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7/11/2014
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Alison Diana
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10 Technologies Changing Diabetes Care

Healthcare organizations turn to technology to reduce the far-reaching, costly impact of diabetes.
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Healthcare providers, payers, and patients expect new technologies and shifts to patient engagement and population health will help the nation's 29.1 million diabetics manage their condition and reduce the costs associated with this dangerous and expensive disease.

In 2012, diagnosed diabetes cost the US $176 billion, and reduced productivity cost another $69 billion, according to the Centers for Disease Control. After adjusting for age and gender differences, average medical expenses for people with diabetes were 2.3 times higher than they would have been without diabetes, the American Diabetes Association reported.

More than 1.5 million Americans have Type 1 diabetes; the vast majority of cases are Type 2 diabetes, which typically is linked to obesity. In Type 2 cases, patients still produce insulin and may improve with lifestyle and diet changes. Unchecked, diabetes can lead to more medical complications and even death.

Without attention, US diabetes cases will increase, fueled by Americans' diet of sugar and processed food, Dr. Brett Osborn, author of Get Serious: A Neurosurgeon's Guide to Optimal Health and Fitness, told InformationWeek.

"More than 30% of Medicare dollars are spent on diabetics and/or related complications. Likely diabetes, or more specifically 'insulin resistance,' will be linked to many more disease processes -- i.e., Alzheimer's disease is also referred to as 'Type III diabetes,' as one of its underpinnings is insulin resistance," he says.

In an effort to improve health, reduce costs, and slow down future cases, healthcare providers are educating non-diabetics about how to avoid the condition and using new and long-established tools to help diabetics live healthier lives.

They're influenced by healthcare's transition to patient engagement -- with its growing reliance on patient portals, mobile apps, and the creation of health-focused communities -- plus population health, which considers the multiple factors that make up the population's individual and overall health.

In Cities for Life, a diabetes management program supported by Sanofi US and conducted by the American Academy of Family Physicians Foundation, patients were connected with community resources to help manage their condition. Partners at the University of Alabama researched resources at local churches, YMCAs, gyms, and other sites, then created a database and website -- MyDiabetesConnect.com -- where residents could locate farmers' markets, exercise programs, and other items conducive to health living.

"Obviously what happens in their doctors' offices is very important, but they need to carry out what they plan in their doctors' offices throughout the year," Dr. Edwin Fisher, global director of Peers for Progress at the American Academy of Family Physicians Foundation, tells us. "We really need comprehensive approaches that bring together clinical care, community care, social support, friends, and neighbors, to help people with diabetes live their lives well and take care of their diabetes well."

Increasingly, that care involves technology.

The information pouring in from glucose meters provides developers, researchers, payers, and other members of the healthcare world with a plethora of data for analysis that could provide insight into new treatments or devices. Tens of thousands of diabetics also use the more than 1,000 apps now available to monitor and manage the condition, further fueling both improved health and big-data solutions.

"Ultimately, more aggressive monitoring -- implantable, continuous -- will lead to tighter glucose control. This equates to reduced formation of advanced glycation products and lower bodily inflammation (the damaging, diabetes-associated epiphenomena)," says Osborn. "Google will likely be introducing a contact lens-based glucose monitor in the next several years. This will allow for real-time monitoring of blood glucose, essentially providing a number upon which people can rapidly act. Aggressive treatment early on is the key -- although prevention obviously is ideal."

Tech companies are venturing into the diagnostics and treatment market. Patients can use smartphones to monitor their condition. In addition to Google's under-development smart contact lens, other companies are creating a bionic pancreas and exploring genomes to control diabetes.

Take a look at some of the technologies currently in use, and let us know what your organization is doing to help diabetic patients control costs and improve their health.

Alison Diana has written about technology and business for more than 20 years. She was editor, contributors, at Internet Evolution; editor-in-chief of 21st Century IT; and managing editor, sections, at CRN. She has also written for eWeek, Baseline Magazine, Redmond Channel ... View Full Bio

