Health Technology for Diabetes Self-Management

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Diabetes is a chronic disease which can affect every part of daily life. Going to the doctor and taking medications are important, but not sufficient for optimal care. Individuals with diabetes can reduce the short- and long-term impact of the disease by practicing self-management skills. This article will review how using health technology makes it easier to manage diabetes.

Basic diabetes self-management includes healthy eating, physical activity, weight control, monitoring blood glucose (sugar), and taking medications.

Hardware and software tools are now making it easier for patients to take greater control.

Healthy Eating

The first step to healthy eating for diabetes is to know what you are eating. This means knowing the amount of carbohydrates, protein, fat, sodium, and calories in food. Only then can you compare your food intake to what is recommended for diabetes.

There are plenty of smartphone apps available for tracking food intake. At the most basic level, there are food diary apps which require you to manually enter the amount and types of foods you are eating.

Many apps can also scan nutrition labels and import the information into a food diary. This makes it much easier to keep track of calories, carbohydrates, and other key nutrients over the long term.

But what if you don’t know what’s in your food? A home-cooked dinner doesn’t come with a nutrition label. Now there are smartphone apps which can analyze the nutrient content of food from a photo image.

Due to the hidden ingredients, such as oils and butter, they are not completely accurate, but in many cases, they do offer a good estimate.

A hand-held laser device does the same, but with different technology. While the accuracy of these food analysis tools still needs to be improved, the potential for quickly evaluating the nutrient content of non-labeled food is exciting.

In March this year, Spectral Engines Oy was awarded the main Horizon prize for developing an affordable scanner that can accurately measure and analyze food intake. Their Food Scanner uses a small near-infrared (NIR) spectral sensing module and can quickly detect the food’s content of fat, sugar and protein, as well total energy. This novel NIR technology works in conjunction with advanced algorithms, cloud-connectivity and a material library comprised of a vast number of images. Food Scanner can also give information on the potential allergens, so it might be useful to people with allergies and food sensitivities.

Physical Activity

Benefits of physical activity for diabetes include controlling blood glucose levels, improving cardiovascular fitness, maintaining lean body mass, reducing body fat, and controlling weight.

Smartphone apps for tracking physical activity vary widely in sophistication. The simplest just allow you to enter your activity into a diary. Others use the phone’s GPS to track distance and speed as you walk, run, or cycle.

Pedometers measure steps, while accelerometers measure steps as well as other dimensions of physical activity. Many of these wearable devices send data to a smartphone app or website.

Apps for strength exercise are catching up to those for aerobic exercise. For example, Runtastic apps use the phone’s accelerometer to track repetitions for push-ups, pull-ups, squats, and sit-ups. The apps include schedules and reminders for gradually increasing repetitions.

Measuring Blood Glucose

Glucose meters (aka glucometers) are small devices for measuring the level of glucose in the blood. Several glucose meters connect by cable or wirelessly to diabetes management programs housed on a computer, smartphone, or the cloud. In some arrangements, health care providers can view the measurements and give feedback to patients.

Non-invasive monitors, that measure glucose without a skin prick, have been in the works for many years and in many styles, including a glucowatch. In September, the FDA approved the first continuous glucose level monitoring system for adults, the Free Style Libre Flash. A patient has a tiny sensor wire inserted below the skin and uses a wireless mobile reader to show data. Other non-invasive solutions might soon be available, too.

Measuring Other Health Metrics

Maintaining a healthy weight and blood pressure is important for people with diabetes. Similar to glucose meters, scales and blood pressure monitors are available with options allowing users to track trends and share data with others, including health care providers.

Simple Reminders

Apps and calendar functions are useful for reminding you to take medications, exercise, and measure blood glucose. Patients with diabetes can also benefit from alerts that prompt them to adjust behavior, for example, check their feet or get off their feet. Tekscan offers two devices that can be useful to people with diabetes, the F-Scan and the F-Mat. The F-Scan is an in-shoe pressure monitoring system, while the F-Mat is a pressure sensing mat and can be used to analyze foot function and gait.

Social Support

Coping with diabetes can take a physical, mental, and emotional toll. Many patients would benefit from support from other patients in the same situation. Online communities and smartphone apps can open up avenues of support.

Tying it All Together

Look for platforms to emerge that connect with devices and apps to display data from multiple self-management activities in one interface.

If you track different parameters relevant to diabetes self-management, you might start noticing different correlations, for example, between your blood sugar levels, what you do, and what and when you eat. Many experts also believe that the goal is to be able to integrate self-management apps to the electronic health records (EHRs). Some insurers are already seeing mHealth as a way to reduce complications and cost and are offering apps and digital technologies for diabetes for free, or at discounted prices.

Sources

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Hood JR. C. Diabetes and mHealth: Using SmartPhones, Apps, and Other Technologies: Can we create "smarter" diabetic patients through electronic self-management of disease?. Podiatry Management. 2017;36(9):61-66.

Hoppe C, Cade J, Carter M. An evaluation of diabetes targeted apps for Android smartphone in relation to behaviour change techniques. J Hum Nutr Diet. 2017;30(3):326-338.

Kennedy E, Oliver N. Emerging technologies for diabetes. Practical Diabetes. 2017;(7):240-244

Rateni G, Dario P, Cavallo F. Smartphone-Based Food Diagnostic Technologies: A Review. Sensors. 2017;17(6

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