How m-Health application on nutrition informatics can be useful for diabetic care at home?

Mobile technology has been increasing day to day so by implementing these apps it very helpful for the person who is diabetic will come to know what all care and the precautions to be taken for preventing and ones control over diabetes. But there are many people who doesn't know how to use all these apps. The apps should be designed in a such a that they can be used by a person who is unaware of their control and keep tracking their blood glucose levels and insulin dosage. So these health applications will be very helpful for self care and self management of their health and to prevent further complications. It should have some tips for one's control and dietary modifications.

As per DG Health System "In India, the National Programme for Prevention and Control of Cancer, Diabetes,Cardiovascular diseases and Stroke (NPCDCS) was launched in 2010. The objectives of this programme include preventing and controlling NCDs through behavior and lifestyle changes; providing early diagnosis and management of common NCDs; building capacity at various levels of health care and training of human resources, etc

Diet has as an important role in diabetes. High consumption of brightly coloured fruits and vegetables such as oranges and tomatoes, whole grains and cereals and beans (phytochemicals) decreases risk of diabetes. Asian Indians have increased genetic risk for diabetes. This risk is worsened by dietary factors such as high calories, fat and sugar intake, low consumption of fibre rich food. Diseases which are associated with obesity and overweight: type 2 diabetes; gall bladder diseases; hypertension; dyslipidemia; cancer (breast, endometrial, colon and others); reproductive abnormalities/impaired fertility; fatty liver; sleep apnea; breathlessness; respiratory disease; hernia; social isolation and depression; day –
time sleepiness and fatigue, osteoarthritis; psychological problems.

//www.vstech.com/healthcare-initiatives/food-nutrition-informatics/

Choosing the right technology that can be easily adopted should be the first outlook while developing such a platform. The introduction of DM informatics in the Indian healthcare system in medicine should be in-line with the following characteristics within the application;

1. Should have relatively good advantages over the existing system which which usually take time but its a good practice. Streamline the workflow thereby saving time and efforts

2. Should be compatible and user friendly to medical professionals as well as the patients

3. Should have a satisfactory degree of peer review from proof of concept to its validation

4. Evaluation of app using plan do study act (PDSA) will help tocustomise the platform considering the demographic factors of clients living in various geographical location.

In my opinion m-health application is an amazing idea put forward on nutrition informatics which would help people in maintaining normoglycemia. As we all know diabetes is a  progressive disease which can further lead to chronic complications if untreated or left uncontrolled. Undoubtedly diet and physical activity plays a major role in preventing as well as controlling diabetes. This app would be more helpful if it includes distinct features unlike other available apps, such as;

#Provide carbohydrate counting in each meal according to the insulin dosage prescribed to the patient along with personalized diet plans.

#Provide everyday motivation goals, tips ,quotes etc. as diabetics may demotivate very often or lose interest to follow the regimen so this would provide great impact on them.

#Provide tailor-made exercises and yoga routine for specified time with one-one training , healthy recipes, practicing portion sizes and portion control would help in controlling glucose levels.

# Water reminders, treatment of hypoglycemia tips , weight management regimen, self motivation points should be featured exclusively which would be an helping hand for diabetics.

#The app should be easily accessible by any one regardless of literacy with many local languages and voice notes would really help.

Because it is difficult for any health care practitioner in monitoring a patient one to one -24/7, so developing this apps is a need for this generations as smart phones act as a boon for all of us.

Chronic diseases, especially diabetes mellitus, are huge public health burden. Therefore, new health care models for sharing the responsibility for care among health care providers and patients themselves are needed. Self care management for diabetes is very important in order to stay healthy. The concept of empowerment promotes patient’s active involvement and control over their own health. It can be achieved through education, self-management, and informed decision making.
Introduction of new methods should be done with the understanding that more than 95% of diabetes care is done by the patients themselves . This is just one of several reasons why diabetes patients are excellent candidates for managing their disease with the help of mobile health technologies (mHealth).Furthermore, there are numerous smartphone applications, working with manual data input or data from previously mentioned devices, that assist users in managing their health or diabetes in. particular.
One of the key challenges in diabetes management is a lack of adherence to medication regime and lack of lifestyle changes. So proper Education, Exercise, Diet and meditation is important for Diabetes management.

//www.intechopen.com/books/mobile-health-technologies-theories-and-applications/empowering-diabetes-patient-with-mobile-health-technologies

Diabetes mellitus is a significant cause of disability and death around the world. Low- and middle-income countries (LMICs) are particularly challenged by diabetes, with juvenile onset, escalating prevalence rates, fewer patients achieving control of their condition,  coupled with  shortage of healthcare systems. Mobile health (mHealth) technologies have been proposed as cost-effective, widely accessible strategies for overcoming many of the barriers to effective diabetes management. mHealth interventions enable the real-time exchange of information between patients and healthcare providers, allowing for responsive and timely treatment recommendations, which has the potential to increase the capacity of patients in self-managing their conditions. Previous reviews of mHealth interventions for diabetes care have found positive effects on key diabetes outcomes. However, to date, all reviews have largely reported on studies conducted in high-income countries (HICs). The effectiveness of these interventions in LMICs is less clear.

