When a patient is diagnosed with diabetes, their day-to-day life becomes rife with challenges, from what they eat hour to hour to how they check their blood sugar to the medication they need and the associated costs.
The out-of-pocket cost of insulin alone has doubled in recent years, one of the most glaring examples of challenges of diabetes self-management—but there are many others that we don’t even consider that can have a huge impact on patients as well.
The biggest challenges that diabetes patients face involve lifestyle changes on their end, and unfortunately, many fail at making these adaptations. It includes strict adherence to medication dosages and timing, regulated diet, self-training, and appropriate glucose management.
For healthcare providers, helping patients manage their diabetes used to be limited to the confines of the office visit. Given that effective treatment requires round-the-clock hyper-vigilance, a visit and a couple of follow-ups in a year have simply not proven effective for helping patients make the proper lifestyle changes they need to take control of blood sugar levels. The failure to manage diabetes is harsh and leads to conditions including kidney disease and blindness.
In my experience serving diabetes patients, I have found that the only effective way to overcome these challenges is to help address behavioral change.
n the past 20 years, the technology revolution has produced new and powerful ways to stay connected with and communicate with family, friends and coworkers regardless of time and space. These same solutions can work in a provider-patient relationship. New engagement solutions are helping me as a physician reach and connect with my patients on an ongoing basis and this is absolutely vital to effectively treat diabetes.
There have also been significant developments and advances in connecting the flood of innovative healthcare devices and wearables such as fitness watches and glucose monitors to electronic health record (EHR) systems, giving providers a more comprehensive and holistic look at a patient’s overall health and activities that are critical to guiding them to improved care.
There is much more work to be done to create a comprehensive ecosystem that supports full data interoperability and to ensure affordability to those who need these devices but as more EHR-integrated tech solutions enter the market, we’re getting there one step at a time.
In my experience there are three ways that technology can help foster behavioral change among diabetic patients:
Tele-visits to improve eating habits. I use telehealth not to replace a traditional visit, but to ask my patients to invite me into their homes, virtually, so that I can literally see inside their refrigerator and pantry. This is so much more powerful than an imprecise discussion at the doctor’s office.
If, for example, I see that a patient’s refrigerator is stocked with unhealthy options, I can instantly suggest healthier alternatives that will help them manage their condition more effectively. It may sound trivial, but allowing your doctor a peek into your actual food habits can be a powerful trigger to improve your diet.
Medical devices that close the feedback loop in real-time. Insulin devices are becoming incredibly sophisticated. What used to be a prick in the finger several times a day has turned into an automated process for monitoring patient levels every second of the day, and in some cases dispensing insulin based on this data.
When it comes to making behavioral changes, there’s nothing quite as effective for modifying behavior as an audio alarm when a patient’s blood levels spike. Rather than going for the candy bar treat, an immediate feedback-loop can be created that helps the patient rethink their choices, and achieve a more consistent diet and more consistent health.
Targeted text messages. A full 99% of the U.S. population owns a cell phone, which rarely leaves their hand or pocket. This makes texting one of the most effective and ubiquitous ways to communicate.
As one of this country’s biggest epidemics, the impact of social determinants of health cannot be overlooked as it relates to Type 2 diabetes. Reaching patients via text to help educate and guide them is critical.
As providers, research has helped us understand when patients are more susceptible to information. With new mobile-first patient engagement solutions, I’m able to send educational videos, reminders, or even medical advice to my diabetes patients to help guide them on their journey to behavioral change. It allows me to give care to patients even when they’re not in the office, freeing up time to serve more patients in the process.
New technologies give doctors and patients more information and data about the impact of their behavior on their condition. Equally important, technology empowers a two-way ongoing conversation to help reinforce these habits. It’s an ongoing process and one that I’m very keen to see succeed.
In my own practice serving hundreds of patients every year, I see how small changes in the way we use technology have a real impact on people’s lives. Easier and ongoing access, from both sides, supports care and certainly helps support and manage the lifelong changes diabetes patients have to make to their habits and in their lives.
Medhavi Jogi, M.D., is the co-founder and managing partner at Houston Thyroid and Endocrine Specialists