Transforming Diabetes Management 1

This article was originally published in LinkedIn.

I recently wrote an article describing healthcare as ugly – from the point of view of trying to re-engineer how it is delivered using technology.

It’s ugly since it’s so complex.  It would be beautiful if it were transformed, resulting in better quality and cheaper care for more people.

I’m not talking here about individual medications or new surgical technologies which, valuable as they may be, improve one step of care.  Neither am I talking about streamlining the paperwork of healthcare administration – where steady improvements are happening, with much more to come with AI.

What we are trying to reengineer using technology is the system of care delivery, especially for chronic diseases like diabetes.  Getting this right (eventually) will be a real game-changer.

How does diabetes care work?

Let’s take a closer look at how diabetes care works in most countries.

A common approach goes lie this: patients see their doctor once in 3 months, when a standard test (’HbA1c’) is done to determine how well-controlled their diabetes has been over this period.  Based on this, and discussions with the patient, a doctor will usually provide advice on lifestyle management and may adjust medications. Repeat in 3 months time with no contact in between, unless a problem arises.

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Diabetes is often associated with other conditions such as high cholesterol and obesity.  If poorly managed, in the longer term it cause severe complications such as heart disease, blindness and kidney failure.

The role of medical care for diabetes is to support patients to better manage their lifestyle, prescribe appropriate medication and screen for complications of diabetes.  All this with one ultimate goal – good blood sugar control and minimised risk of catastrophic complications.

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It is working?

How effective is the current approach to diabetes care?  By many measures not very well.

Diabetes clinics are still full of patients whose HbA1c is a lot higher than target.  Patients with the complications of diabetes are abundant and 12.3% of deaths in adults aged 20-79 globally are the result of diabetes or its complications*.

This is in spite of effective medications and scientific proof that good diabetes management is highly effective at reducing risk of complications.

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What’s wrong?

Here’s my summary diagnosis:

• Patients often don’t know enough or don’t care enough about their diabetes
• Doctors often don’t have enough detail to manage patients well
• Many doctors don’t have the time or training to handle diabetes patients
• Other clinical staff who could help (diabetes nurses) are in short supply

How to fix this?

Diabetes is a disease where technology should be able to play a massive role because it is a highly data-intensive condition.  The challenge is to collect and use the right data about a patient’s diabetes to improve patient management.

Here’s where the story turns personal – I became so convinced of the need and the opportunity to apply technology to diabetes that I spent several years developing a comprehensive system which I believed would address many problems in diabetes care: SugoSure.

SugoSure supports the creation of best practice care and lifestyle plans for patients with diabetes and helps them to monitor their condition accurately.  It then applies rules-based analysis to look for patterns in this data and presents patient records in a structured way to doctors and nurses, whose productivity and care quality is enhanced through remote monitoring and protocol-driven care pathways.

My next article will describe the challenges I have faced implementing SugoSure and summarise some key learnings relevant to all who are trying to tackle to ugly problem of applying tech to healthcare.

* International Diabetes Federation Diabetes Atlas 10th Edition p55

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