‘Digital therapeutics can help in timely diagnosis and better management of diabetes’ | The Financial Express

‘Digital therapeutics can help in timely diagnosis and better management of diabetes’

World Diabetes Day 2022: The digital therapeutics approach to diabetes care revolves around three subsets according to the stage of diabetes: prevention, management and remission.

‘Digital therapeutics can help in timely diagnosis and better management of diabetes’
World Diabetes Day 2022: With the evolving technology, new treatment measures and preventive tools have also come up. (Image Credit: Pixabay)

World Diabetes Day 2022: The digital transformation of healthcare has evolved existing ways of patient care and treatment. According to the World Health Organization (WHO), technologies such as the Internet of things, virtual care, remote monitoring, artificial intelligence, big data analytics, blockchain, smart wearables, and other tools have enhanced health outcomes.

The digitisation of the healthcare system has also improved medical diagnosis, data-based treatment decisions, digital therapeutics, clinical trials, self-management of care, and person-centred care as well as creating more evidence-based knowledge, skills and competence for professionals to support healthcare, as per the global health agency.

With the evolving technology, new treatment measures and preventive tools have also come up. Digital therapeutics, a subset of digital health, is also becoming a part of the mainstream care and treatment system. According to reports, the estimated budget of the global digital therapeutics market is $1.8 billion in 2018, which is projected to reach $7.1 billion by 2025. The term first came in 2015, has, according to experts, led to “increase accessibility and effectiveness of healthcare.”

What is Digital Therapeutics?

Digital therapeutics is a treatment or therapy that utilizes digital and often Internet-based health technologies to spur changes in patient behaviour through the prevention and management of diseases.

“It uses methods rooted in cognitive behavioral therapy to encourage patients to make lifestyle changes. This method is used to manage and prevent numerous conditions, including type II diabetes, Alzheimer’s disease, dementia, congestive heart failure, chronic obstructive pulmonary disease, asthma, lung disease, obesity, substance abuse, ADHD, insomnia, hypertension, anxiety, depression, and others,” Dr. Ashutosh Niranjan, MBBS, MS, Dean of Noida International Institute of Medical Sciences (NIIMS) told Financial Express.com.

It is directed at a specific health condition such as diabetes to improve outcomes. Dr. Arbinder Singal, Co-Founder and CEO, Fitterfly told Financial Express.com that digital therapeutics help in timely diagnosis and better management of health conditions.

Industry experts maintain that digital therapeutics is a critical communication method used to share patient data through software programs with a doctor when a patient is located at a distance. 

Digital Therapeutics in Healthcare

According to Dr. Anil Bhoraskar, Senior Diabetologist-SL Raheja Hospital, Mahim & Secretary-Diabetic Association of India (Scientific Section), in digital therapeutics, a person transmits information like case history, test results, and other signs and symptoms through a portal to the doctor.

During the pandemic, digital therapeutics became a prevalent mode of communication. This communication method between the person suffering and the person delivering the therapy, often called digital therapy, has many advantages and disadvantages, he told Financial Express.com.

To provide an effective and precise solution, the tools of digital therapeutics have been developed with the aim of increasing patients’ accessibility to effective and clinically safe treatments.

It also helps in providing clinical solutions for untreated or undertreated health conditions, extending physicians’ ability to treat patients, providing therapeutic solutions in multiple languages, and providing accurate results and information on personalized disease management and outcomes to patients and physicians.

Digital Therapeutics in Diabetes

According to Dr. Ashutosh Niranjan, MBBS, MS, Dean of Noida International Institute of Medical Sciences (NIIMS), in diabetic care, connected devices like insulin pumps, blood glucose meters, and wearable gadgets can all send data to a unified system. Every year on November 14, World Diabetes Day is celebrated to raise awareness about the lifestyle disease.

“The therapy also uses self-reported data like diet or other lifestyle factors. It also monitors the potential heart and lung conditions and suggests changing behaviours like smoking, poor diet, or a lack of exercise. People can see their sugar data many times a day and monitor their sugar levels smartly without pricks. In some of the devices, if the blood sugar goes up, the technology suggests ways to bring it to normal. The real-time insights enable them to make quick changes in their meal and exercise plans on a daily basis. This results in better management of diabetes by lowering blood sugar,” Dr. Niranjan told Financial Express.com.

The digital therapeutics approach to diabetes care revolves around three subsets according to the stage of diabetes: prevention, management and remission.

