Current trends of digital solutions for diabetes management

Need for an Artificial Intelligence-based Diabetes Care Management System in India and the United States

Objective

Diabetes mellitus is an important chronic disease that is prevalent around the world. Different countries and diverse cultures use varying approaches to dealing with this chronic condition. Also, with the advancement of computation and automated decision-making, many tools and technologies are now available to patients suffering from this disease. In this work, the investigators attempt to analyze approaches taken towards managing this illness in India and the United States.

Methods

In this work, the investigators have used available literature and data to compare the use of artificial intelligence in diabetes management.

Findings

The article provides key insights to comparison of diabetes management in terms of the nature of the healthcare system, availability, electronic health records, cultural factors, data privacy, affordability, and other important variables. Interestingly, variables such as quality of electronic health records, and cultural factors are key impediments in implementing an efficiency-driven management system for dealing with this chronic disease.

Conclusion

The article adds to the body of knowledge associated with the management of this disease, establishing a critical need for using artificial intelligence in diabetes care management.

Perspectives and Needs of Malaysian Patients With Diabetes for a Mobile Health App Support on Self-Management of Diabetes: Qualitative Study

BACKGROUND

Effective self-management of diabetes is crucial for improving clinical outcomes by maintaining glucose levels and preventing the exacerbation of the condition. Mobile health (mHealth) has demonstrated its significance in enhancing self-management practices. However, only 20% of Malaysians are familiar with mHealth technologies and use them for health management.

OBJECTIVE

This study aims to explore the perceived benefits and challenges, needs and preferences, and willingness of patients with diabetes to use mHealth apps for self-management of diabetes.

METHODS

The study involved one-on-one semistructured online interviews with a total of 15 participants, all of whom were aged 18 years or older and had been diagnosed with diabetes for more than 6 months. An interview guide was developed based on the constructs of the Technology Acceptance Model (TAM), the Health Information Technology Acceptance Model (HITAM), and the aesthetics factor derived from the Mobile Application Rating Scale. All interviews were recorded in audio format and transcribed verbatim. The interview content was then organized and coded using ATLAS.ti version 8. Thematic analysis was conducted in accordance with the recommended guidelines for analyzing the data.

RESULTS

From the interviews with participants, 3 key themes emerged regarding the perceived benefits of using mHealth app support in diabetes self-management. These themes were the ability to track and monitor diabetes control, assistance in making lifestyle modifications, and the facilitation of more informed treatment decision-making for health care professionals. The interviews with participants revealed 4 prominent themes regarding the perceived barriers to using mHealth app support for diabetes self-management. These themes were a lack of awareness about the availability of mHealth support, insufficient support in using mHealth apps, the perception that current mHealth apps do not align with users' specific needs, and limited digital literacy among users. The interviews with participants unveiled 4 key themes related to their needs and preferences concerning mHealth app support for diabetes self-management. These themes were the desire for educational information, user-friendly design features, carbohydrate-counting functionality, and the ability to engage socially with both peers and health care professionals. The majority of participants expressed their willingness to use mHealth apps if they received recommendations and guidance from health care professionals.

CONCLUSIONS

Patients generally perceive mHealth app support as beneficial for diabetes self-management and are willing to use these apps, particularly if recommended by health care professionals. However, several barriers may hinder the utilization of mHealth apps, including a lack of awareness and recommendations regarding these apps from health care professionals. To ensure the effective development of mHealth app support systems for diabetes self-management, it is crucial to implement user-centered design processes that consider the specific needs and preferences of patients. This approach will help create apps that are tailored to the requirements of individuals managing diabetes.

Scaling digital solutions for wicked problems: Ecosystem versatility

Digital solutions are increasingly used to address "wicked problems" that are locally embedded but require global approaches. Scaling these solutions internationally is imperative for their success, but to date we know little about this process. Using a qualitative case study methodology, our paper analyzes how four digital solutions driven by the United Nations are built and how they scale internationally. These solutions address wicked problems through artificial intelligence, blockchain, and geospatial mapping, and are embedded in networks of partners which evolve during scaling to create unique ecosystem roles and configurations. We identify different ecosystem roles and find that the specific properties of digital solutions - modularity, generativity and affordances - enable either adaptation or replication during scaling. Building on these insights, we derive a typology of four different types of international scaling, which vary in their ecosystem versatility (how the ecosystem changes across locations) and the local adaptation of the application (the problems the solution addresses). This study presents a new way to examine the replication and adaptation dilemma for ecosystems and extends internationalization theory to the digital world.

