Telehealth technology for diabetes care
There are a wide range of telehealth technologies that can be used for diabetes, including interactive messaging between patients and providers, web-based portals where providers can adjust medications, and devices that allow patients to monitor and manage health measures.
Health care professionals can use telehealth technology to provide education and self-management support for individuals with type 1, type 2, or gestational diabetes. Other technologies include smart devices, such as glucose meters, continuous glucose monitoring devices (CGMs), insulin pumps, and smartphones. Additionally, patients can use software applications to self-monitor blood glucose levels, insulin dosage, diet, and physical activity.
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Blood glucose monitoring technologies
Some diabetes technologies allow patients to track their blood glucose levels, which helps them make real-time changes to improve their health.
- Wearable devices — Technologies such as smart rings contain sensors that track the physiological signs of a patient, such as heart rate and skin temperature, which may be factors related to diabetes management and control for both type 1 and type 2 diabetes.
- Continuous glucose monitors — Continuous glucose monitoring (CGM) devices are most often used for monitoring blood glucose levels by using a sensor inserted under the skin to test glucose every few minutes and send the results to a monitor that can be viewed by the patient.
- Smartphone applications — Many smartphone applications, such as those that interact with CGM devices, increase the self-management skills of patients with diabetes, facilitate communication between the patient and provider, and increase the patient's adherence with treatment.
Diabetes management technologies
The main goal of using technology to support diabetes management is glucose control to prevent complications, and to make sure patients do not have dangerously high (hyperglycemia) or low (hypoglycemia) blood sugar levels.
- Insulin pumps — Insulin pumps are small, computerized devices that deliver a small insulin dose in a steady, measured amount and as needed during mealtimes based on the food that is eaten. These devices are especially useful for people who have type 1 diabetes or insulin-dependent type 2 diabetes.
- Blood glucose meters — A glucose meter uses a small drop of blood to determine a patient's blood glucose level. These glucose readings provide necessary information for patients and providers to help decision-making around diet, medications, and lifestyle changes to control diabetes.
- Smart pens — A smart insulin pen is a reusable injector pen that communicates electronically with a smartphone application to help patients with diabetes better manage insulin administration. The system calculates and tracks doses and provides helpful reminders, alerts, and reports for patients. This automated insulin delivery system reduces the significant burden of disease management for people with type 1 and type 2 diabetes.
- Closed-loop systems — Some people with type 1 diabetes use an automated insulin delivery system which interacts with a continuous glucose monitor to track blood glucose levels and adjust insulin as necessary.
- Artificial pancreas — This technology uses insulin plus an additional hormone (such as glucagon) to achieve better glycemic control for type 1 diabetes as compared with insulin-only.
Technologies for tracking and sharing diabetes data
Patients can use telehealth technology to collect and track data, such as glucose levels, heart rate, physical activity, and sleep. Patients can share this data with their provider in order to better manage their health.
- Artificial intelligence voice recognition — Artificial intelligence (AI) voice recognition lets patients interact with technology by speaking directly to a device. This allows patients to transmit data related to their diabetes such as glucose levels from continuous glucose monitors and other technologies directly to providers. This is particularly helpful for patients with visual impairments.
- Mobile applications — Many diabetes management platforms on smartphone devices offer benefits such as monitoring blood glucose levels and food intake, recording physical activity, tracking insulin and medication, and providing education on various aspects of diabetes care. Smartphones also can be used to transmit information to a provider on a regular basis.
- Glucometer — Wireless glucose monitors analyze a patient's blood sugar level and store information so the data can be sent to a provider over a wireless network in real time or transmitted by the patient in bulk when convenient.
- Patient web portals — People with diabetes can use dedicated web portals to transmit their data to their providers. This can support discussions between the patient and provider on treatment for diabetes.
Emerging diabetes technologies
Recent technological advances have led to the development of non-invasive medical devices and the use of artificial intelligence (AI) to prevent diabetic complications. These can help detect and treat out-of-range blood sugar levels before they lead to health problems.
- Pupillometer — This device provides assessments of pupillary function, such as the size of the pupil, its shape, and its reactivity to light, which are strong indicators of diabetic autonomic neuropathy, a condition that has a negative impact on quality of life and health outcomes.
- Neuromodulation — This technology uses a device that stimulates a patient's nerve activity, restoring a patient's nerve signals to a healthy state. Neuromodulation can generate changes with greater precision than medication with fewer side effects. This therapy may prevent complications associated with diabetic neuropathy.
- Smart contacts — A smart contact lens contains ultrathin, flexible electrical circuits that provide both continuous glucose monitoring and treatment of diabetic retinopathy.
- Artificial intelligence — AI can be used to generate predictive models that provide individualized nutrition, sleep, activity, and breathing guidance to patients.
Using telehealth to support children with diabetes
More than a quarter of a million children under the age of 20 have type 1 or type 2 diabetes. Finding out that a child has diabetes can be scary for parents and caregivers, but telehealth technologies can help manage their child's diabetes. In fact, research shows that using technology devices shortly after a type 1 diagnosis can have a measurable impact on the child's health within just one year.
Diabetes technology, such as a continuous glucose monitors and linked applications, can help parents and caregivers assist children in monitoring their blood glucose. These technologies can track blood glucose levels over time through smartphone apps and quickly detect any values out of the normal range. In addition, smartphone applications can provide age-appropriate, engaging diabetes education for children. Apps also allow children to share information with their provider with help from their parent or caregiver. Capturing data on blood sugar levels engages both the caregiver and the child and provides opportunities for shared decision-making between the patient, their caregiver, and the provider. Schools can also serve as partners in using telehealth to treat students with diabetes.