Diabetes Technology: Improving Care Through Innovation

Research indicates that continuous glucose monitoring has helped people with Type 2 diabetes either on long-acting insulin therapy or non-insulin OAD therapy, significantly reducing their HbA1c levels

New Delhi: India has the second-highest diabetes population in the world. Recent studies show that healthcare for non-communicable diseases had been interrupted in the country, with up to 87% of persons with diabetes reducing visits to their doctor due to the pandemic and less than half possessing a blood glucose measuring device at home. The recent ICMR study highlighted how the disease has become apparent in the age group of 25–34 years in both urban and rural areas and how more and more children are being diagnosed with type 1 diabetes in India.
Wearable Technologies for continuous glucose monitoring
Diabetes must be monitored on a regular basis, failure to which can result in treatment delays and diabetes-related consequences. Today, there are new therapies and revolutionary wearable technologies that continuously monitor one’s glucose levels in real time. According to a 2019 study undertaken by American Diabetes Association (ADA), for adults with type 2 diabetes on intensive insulin, HbA1c dropped from 8.9% to 8% with at least three months of using a continuous glucose monitoring system, in this case FreeStyle Libre.. This results in a vast use of the technology to benefit those living with diabetes. The ADA further states that people with Type 1 and Type 2 diabetes must aim for a Time in Range (TIR) of at least 70% of readings.
A smooth transition to effective diabetes management
Glucose levels are affected by lifestyle factors like nutrition, activity, sleep, and, most critically, medications. A single tablet is usually the first step in diabetic treatment. The number of Oral Anti-Diabetic Medications (OADs) prescribed in the quest for optimal HbA1c levels may rise over time.
For certain patients, the transition from OADs to insulin injections is necessary due to increased glucose levels despite medicines. While patients may be apprehensive about insulin and may wish to delay initiation as much as possible, insulin therapy regimens are added to keep blood glucose levels under control, especially after meals. Additionally, despite the polypill therapy, which is a fixed-dose combination of medications, at times patients are unable to meet their objective, i.e., optimal glucose co-ordination.
Prof. Dr. Debmalya Sanyal, Professor, Dept. of Endocrinology, KPC Medical College, Kolkata, said, “Research indicates that continuous glucose monitoring has helped people with Type 2 diabetes either on long-acting insulin therapy or non-insulin OAD therapy, significantly reducing their HbA1c levels. CGM when added to insulin therapy treatment regimens helps in getting detailed information about glucose level fluctuations and enables titration of insulin dose easily. With the use of the CGM device, patients on polypills who had poor glucose control reported a significant reduction in acute diabetes events or complications that can arise from diabetes. This resulted in reducing all-cause hospitalizations in these patients.”
Time-In-Range and Diabetes
TIR is useful in the management of diabetes, the optimization of OADs in polypill patients, and as a tool for hospitalized surgical and non-surgical patients. It can also properly map the extent of glycemic control and direct therapeutic treatments in real time, which is useful for persons with Type 1 and Type 2 diabetes, pregnant women, young adults, paediatric patients, and elderly people with comorbidities. One should try to be in range for around 17 out of every 24 hours. Simply said, the higher the TIR, the better the glucose management in diabetes.
Growth in self-awareness among people with diabetes
With the pandemic leading to a growing digital adoption across the country, there is an increase in awareness among people with diabetes. Additionally, accessibility to prick-free, hassle-free gadgets such as continuous glucose monitoring devices that help people who aren’t heavy insulin users, is allowing them to read charts and understand statistics along with their health provider. Technology gives people an opportunity to build confidence in managing diabetes. These people now make conscious, considered decisions along with the doctor. Patient participation in therapeutic decisions is now becoming the norm.