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Alison_Diana
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Alison_Diana,
User Rank: Author
7/11/2014 | 12:17:06 PM
Focused Condition
When I speak to healthcare executives at hospitals and payers, many focus on diabetes when they pilot a technology initiative such as big data, analytics, or other solution. In addition to helping patients manage and cope with this condition, more healthcare providers (from solo practitioners up) want cost-effective, efficient, user-friendly ways to help individuals never get this condition. Encouraging patients to eat right, exercise, and get regular checkups are all good advice -- and many people enjoy using apps to help them attain these laudable goals. 
RogerB641
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RogerB641,
User Rank: Apprentice
7/12/2014 | 2:52:40 PM
Solution
All this great and expensive technology when the solution to type 2 diabetes is incredibly simple and obvious.  Start with a hardcore low carb diet.
pamelahazelton
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pamelahazelton,
User Rank: Apprentice
7/12/2014 | 6:39:59 PM
Re: Solution
For many, yes, but not all. We wish it were that simple of a solution for everyone.
RogerB641
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RogerB641,
User Rank: Apprentice
7/13/2014 | 12:04:35 AM
Re: Solution
Yes, I agree.  But the money and attention goes towards the most expensive and the most technologicall advanced solution
Alison_Diana
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Alison_Diana,
User Rank: Author
7/13/2014 | 7:23:25 PM
Re: Solution
I linked to an April New York Times article that discussed how small advances in technology can dramatically increase the price of insulin pumps and other medical devices diabetics need to stay healthy. The article generated a lot of comments -- many negative -- from organizations such as the American Diabetes Association that point to the improvements these new devices deliver. I think it's exciting to see other ways in which researchers are using technology to help prevent and manage diabetes, things like using big data and analytics to figure out not only preventative measures (some of which are common knowledge at this point) but which methods are best-suited for particular individuals. Or designing a "bionic pancreas" or less invasive, painful ways to deliver insulin so more patients will be compliant with their doctors' orders. 

When speaking to healthcare professionals, they realize diabetes is expensive but in the vast, vast majority of cases these pros truly want their patients to get well or have happier, healthier lives for their patients' sake. It truly is a win-win when you have healthier patients and, btw, the health system pays less. 
DuaneW534
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DuaneW534,
User Rank: Apprentice
7/14/2014 | 9:52:24 AM
Re: Solution
The technologies are for treatment.  I think Roger is making a very important point.  When diagnosed, you have to change your lifestyle and 90% of Type 2 diabetes is reversible.
Alison_Diana
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Alison_Diana,
User Rank: Author
7/14/2014 | 10:36:01 AM
Re: Solution
That is one reason Cities for Life was so well-received in its area. Organizers called or surveyed organizations in the entire region that offered anything related to healthy living -- that included religious organizations that had exercise classes ranging from walking and zumba to yoga and meditation to farmers' markets and cooking classes. They then compiled all this information on the website so diabetics (and, to be quite frank, anyone else interested in a healthier lifestyle) could discover exercise or food-related places near to their work or office. Although they have not yet been able to determine the results (in terms of analyzing how knowledge translated into improvements in diabetes) they did see increases in usage.
Alison_Diana
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Alison_Diana,
User Rank: Author
7/14/2014 | 10:39:26 AM
Re: Solution
Many apps, including those for managing diabetes, also help in turning back diabetes I would think. If you can reverse type 2 diabetes by eating better and exercising, apps (and/or devices like Fitbit, Jawbone, et al) should surely encourage patients to improve their health by tracking their exercises and diets? I know Montefiore, for example, was considering piloting a program using personal health trackers to treat diabetic teens, when I spoke to the organization's chief strategist a few months ago.
pamelahazelton
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pamelahazelton,
User Rank: Apprentice
7/12/2014 | 6:38:46 PM
All Great, But Missing a BIG Piece of the Puzzle
I'm referring to the BLIND diabetic. And many diabetics are totally blind. While all these technologies are great, there is very little available (and even less in the works) to assist low-vision and/or totally blind diabetics in managing the disease. How many talking meters are there? The good ones have been discontinued. Talking or sound-used pumps? None cover everything a diabetic needs to manage entirely on his/her own. 

You'd think with blindness being a big issue with diabetes there would be more tech for those folk, but the availability is very limited, and much of what is available is quite expensive.
Alison_Diana
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Alison_Diana,
User Rank: Author
7/13/2014 | 7:16:30 PM
Re: All Great, But Missing a BIG Piece of the Puzzle
Thank you for raising a very, very important point. I had thought there would be more voice-activated pumps and other technologies available for diabetics and was surprised at the dearth of these devices. Why, do you think, there are so few? Is it a technological issue (which seems unlikely, given the growth of voice activation in other areas); profitability; insurance; complexity, or something else completely? 
pamelahazelton
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pamelahazelton,
User Rank: Apprentice
7/18/2014 | 2:40:19 AM
Re: All Great, But Missing a BIG Piece of the Puzzle
[[Why, do you think, there are so few?]]