The review paper //jhmhp.amegroups.com/article/view/4403/5182   provides an assessment of the published evidence for the effectiveness of mHealth interventions on key diabetes outcomes in LMICs. The review found promising but limited evidence for the effectiveness of mHealth interventions for improving glycaemic control in LMICs. It is timely that researchers examine the effectiveness of various mHealth interventions for diabetes care using rigorous study designs, scalable interventions, measuring both clinical and behavioural diabetes-related outcomes in LMICs.

Mobile phones may serve as a unique means of administering health interventions to populations. Digital health interventions (DHI) have enormous potential as scalable tools to improve health and healthcare delivery by improving effectiveness, efficiency, accessibility, safety, and personalization.

m- Health is a component of eHealth. The Global Observatory for eHealth (GOe) defined mHealth or mobile health as medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices. Mobile technologies present an opportunity to circumvent this challenge by connecting patients, community health workers, and physicians in urban and rural areas to improve the quality of care at the point of care and reduce unnecessary referrals. mHealth involves the use and capitalization on a mobile phone’s core utility of voice and short messaging service (SMS) as well as more complex functionalities and applications including general packet radio service (GPRS), third and fourth generation mobile telecommunications (3G and 4G systems), global positioning system (GPS), and Bluetooth technology. //www.who.int/goe/publications/goe_mhealth_web.pdf. The current pandemic has created a need for an e-health era that is compiling humans to have a shift towards e-health. //journals.sagepub.com/doi/abs/10.1177/1359105303008001426

Diabetes is a lifestyle disorder. A sedentary lifestyle lead by human beings sometimes is a major contribution to the increasing cases of diabetes.  And m- health apps should include short team goals as a minor module in it so as to achieve them easily by the patient which gives them a psychological satisfaction when they are achieved as they are set by the patient himself in terms of his own decisions like which are the major components of diabetes self-management:

1.Diet- Carb Counting

2.Physical Exercise

3.Insulin Monitoring.

So focus should be laid mainly on developing an app that could be helpful for every diabetic patient in order to whether they are “pre-diabetic screening tool” because Self-Management being a key for Diabetic Management.  Before people develop type 2 diabetes, they almost always have "prediabetes"—blood sugar levels that are higher than normal but not yet high enough to be diagnosed as diabetes. But, Doctors sometimes refer to prediabetes as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), depending on what test was used when it was detected. //www.diabetes.org/a1c/diagnosis This pre-diabetes condition puts you at a higher risk for developing type 2 diabetes and cardiovascular disease. The development of a minor module to achieve short-term goals can be made through using telemedicine by using the Heuristic approach in order to set the achieved preset short team goals. //www.researchgate.net/profile/JiajieZhang/publication/7299431_Applying_Heuristic_Evaluation_to_Improve_the_Usability_of_a_Telemedicine_System/links/5491937c0cf2d1800d89e530/Applying-Heuristic-Evaluation-to-Improve-the-Usability-of-a-Telemedicine-System.pdf

Client Health was found to be the more focused area by client education which found to increase the access to health information and was the most widely used m health service delivery tool. //www.georgeinstitute.org.in/sites/default/files/scoping_health_report_final_uploaded.pdf

Hence I think the  Development of an m-Health app in fact is  “need of the hour”. Because most of the doctor and patient consultations were through an m-health app only during this pandemic time creating a need for its wide usability among the populations. So in my view, I think the development of m health app would be a great help to diabetic's decision-making in this Covid pandemic time.

I have found an interesting paper that explains that the usage of mobile app-based interventions found to yields a clinically significant HbA1c reduction among adult outpatients with diabetes, especially among those with type 2 diabetes. This study suggests that the clinical decision-making function can be further improved and evaluation has to be done before being added to apps. //mhealth.jmir.org/2017/3/e35

This is another interesting DIAMANTE Study which was about the mHealth apps using machine learning to increase physical activity in diabetes and depression. //bmjopen.bmj.com/content/bmjopen/10/8/e034723.full.pdf

Diabetes is the most prevalent disease world wide, and India being the diabetic capital its essential that each and every positively contributing aspect is considered in improving the situation.

In present world technology is a revolution. Mobile health technology has been highly beneficial for people with chronic conditions, and is especially useful for people who have diabetes. 

From tracking blood sugar, meals, exercise, and medications, people with diabetes must record and manage an abundance of important information related to their condition.

All of this information can be tracked with pen and paper, but mobile health technology has simplified, enhanced, and improved this process.