Technology in diabetes worldwide
Worldwide, there are approximately 463 million adults living with diabetes. This is an increase of over 300% in the last 20 years, and is predicted to rise by over 50% to around 700 million by 2045.1 In this time, the technology available has vastly improved and the accessibility of this technology has also increased greatly, with billions of people all around the world now using the internet on a regular, if not daily, basis.
Technology in the NHS
The NHS has incorporated a digital focus into their Long Term Plan, with the aim of making digitally-enabled care mainstream throughout the NHS.2 The move to more digital care has already begun; with the NHS App Library incorporating over 70 apps and the introduction of both the NHS App and NHS 111 online. There have also been many additional digital offerings, such as virtual clinics, being introduced in a very short time span over recent months, with Covid-19 accelerating the timelines.
Offering world-class care and support to 3.8 million people with diabetes, the NHS have made great strides in digital diabetes care in recent years, with apps, data management systems and digital lifestyle management solutions currently being delivered across parts of the NHS. However, there is currently no requirement for individual trusts to fund these technologies. Improving the integration of technology would enable the NHS to deliver more consistent and streamlined care, as well as improve outcomes for people with diabetes.
There is still plenty of scope for the NHS to build on this success and go further, by drawing inspiration from other countries.
Technology in different countries
All over the world, technology is being used in different ways to deliver digital solutions that can offer improvements in outcomes for people with diabetes. Some examples of these are:
In Mexico, the introduction of a resource for people with type 2 diabetes; which combined a blood glucose monitoring platform, education and a cost-effective treatment; enabled increased self-management. This led to improved outcomes, with a significant increase in time in range and a reduction in HbA1c due to both improved self-monitoring (0.8%) and the treatment (1.45%).4
In Italy, an initiative to integrate mySugr data into the national electronic medical record system allowed for continuous monitoring by healthcare professionals. This is expected to improve the contact between people with diabetes and their healthcare professional, as well as enable more personalised support by the healthcare team.
In the Netherlands, a collaboration between hospitals, insurance companies and industry allowed for the set up of a digital diabetes clinic that changed care pathways to better suit individuals. This led to improved outcomes for people with diabetes, as well as easier remote monitoring of these outcomes by healthcare professionals.
All of these countries are seeing improvements in diabetes care following the introduction of these digital solutions.
What can we learn from this?
There are a number of ideas that can be taken from these examples and could be incorporated into the care pathways delivered within the NHS. All of the solutions mentioned can improve outcomes for people with diabetes, and some even have the potential for cost-savings if implemented.
The wide-scale roll-out of digital technologies in combination with cost-effective treatments, and building them into existing care pathways can support more personalised care by building a care model around people’s individual needs. Not only can this improve self-management, but can also have a positive impact on outcomes - including HbA1c.
In addition, the use of data from digital products on a large scale across the NHS could help provide healthcare professionals with real-time information, allowing them see how people are managing their diabetes and provide them with the right support at the right time.
How has Covid-19 impacted this?
Since the start of the Covid-19 pandemic, healthcare has had to change. More than ever before, technologies have been used to enable access to care without needing to go into the hospital or clinic and see healthcare professionals face-to-face. Not only can this save time but also improve access, with people only needing to take 30-60 minutes out of their day to attend an appointment rather than taking half a day or a full day off work.
Now, following Covid-19, there have been a lot more discussions worldwide at diabetes conferences about how healthcare professionals can learn from the changes throughout 2020 so that they can continue to provide people with diabetes with the right support at the right time.
Diabetes Atlas - 9th edition, International Diabetes Federation, 2019 (https://www.diabetesatlas.org/upload/resources/2019/IDF_Atlas_9th_Edition_2019.pdf)
Long Term Plan - Chapter 5, NHS, 2019 (https://www.longtermplan.nhs.uk/online-version/chapter-5-digitally-enabled-care-will-go-mainstream-across-the-nhs/)
Applying international best practice in access to diabetes technology, Roche Diabetes Care UK, 2020