I'm at a loss. When it comes to certain tech, we're falling backwards. My husband's first pump had a piston rod that was akin to a standard screw, so he was able to follow a few different tones and change insulin cartridges himself - a great thing when I would travel. Now it's all electronic and, while it's "possible" for him to do it, the margin for error is huge. 

Plenty of devices (pumps, meters, etc) have some utilizable components, but none on their own allow for a totally blind diabetic to be completely on his own.

Best example I can give is his recent "forced move" to an iPhone. When his old flip phone, with easy to use "push" buttons (and a dot on the 5), and "speak out" numbers as he dialed gave up, we couldn't find a blind-friendly cell phone outside of purchasing a high-end exclusive one. Now he lets Siri do whatever she can for him. But for his insulin pump? We have to arrange for a family member or friend to stop by every 2-1/2 to 3 days whenever I'm gone.
Alison_Diana
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Alison_Diana,
User Rank: Author
7/29/2014 | 9:33:18 AM
Re: All Great, But Missing a BIG Piece of the Puzzle
That's a shame because, with so many healthcare organizations and developers now focusing on ways to help people live independently -- across a spectrum of conditions -- you'd think there would be a pump designed with independence in mind. I'm glad Siri helps your husband with his phone. I wonder if Google's Android voice system would be equally helpful?
Alison_Diana
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Alison_Diana,
User Rank: Author
7/13/2014 | 7:26:49 PM
Blindness and Diabetes
Have you found any technologies -- apps, voice-activated devices or websites, or other tools -- that help blind diabetics? If so, please share them. 
pamelahazelton
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pamelahazelton,
User Rank: Apprentice
7/18/2014 | 2:44:13 AM
Re: Blindness and Diabetes
[[Have you found any technologies]]

They're scarce and often difficult to understand. However, any blind users using JAWS or similar software to navigate the web will find that joining the user-base forums for those tools a good place to network and seek advice from other blind folk.
tekedge
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tekedge,
User Rank: Moderator
7/23/2014 | 8:35:07 PM
Changing Diabetes Care
I think insurance companies give their employees monetary discounts if they have regular checkups and take care to bring down higher health numbers. This has started working well for most employees who get their physicals done regularly and can catch the major conditions earlier or help prevent developing them. This will in the long run reduce health costs...
Alison_Diana
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Alison_Diana,
User Rank: Author
7/29/2014 | 9:35:29 AM
Re: Changing Diabetes Care
You're right, @tekedge. Also, I'm finding more payers (whether insurance companies or employers) are giving consumers more discounts for sharing info. For example, diabetics who agree to participate in a particular program, share their vital statistics and allow themselves to be monitored (often via a wearable device/app and/or occasional videoconference) get a big discount. The goal, of course, is improved health for patients -- and reduced costs for the payer -- a win for all!
SachinEE
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SachinEE,
User Rank: Ninja
7/29/2014 | 6:08:31 AM
Re: Double Advantage
Even though the primary purpose of the smart contact lens from Google will be to help diabetics control the disease by constantly monitoring their blood level, I love the way that Google have managed to introduce an additional element of functionality to the device. There are many other options that they could have gone for and still achieved the same results but am particularly impressed by the fact that they chose to do it in the form of a contact lens. This means that if the lens is made just right, it could also be helpful to people that suffer from eye defects along with the diabetes.
Alison_Diana
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Alison_Diana,
User Rank: Author
7/29/2014 | 9:40:08 AM
Re: Double Advantage
I agree, @SachinEE. There are several possibilities -- cataracts, for example -- that I'm sure Google will explore with health partners (if it's not already doing so).
SachinEE
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SachinEE,
User Rank: Ninja
7/29/2014 | 6:11:47 AM
Re: Convenient
Now this is a very resourceful and highly convenient way to monitor your own blood glucose levels if you are a diabetic. You will most probably always have your phone with you and the easy with which the app works means you can do the test anytime anywhere. So out of all the ten technologies in this list, this one takes the cake for me. I only have one question though; why is it only available for iPhones? I believe many other Smartphones would probably do the same job, or even better. No hating- I just don't love Apple that much!
Alison_Diana
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Alison_Diana,
User Rank: Author
7/29/2014 | 9:42:03 AM
Re: Convenient
A lot of times we see developers pick one platform over another, then develop for the second major smartphone platform within (generally) 6-12 months. As you can see from one earlier commenter, sometimes a healthcare device is the reason someone picks their phone. She mentioned choosing iPhone specifically because of Siri, which her blind husband needed. 
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