Technology and Diabetes Care | questions from the AADE annual meeting

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Nora Saul, M.S, R.D., L.D.N., C.D.E.

Nora Saul is a Certified Diabetes Educator and Manager of Nutritional Education at Joslin Diabetes Center.

Greetings from the annual meeting of the American Association of Diabetes Educators (AADE) in sunny, hot and sizzling Las Vegas.  Thousands of us gathered in the city of sin to network and learn what is new and exciting in the field.  And today I want to share some of what I learned with you.

So much of the conference focused on cost and new technologies.  And how new technologies can help drive cost down.

We all know diabetes is spiraling out of control with more than 430 million people projected to have diabetes by the year 2030.

That’s a lot of people.  Unfortunately, the growth rate for endocrinologists is not keeping up; nor is the liquidity of Medicare and Medicaid.

Can technology fill the gap?

The talk on the street is about using web-based technologies and Smartphone apps to have patients log, send and receive information about their blood glucose over the internet in both real and delayed time.

Some of this technology exists now—programs from the pump companies allow you to download pump and meter logs and give your health care providers access to your results at your discretion.  There are “email-like” programs that allow you and your provider and educator to see your blood glucose, blood pressure and other lab results and give you feedback in almost real time.  And camera phones that would allow you to see your provider while you talk with them.

These types of technologies would have positive benefits: doctors and educators could “see” more patients and patients wouldn’t have to drive long distances or spend hard-earned dollars on exorbitant parking fees.

At present, these types of “visits” are not reimbursed by insurance companies.  Financial systems are often way behind technological advances.  And there is another problem.  What about the soft side of medicine and education.  Do we lose something when people don’t meet face to face?  Will patients feel as comfortable discussing delicate personal matters over the internet?

Let us know:

Are you in favor of fewer face to face visits with your healthcare provider but more regular contact over the “digital highway” with them?

Do you think higher-tech is the future of diabetes care?

10 Responses to Technology and Diabetes Care | questions from the AADE annual meeting

  1. Linda Spencer says:

    A combination of some communication by e-mail and appointments would be good for helping me manage my diabetes. My diabetes educators have sometimes used e-mail and that has been helpful as I live a distance from Boston. If instead of a trip into Joslin an issue can be resolved through an e-mail– that is very helpful to me and very satisfactory.

  2. Ravindranath says:

    Using both formula (face to face visits and regular contact over the digital highway ) in balance will help

  3. Claire Blum says:

    Technology cannot replace the need for human touch and face to face encounters, but it can open channels for learning and engaging, and be presented with the softness of compassion. High Tech demands High Touch . . . the challenge is in finding ways to make our “touch” more personal and powerful . . . both in person and in use of technology.

  4. Maureen McNeil-Stone says:

    Having people go out of their way to go to the endocrinologist makes them think more about their diabetes. Also, a doctor needs to lay eyes on people especially their feet.

  5. DAVID WHEELEER says:

    Are you in favor of fewer face to face visits with your healthcare provider but more regular contact over the “digital highway” with them?

    Yes, BUT there has to be s professional at the other end to support the patient entry. At this time, I am supportive of some blogs and web sites for diabetes information and commiseration. The PCP is still the essential caregiver. Th0ugh I imagine that it won’t be long before there is a somewhat robotic problem, diagnostic, etc. answering device.

    Do you think higher-tech is the future of diabetes care? Unquestionably. What else is there, really? Dr. Spock is off the air & divine intervention is too capricious – but not to be ignored.

  6. jan sullivan says:

    hi–
    i read all your e-articles with great interest. i am a type 2 diabetic, under the care of Liz Blair at the Root Team at Joslin. She is wonderful, as is the 24/7 emergency phone service, with doctors who call back within 5 minutes!!!
    i was told that pain, stress, lack of exercise and incorrect eating will cause bg to rise. my eating is PERFECT, because i am afriad (after several ER runs). The other 3 i am working on with a new Primary (thank god!). i had a construction accident 2 yrs ago–17 pieces of double-sized sheet rock fell on me, causing broken left wrist (with bone chip still floating around, causing intermittent pain), extensive soft tissue damage in right foot, frozen right great toe, large bunion that was not there prior to accident, and a meniscal tear in right knee that kept getting reinjured due to meds prescribed by my former Primary (esp. Tramadol!). i had acute renal failure last october, hospitalized for a week in telemetry unit, my GRF kept going DOWN after i was admitted, but immediately began to improve when i refused the 2 tylenol they were giving me every 4 hrs., AMA. GNR is now, finally, very close to normal. i am on fewer meds than i have been in the 4 years i’ve been a type 2.

    My new Primary gave me small amount of pain meds (5 mg oxycodone, no additives) and for the past 4 days, i have needed NO meds, neither glyburide nor insulin!!! A very tense (and painful) morning today brought bg up to 148. 1 glyburide brought it down to 110 in less than an hour. i am able to THINK again, perform ADLs such as shopping, cleaning house, working very conscientiously on my physical therapy exercises for the knee, wrist and foot….and hope to become the low-maintenance patient i was for my entire life until 2 years ago.

    until i got my new Primary (last week), my high bg from pain, tension, etc. was treated with INSULIN, which is not an optimum situation.

    some documention to back up my experience, which to me is a phenomenon a/k/a miracle, would be wonderful, and my new doc would appreciate it, too.

    if this is not the appropriate venue for my q&a, please let me know what is. the joslin center is the best thing i’ve ever done for myself!!
    thank you
    janet h sullivan
    1-508-255-8572.
    143 Tonset Rd.
    Orleans, MA 02653
    med recs available thru Root Center/Liz Blair

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  8. Enhanced communication that is efficient, convenient, informative and specifically doctor-patient focused would be able to increase the base of patient care delivery. Insurance must be convinced it is financially beneficial as well as improving patient care delivery. These doctor visits must become covered by insurance to take off. These communication visits probably should be subject to co-pays to bring finical benefit to the company. If so, expansion of care would become a normal everyday occurrence. It would probably require additional office perdonell to increase patient delivery of care. But this as well as additional improved technology will scone the wave of the future if insurance companies can see some financial compensation benefit. There weevil free lunches.

  9. Crystal Pina says:

    I so agree with using an app to report sugars. Being able to upload my information will make my doctor’s visits more productive. She can look into the computer and see what my sugars have been (I always forget to bring my book!). I don’t see this replacing doctors appointments because, as someone said, they need to see your feet and do A1Cs. This is a new age. It’s time to adapt.

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