Control of diabetes, the challenge is also digital

Control of diabetes, the challenge is also digital

New tools to keep diabetes under control with App for patients and doctors: how they work

We are always at odds with apps, well-being measurement systems that are able to perceive how many steps we take, heart rate and sleep times. Even if nothing can completely replace the doctor-patient relationship and interpersonal empathy, there is no doubt that also due to the distancing needs imposed in different times and ways than the Covid-19 pandemic, the management of various chronic conditions has had a significant acceleration towards the possibility of remote controls and monitoring in this period.

Diabetes, in this sense, is certainly a model that already today, and especially in the future, will be able to see a real “plus” in technology and in the availability of data collection and transmission tools. As the experts reported on the occasion of the “Panorama Diabete” conference, in fact we are making great strides towards “Digital Diabetes”. The results of the first studies on telemedicine applied to this pathology show that patients assisted remotely or in hybrid mode have on average a glycated hemoglobin half a point lower than those assisted in traditional mode.

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From wearable devices to signal transmission

“Digital is already present in many aspects of patients’ lives – explains Luigi Laviola, professor of Internal Medicine at the University of Bari – from the pre-visit (information on diseases, search for symptoms, doctors and facilities), to the visit (booking , consultation, payment, sending reports, to treatment (administration, monitoring of the course of the disease).

But the real revolution is even more evident in diabetes devices (insulin pumps, “smart” insulin pens, hybrid artificial pancreases, implantable and wearable blood glucose sensors), in the apps for patients and for doctors from smartphones, in the websites patient support web and data management software. And we are already looking at the next frontiers, such as decision support apps for doctors, artificial intelligence algorithms (already involved in diabetic retinopathy screening) and systems for integrating information from social media. Then there is the whole area of ​​digital therapeutics, ie apps used as drugs, which will be validated by clinical trials on e-cohorts “.

In short, digital health is already a reality and will grow more and more in the future. Also and above all because it allows you to remotely control a situation, as happens in people with diabetes who, thanks to the devices, can send any changes in glycaemia directly to the care provider and can even have “intelligent” tools capable of releasing insulin in response to stimulus recognized.

“Diabetes – comments Laviola – is perhaps the best example of how these aspects of digital health can be effectively connected: m-health allows the patient to record on his smartphone and send data relating to blood sugar to the cloud, for example. ; telemonitoring allows the doctor to view this data on his computer and to give it an interpretation; Telemedicine in the strict sense is the link between these two actors and uses the information provided by the patient and the considerations made by the doctor, to better manage the disease “.

In diabetes, we are already in a context in which these various aspects are linked together. Also because a number, not followed by an action, has no meaning and is of no use to the patient. But this is also the way to go because from the point of view of efficacy, research says that these strategies lead to a half point reduction in glycated hemoglobin, a clinically significant improvement in diabetes compensation.

The effects of lockdowns

In some ways, the Covid-19 pandemic represented a sort of “test”, especially in the most complex periods to manage due to the almost total impossibility of carrying out check-ups in the clinic. In the US, face-to-face visits decreased by over 60% in this period and only 14% of these were recovered through tele-visits; while in Italy, in the 8 weeks of the hardest lockdown (in March), many diabetes centers managed to complete over 90% of the visits booked thanks to telemedicine. And a paradox has even been generated, that of the lockdown effect: some parameters of glyco-metabolic compensation of the Italian patients followed in telemedicine have even improved during the lockdown. Perhaps because, even from a distance, diabetes can be kept under control.

Category: Health
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