Patient self-management key to diabetes

Among the patient population with chronic illnesses, diabetes is the most common catalyst and comorbidity, which makes it one of the most complex and important disorders facing providers. And its growth, gradually rising for decades, continues unabated.

The numbers show that Type 2 diabetes has become a global epidemic, with more than 400 million people currently affected internationally and the total is projected to swell to more than 640 million by 2040. Domestically, the number of people with type 2 diabetes reached an estimated 30.3 million in 2015, or nearly 10% of the population.

Because the patient base is so vast, it is virtually impossible for providers in the acute and post-acute care sectors to furnish the necessary products and services through face-to-face visits. So the healthcare industry is relying more on technology to serve as self-management tools for diabetes patients to control their disease.

“Most people with Type 2 diabetes only see a healthcare professional for a total of a couple hours a year—the rest of the time they rely on self-management, which is particularly critical,” said Michael Kloss, CEO of Ascensia Diabetes Care, an international diabetes specialty company that has U.S. offices in Parsippany, N.J. “As the number of people with diabetes increases, self-management becomes even more important as a way to effectively monitor, treat and support this growing population.”

Diabetes management encompasses various approaches, from prevention to lifestyle interventions to monitoring equipment and treatments. Ultimately, it is up to patients to closely monitor their nutrition, blood glucose testing, medication management and exercise, but through remote communications with their clinical team, patients can maintain healthy sugar levels and keep the disease under control, Kloss said.

“Putting all their treatment goals into action is very challenging and contact with healthcare professionals is limited in terms of hours per year, meaning that most of their disease management is managed alone,” he said. “Effective solutions can be found to support various aspects of diabetes management, but it is important they fit seamlessly into the lives of people with diabetes and make management of their condition easier.”

'Digital' health solutions

Patient self-management fits squarely within the domains of disease state management and telehealth, utilizing digital communications through smart phones, iPads, FitBits and other devices that operate within the wireless network infrastructure. Health technology companies like Plano, Texas-based Vivify Health help facilitate communications between patients and providers.

Robin Hill, RN, chief clinical officer for Vivify, says the first step toward enabling patients to self-manage their disease is to educate them about the condition and the procedures they must follow in order to keep their sugar levels under control.

“The majority of diabetes patients want to take care of themselves, but lack the understanding of it,” Hill said. “Because diabetes is prevalent comorbidity, our program helps patients understand their blood glucose levels, the risk of hypoglycemia and how to take action on ensuring wellness. Instead of clinicians pulling data from patients, the patients are pushing data to clinicians.”

Patients can monitor their conditions using their own mobile or electronic device or can use a Vivify Pathways home kit that includes a tablet that connects wirelessly with glucose meters, blood pressure cuffs, thermometers, pulse oximeters and spirometers.

“This is definitely the new normal and expected for discharge and care of the patient across the post-acute spectrum,” Hill says. “It is no longer standard practice that patients are left on their own.”

Colin Roberts, vice president of product strategy for Omaha, Neb.-based West Corp., was diagnosed with Type 1 diabetes 12 years ago, which gives him a special empathy with patients.

“When you have diabetes, you're not just a patient, you're a nutritionist, mathematician and behavioral psychologist,” he said. “Patients need the right support and education around those factors.”

As a telecommunications company, West focuses on facilitating “enhanced” interaction between providers and patients. By furnishing services like the Interactive Voice Response call center, outbound notifications and refill reminders, West is a conduit and coach for “nudging diabetics to remember what their doctor told them.”

Innovation wanted

Through its Diabetes Challenge, a global competition for innovative digital solutions to support diabetes management, Ascencia is inviting new ideas to tackle the epidemic. The aim is to “unearth undiscovered solutions from diabetes innovators,” Kloss said. Finalists, runners-up and the winner all receive cash prizes to support further development of their ideas.

“This challenge represents the modern approach to finding innovative solutions for people with diabetes, alongside our own R&D,” he said. “This challenge will not solve the diabetes epidemic on its own, but it is a critical step in the development of new diabetes solutions.”