Diabetes: In the Absence of a Cure, Technology is the AnswerBy María Jesús Salido Rojo | Wed, 10/07/2020 - 16:15
The global evidence on diabetes demonstrates an urgent need for a solution to this pandemic. The figures in the Diabetes Atlas are as follows, according to the International Diabetes Federation, based on the ninth edition of the IDF Diabetes Atlas 2019:
- Approximately 463 million adults (20-79 years) were living with diabetes; by 2045 this will rise to 700 million
- The proportion of people with type 2 diabetes is increasing in most countries
- 79 percent of adults with diabetes were living in low- and middle-income countries
- 1 in 5 of the people who are above 65 years old have diabetes
- 1 in 2 (232 million) people with diabetes were undiagnosed
- Diabetes caused 4.2 million deaths
- Diabetes caused at least US$760 billion in health expenditure in 2019 – 10 percent of total spending on adults
- More than 1.1 million children and adolescents are living with type 1 diabetes
- More than 20 million live births (1 in 6 live births) are affected by diabetes during pregnancy
- 374 million people are at increased risk of developing type 2 diabetes
- Mexico is in first place for Mellitus Diabetes prevalence among the OECD (2017) countries with more than 15 percent of the population
With this evidence, it is clear that diabetes is a pandemic with an imminent and multidimensional urgency that needs to be addressed from a health, social and financial perspective. Diabetes is a disease that requires all of our attention, intelligence and dedication.
At present, the combination of COVID-19 with the global health context has exacerbated the crisis. Therefore, more than ever, circumstances require us to make use of the technology available to ensure access to health and quality of services, in particular for a group (people with diabetes) that is particularly vulnerable to the effects of COVID-19.
We are at a turning point.
We have used technology to digitalize processes over the last 10 years but we are just beginning the path of the great transformation required by the health sector. We need to continue to move forward as well as push this transformation further into the future. At the moment, we are forced by the global crisis we face: empowering patients, implementing digital therapeutics, making smart use of data and designing new business models.
Diabetes is a complex concern that has historically been addressed with simple solutions that can be considered as partial and biased, since the solutions proposed are only for the use of one actor and not all those involved. In other words, we have industry-specific solutions that often exclude healthcare professionals and patients. We also have solutions that are intended for patients only or for health professionals only, and they exclude the other players in the system.
We need comprehensive and sensitive approaches to the needs of each group, proposals that align the interests of all agents involved: payers, health providers, the drug and medical devices industries, regulatory bodies and, of course, patients.
Preventing the adverse effects of diabetes requires initiatives capable of connecting all the nodes but above all, and although it is an idea already explained many times, it is important to reaffirm that the initiatives must be based on patient-centricity.
There is no successful commercial or public policy project without the complicity of the end user. It is not possible. Diabetes is a lifestyle disease that requires a deep change of habits, an important self-monitoring capacity and basic knowledge about clinical concepts on which patients constantly makes critical decisions for their own health.
Whatever we do, it will not work if we leave the patient experience out of the design.
When SocialDiabetes was born, it was done to enhance that idea of patient focus. And it was based on our mission to revolutionize how healthcare providers and payers optimize diabetes care and empower patients through smart connectivity and data insight enabling accessible and quality care.
We provide the entire industry, all agents in the value chain, with technological and data solutions, and we have, of course, supervised to prioritize the patient from the beginning. Markets are being transformed by users, clients and citizens in the 21st century. Their pressure is such that you cannot win the market, forgetting the community, thanks to digitalization and connectivity. We long ago stopped being passive consumers. We are more or less active, demanding, critical and proactive activists of our realities.
There is a thriving middle class in Mexico, and in Latin America in general, ready to invest in quality of life and health. It has a high level of technological adoption and is increasingly educated and insistent. We can take advantage of this. We have technology that increases patients’ ability to treat their illness intelligently, and we have a society that is less and less tolerant of products and services of scarce value.
They need us, and they need us now.
What about patients with diabetes?
- Risk, fear, stress, isolation are what patients live with
- The overall poor adherence to treatment makes it hard to keep blood sugar under control
- They need education on the basics of managing their illness. I am not talking about user manuals or educational videos (which nobody reads). I am speaking of immersion in playful, meaningless meanfull educational experiences, in real language and suitable for the patient's social and educational context.
- They need resources, supplies, daily, easily available resources (meeters, test strips, drugs). The technology allows us to link the prescription made by a telemedicine platform with a supply management marketplace that generates logistical processes for delivering treatment at home. Despite this, the fact is that there is no free and guaranteed access to test strips and meters in countries like Mexico.
- They need to have services at their fingertips that provide care. But professionals who read their data in real time in an intelligent and personalized way: real-time feedback from real-time data.
- And they need devices that promote their self-monitoring, smart technology that makes life easy. Tools that allow them full control and autonomous management of their lives in a safe and flexible way.
What about Health Professionals?
- As current diabetes care is labor intensive with on-site interventions, health professionals and public and private systems are overflowing. Does this make sense in the 21st century?
- We are facing a crisis due to the endocrine and primary care workforce shortage
- Almost 90 percent of people with diabetes are treated by primary care physicians with poor knowledge about insulin therapies
Professionals handle a large amount of information from non-universal devices in various formats, making it difficult to manage the data in an integral and friendly manner. Since diabetes is a data disease, it is mandatory to provide HCP with platforms for data collection management.
- Remote assistant tools can improve contact frequency with patients, optimize operational cost savings and address the growing patient demand
What about Payers?
- Payers are under heavy financial pressure because diabetes accounts for at least 10 percent of total adult health spending
- Diabetes is a major growing burden for the sustainability of healthcare systems worldwide
- 70 percent of diabetes-related costs are due to complications (not managed) that can be avoided payers need to understand patient/physician behavior and define population management plans
- The entire system needs to ensure the access of all society to affordable quality care. It is not only a question of ethics but also of economics
It is time to innovate, not only in technology and processes but to take advantage of all the innovations already done so far to design platforms and consortiums that integrate all stakeholders, align their needs and systemically address the problem.