COMPARATIVE PHARMACOECONOMIC ANALYSIS OF SELF-CONTROL OF DIABETES MELLITUS USING GLUCOMETERS

OBJECTIVE

The aim: To pharmacoeconomic analysis of direct medical costs for self-control of diabetes in Ukraine, Moldova and Georgia. Our observational, cross-sectional study aims at finding out the real costs of covering expenses in order to make decisions on the reimbursement of self-control means.

PATIENTS AND METHODS

Materials and methods: 1) International and national clinical guidelines for diabetes; 2) information about the prices of glucometers, test strips from online pharmacy services. Systematization, generalization and pharmacoeconomic analysis of direct medical costs were used in the study.

RESULTS

Results: Based on the generalization of recommendations on the frequency of blood glucose control, 3 scenarios were identified, according to which the costs were calculated: Type 1 diabetes; Type 2 diabetes (insulin therapy); Type 2 diabetes (oral hypoglycemic therapy). The authors conducted pharmacoeconomic analysis of direct medical costs for self-control of DM for PWD in Ukraine, Moldova and Georgia. The study shows that the lowest cost of self-control is provided in Ukraine, in addition, Ukraine has a wider choice of glucometers and test strips. It was revealed that the pharmaceutical markets for glycometers in the three countries depends on the import of equipment.

CONCLUSION

Conclusions: It is advisable to introduce in Ukraine the reimbursement of self-control devices, namely, glucometers and test strips for all categories of PWD, which will contribute to self-control and, as a result, will be able to prevent the development of complications. Certification of continuous glucose monitoring systems will increase access to new technologies that are already widely used in many countries.

Bioengineering Technology in Context of COVID-19 Pandemic: Potential Roles and Applications

Bioengineering (BE) technology has significant influence on the healthcare environment. This has grown steadily particularly since the medical practice has become more technology based. We have tried to assess the impact of bioengineering in tackling the COVID-19 pandemic. The use of bioengineering principles in healthcare has been evaluated. The practical implications of these technologies in fighting the current global health pandemic have been presented. There has been a shared drive worldwide to harness the advancements of bioengineering to combat COVID-19. These efforts have ranged from small groups of volunteers to large scale research and mass production. Together the engineering and medical fields have worked to address areas of critical need including the production and delivery of personal protective equipment, ventilators as well as the creation of a viable vaccine. The fight against COVID-19 has helped highlight the work and contributions of so many professionals in the bioengineering fields who are working tirelessly to help our health services cope. Their innovation and ingenuity are paving the way to successfully beat this virus. We must continue to support these fields as we evolve our health systems to deal with the challenges of healthcare in the future.

Present and Future of Digital Health in Diabetes and Metabolic Disease

The use of information and communication technology (ICT) in medical and healthcare services goes beyond everyday life. Expectations of a new medical environment, not previously experienced by ICT, exist in the near future. In particular, chronic metabolic diseases such as diabetes and obesity, have a high prevalence and high social and economic burden. In addition, the continuous evaluation and monitoring of daily life is important for effective treatment and management. Therefore, the wide use of ICTbased digital health systems is required for the treatment and management of these diseases. In this article, we compiled a variety of digital health technologies introduced to date in the field of diabetes and metabolic diseases.

Design and implementation of an intelligent monitoring system for household added salt consumption in China based on a real-world study: a randomized controlled trial

BACKGROUND

A high intake of salt is a major risk factor for cardiovascular diseases. Despite decades of effort to reduce salt consumption, the salt intake in China is still considerably above the recommended level. Thus, this study aims to design and implement an intelligent household added salt monitoring system (SALTCHECKER) to monitor and control added salt consumption in Chinese households.

METHODS

A randomized controlled trial will be conducted among households to test the effect of a SALTCHECKER in Chongqing, China. The test modalities are the SALTCHECKER (with a smart salt checker and a salt-limiting WeChat mini programme) compared to a salt checker (with only a weighing function). The effectiveness of the system will be investigated by assessing the daily added salt intake of each household member and the salt consumption-related knowledge, attitude and practice (KAP) of the household's main cook. Assessments will be performed at baseline and at 3 and 6 months.

DISCUSSION

This study will be the first to explore the effect of the household added salt monitoring system on the reduction in salt intake in households. If the intelligent monitoring system is found to be effective in limiting household added salt consumption, it could provide scientific evidence on reducing salt consumption and preventing salt-related chronic diseases.

TRIAL REGISTRATION

Chinese clinical trial registry (Primary registry in the World Health Organization registry network): ChiCTR1800018586. Date of registration: September 25, 2018.

