Illustrative progression from descriptive codes to themes and analytic interpretation.

Illustrative descriptive codes	Theme	Analytic interpretation
Checking glucose; seeing trends; immediate response	Real-Time Monitoring and Awareness	Making diabetes visible and actionable in real time
Medication alerts; logging meals; schedules	Technology as a Reminder and Organizational Tool	Externalizing routine management and supporting independent organization
Searching readings; app explanations	Learning and Self-Education	Building self-management knowledge outside clinical encounters
Sharing readings; showing phone; portal messages	Communication With Healthcare Providers	Linking self-directed management with data-centered clinical help-seeking
Progress displays; alerts; “coach in your pocket”	Motivation and Accountability	Combining autonomy with continuous feedback and accountability
Cost; too many devices; technical failures	Barriers and Frustrations With Technology Use	Limits on sustained digital engagement and transferability

Discussion

This study explored how men with T2D incorporated digital technologies into everyday self-management. The six themes describe familiar functions of digital health—monitoring, organization, education, communication, motivation, and barriers—but the men’s accounts also reveal a cross-cutting pattern that helps clarify the contribution of the study. Digital tools frequently transformed diabetes management into concrete, visible, and actionable work that participants could undertake on their own while retaining access to professional support when needed. Technology was therefore experienced not simply as a collection of devices, but as an infrastructure for autonomy, practical problem-solving, accountability, and data-informed interaction with healthcare professionals.

The prominence of real-time feedback is consistent with research showing that digital diabetes tools can support self-monitoring and behavioral adjustment.^1–6 The present findings add qualitative detail by showing how participants interpreted that feedback as reducing uncertainty and increasing their sense of control. Prior qualitative work has similarly found that digital interventions can help people with T2D understand and control their bodies and develop self-care expertise.^7,8 Our findings should therefore not be presented as establishing a new functional benefit of CGMs or applications. Rather, their contribution lies in showing how a diverse group of men described integrating those functions into the practical and identity-related work of managing diabetes.

The findings also provide a basis for considering men’s health without assuming that all men share a single approach to illness. Scholarship on masculinity and help-seeking has emphasized that men may frame health action in ways that preserve competence, responsibility, and control rather than simply rejecting care.^11,12 In this study, participants’ descriptions of immediate feedback, self-directed information seeking, reminders, and organized personal data were compatible with an action-oriented form of self-management. At the same time, technology did not replace healthcare professionals. Participants used portals and device-generated data to facilitate clinical conversations, suggesting that autonomy and help-seeking were not opposites.

This interpretation is consistent with literature showing that men’s experiences of T2D are shaped by disclosure, self-monitoring, use of resources, and social context.^13,14

Participants’ direct reflections on gender provide additional context for interpreting the broader themes. Some men associated digital technology with independence, self-reliance, privacy, control, and practical problem-solving, while others explicitly rejected the idea that their technology use was shaped by being a man. These divergent accounts are important because they resist a singular characterization of men’s digital self-management. Although some participants’ accounts resonate with scholarship describing self-reliance and reluctance to seek assistance as dimensions of masculine health practices, other participants regarded technology use as a matter of convenience, individual preference, or diabetes management rather than gender. Because the study did not include a gender comparison group, these findings should be understood as men’s interpretations of gender within their own self-management experiences rather than evidence that these patterns are unique to men. Because the study included men only, it cannot establish whether the identified patterns differ from those experienced by women or other gender groups.

Future comparative research should directly examine whether and how these patterns vary by gender, age, race and ethnicity, socioeconomic position, digital literacy, and duration of diabetes. Participants also described important limits to digital self-management. Cost, device complexity, and concerns about accuracy could undermine sustained use. These findings align with evidence that digital inclusion and access are social determinants of health.^9,10 This concern is especially important for interpreting the present sample: eligibility required experience using digital technology, meaning men with little or no digital access were unlikely to be represented. From an intervention-design perspective, the findings suggest that digital resources for men with T2D should prioritize actionable feedback, simple organization of self-management tasks, trustworthy educational information, and seamless mechanisms for sharing patient-generated data with healthcare professionals. Features that support privacy and self-directed use may be valuable, but they should not isolate users from clinical or social support.

Strengths and limitations

A strength of this study is the use of in-depth semi-structured interviews with 41 men from multiple racial and ethnic backgrounds, combined with a pilot-tested interview guide that explicitly examined digital self-management and participants’ perceptions of whether being a man influenced technology use. Interviews ranged from 25 to 75 minutes, and both authors participated in coding and thematic development. Several limitations should be considered. First, the study relied on participants’ self-reported T2D status and technology experiences rather than verification through medical records or device data. Second, eligibility required prior use of digital technology for diabetes self-management, likely underrepresenting men with limited digital access, low digital literacy, technology aversion, or financial barriers. Third, participants were recruited in southeastern Texas through purposive, community-based, and snowball approaches; findings may not transfer to men in other geographic, healthcare, or sociocultural contexts. Fourth, the study included men only and cannot determine whether the identified patterns differ from those of women or other gender groups. Fifth, member checking was not conducted. Finally, qualitative interpretation is shaped by researcher perspectives despite reflexive discussions, analytic memoing, collaborative coding, and an audit trail.

Implications for future research

Future studies should examine digital self-management among men who have limited access to or experience with health technologies, including those with lower digital literacy or financial constraints. Comparative qualitative research could examine how autonomy, privacy, accountability, and technology-mediated help-seeking vary across gender and other social positions.

Intervention research should evaluate whether digital diabetes tools designed around actionable feedback, self-directed problem-solving, and clinician connectivity improve sustained engagement among men with T2D. Longitudinal studies are needed to determine how engagement changes over time and whether these approaches influence glycemic outcomes, self-efficacy, healthcare engagement, and quality of life.

Conclusion

Digital technologies were embedded in how participants organized, monitored, learned about, and responded to T2D in everyday life. Beyond their functional benefits, these tools often enabled participants to translate health information into immediate action, maintain a sense of autonomy, and approach healthcare encounters with organized personal data. Digital interventions for men with T2D may be strengthened by emphasizing actionable feedback, practical self-management support, trustworthy information, and integration with clinical care while minimizing cost and usability barriers.

ORCID iD

Ledric D. Sherman https://orcid.org/0000-0003-0858-9967

Data Availability Statement

De-identified interview transcripts are not publicly available because they contain detailed qualitative accounts that may present a risk of deductive disclosure. Data supporting the reported findings are presented in the article through thematic summaries and illustrative quotations. Additional de-identified materials may be considered upon reasonable request and subject to institutional and ethical requirements.*