“It works on the premise that every person has a different blood sugar rise to different foods “(personalised glycemic response)”and therefore, the interventions are also personalized according to the individual. Through the digital therapeutics platform, people living with diabetes are offered a tailor made programme involving diet-related guidance, and access to motivational and mental and physical wellness coaches. All of this is done in close coordination with the doctors,” Dr. Singal told Financial Express.com.

Meanwhile, Dr. Bhoraskar emphasises that first and most importantly, diabetes is a condition that has opened many avenues through many therapeutic options.

“Once the patient is clinically examined, they visit a doctor for further treatments. The patient must give information about his disease to the doctor so that it can be treated effectively. Today, diabetes is a disease that affects many biochemical parameters in the body and needs to be conveyed to his health caregiver. The examination can be in the form of a leaflet of a pathology report, ECG or ECHO graphic finding or maybe an eye examination. In any case, the doctor needs to understand and study all the relevant reports,” Dr. Bhoraskar told Financial Express.com.

He also pointed out that earlier, the patients used to come to the clinic by travelling for many hours from different areas or cities.

“However, during COVID-19, they started relying more on digital means like e-mail, WhatsApp, and online forms of technology. Today, patients share their symptoms and current line of treatment and reports on WhatsApp, which the doctor then studies for further treatment procedures. After reviewing the patient’s history and findings from their report, the doctor gives therapeutic options, including diet, therapy and insulin dosage as required,” he added.

Another important factor is the role of digital technology in monitoring which is extremely important in diabetic management.

“Diabetes is not a one-time disease, and it’s not like typhoid, where the patient is free of the disease after receiving treatment. It is a disease with which a person sometimes must live during their entire life. While clinical monitoring can be done periodically, a diabetic patient needs to monitor their blood sugars and other biochemical parameters such as lipids, thyroid functions, or creatinine in kidney functions at regular intervals…Technology has played a significant role with the advent of a home glucose monitor as people don’t have to visit a laboratory for blood tests and can monitor them at home,” he said.

India’s Position in Digital Therapeutics

According to Dr. Anil Bhoraskar, India is relatively advanced when it comes to individual therapy in diabetes.

“Our country can boast of having one of the finest networking systems in the world, as Wi-Fi networks and data plans connect almost all regions of the country. Young people are technologically savvy in all aspects, even if they are just ten years old. Today, not just Tier 1 cities but tier 2 and 3 cities are well connected through digital technology, which has helped many people during COVID,” he said.  

He also emphasised that although patients had a tough time visiting a clinic, doctors still managed to communicate with patients for treatments through digital technology.

“Further, the drugs supplied by the chemist online increased by almost 20 to 30% as patients began purchasing all their medicines on the net. In fact, this access will only grow and increase in the coming days, which is a good thing for the healthcare system in our country,” he added.

Meanwhile, Dr Arbinder Singal, Co-Founder and CEO, Fitterfly emphasised that digital therapeutics is a novel industry in India and not much has been in the area of using technology to improve actual health outcomes.

“In western countries, digital therapeutics require specific regulatory approval such as from FDA in the USA or DiGA in Germany. In India, the regulatory framework is still being drawn up. The one framework which is currently available is registration under CDSCO as a SaMD (Software as a Medical Device). With the advent of more data and more startups focussing on DTx, we hope that India will also come up with a definite regulatory framework for DTx,” he added.

‘No Shortcuts in Medicine and Clinical Examination’

Dr. Niranjan pointed out that many people especially in Tier 2 and 3 cities are not aware of such therapies and their benefits.

“Doctors at Primary Healthcare Centres are also not skilled and trained enough to impart such knowledge to the patients and caregivers. The lack of accessibility and availability of such Internet-based health technologies is one of the greatest challenges in India. In India, many people are suffering from diabetes and related health issues due to ignorance and lack of awareness. Making them aware of digital therapeutics adds to this challenge,” he added.

Meanwhile, Dr. Anil Bhoraskar maintained that along with the advantages, the drawback of digital technology is that there are no shortcuts in medicine and clinical examination, and their medical history is thoroughly examined when the patient comes to the doctor.

“…compassion and kindness displayed by the doctor or caregiver cannot be transmitted through digital technology and can only be expressed through physical touch. More importantly, just because a patient is not examined physically, they should not be denied the right to proper scientific treatment. Sometimes the shortcomings of being unable to visit a doctor or consultant at a senior level can lower the patient’s confidence,” he added.

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First published on: 14-11-2022 at 18:32 IST