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Navigating technology for People with Diabetes
Susan Weiner, MS, RDN, CDE, FAADE
Jennifer C. Smith, RD, LD, CDE
Presenter Disclosure InformationIn compliance with the accrediting board policies, the American Diabetes Association requires the following disclosure to the participants:
Name of Presenter: Susan Weiner
Advisory Panel: Clinical Advisory Board Livongo
Diabetes in Real Life Columnist, Endocrine Today
Presenter Disclosure InformationIn compliance with the accrediting board policies, the American Diabetes Association requires the following disclosure to the participants:
Name of Presenter: Jennifer Smith RD, LD, CDE
Disclosed no conflict of interest
Objectives:At the end of this presentation participants will be able to:
Discuss how apps may assist a person with diabetes with daily self-management
List 4 categories of apps which may be useful for managing diabetes
Discuss why health literacy and numeracy must be considered in app use and development
The feeling of being dragged down by the day‐to‐day demands of diabetes.
Richard R. Rubin, Ph.D., C.D.E.
Diabetes Overwhelmus
What Makes an app Useful?? Convenience
Ease of Use
Improved Diabetes Organization
Real time
Decision support
Cost effective
Reduce diabetes burnout
Improved communication with providers and caregivers
Potential improved clinical outcomes
Improved response time
Takes the remembering out of remembering
As Diabetes Devices Change, Apps Follow
https://beyondtype1.org/the-evolution-of-diabetes-technology/
The Evolution of Diabetes and Lifestyle Apps
Self-monitoring
Smartphones
Guiding management strategies
Provider communication
Care-giver communication
Personal empowerment
Useful Apps May Make Life Easier
Less Inner Monologue to manage
Eliminate “parts”
Seamless data management/communication
Assistance with data analysis
Alerts - quick response
There’s an App for Everything Food tracking/recipe
assistance
Exercise tracking
Accuracy in Carb Counting
Dosing assistance (for those on MDI)
Data analysis – data loading from devices
BG prediction
Insulin titration
App Selection Individualized need
Data tracking
Information for accuracy
Dosing assistance
Social connection
Combination/all-inclusive
Health literacy/numeracy
OnDuo for Diabetes Google’s healthcare arm (Verily) and drug
manufacturer Sanofi partnered to form a new diabetes company, Onduo
Program includes:
• Access to a dedicated Care Team • Devices to track glucose and diabetes supplies at no cost to you• Simple, targeted strategies for improving your health that fit your life
The Onduo app integrates with the Apple Health app to collect step data and retrospective continuous glucose data. This data is displayed on the dashboard and history views in the Onduo app
Welldoc BlueStar Insights – smarter with each
interaction
Wisdom – Accessible, in-app diabetes education (via AADE)
Coaching – 25,000+ automated, tailored messages
Engagement – Weekly challenges to engage/prompt
Connection – SMART visit reports to share in app
One DropBluetooth-enabled glucose meter • Strips & lancets delivered to your door – low cost• Certified diabetes coaches available 24/7 • Award-winning app to track glucose, food, meds, and activity
InPen.
Designed for insulin-dependent individuals 12 and older on MDI.
Dosing in 0.5 to 30 units of insulin, dialed in half-unit increments.
Compatible with Lilly Humalog® and Novo Nordisk Novolog® U-100 3.0 mL insulin cartridges and single-use detachable and disposable needles (not included).
Lasts for one year – no recharging needed
The App
The InPen app is the other half of InPen’s smart diabetes management tool.
Helps calculate your doses/ keeps track of injection data.
Paired via Bluetooth® with the smartphone app, keeps tabs on units received at last injection, time taken
Allows share therapy data with your doctor or family, and much more.
** iOS only at present
RapidCalc DM ManagerINSULIN ON BOARD TRACKING
AUTOMATIC TARGET AND RATIO SELECTION
QUICK DATA ENTRY AND DOSE SUGGESTION
BASAL DOSE RECORDING WITH REMINDERS
"PUMPING WITHOUT A PUMP"
ACTIVITY BASED DOSE ADJUSTMENT
LOG BOOK, STATS AND CHARTING
Other FEATURES:
> Choice of mmol/L or mg/dL blood glucose units> Enter Carbs in grams or portions of 10, 12 or 15g> Choice of % or mmol/mol HbA1c units> Built-in help
A Digital Therapeutic for Patients and ProvidersPeople with Diabetes (PWD) Health Care Providers
A companion app (Android or iOS):
→ Insulia automates real-time basal insulin
dosing to help PWD get to the right dose.
