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数字健康技术与糖尿病管理。

Digital health technology and diabetes management.

机构信息

The Diabetes Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel.

Endocrinology and Metabolism Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel.

出版信息

J Diabetes. 2018 Jan;10(1):10-17. doi: 10.1111/1753-0407.12606. Epub 2017 Nov 6.

DOI:10.1111/1753-0407.12606
PMID:28872765
Abstract

Diabetes care is largely dependent on patient self-management and empowerment, given that patients with diabetes must make numerous daily decisions as to what to eat, when to exercise, and determine their insulin dose and timing if required. In addition, patients and providers are generating vast amounts of data from many sources, including electronic medical records, insulin pumps, sensors, glucometers, and other wearables, as well as evolving genomic, proteomic, metabolomics, and microbiomic data. Multiple digital tools and apps have been developed to assist patients to choose wisely, and to enhance their compliance by using motivational tools and incorporating incentives from social media and gaming techniques. Healthcare teams (HCTs) and health administrators benefit from digital developments that sift through the enormous amounts of patient-generated data. Data are acquired, integrated, analyzed, and presented in a self-explanatory manner, highlighting important trends and items that require attention. The use of decision support systems may propose data-driven actions that, for the most, require final approval by the patient or physician before execution and, once implemented, may improve patient outcomes. The digital diabetes clinic aims to incorporate all digital patient data and provide individually tailored virtual or face-to-face visits to those persons who need them most. Digital diabetes care has demonstrated only modest HbA1c reduction in multiple studies and borderline cost-effectiveness, although patient satisfaction appears to be increased. Better understanding of the barriers to digital diabetes care and identification of unmet needs may yield improved utilization of this evolving technology in a safe, effective, and cost-saving manner.

摘要

糖尿病的护理在很大程度上依赖于患者的自我管理和赋权,因为糖尿病患者必须每天做出许多决策,例如吃什么、何时运动以及确定胰岛素剂量和时间(如果需要)。此外,患者和提供者正在从许多来源生成大量数据,包括电子病历、胰岛素泵、传感器、血糖仪和其他可穿戴设备,以及不断发展的基因组、蛋白质组、代谢组学和微生物组学数据。已经开发出多种数字工具和应用程序来帮助患者做出明智的选择,并通过使用激励工具并结合社交媒体和游戏技术的激励来增强他们的依从性。医疗保健团队 (HCT) 和健康管理人员受益于数字发展,可以筛选大量的患者生成数据。数据以自解释的方式获取、集成、分析和呈现,突出显示需要关注的重要趋势和项目。决策支持系统的使用可能会提出数据驱动的行动,这些行动在大多数情况下需要患者或医生最终批准后才能执行,一旦实施,可能会改善患者的结果。数字糖尿病诊所旨在整合所有数字患者数据,并为最需要的人提供个性化的虚拟或面对面就诊。尽管患者满意度似乎有所提高,但在多项研究中,数字糖尿病护理仅显示出 HbA1c 适度降低和边缘成本效益。更好地了解数字糖尿病护理的障碍和确定未满足的需求,可能会以安全、有效和节省成本的方式提高对这种不断发展的技术的利用。

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