COVID-19: The Impact on Diabetes Management & Future Considerations

In this article, Dr M Wasim Ghori, Medical Director & Consultant Diabetologist, Heart & Diabetes Clinics, Mumbai explains how efficiently the new age technologies is reducing the burden of diabetes

Diabetes management is challenging for the patient as well as the healthcare provider. It is not always easy to keep up with exercise schedules, diabetes meal plans, blood sugar check, medications, and much more. Diabetes care demands a lot of self-management on a day to day basis. This is where the real challenge begins for a patient. On the other side, doctors too have a tedious task of analysing blood sugar fluctuations, medication adherence and other factors that influence the outcome of diabetes care. Thinking through the present operational challenges, restrictions imposed by the national lockdown and changing attitudes and behaviours, it appears that technology has been provided with an opportunity to prove its worth and can play an important role more than ever before in times of COVID-19.

In the modern world today, technology governs almost every aspect of our lives and healthcare is no exception. With the development of advanced technologies such as health apps, pedometers, food trackers and glucometers, data tracking has become manageable. Social media is another evolved technology that many patients with diabetes use to educate themselves and drive motivation to bring lifestyle change. But how efficient is the technology in reducing the burden of diabetes and where are we heading to in the technology-driven future and the post-COVID-19 era? Let’s discuss more in this article. 

Technology and devices included in diabetes management

In India, management of diabetes and its complications is a huge challenge due to problems such as lack of awareness, scarcity of healthcare specialists, lack of data that helps in therapeutic decision-making, poor access to healthcare and others. All these issues significantly contribute to delayed presentation to the clinics and missed diagnosis. Technological innovations seem like an answer to these problems in diabetes care. The advances in information technology and food technology have revolutionised the way diabetes is diagnosed and treated. 

 The most common and popular digital health products and services are discussed further. 

• Mobile apps

Did you know the usage of a mobile phone is described as 128 per cent in developed countries (i.e., more phones than people) and 89 per cent in developing countries? Another report suggests that by 2020 70 to 90 per cent of the world’s population will start using smartphones. With the emergences of health apps, smartphones may be used to address many aspects of health care. Most diabetes apps take care of diabetes self-management part as they allow manual entry for blood glucose, food intake, exercise time and insulin intake.  Some advanced apps are also connected to wearable devices that may give immediate feedback on exercise level. However, it needs active co-operation from the patients’ side. 

• Electronic Medical Records (EMR)

Electronic Medical Records (EMR) has brought about a transition from paper medical records. EMR allows for infinite data storage that can be referred by health care professionals at any time. EMR can change the way treatment is delivered to the patients and can improve care. The data stored in EMR is also of importance to conduct research due to its large patient count and long follow up period. 

• Telehealth

Telehealth refers to remote consultation, where a doctor and patient can exchange health information through electronic communication such as video calls or SMS. The doctor may also be able to prescribe medications remotely. Telehealth can provide several benefits particularly related to chronic illnesses such as diabetes. A patient can get treated from a specialist of choice without having to travel. Although there are no confirmed benefits of this service in diabetes care, it seems like a promising tool. 

In perhaps one of the most significant changes to occur in health care as a result of the coronavirus disease 2019 (COVID-19) pandemic, Telehealth has suddenly reached the widespread adoption many proponents have championed for years. Recognising the necessity of Telehealth considering the current crisis – both to address increased treatment needs and to prevent unnecessary in-person contact – state legislators have loosened certain restrictions regarding its use across clinical specialities. Moreover, the WHO recently mentioned Telehealth among essential services in strengthening the health systems response to COVID-19 policy. According to this new policy, within the optimising service delivery action, Telehealth should be one of the alternative models for clinical services and clinical decision support.

• Social media and online education 

Web portals, blogs, educational videos and structured online educational materials are becoming a convenient and easy to use means to understand diabetes and its complications. It is of importance for people who take interest in self-management of their condition with lifestyle changes. Social media allows communication among patients and is also a useful source of information to get an education on living with diabetes. Interactive forums, as well as information, can encourage behavioural change and better outcomes in diabetes management.

• Glucose monitoring devices

A glucometer is one of the most important digital devices a person with diabetes needs for self-monitoring of glucose. The advances in technology have led to the development of cloud-connected glucose meters and continuous glucose monitoring (CGM) devices from which the data can be transferred directly to the web-enabled devices. 

How is technology benefiting diabetes care?

Studies report that by 2025, India may become the world’s diabetic capital. Unfortunately, we do not have enough highly skilled specialist to participate in the management of diabetes and other lifestyle disorders.  Another challenge in diabetes management is the participation of a patient in his own care. People with diabetes may have to self-treat them with insulin, take blood glucose measurement at given intervals, keep a count of calorie intake and activity levels.  On average, a person living with diabetes is likely to spend 58 minutes of his day in self-care. The technology and digital devices can address some of these challenges and give the following benefits;

• Empower patients with the right health education and prepare them for self-care
• Technology like telemedicine can break the geographical barrier and allow more doctor-patient interaction
• Products like EMR allow for data storage and quick reference for past records
• Mobile Apps allow for better tracking of important data from patients on a daily basis 
• Digital glucometers that automatically transfer data to devices reduce the burden on doctors

What’s the future of digital diabetes health management in the post-COVID-19 era?

For many people, technology has become an integral part of their lives. Diabetes management has undergone some great transitions due to development and involvement of technology. With the use of glucometers, digital clinics, EMRs and mobile apps data tracking, as well as behaviour modification for a lifestyle change, have become much easier. The technology will continue to bring new developments, especially at a time, when social distancing is among major concerns used to fight the COVID-19 pandemic. The major challenge in the health industry needs technology that is clinically validated and is efficient to improve patient outcomes. Combining health and technology will surely show us some meaningful developments in diabetes care. We must gear up to accept the change and move ahead with times.