Every day
→ Insulia supports PWD with educational
coaching messages based on blood glucose
values
A prescription-based web portal delivers:
→ Ability to configure personalized treatment
plans based on patient’s profile,
prescription and BG targets
→ Enhanced data management to support
effective diabetes management through
remote monitoring
Insulia® is a prescription-only, FDA cleared, digital basal insulin titration device for people with type 2 diabetes and their providers
Dexcom Share/FollowDexcom Follow –• Allows 5 people to remotely monitor glucose data and trends
on their smart phone • Allows alerts for high/low BG to caregivers
Medtronic Guardian ConnectApp – displays Sensor glucose data, trends and alerts ** Does not integrate with Medtronic pump
Works with Sugar.IQ assistant** Provides insight into trends and factors affecting them to help with informed decisions
Caregiver Data Share* Carelink Connect – access to glucose levels and automatic text message alerts
Abbott Libre
https://www.mobihealthnews.com/content/new-fda-clearance-abbott-freestyle-libre-users-can-ditch-handheld-readers-app
Freestyle LibreLink app• Current glucose• Trend arrow• Glucose history – 8 hrs• Notes –
food/insulin/exercise/health• Share reports
Data Collection Apps Data download and analysis:
Glooko (download all pumps and Dexcom CGM)
Accessible via App for Dexcomupload
Diasend (download all pumps and Dexcom)
Accessible via app
CGM Data at Your FingertipsDexcom Clarity App:
Time in range
Data insights for pattern analysis and adjustment
Email and on-phone screen notifications
Predicted A1C – comparison of current and past data
Decisions, Decisions
Self-Care Choices Key Situations
To snack?
To check again soon?
To exercise?
To adjust insulin?
Driving
Sports
Tests/Stress
Bedtime
Non-Diabetes Specific Apps
Medical ID App (ICE)
Sleep
Stress Management
Organizing
When to take meds
Health Literacy and Numeracy Assess health
literacy/numeracy
Evaluate individuals
desire to use an app
Provide options based on
need
Language MattersProblematic Preferred Rationale
Diabetic (adjective)Diabetic footDiabetic educationDiabetic person
“How long have you been diabetic?”
Compliance/compliance
Non-compliant/non-compliance
Foot ulcer, infection of the footDiabetes educationPerson with diabetes
“How long have you had diabetes?”
EngagementParticipationInvolvementMedication taking
“She takes insulin whenever she can afford it.”
• Focus on the physiology or pathophysiology
• Diabetic education is incorrect (education doesn’t have diabetes)
• Put the person first• Avoid using a disease to
describe a person
• Compliance and adherence imply doing what someone else wants, i.e., taking orders about personal care as if a child. In diabetes care and education, people make choices and perform self-care/self-management.
The Use of Language in Diabetes Care and Education, Jane K. Dickinson, RN, PhD, CDE et al October 17, 2017
Mission Statement
DANA is a resource to enable professionals working in partnership with persons with diabetes to have access to best in class information about diabetes technology.
Our goal is to empower collaborative decision making in the care and management of people with diabetes, leading to positive health outcomes.
DANA The Diabetes Advanced Network
Access Website
Take Aways: Respect a person’s individual needs
Do your homework – explore available Apps
Explore Devices– play with Apps
Interpret and use data analysis in the Apps
Use person centered language
Consider health literacy
“People don’t always remember what you say or even what you do, but they always remember how you made them feel.”
- Maya Angelou
References www.companionmedical.com - InPen
www.myOmnipod.com
www.medtronicdiabetes.com
www.mySugr.com
www.dexcom.com
www.tandemdiabetes.com
ADA Standards of Care 2019 -https://www.professional.diabetes.org/content-page/practice-guidelines-resources
www.itunes.com
https://play.google.com/store
www.diatribe.com
Resources DANA – www.danatech.org
App Stores
iTunes, GooglePlay
ADA – www.diabetes.org
AADE- www.diabeteseducator.org
Contact
Susan Weiner Nutrition, PLLC Jennifer C. Smith, RD, LD, CDE