Digital tools progressing diabetes care

The overwhelming scale of the diabetes crisis has compounded healthcare’s perennial struggles to communicate among care partners, engage patients, and leverage digital tools to improve the efficiency and effectiveness of services.

Diabetes is a real and immediate issue for close to half of American adults. Over 11 percent of the population has been diagnosed with diabetes, and a further 38 percent are estimated to have prediabetes that may progress without appropriate treatment and lifestyle changes.

The results for patients are deeply worrisome: new research reveals that over the past 30 years, the prevalence of overall glycemic control among patients has remained nearly unchanged at approximately 30 percent, while racial and ethnic disparities in blood sugar control have only worsened.

Providers clearly need new solutions for diabetes management. Fortunately, better digital tools and strategies are now becoming widely available.

The advent of digital devices like continuous glucose monitors (CGMs), the rise of virtual care, and the development of more advanced analytics and health information exchange capabilities are changing the game for people with diabetes, said Robert Gabbay, MD, chief scientific and medical officer for the American Diabetes Association (ADA).

The healthcare system needs to accelerate its ability to integrate these options with existing chronic disease management strategies.

“The biggest challenge around diabetes management has been the equitable access to technology,” he told Digital Health Insights. “With advancements like the broader availability of CGM, remote monitoring tools, and virtual care, health care providers will be able to individualize treatment plans for their patients, which will hopefully lead to more successful outcomes.”

The promise of digital devices for improved diabetes management

Diabetes is a 24/7 disease that requires constant, close attention from the person with diabetes, their loved ones, and their extended care team. The latest generation of digital devices has been extraordinarily helpful for keeping patients and their providers informed about how to best control blood sugar on an hour-to-hour basis, says Gabbay.

“Having digital tools that reduce the burden of disease and allow reminders to help adherence or answer questions in real time provide real support to patients in managing the disease,” he explained.

“And patients are eager to use them,” he continued. “In a recent survey from Podimetrics, a digital health company focused on preventing diabetic amputations, 95 percent of patients who were recommended health-tracking services or remote monitoring devices usually follow their doctor’s advice. So digital tools and digital health hold great promise in the diabetes community.”

Integrating digital tools with the real-world care environment

Unfortunately, the same survey reveals that the potential of digital health isn’t yet translating into better results for patients. Half of all people with diabetes say managing their condition has a negative impact on their mental health, and 45 percent say they experience financial strain from the disease.

Thirty percent have trouble accessing high-quality care in their area, with numbers rising among racial and ethnic minority groups. And even when patients can access care, it’s primarily reactive.

Only a quarter of patients feel that the healthcare system is focused enough on prevention—a situation that must be solved with more robust, proactive care and greater integration between diabetes specialists, primary care providers, and patients.

“Moving technologies like the continuous glucose monitor (CGM) from the specialist world to primary care, where most people with diabetes get their care, has proved to be a challenge,” acknowledged Gabbay. “The ADA has focused on working with the primary care community to provide the appropriate guidance and skills to implement this technology in their clinics.”

“In this year’s Standards of Care in Diabetes, for example, we have a host of recommendations for action items, including, but not limited to, more aggressive vascular risk reduction (lower blood pressure and LDL cholesterol goals), a stronger focus on weight management, and the importance of addressing the social determinants of health and utilizing the entire care team to help fit diabetes management into people’s lives.”

Primary care providers will also need access to additional training about how to incorporate continuous data streams into digital workflows, interpret the data without overwhelming staff, and communicate with patients when a change needs to be made.

Additionally, practices must be equipped with health information exchange capabilities to better collaborate with specialists, including endocrinologists, podiatrists, nutritionists, social workers, and others who play crucial roles in managing diabetes and overall health.

“A key need is to connect what is being done in the digital health space with what health care providers are doing for those in the diabetes community,” asserted Gabbay. “Our healthcare system needs to get better at integrating digital health into educating patients about self-care and keeping them engaged so we can keep moving forward and achieve better outcomes for people with diabetes.”

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.