Role of m-Health in Diabetes

The prevalence of diabetes is increasing, and people are unaware of many risk factors like stress and sleep. This is the generation of technology. mHealth plays a great role in self-managing diabetes. It incorporates a new dimension of diabetes management – enables greater self-efficacy, and disease understanding, especially among technology-savvy people. 

Reference and good to read: //bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05955-3

The theme of World Diabetes Day 2021-23 for the second year is "Access to Diabetes Education." This reiterates the significance of the impact of education/knowledge about diabetes(1). Diabetes self-management education and support (DSMES) services through telehealth, pharmacy-based, or community health-based services help persons with diabetes achieve their daily and long-term diabetes goals. Of the approaches, Telehealth such as the use of mobile-health-based information holds great promise because: It can reach a larger number of people than traditional in-person programs. M-health technologies are less constrained by geographical and time constraints, making them more accessible to rural and underserved communities(2). This importance is highlighted in an editorial in Lancet which states that Diabetes information is very valuable as it has the potential to save lives. Improving diabetes education would not only help to reduce the growth in diabetes and the related rising health-care expenditures (US$966 billion globally in 2021), but will also help to improve overall health literacy. Thus using m-health technology to enhance awareness of diabetes or in DSMES services can have a huge impact globally. 

References:

1. Worlddiabetesday.org. “World Diabetes Day | Access to Diabetes Care: If Not Now, When?,” 2022. //worlddiabetesday.org/.

2.CDC. “Increasing Access to Diabetes Education.” Centers for Disease Control and Prevention, March 23, 2022. //www.cdc.gov/diabetes/health-equity/increase-diabetes-education.html.

3.The Lancet Diabetes & Endocrinology. “Diabetes Education: The Key to a Brighter Tomorrow.” The Lancet Diabetes & Endocrinology, November 2022. //doi.org/10.1016/s2213-8587(22)00323-0.

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Diabetes is the biggest killer to humankind, but the good part is it can be stopped with the right direction of education and practice. World diabetes day is observed on 14 November to commemorate the birth anniversary of Sir Frederick Banting, He co-discovered insulin in 1922.

mHealth is well-suited to diabetes management. The big tech giants are entering the field of mHealth through wearable device to track health, it seems like one day, there will be a revolutionary shift to managing diabetes. I found one article a good read //link.springer.com/article/10.1007/s00125-019-4864-7  

Our organization is also embarking on the field of mHealth to manage diabetes and had one successful project to manage diabetes //www.researchprotocols.org/2022/3/e13635. Apart from this, we are having PODCAST on Diabetes Management.  //sangyan.libsyn.com/category/Hindi+-+Diabetes  

High blood glucose level and either insufficient or ineffective insulin are symptoms of the metabolic syndrome known as diabetes. Diabetes causes heart attack, organ failure, blindness, and amputation. It is the third largest cause of death in many developed countries. As according to estimates, this illness affected 285 million people globally in 2010—roughly 6.4% of the adult population. In the absence of advances in treatment or control, this number is expected to increase to 430 million. The two main causes of the increase are aging and obesity.
Moreover, it has been proven that around 50% of claimed diabetics do not obtain a diagnosis until 10 years after the start of the disease; as a reason, the true prevalence of diabetes globally must be astronomical.

//www.ijcst.org/Volume8/Issue1/p3_8_1.pdf

The term "mobile health," or "mHealth," refers to the use of mobile computing and communication technologies (such as wearable sensors and mobile phones) to deliver healthcare services and information about one's health.

Approximately 5 billion people use mobile phones worldwide.  mHealth has the ability to save costs while raising the standard of diabetes care. Mobile digital gadgets can promote self-management, facilitate remote patient monitoring, and improve patient-provider communication. Despite the growing popularity of smartphones, simple mobile phone features like voice calls and texting continue to significantly improve the clinical outcomes of diabetes management. Interventions in mHealth seem to have promise for enhancing the management of cardiovascular risk factors, which depends on people choosing healthy lifestyle decisions.

References:

//link.springer.com/article/10.1007/s11883-017-0650-5

//www.liebertpub.com/doi/abs/10.1089/dia.2016.0430?journalCode=dia

One of the earliest uses of mobile health (m-health) was for remote monitoring and self-management of diabetes. This is made worse by more recent developments and the increased global acceptance of m-health for diabetes self-management and care. It is well known that m-health can offer a crucial and significant opportunity for reducing the enormous global healthcare challenges and economic burdens associated with diabetes and its long-term complications. Patients themselves play a central participatory role in their diabetes self-management and care process through their smart mobile phone apps, which will allow better education and awareness of their disease condition. In many countries The adoption of m-health improved and strengthened patients' ability to care for themselves, yet m-health usage is still not widely accepted by the general population. But apps could play a significant part in completing multidimensional diabetes care.  Apps should ideally be regulated, situationally, and more suited to users' needs with clear instructions for patients and clinicians about the options. 

Sources

In 2013, it was predicted that mhealth apps will be next big thing in Healthcare technology. This has come true in 2022, accelerated by Covid -19 in 2020. We have come a long way, initially expected to record patients symptom and blood sugar level data now has features from doctor consultation, monitoring  saturation in oxygen to lab test at home with click of a button. M health applications have truly revolutionaries Healthcare delivery and more so in Non communicable  diseases like Diabetes. In 2013, concerns were predicted regarding m health apps and diabetic patient about privacy, clinician satisfaction level, economic benidit to diabetic patient as thechronic condition requires healthcare assistance throughout life. It still is a debated concept and has its limitation but at the same time features in mhealth app have become more user friendly, apple and other tech giants have made it ever so easy that one can just speak into it instead of even typing data, or self monitoring by just using m health connected smart watches in 2022. That too at affordable rates which is why other companies  have made affordable forms of m health app and devices. In 2022, using mhealth app for self care is categorised into self care monitoring of data among diabetic individuals which consist of feedback, reminders, data entry, easy sharing features in the application. 

