12.07

2018
Digital innovation in diabetes care
Written by Dr Niamh O’Reilly

 

It is National Diabetes Week from July 8th – 14th and Diabetes Australia has launched the “It’s About Time” campaign to raise awareness about the importance of early detection and treatment of all types of diabetes (1). There are an estimated 451 million people with diabetes worldwide including 1.7 million Australians, the majority (up to 90%) of whom have type 2 diabetes (2, 3). The prevalence of diabetes worldwide is expected to grow to over 690 million people by 2045 (2).

In Australia, the total annual cost burden of diabetes including healthcare and indirect costs caused by loss of productivity and missed days of work is estimated at $14.6 billion (1). Yet even with substantial healthcare resources dedicated to diabetes care and the availability of effective, affordable monitoring devices and medications, many people still experience serious complications related to poor management of blood glucose. There is a looming population health crisis associated with the increasing type 2 diabetes disease burden.

Here we discuss the potential for digital health interventions to improve the management and treatment of diabetes.

Challenges of diabetes management

Diabetes is a complex chronic condition which affects not only people’s physical health but also their cognitive, psychological, emotional and social well-being. Effective diabetes management requires a combination of input from healthcare professionals and self-management by the individual to monitor and control their blood glucose, take medications and follow a healthy lifestyle. Incorporating strict glucose monitoring and control into their daily lives is challenging for many people.

Poor diabetes management is associated with the risk of developing long-term complications such as damage to the eyes, kidneys, nerves and heart. Measurement of glycated haemoglobin (HbA1c) is the current gold standard test used by doctors to assess glucose levels over a 2-3 month period and predict the risk of developing long-term complications (5). Yet this test does not reflect the potential daily highs and lows in blood glucose experienced by an individual (5). This means people with a normal HbA1c may still experience daily fluctuations in blood glucose which could impact their long-term health (5).

However, the added support offered by digital diabetes management tools for everyday living could be routinely introduced to potentially revolutionise diabetes care in helping people to take control of their glucose levels.

Digital innovation for diabetes care

Indeed, technological advances have powered the re-invention of industries such as banking, music, retail, travel, publishing and transportation to become more efficient and consumer friendly. Digital interventions in the healthcare industry such as the introduction of electronic medical records, telehealth and mobile applications to track health related data are becoming increasingly popular, although mainstream adoption of digital healthcare tools has been slow.

As technology advances, there is increasing potential to use digital solutions to improve diabetes care and enable people to take a more proactive approach to self-management. Importantly, there is growing evidence to support the value of digital interventions such as smart phones, mobile applications, wearable devices and telehealth for diabetes management (6-9). In particular, a variety of digital health solutions are available with applications for health data collection and analysis, prediction of poor diabetes management, delivery of patient education and reinforcement of health choices and successful disease management.

The functions offered by mobile applications include monitoring blood glucose measurements, carbohydrate intake, medications, exercise, sleep and stress levels, the tracking of which is beneficial for the health of people with diabetes. Some apps are designed to send personalised self-management support (e.g. encouragement, education, reminders and recommendations) based on an individual’s tracked health data, while others may enable sharing of this data with health care professionals.

A recent analysis of multiple studies showed that clinically relevant improvements were gained using mobile technologies particularly in patient self-management of type 2 diabetes (7). Another study reported that mobile phone app strategies were associated with significant reduction of HbA1c levels among app users (8).

Diabetes is a chronic condition requiring vigilant monitoring and management of daily blood glucose fluctuations, which can seem to be a relentless task. Digital tools could assist people with diabetes to monitor and make adjustments to their day-to-day behaviour based on improved visibility and understanding of their own healthcare data, which could potentially ease the burden of diabetes self-management.

 

CRC’s expert team has extensive medical affairs experience in diabetes and across many other therapeutic areas. We develop and deliver strategic solutions that are tailored to maximise our clients’ commercial success.

 

References:

  1. Diabetes Australia. National Diabetes Week 2018. Available at: https://bit.ly/2IloTRS
  2. Cho N. H., et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. 2018. Diabetes Research and Clinical Practice. https://www.ncbi.nlm.nih.gov/pubmed/29496507
  3. Diabetes Australia. 2018. Available at: https://www.diabetesaustralia.com.au/about-diabetes
  4. Diabetes Australia2018. Available at: https://www.diabetesaustralia.com.au/diabetes-globally
  5. Diabetes Australia2018. Available at: https://www.diabetesaustralia.com.au/type-2-diabetes
  6. Adolfsson P., et al. Selecting the appropriate continuous glucose monitoring system – a practical approach. 2018. European Endocrinology.
  7. Kitsiou S. et al. Effectiveness of mHealth interventions for patients with diabetes: An overview of systematic reviews. 2017. PLOS One.
  8. Cui M., et al. T2DM Self-Management via Smartphone Applications: A Systematic Review and Meta-Analysis. 2016. PLOS One.
  9. Kaufman N. and Khurana I. Using digital health technology to prevent and treat diabetes. 2016. Diabetes Technology and Therapeutics.