Pains and needs of patients with type 2 diabetes as targets for novel technologies
Abstract
Background. As diabetes affects multiple spheres of life the aim of this study was to explore the pain points of diabetes management as perceived by persons with type 2 diabetes and to identify their expectations towards new technologies.
Methods. Patients with type 2 diabetes treated with oral hypoglycemic agents and/or insulin were surveyed. Respondents were asked to rate (i) the impact of diabetes on their daily life and (ii) their needs for improvements in different aspects of diabetes management on a five level Likert-type scale.
Results. One hundred and fifty-four persons with type 2 diabetes were included. Most frequently reported challenges were: fear of diabetes complications development or progression (98.7% of patients), presence of diabetes complications (65.6%), frequent hyperglycemia (53.2%), and diabetes limiting one’s daily activities (50%). Most frequently expressed needs were: to evaluate glucose concentrations without finger pricking (98.1%), contact with a physician using mobile solutions and/or telemedicine (98.1%), and automation of insulin dosing (91.6%) and of calories/carbohydrates’ evaluation in meals (84.4%). Needs for telemedicine development, automation of insulin dosing and that the others help patients with diabetes management were more frequently reported by persons with: higher HbA1c, positive severe hypoglycemia history, concomitant chronic complications or diseases, and by those who were on insulin therapy.
Conclusions. Although many diabetes technologies which meet the needs of patients with type 2 diabetes are already available, the study uncovers a high requirement for integrating them into disease management. The challenge pertains to implementation of the right technological solutions fulfilling needs of particular groups of patients and to helping them to embrace novelties into their daily lives.
Keywords: digital healtheHealthpatientstelemedicinetype 2 diabetesartificial pancreas
References
- Ogurtsova K, da Rocha Fernandes JD, Huang Y, et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract. 2017; 128: 40–50.
- Rubin R, Peyrot M. Quality of life and diabetes. Diabetes/Metabolism Research and Reviews. 1999; 15(3): 205–218, doi: 10.1002/(sici)1520-7560(199905/06)15:3<205::aid-dmrr29>3.0.co;2-o.
- Arnolds S, Heckermann S, Koch C, et al. How do patients' preferences compare to the present spectrum of diabetes research? Exp Clin Endocrinol Diabetes. 2013; 121(1): 60–63.
- Arnolds S, Heckermann S, Heise T, et al. Spectrum of Diabetes Research does not Reflect Patients' Scientific Preferences: A Longitudinal Evaluation of Diabetes Research Areas 2010-2013 vs. a Cross-sectional Survey in Patients with Diabetes. Exp Clin Endocrinol Diabetes. 2015; 123(5): 299–302.
- Barber S, French C, Matthews R, et al. The role of patients and carers in diffusing a health-care innovation: A case study of "My Medication Passport". Health Expect. 2019; 22(4): 676–687.
- Bailey TS, Walsh J, Stone JY. Emerging Technologies for Diabetes Care. Diabetes Technol Ther. 2018; 20(S2): S278–S284.
- Gonder-Frederick LA, Shepard JA, Grabman JH, et al. Psychology, technology, and diabetes management. Am Psychol. 2016; 71(7): 577–589.
- Fatehi F, Menon A, Bird D. Diabetes Care in the Digital Era: a Synoptic Overview. Curr Diab Rep. 2018; 18(7): 38.
- Cefalu WT, Tamborlane WV. The artificial pancreas: are we there yet? Diabetes Care. 2014; 37(5): 1182–1183.
- Schliess F, Heise T, Benesch C, et al. Artificial Pancreas Systems for People With Type 2 Diabetes: Conception and Design of the European CLOSE Project. J Diabetes Sci Technol. 2019; 13(2): 261–267.
- Benhamou PY, Franc S, Reznik Y, et al. Closed-loop insulin delivery in adults with type 1 diabetes in real-life conditions: a 12-week multicentre, open-label randomised controlled crossover trial. The Lancet Digital Health. 2019; 1(1): e17–e25.
- Park C, Le QA. The Effectiveness of Continuous Glucose Monitoring in Patients with Type 2 Diabetes: A Systematic Review of Literature and Meta-analysis. Diabetes Technol Ther. 2018; 20(9): 613–621.
- Bally L, Thabit H, Hartnell S, et al. Closed-Loop Insulin Delivery for Glycemic Control in Noncritical Care. N Engl J Med. 2018; 379(6): 547–556.
- Reznik Y, Cohen O, Aronson R, et al. Insulin pump treatment compared with multiple daily injections for treatment of type 2 diabetes (OpT2mise): a randomised open-label controlled trial. The Lancet. 2014; 384(9950): 1265–1272.
- De Rekeneire N, Resnick HE, Schwartz AV, et al. Health, Aging, and Body Composition study. Diabetes is associated with subclinical functional limitation in nondisabled older individuals: the Health, Aging, and Body Composition study. Diabetes Care. 2003; 26(12): 3257–3263.
- Faraji Gavgani L, Sarbakhsh P, Asghari Jafarabadi M, et al. Identifying Factors Associated with Functional Limitation Among Diabetic Patients in Northwest of Iran: Application of the Generalized Additive Model. Int J Endocrinol Metab. 2018; 16(2): e12757.
- Papaspurou M, Laschou VC, Partsiopoulou P, et al. Fears and Health Needs of Patients with Diabetes: A Qualitative Research in Rural Population. Med Arch. 2015; 69(3): 190–195.
- Grammes J, Stock W, Mann CG, et al. Focus group study to identify the central facets of fear of hypoglycaemia in people with Type 2 diabetes mellitus. Diabet Med. 2017; 34(12): 1765–1772.
- Watterson JL, Rodriguez HP, Shortell SM, et al. Improved Diabetes Care Management Through a Text-Message Intervention for Low-Income Patients: Mixed-Methods Pilot Study. JMIR Diabetes. 2018; 3(4): e15.
- Dobson R, Whittaker R, Jiang Y, et al. Effectiveness of text message based, diabetes self management support programme (SMS4BG): two arm, parallel randomised controlled trial. BMJ. 2018; 361: k1959.
- Shan R, Sarkar S, Martin SS. Digital health technology and mobile devices for the management of diabetes mellitus: state of the art. Diabetologia. 2019; 62(6): 877–887.
- Tanenbaum ML, Adams RN, Iturralde E, et al. From Wary Wearers to d-Embracers: Personas of Readiness to Use Diabetes Devices. J Diabetes Sci Technol. 2018; 12(6): 1101–1107.
- Kempf K, Altpeter B, Berger J, et al. Efficacy of the Telemedical Lifestyle intervention Program TeLiPro in Advanced Stages of Type 2 Diabetes: A Randomized Controlled Trial. Diabetes Care. 2017; 40(7): 863–871.