The truth is as there is advancement in  m health will evolve, get better with data. M health app has transformed care of diabetic patients tremendously and made diabetic care patient centric and key responsibility  to the diabetic individual.  Whereas in past health would be more of responsibility  of healthcare workers. M health applications role in diabetic individual is associated with more positive regards than negative. But studies need to be conducted on it on larger scale.

Reference: //link.springer.com/article/10.1186/s12902-022-01039-x

//journals.sagepub.com/doi/abs/10.1177/193229681300700321

Diabetes is a lifestyle disease. Therefore, awareness is the key to reverse this condition to a certain extent. Now days, it is not even confined to any particular age group, but even young children are witnessed to have juvenile diabetes, which indeed poses a major concern.

Smart phones, mobile phones...in short technology runs today's worlds. Every second person, yet again irrespective of age has engaged themselves in phones and technology. Therefore, according to me using mobile phones for management of diabetes is a very smart, affordable and convenient method. Using mobile apps for keeping a watch on such a condition will prevent patients from procrastinating with their treatment measures and help them to manage their bodies. Using mobile apps for instance, they can keep a count on their daily calorie intake, number of steps walked, check their heart rate and be vigilant on a daily basis about the fluctuations in their blood sugar level. In addition to this there are many applications which are designed, especially for type 1 diabetes management to check insulin levels and glucose intake and its presence in the blood according to which required action can be taken.

References - 

//www.ncbi.nlm.nih.gov/pmc/articles/PMC7048878/

WHO identifies diabetes as a “chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces.” Early diagnosis and treatment of diabetes along with dietary modifications and physical activity can be effective in diabetes management. However, the advent and growth of mhealth and telehealth technologies have also been reported to increase physical activity, reduce sedentary behaviors, and improve glycemic control.

//www.who.int/news-room/fact-sheets/detail/diabetes

//www.ncbi.nlm.nih.gov/pmc/articles/PMC8486348/

According to the World Health Organization, the global prevalence of diabetes mellitus (DM) is increasing dramatically, and DM accounts for a significant portion of the global disease burden. At the same time, the ongoing digitalization of society today offers novel ways to address this challenge, such as the development of mobile health (mHealth) apps. The purpose of this study is to assess the clinical effectiveness of mHealth apps in diabetes management by analysing health-related outcomes in patients with type 1 diabetes (T1DM), type 2 diabetes (T2DM), and gestational diabetes (GDM).

Reference: 

Eberle C, Löhnert M, Stichling S. Effectiveness of Disease-Specific mHealth Apps in Patients With Diabetes Mellitus: Scoping Review. JMIR Mhealth Uhealth. 2021 Feb 15;9(2):e23477. doi: 10.2196/23477. PMID: 33587045; PMCID: PMC7920757.

 m Health has enabled patients’ to become vastly more knowledgeable, and are even considered “experts” by some. By gaining insight into their own disease self-management, patients are now more capable of bringing this understanding and patient-gathered data (PDG) to consultation discussions with their healthcare providers. Therefore, there is a need for data-sharing systems to be able to transfer, structure, and present this data in a way that facilitates collaborative discussions and shared decision-making in diabetes care. Previous studies in the field of health technology have provided knowledge regarding the need for data integration and patients and healthcare providers (HCP) expectations and their needs from data-sharing technologies. 

Experience-based co-design (EBCD) (hereby referred to as co-design) allows patients, and providers to impose their collaborative insights on the design and development of the tools and services that they are eventually meant to use. Unfortunately, many “patient-centred” research efforts do not always involve patients or other end-users in such design, and/or development.

Reference:

Bradway M, Morris RL, Giordanengo A, Årsand E. How mHealth can facilitate collaboration in diabetes care: qualitative analysis of co-design workshops. BMC health services research. 2020 Dec;20(1):1-20.

Self-management is one of the most crucial factor in ensuring that blood glucose levels are well-controlled, hence preventing diabetes complications. Self-management has the ability to reduce the burden on healthcare system by regular monitoring of the disease and ensuring patient’s autonomy. It has been seen that apps are the feasible tools in the improving self-management of diabetes. App use has shown to result in positive and improved self-management behavior, like improved eating habits, increased and regular physical activity and monitoring BGLs. The study shows that most of the app-users found the apps to improve their diabetes self-management and overall health. Also, the app recommendation by health professionals, and positive interactions with them, increased their satisfaction. However, only a fraction of patients had their practitioners involved in their app use.

Reference:

//dmsjournal.biomedcentral.com/articles/10.1186/s13098-019-0480-4

Diabetes is a complex chronic disease, and with rising diabetes prevalence and costs associated with long-term complications (e.g. cardiovascular disease, strokes, retinopathy, nephropathy, and amputations). Mobile technologies, such as cell phones/smartphones, handheld tablets, and other wireless devices known as mHealth, provide new and exciting opportunities to address some of these challenges by enabling remote patient monitoring and clinical advice delivery via a variety of functions (e.g. text messaging, web browsing, email, and videos). Mobile phones have become ubiquitous, with global usage rates approaching 100% (96% globally, 128% in developed countries, and 89% in developing countries). The popularization of mobile phones, combined with their ever-evolving processing and connectivity power, creates opportunities for new and innovative approaches to support blood glucose and diet monitoring, daily physical activity measurement, education, and other activities that can aid in diabetes self-management and improve patient-provider communication.

Reference

//journals.plos.org/plosone/article?id=10.1371/journal.pone.0173160