Potentials of Digitalization in Sports Medicine: A Narrative Review

Digital transformation is becoming increasingly common in modern life and sports medicine, like many other medical disciplines, it is strongly influenced and impacted by this rapidly changing field. This review aims to give a brief overview of the potential that digital technologies can have for health care providers and patients in the clinical practice of sports medicine. We will focus on mobile applications, wearables, smart devices, intelligent machines, telemedicine, artificial intelligence, big data, system interoperability, virtual reality, augmented reality, exergaming, or social networks. While some technologies are already used in current medical practice, others still have undiscovered potential. Due to the diversity and ever changing nature of this field, we will briefly review multiple areas in an attempt to give readers some general exposure to the landscape instead of a thorough, deep review of one topic. Further research will be necessary to show how digitalization applications could best be used for patient treatments.

DEVELOPMENT OF HPLC-MS METHOD OF VOGLIBOSE AND QUERCETIN QUANTITATION IN HYPOGLICEMIC ACTION TABLETS

Aim. The purpose of our study was to develop a method for simultaneous quantitation of voglibose and quercetin in a solid dosage form. Materials and methods. The objects of the study were voglibose, quercetin, tablets containing voglibose - 0.2 mg and quercetin 100 mg. Measurements were carried out by high-performance liquid chromatography (HPLC) according to SPHU, supp. 1, 2.2.29, N, using the following equipment: a mass-selective detector Agilent 6530 Q-TOF was used as the detecting system. Results. According to the developed method, the quantitative determination of voglibose and quercetin in the tablets of hypoglycaemic action was investigated. The following results were obtained: the content of C 10 H 21 NO 7 (voglibose) in one dosage unit of the test drug was 0.2 mg; and the content of C 15 H 10 O 7 (quercetin) -0.105 g, which suggests the validability of the proposed method for quantitation of the active substances in tablets for the prevention and treatment of type II diabetes mellitus. Conclusions. In the course of the study, a method was developed for determination of voglibose and quercetin in a hypoglycaemic action preparation using high-performance liquid chromatography (HPLC) with a gradient mode of elution. It has been established that the chosen chromatographic conditions allow quantitative determination of the active pharmaceutical ingredients studied in a solid dosage form with a tolerance of ±5 %. Validation of the developed methodology has been conducted and its suitability for the simultaneous quantification of quercetin and voglibose in tablets has been demonstrated. The reproducibility of this method has been proved.

Popular Diabetes Apps and the Impact of Diabetes App Use on Self-Care Behaviour: A Survey Among the Digital Community of Persons With Diabetes on Social Media

Introduction: This study aimed to identify popular diabetes applications (apps) and to investigate the association of diabetes app use and other factors with cumulative self-care behaviour. Methods: From November 2017 to March 2018, we conducted a web-based survey with persons 18 years of age and above. We recruited respondents via diabetes Facebook groups, online patient-forums and targeted Facebook advertisements (ads). Data on participants' demographic, clinical, and self-management characteristics, as well as on self-care behaviour and characteristics of the diabetes apps use were collected. Self-care behaviour was measured using a licensed version of the Summary of Diabetes Self-care Activities (SDSCA) questionnaire. The cumulative self-care score was calculated by summing up scores for "general diet," "specific diet," "exercise," "blood glucose testing," "foot care" and "smoking." To identify popular diabetes apps, users were requested to list all apps they use for diabetes self-management. Two sample t-test and multiple linear regression stratified by type of diabetes were performed to examine associations between app use and self-care behaviour, by controlling for key confounders. Results: One thousand fifty two respondents with type 1 and 630 respondents with type 2 diabetes mellitus (DM) entered the survey. More than half, 549 (52.2%), and one third, 210 (33.3%), of respondents with type 1 and 2 DM, respectively, reported using diabetes apps for self-management. "mySugr" and continuous glucose monitoring apps, such as "Dexcom," "Freestyle Libre," and "Xdrip+" were some of the most popular diabetes apps. In both respondent groups, the cumulative self-care behaviour score was significantly higher among diabetes app users (compared to non-users) and scores for three individual self-care components, namely "blood glucose monitoring," "general diet," and "physical activity" were significantly higher among diabetes app users than among non-users. After adjusting for confounding factors, diabetes app use increased the cumulative self-care score by 1.08 (95%CI: 0.46-1.7) units among persons with type 1 DM and by 1.18 (95%CI: 0.26-2.09) units among persons with type 2 DM, respectively. Conclusion: For both, persons with type 1 and type 2 diabetes, using diabetes apps for self-management was positively associated with self-care behaviour. Our findings suggest that apps can support changes in lifestyle and glucose monitoring in these populations.