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How digital health solutions for diabetes may help make life easier

Digital technology is advancing in almost every aspect of life, and managing diabetes is no exception. The COVID-19 pandemic triggered a dramatic advance in digital health and health technologies, largely because of social distancing requirements.1 Diabetes is well-suited to digital monitoring, apps and online tools, and diabetes technology is developing at an extremely rapid pace.2 With support from your doctor and diabetes educator, this new technology is not difficult to understand. It could make it easier for you to manage your diabetes, helping you feel more in control.

The rapid advances in digital health have given many people new and different ways to help them manage their diabetes.3 With digital monitoring devices and diabetes apps on smartphones, you can access more information than ever before, which can give you more support in everyday life.4 Digital health and health technologies are going to play an increasingly important role in diabetes management.4

So, with these new advancements, what choices do you have, and how can this new technology help you control your diabetes?

Real-time blood sugar tracking

Traditionally, self-monitoring blood glucose (SMBG) devices have been used to test blood sugar at home using glucose test strips to take a snapshot of your blood sugar levels at a single point in time.5 But you need to prick your finger and physically take several readings throughout the day.5

More recently, devices have been developed that allow real-time 24-hour monitoring of your blood sugar levels, called continuous glucose monitors (CGM).2,6 A CGM device takes your ‘interstitial’ glucose measurements using a small sensor attached to your body through a tiny wire just under the skin.

Interstitial glucose sounds complicated but all it means is that the monitor measures the sugar level in the fluid under your skin rather than directly from your blood.2 The sensor sends this information to a reader which then shows the numbers and stores all the data.2 CGMs allow you to quickly check your sugar levels without having to do finger pricks, as they track your glucose levels continuously, around the clock. This gives you a more accurate understanding of your day-to-day fluctuations.6

The data from a CGM is sent to your smartphone app or reader, providing useful insights to help you increase your understanding of your daily sugar patterns and manage your diabetes better. CGMs can show you lots of different useful measures, including:6

  • Current and average glucose levels
  • How much your glucose levels vary (known as glycaemic variability)
  • Trend arrows that show if your glucose levels are going up or down
  • The amount of time you spend within, above, or below your target glucose range (known by the medical profession as Time in Range, Time Above Range and Time Below Range)

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Using data to support your diabetes control

It is easy to ‘turn off’ when data is mentioned. But getting more information about your glucose levels could help you manage your diabetes better. The ability to check your sugar levels easily and quickly can build a sense of control.7 CGMs have alarms that can help you avoid both low sugar levels (hypoglycaemia) and high sugar levels (hyperglycaemia). Avoiding lows and highs can reduce your risk of complications in the future.6,7 People using digital health solutions, such as CGMs, have said that these devices have helped them adopt a healthier lifestyle.8

Would a digital device motivate you to go for a walk or swap a piece of cake for a healthier option?

Everyone’s diabetes is different, and CGMs may provide a more flexible and personalised approach to your diabetes.6 Continuous glucose monitoring may also help you to have better conversations with your healthcare professional.6 The measurements and insights from your CGM monitor are automatically made into an easy-to-read report which you can discuss and then use to make decisions together about managing your diabetes.6

Time in Range (TiR) is one CGM measure that can help you keep track of and manage your glucose variations. Time in Range uses the numbers from your CGM to show how much time you spend in your target blood sugar range. For most people, this is between 3.9–10 mmol/l.6 During the global pandemic, many people successfully used digital health and TiR to monitor their glucose levels, and it has been suggested that the new measure could help give people more control over their diabetes.9,10

Experts recommend that if you have type 1 or type 2 diabetes, most people should spend at least 17 hours (70%) of their day within this range.6 (Check with your doctor for your personal target).

CGMs and Time in Range (TiR) are just some examples of diabetes digital health that can help you better manage your diabetes.6 There are other innovations on the horizon.4 By using diabetes monitoring devices like CGMs that connect to a smartphone or tablet, you can stay on track hour by hour with your sugar levels.6 By using Time in Range (TiR), with the support of your healthcare professional, you can make treatment decisions and personalised choices about your diet and lifestyle that work for you. And you don’t need to wait until your next appointment to see how you’re doing; with a CGM you can monitor your diabetes every day.7

References
  1. Peek N, Sujan M, Scott P. Digital health and care in pandemic times: impact of COVID-19. BMJ Health Care Inform 2020;27(1):e100166.
  2. American Diabetes Association. Diabetes Technology: Standards of Medical Care in Diabetes 2022. Diabetes Care 2022; 45 (Suppl 1):S1-S264.
  3. Danne T,et al. Telemonitoring, Telemedicine and Time in Range During the Pandemic: Paradigm Change for Diabetes Risk Management in the Post-COVID Future. Diabetes Ther 2021 Sep;12(9):2289-2310.
  4. Alcanatara-Aragon V. Improving patient self-care using diabetes technologies. Ther Adv Endocrinol Metab 2019, Vol. 10: 1–11 DOI: 10.1177/2042018818824215
  5. Benjamin EM. Self-Monitoring of Blood Glucose: The Basics. Clinical Diabetes 2002; 20(1):45–47.
  6. Battelino T, Danne T, Bergenstal RM, et al. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range. Diabetes Care 2019; 42(8):1593-1603.
  7. Novo Nordisk. Data on file: TIR Patient Qualitative Research Global Summary Report. Data collection 2021–2022.
  8. Ehrhardt et al. CGM as a behavior modification tool. Clin Diabetes 2020 Apr;38(2):126-131. doi: 10.2337/cd19-0037.
  9. van der Linden J et al. Real-Time Continuous Glucose Monitoring During the Coronavirus Disease 2019 Pandemic and Its Impact on Time in Range. Diabetes Technol Ther 2021; 23(S1): S1–S7.
  10. Garg S, Norman GJ. Impact of COVID-19 on Health Economics and Technology of Diabetes Care: Use Cases of Real-Time Continuous Glucose Monitoring to Transform Health Care During a Global Pandemic. Diabetes Technol Ther 2021; 23(S1): S15–S20.