CMHC Pulse Blog

With increasing smartphone and digital device usage, there is a growing opportunity for technological tools to be incorporated into diabetes self-management (DSME). Although studies are limited thus far, scientific advancements in diabetes care have reduced long-term complications by improving glucose control, and simplifying disease management. Poor glucose control can lead to long-term diabetes, micro- and macro-vascular complications, and other health issues: all of which generate higher morbidity and mortality rates. The CDC reports that 100 million U.S. adults live with diabetes or prediabetes: a number expected to rise to 592 million by 2035.

Only about 20% of diabetic individuals are under professional care, according to an article from BioMed Central, and 77% of people with diabetes live in low- to mid-income countries with a lack of resources for adequate diabetes self-management training: an essential component of preventing long-term complications. There is both an opportunity and need for the development of cost-effective tools to support DSME in order to improve overall diabetes outcomes, particularly in developing countries. The increase of smartphone and digital device users has influenced the rise of mobile app technology, designed to help patients manage their diabetes. Applications that monitor food intake, physical activity, medication adherence, blood glucose levels and insulin doses are designed to assist patients with daily management of their condition. Other helpful tools such as diabetes education platforms as well as relaxation and meditation apps are also becoming increasingly available.

Diabetes self-management training is tailored to people with or at risk for diabetes, and allows them to gain the knowledge and skills necessary to successfully manage the condition. This includes information on healthy eating, self-monitoring of blood sugar levels (SMBG), medication adherence, and other risk-reduction behaviors. Not only has DSME proven effective in lowering A1c and blood pressure levels, it is also cost-effective. DSME training support is becoming more widely available to patients through online education materials provided by government organizations, professional organizations such as the American Diabetes Association, and nonprofits.

As weight management is crucial to the prevention of long-term diabetes complications, conducted studies have revealed a marked increase in weight loss results with the use of monitoring apps. Nutrition trackers and other healthy eating applications—such as Healthy Out, Foodily, and CarbControl—offer features to assist with meal planning and weight management. Extensive nutritional information, calorie and food trackers, and personalized diet plans can help modify behaviors while controlling blood glucose levels: all from a smartphone device. Readily available physical activity tracking applications, including MyFitnessPal and Endomondo, allow users to monitor activity levels, count calories, and set targeted goals for weight management.

Specifically designed blood glucose monitoring applications and insulin dose calculators are additional technological advancements that assist with daily self-management. Patients prescribed multiple daily insulin injections are recommended to check blood glucose levels at least three times a day, which can prove bothersome due to bulky devices, frequent blood drawing, and manual result logging. Apps such as EasyDose, Insulin RX, and Glucose aim to simplify the process of SMBG levels and calculate accurate insulin doses while increasing patient compliance rate.

Medication non-adherence is another recurring issue with diabetes patients, resulting in poor glycemic control and increased risk of long-term complications. MyMedSchedule, MedSimple, and other applications developed to solve this problem are simple and cost-effective, reminding patients to take medication, and thus improve overall glycemic results.

These new developments in DMSE technology have additionally increased the amount of data available to healthcare professionals, giving them enhanced access to reliable information, and allowing them to effectively support patient care. The expansions in diabetes technology provide exciting opportunities in health care for both patients and physicians seeking more effective care management. While robust data on the benefits of these health-related apps is still lacking, small-scale studies have demonstrated better glucose control, improved SMBG outcomes, and enhanced medication adherence. The future of digital diabetes management is promising; further studies on the benefits of digital technology with larger randomized control trials are underway, and the development of technological applications and digital devices continues.

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