One in six people are affected by diabetes or pre-diabetes in the UAE1. Diabetes remains an underlying factor in just under 70% of deaths reported. What is more disturbing is that amongst the type 2 diabetes population in the UAE, a large portion of these patients, around 40%, are not adherent to the treatment plans set up by their providers and only 23% have well managed sugar levels1.
Why is it that a disease that affects so many people is so poorly managed?
If we consider that people with type 2 diabetes, on average, self-manage their condition around 8000 hours per year (that’s 91% of the hours in a total year), we will understand why compliance rates are so low. Diabetes self-management is essentially a full-time job. No other disease has such a high self-managing process. Every facet of their lives affects their overall outcome. People with diabetes need to consider activities such as taking their medication, measuring their glucose numerous times per day, calibrating their devices, managing their diet exercise regiment, monitoring their sleep patterns, measuring and taking their insulin dosages correctly, etc. Even motivated patients usually drop the ball on one or more of these items, resulting in below average outcomes and unnecessary visits to the clinic due to hypo/hyper glycemic events.
The issue we face is that current diabetes methodologies in managing patients are outdated and limited to a few in-clinic parameters. Providers generally have a one-dimensional view when it comes to managing their diabetic patients: a plan typically based upon blood results taken once every quarter. On average a diabetic patient will spend around 20 minutes every quarter with their endocrinologist, and this accounts for less than 1% of the total time required to manage his/her diabetes throughout the year. The remaining 99% of their management is conducted outside the walls of the clinic. Critical data on the self management portion is lost as this is done in total isolation of the provider. It becomes quite obvious why this is leading to low compliance rates resulting in further expensive complications. The total global healthcare budget spent on diabetes1 is now at 15% of the overall healthcare budget driven by poor outcomes and low compliance..
As providers, we simply cannot expect patients to produce the desired outcomes by just interacting with the patient several times per year. With advances in technology, we are now in a position to manage diabetes at all times regardless of whether the patient is at home, work or in clinic. Enter COVID and the new normal. Since COVID-19 began, 60% of patients with diabetes have simply abandoned care they would have otherwise received4 — and 42% are concerned or very concerned about going to the doctor’s office or ER. When it comes to COVID and diabetes, whilst there is no evidence showing an increased rate of being infected with COVID if one has diabetes, there is a disproportionately high chance of death if a diabetic patient gets infected with COVID. In fact, according to the UAE Ministry of Health, 40% of all COVID-related deaths in the UAE have been associated with those who have diabetes2. These statistics are alarming and are expected to get worse. Diabetic patients will continue to resist coming in for routine care, leading to poorer management of their diabetes, and even higher risk of injury if infected with COVID.
Diabetes management needs a fundamental change. Glucare believes these challenges can be overcome through the adoption of digital health, and more specifically, digital therapeutics (DTx).
Digital therapeutics, a subset of digital health, are evidence-based therapeutic interventions driven by high quality, artificial intelligence driven, software programs to prevent, manage, or treat a medical disorder or disease.
Glucare’s solution is multi-faceted:
– Create an in-clinic environment that minimizes wait-times and ends the need for multiple unnecessary visits to the clinic
– Create a digital platform where a patient is continually monitored remotely on the most important parameters, beyond simply glucose, that are relevant to their diabetes
– Incorporate the power of machine learning and artificial intelligence so that the care team is able to get real-time insights into the disease risk factors of patients beyond diabetes at all times
– Allow for a continuous two-way communication between provider and patient to close the feedback loop that currently exists in diabetes management programs.
– Develop and push out relevant and personalized educational content to patients at the right time to nudge behavioural change.
– Measure patient compliance (remote data) and clinical outcomes (remote and in-clinic data) demonstrating to stakeholders that a combination of DTx and human care is required
Glucare Integrated Diabetes Center is now treating patients in the United Arab Emirates, and further centers are expected to be rolled out soon.
3 Tropical Journal of Pharmaceutical Research June 2014; 13 (6): 989-995