A new paper suggests that the diabetes community in India has immensely benefitted from various “innovative and evolving technologies” considering that “diabetes burden” has increased worldwide with India having the second-largest numbers in the world after China with 77 million people with diabetes, as per Indian Council of Medical Research—India Diabetes (ICMR—INDIAB) study.
In addition, the October 2021 paper Digital Health and Diabetes: Where are we now? published in the Therapeutic Advances in Endocrinology and Metabolism journal notes that the data gathered using digital technologies helps to improve the quality of healthcare by facilitating better therapeutic decisions and eventually addressing the rising burden of diabetes considering India also has a high prevalence of prediabetes and undiagnosed diabetes.
What is digital health?
Digital health comprises technologies, platforms, and systems to encourage lifestyle, wellness, and provide treatment of chronic diseases such as diabetes, said Dr Pritam Moon, consultant physician, Wockhardt Hospital Mira Road.
“The use of digital technology has been effective in the prevention and treatment of diabetes. Telemedicine has immensely supported the healthcare providers in the country for diabetes management during these unprecedented times. Digital solutions have supported patients with diabetes to improve their outcomes and avail high-quality and cost-effective care,” Dr Moon said.
What exactly is this technology?
Paper authors Dr Jothydev Kesavadev, Gopika Krishnan and Viswanathan Mohan — mention how the diabetes community has been adopting various technologies such as connected glucose meters, continuous glucose monitoring systems, continuous subcutaneous insulin infusion, closed-loop systems, digitalisation of health data, and diabetes-related apps for the prevention and management of the condition.
“With rapid surge in diabetes and it’s costly complications the only solution is harnessing the benefits of cost-effective technologies. Patients need continued education, counselling and coaching. There are a few mobile health technologies which are really good in delivering these services. Currently costly technologies are used for treating complications of diabetes in hospitals. Instead, patients can be trained and empowered to use simple technologies for monitoring glucose, blood pressure, titrating dosages of insulin, communicating with doctors via telemedicine, etc., which could save money and also lives,” Dr Kesavadev, diabetologist and MD of Jothydev’s Diabetes Research Centres told indianexpress.com.
How is it a significant step for diabetes care?
Luke Coutinho, Holistic Lifestyle Coach – Integrative and Lifestyle Medicine and Founder of YouCare – All about YOU by Luke Coutinho believes “the integration of technology in diabetes management” is an excellent step towards changing the face of this epidemic in our country and the world.
“One thing that we are constantly being reminded of through our day-to-day practice is the fact that each of us are bio individuals, in not just genes, but also the way our body responds to a particular food or ingredient. This is where technologies like CGMS (continuous glucose monitoring system) can help us personalise and tailor our approach towards a particular individual,” he explained giving an example of how ragi (finger millet), touted to be a superfood for diabetes, may “create havoc with blood sugar levels for so many individuals” suggesting that “no two individuals’ blood sugar levels can behave the same way in response to a particular food item”.
“Imagine using this data to personalise someone’s nutrition and lifestyle plan. It’s so much better than just creating a plan based on what we already know about foods that support or disturb blood sugar levels. In fact, you don’t have to be diabetic to use this. It is an excellent way for otherwise healthy individuals to get a complete and holistic understanding of their bodies,” Coutinho told indianexpress.com.
Indeed, the COVID pandemic era has witnessed the wide acceptance of telehealth, electronic, and mobile health platforms for diabetes care, notes the paper.
What do these smart diabetes management wearables do?
Some wearable are:
Sensor-based tracking – Glucose levels can be measured every minute in interstitial fluid through a small (5.5mm long) filament that is inserted just under the skin and held in place with a small adhesive pad. A quick scan of the sensor with a reader provides a real-time glucose reading and a detailed picture of a person’s glucose levels.
No finger-pricks required – The devices are designed to free people from the pain and hassles of finger sticks.
Continuous glucose monitoring helps identify weekly, daily or even hourly glucose patterns. Experts also note how continuous glucose monitoring helps users respond immediately to hyperglycemia (high glucose levels) or hypoglycemia (low glucose levels), and how the device alarms for high and low glucose levels even whilst sleeping.
“Another is gene testing, where a detailed report on what kind of nutrition, exercise, foods, will suit a particular individual. It can also find out our genetic predisposition to a specific condition, and in this case, diabetes,” said Coutinho.
As per Dr Kesavadev, point-of-care or wearable monitoring solutions go well beyond convenience as they enable both the doctor and patient to link undesirable highs and lows to specific actions and habits. “With the current pandemic, the use of modern technology to continuously monitor glucose has proven to be very useful. With wearable devices slowly enabling for precision medicine and remote monitoring, they will cut through the prevailing challenges and will continue to benefit numerous groups of people as we look at the next 10+ years and beyond,” he said.
Is such technology accessible to everyone?
The paper noted that digitalisation of diabetes care in India has to overcome the several obstacles including inadequate access, low insurance penetration, and an increasing disease burden. Many domestic initiatives have helped in decreasing the prices of diabetes care products. Parallelly, changes in policy by regulators and supporting technological interventions is the need of the hour.
Despite the emphasis on management of diabetes, there is an urgent need felt to make people aware of lifestyle changes that can help prevent chronic conditions like diabetes.
“I feel there is a lot of time, energy, and money being invested in a cure where we get better at diagnosing and monitoring the disease and not much in prevention and management. If we genuinely want to overcome the diabetes epidemic, we need to stall it right from the start. We need to invest in educating individuals about preventing diabetes and introducing lifestyle and the immense impact it can create not just in avoiding diabetes but also in managing it effectively,” said Coutinho adding that an “improved lifestyle comes an enhanced response to the drugs, lesser side effects, and better outcomes”.