Jason Collier - 2nd Sept 2018 - Mobile Health
Diabetes is a becoming a rising epidemic in the world today. The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014 according to WHO. The global prevalence of diabetes among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014! This is largely due to the fact that the diabetes prevalence has been rising rapidly in low- and middle-income countries. This provides an opportunity for mHealth to be used as a tool to address the diabetes healthcare issues.
Diabetes is a chronic, non-communicable condition which affects the way the body processes glucose, a type of sugar, which is broken down from food or drink and transported in the blood stream to the necessary cells in the human body. The pancreas releases insulin into the blood stream on demand to regulate the amount of glucose in the blood. The majority of diabetes cases fall under three categories: Type 1 Diabetes (T1D), Type 2 Diabetes (T2D) and Gestational Diabetes (GD).
Known as the "silent killer", diabetes was the direct cause of 1.6 million deaths in 2015. It is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation in cases where diabetes is not properly managed. However, diabetes can be managed via a healthy diet, regular physical activity, medication and regular monitoring of glucose levels . It is in the management of diabetes where mHealth can play a roll.
Source: Medical News Today
The major problem with diabetes is the ongoing self-management which is required. Diabetics are required to monitor their blood glucose levels numerous times daily, visit their doctor for a check-up and to renew medication every few weeks, make lifestyle changes and regularly take their medication. Diabetic patients need to be knowledgeable about their disease in order to understand and implement the needs of medical care, because self-management is crucial if the patient wants to avoid diabetes complications.
Source: Doc Nitin Agrawal
Most diabetics test and record their blood glucose levels at least once a day. However, depending on the type of diabetes and the severity of the condition, some are encouraged to record their glucose levels up to four times daily. Many of the modern handheld glucose meters have Bluetooth functionality to automatically transfer data to a mobile application (app), like the Accu-Chek Guide meter for example. This makes it easier to record glucose levels and therefore promotes extra recordings. Some patients with T1D record their glucose levels using a continuous glucose meter (CGM) like the Dexcom G6® CGM!
This frequent testing means that there is a lot of data to remember – too much for a human brain. Diabetic patients have historically recorded glucose readings in a diabetes logbook which they can show to their primary care provider to analyse trends and progress. In these modern times, apps are being used to record the data and display them in trend graphs which can be easily analysed by both the patient and the healthcare professional. These apps can also be used to remind the patient to regularly record blood glucose levels too!
If you’re wanting to use an app to manage your condition, check out this list of the 5 best diabetes monitoring apps.
Healthcare professionals will usually require patients to return for check-ups and for renewal of medication every few weeks at first (as often as once every 2 weeks in some cases). Once the condition is under control, healthcare professionals will extend the prescription to about 6 months so that the patient can be checked biannually.
The frequent doctor visits can put a financial and time strain on many diabetic patients, especially in the weeks following the diagnoses or when diabetes complications are occurring. The financial strain resulting from transport costs is especially apparent in rural communities of low- and middle-income countries. MHealth can be used in the form of a mobile application to allow healthcare professionals to remotely monitor their patients. This will reduce the number of doctor visits required, minimising transport costs. It also allows healthcare professionals to keep a close eye on their patients!
Source: Yellow Pages
Patients with T2D will be encouraged to manage their disease with a healthy diet, regular exercise and frequent blood glucose monitoring. However, this is often not enough, certainly for those with T1D. This is when oral medication or insulin medication becomes important. Apps supply users with timeous reminders to take medication and the dosage required. This will help increase the medication adherence rate!
Source: Health Goes Up
The words of Elliot Joslin hold true: “The person with diabetes who knows the most lives the longest”.
Diabetic patients must be educated about the art of self-care. At the end of the day, it is the patient’s responsibility to manage his or her disease. Education is important when it comes to administering medication, understanding the lifestyle changes that need to be made, understanding the diet to follow and understanding trends in blood glucose levels. Apps can help make this knowledge easily accessible to users.
Source: Joslin Diabetes Centre
Given the increased availability of smartphones worldwide, the ongoing management required for diabetes gives rise to the need for the use of mHealth to aid the process. The benefits of using smartphones are that they are easily accessible, require minimal infrastructure and can therefore be used as a cost-effective solution. Many people are already familiar with smartphones and their apps, so it will be easy for them to use them to improve their health!
However, mHealth is not all good. Disadvantages associated with mHealth include:
The various app stores are flooded with diabetes related apps in response to the growing epidemic. The best diabetes self-management apps have many of the following features:
Two of the most import features offered by the apps is the ability for the user to easily record their blood glucose levels and the ability for their healthcare professional to remotely monitor the patient’s progress. The doctor can then timeously alert the patient if problems are occurring, preventing possible diabetes complications.
In conclusion, as an engineer in the medical industry, I believe that a diabetes self-management and remote-monitoring mobile platform should be used to aid diabetics. It should offer diabetes self-care education, it should track important indicators (glucose levels, medication, exercise and diet) and it should be used by healthcare professionals to remotely monitor their patients. This will help motivate diabetic patients to take regular readings, to adhere to treatment plans and to make the necessary lifestyle changes. The mHealth platform has secondary benefits in that it will reduce the frequency of hospital visits and alleviate the financial burden which results from transportation costs!
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