Digital Intervention for Type 2 Diabetes Patient – Mobile Applications
Introduction
In the last three decades, diabetes has become a global pandemic with its prevalence and management difficulties calling for the need to develop and implement improved approaches for its management. While there are different types of diabetes, the area of interest is on Type 2 diabetes (insulin-dependent diabetes) that is due to insulin resistance. The condition has long-term, life-threatening side effects and affects between 90% and 95% of people with diabetes (Kafali et al., 2013). Digital Health Interventions (DHIs) have significant potential as tools for health improvement and care delivery through the improvement of effectiveness, efficacy, accessibility, safety, and personalization (Murray et al., 2016). Significant potential exists for DHIs, for example, smartphones that offer inexpensive, efficacious, safe, and scalable health and healthcare improvements (Murray et al., 2016). They may also be employed for the promotion of healthy behaviors, for example, physical activity to improve the outcomes of chronic conditions, such as diabetes (Murray et al., 2016). Type 2 diabetes mellitus (T2DM) is, as a result of a sedentary lifestyle that includes the lack of physical activity. Among the key technologies that can be beneficial to patients with T2DM Mobile health (mHealth) technology and specifically mobile applications in the promotion of healthy behaviors to improve the disease prognosis and treatment outcomes(Miyamoto, Henderson, Young, Pande, & Han, 2016). The purpose of this study is to highlight the effectiveness of mobile applications in type 2 diabetes mellitus patients’ self-management.
Mobile Applications in Type 2 Diabetes Management
Mobile health (mHealth) technology has caught the attention of numerous healthcare providers, and researchers in the health system including the technology industry due to the capability it possesses in improving care and care outcomes, services provided, and research in the health sector. These technologies include text message reminders for appointments, fitness apps for mobile platforms, and technology that records real-time data from the patients through sensors(Miyamoto et al., 2016). The poor management of T2DM can result in complications, for example, disease, stroke, failure of the kidney, retinopathy, and foot ulcers that may producer severe disabilities. These disabilities are, for instance, diabetic foot ulcers that may lead to limb amputation (non-traumatic) with diabetic retinopathy leading to blindness(Bene, O’Connor, Mastellos, Majeed, Fadahunsi, & O’Donoghue, 2018). The complications the emerge from poor management also increase the socioeconomic burden linked with a decreased quality of life (QoF) and life expectancy (Bene et al., 2018). Treating T2DM involves controlling the blood glucose levels to prevent and/or reduces diabetes-related complications and disabilities.
In the past, diabetes management involved making hospital visits for regular check-up for glucose levels and other parameters (hospital-management). Also, it required follow-up with professionals at home to ensure adherence and progress monitoring (home care)(Raman, Shepherd, Dowswell, Middleton, & Crowther, 2017). However, over the years, increasing research has indicated the importance of self-management in the treatment of T2DM which involves the patient taking personal responsibility for maintenance of good health (Raman et al., 2017). The documented practices and skills include healthy diets, physical activity, monitoring the blood sugar, adherence to medications, developing problem-solving skills, healthy coping skills, and risk-reduction behaviors (Raman et al., 2017). Mobile applications have proven effective in managing chronic conditions and have also created opportunities for successfully self-managing T2DM.
In the study by El-Gayar, Timsina, Nawar, & Eid (2013), they aimed at establishing the effectiveness of a diabetes mobile application found on the Apple App Store in assisting patients with type 1 or T2DM in self-managing their conditions and the identification of issues that require adoption on a large-scale basis for similar interventions. The App was used as a representative of other available applications, and a systematic review of literature that included all applications that supported diabetes self-management tasks with the patient as the key actor was conducted (El-Gayar et al., 2013). The study revealed that the App promoted self-management and produced relevant behavioral changes (El-Gayar et al., 2013) which is the goal of mHealth technology (Miyamoto et al., 2016). The tasks that were successfully managed include physical exercise, insulin dosage/medication, testing for blood glucose testing, and diet including other support tasks, for example, decision-making tagging input data, and social media integration (El-Gayar et al., 2013). Therefore mobile applications promote self-management in T2DM with results also highlighting that it led to improved attitudes towards treatment that lead to improved QoF and enhanced treatment outcomes due to the reduction in the risk of complications (El-Gayar et al., 2013). The application had a social feature as an individual could connect to the various social media sites, such as, Facebook and Twitter, which promoted sharing.
The DHIs should promote healthy behaviors, improve outcomes in people with chronic conditions, and provide remote access to effective treatments. Given the findings of the study, the latter two conditions are met, and with the increasing usage of mobile technology, as indicated by Miyamoto et al. (2016), it can offer remote access hence meets the DHIs requirements.
Conclusion
Technology has become a vital part of healthcare today, and with the spread of mhealth technology, mobile applications have become a significant part of care provision. The trend towards the management of chronic health conditions is moving towards self-management, and with T2DM being among the most common chronic conditions with harmful long-term consequences, mobile applications provide a platform for self-management that meet the three requirements of DHIs in healthcare.
References
Bene, B. A., O’Connor, S., Mastellos, N., Majeed, A., Fadahunsi, K. P., & O’Donoghue, J. (2018). Impact of mobile health applications on self-management in patients with type 2 diabetes mellitus: protocol of a systematic review. BMJ Open, 9(6).
El-Gayar, O., Timsina, P., Nawar, N., & Eid, W. (2013). Mobile applications for diabetes self-Management: Journal of Diabetes Science and Technology, 7(1), 1-16.
Kafali, O., Stefano, B., Sindlar, M., van der Weide, T., Pelaez, E. A., Schaechtle, U., et al. (2013). COMMODITY12: A smart e-health environment for diabetes management. Journal of Ambient Intelligence and Smart Environments, 0, 1-25.
Miyamoto, S. W., Henderson, S., Young, H. M., Pande, A., & Han, J. J. (2016). Tracking health data is not enough: a qualitative exploration of the role of healthcare partnerships and mhealth technology to promote physical activity and to sustain behavior change.JMIR Mhealth Uhealth, 4(1), e5.
Murray, E., Hekler, E. B., Andersson, G., Collins, L. M., Doherty, A., Hollis, C., et al. (2016, November). Evaluating digital health interventions: key questions and approaches. American Journal of Preventive Medicine, 51(5), 843-851.
Raman, P., Shepherd, E., Dowswell, T., Middleton, P., & Crowther, C. A. (2017, October 29). Different methods and settings for glucose monitoring for gestational diabetes during pregnancy. Cochrane Database of Systematic Reviews, 10.