Disclaimer: This Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Each year, 1.5 million Americans are diagnosed with diabetes. This includes Type 1 diabetes, which is most commonly diagnosed in children, teens, and young adults; and Type 2 diabetes, formerly known as “adult-onset diabetes.” An additional 84 million people have prediabetes, a condition likely to progress to Type 2 diabetes over time.
Diabetes cannot be cured, only managed, and treatment hinges on in-depth monitoring and the coordinated care of various health professionals, from primary care physicians and nurses to diabetes educators. It also requires a great deal of attention and self-management outside of the health care setting. Both Type 1 and Type 2 diabetes are serious, chronic conditions that, if poorly-managed or left unmanaged, can result in severe and even life-threatening complications.
Managing the disease is not an easy job, as anyone with diabetes can tell you. It can sometimes feel overwhelming. But you don’t have to manage your diabetes all on your own. Reach out to your health care team for information and support, seek out online communities focused on diabetes, and use credible websites to educate yourself further and stay informed. In the age of telehealth, help and support for those managing diabetes are as close as your computer or your phone.
The Role of Telehealth in Medicine
Telehealth means using computers, along with cell phones or other mobile devices, to make health care more accessible. This includes everything from virtual appointments using videoconferencing software, to sharing data through patient monitoring or health tracking apps, to communicating with providers through text or email.
Telehealth services can be broken down into the subsets of “e-health,” which includes computer-based options, and “m-health,” which involves mobile-dependent options, such as apps. In an age where most individuals have home internet and the majority of people also have cell phones, all of these options have their place in modern health care.
Benefits of e-health/m-health
Virtual appointments, wearables that track and transmit information, and apps that are always accessible on your phone can provide a wide range of benefits.
- Increase accessibility for people in rural communities and other isolated areas. About 20% of Americans live in rural areas, but only 9% of the nation’s doctors practice there. Many rural hospitals have also closed their doors in recent decades, leaving rural areas underserved. Telehealth services can let you see and communicate with your doctor even if you can’t be there in person.
- Make getting care more convenient. There are only so many hours in the day, and fitting a conventional medical visit into your schedule can be challenging. This is especially true if you work or have children; finding childcare may be difficult and some parents simply can’t afford to take time off work, even for something as important as a doctor’s appointment. If your access to transportation is limited — if you rely on public transportation, for instance, or have to travel a long way — or if you have limited mobility, scheduling a traditional appointment can be challenging. Telehealth services can fit more easily into your life and your schedule.
- Provide access to specialists. In areas where specialists are in short supply, telehealth can provide access where it might otherwise be impossible.
- Improve communication and coordination of care among members of your health care team. This is especially important for people with diabetes, where many people are involved in your care. It’s important for each member of your health care team to be aware of what the others are doing.
- Provide support for self-management of your own care. Devices and apps that log and transmit health and wellness information automatically can save time and give you one less thing to worry about. For example, simple apps like calorie- and carb-counters can make it easier to track your diet.
All of these benefits are important. But if you live with diabetes, the biggest advantage of telehealth services may be that they can make your life just a little bit easier — and possibly even safer.
Glenna Thompson, R.N., a former community health nurse at the Health Department of a rural Missouri county, says that patients in rural areas can have particular difficulty when interacting with hospitals or distant doctors’ offices.
“So many times, what happens is someone goes to the hospital and is given new medications — whether it’s insulin or another medication for another problem besides diabetes, and they don’t get the instruction they need to know how to use the medication, why they need to be on the medication, or how long they’re supposed to take the medication.”
This often happens, she says, even when they’re given the instructions as they’re leaving the hospital or doctor’s office. “So telehealth,” she continued, “in addition to a standing physician’s office [visit] or as a follow-up for a hospital visit … could be helpful.”
Telehealth for Diabetes Management
Type 1 and Type 2 diabetes are both forms of the same disease, but they are very different. Though they are both endocrine disorders that result in high blood sugar, their causes are different and treatment is different too.
People with Type 1 diabetes must take insulin. There is no alternative. They must also keep a very close watch on their blood sugar, and may need to count carbohydrates. For people with Type 2 diabetes, some are able to manage the condition with weight loss and changes in their eating habits. Others may still need to take medication, such as metformin (Glucophage), or other drugs, which decrease glucose production or increase insulin sensitivity. Some people may need to take insulin, and some may need a combination of insulin plus other diabetes medications. Also, some may need to closely monitor their blood sugar, while others may only need to test occasionally.
In the case of telehealth, this means that while patients receiving Type 1 and Type 2 diabetes treatment may share some of the same needs (such as virtual appointments and consultations with specialists), those needs may also differ. For example, weight loss is often an important component of care for people with Type 2 diabetes, but less so for those with Type 1. People with Type 1 diabetes, on the other hand, will need to monitor their insulin dosage and response to it, while many people with Type 2 diabetes won’t use insulin at all.
So, what does telehealth for diabetes management consist of? Let’s dive in and take a look.
A patient portal is a secure website which consolidates your health information and gives you 24-hour access from any device with an internet connection. The patient portal lets you do things like view your recent visits, access test results, update your personal information, and often communicate with your doctor. Different clinics and offices may offer different options through their portals, but most allow you to:
- Schedule appointments
- Request refills on prescriptions
- Fill out forms
- Access educational material
- Make payments
- Communicate with any specialists you’re seeing
Virtual appointments are conducted via videoconference. If you’re using a computer, you’ll probably connect through the website of the provider you’re using. If you’re using a smartphone or tablet, you’ll probably need to download their app. Some clinics and offices also offer their own virtual appointments, where you can have a virtual visit with your own doctor, nurse practitioner, or other health care provider for care that doesn’t require you to be there in person.
Although they can’t take the place of regular primary care, virtual appointments certainly have their place in treating the type of minor ailments that you might visit a drop-in clinic for. Whether you’re seeing your own doctor, or using a telemedicine service like Doctor On Demand or Teladoc, the doctors conducting these virtual visits can do the same things that an in-office doctor can, such as prescribe medication or order tests.
Remote monitoring can be a very useful tool for both you and your doctor. With remote monitoring, you use dedicated portable devices or mobile apps to track and record pertinent aspects of your health. This information is then electronically transmitted to your doctor, usually automatically and often in real time. There’s a whole ecosystem of remote monitoring devices and apps, many of which go far beyond even the needs of diabetes management. These include:
- Apps to record and track your glucose readings (Glucose Buddy, DiabetesConnect, MySugr)
- Devices that track and transmit information on blood pressure, blood glucose, or lung function, such as:
- Omron 10 Series® Wireless Upper Arm Blood Pressure Monitor
- Evolv® Wireless Upper Arm Blood Pressure Monitor
- Withings BPM Connect
- Dario (glucose monitoring)
- Wing (lung function)
- Wearables that track and transmit information on heart rate, gait, posture, tremors, sleep patterns, and physical activities; these range from simple consumer devices like FitBit to FDA-approved devices, such as InfoBionic’s MoMe Kardia.
- Home monitoring devices for the elderly, especially for those with dementia. These devices use GPS tracking and may include sensors, which can send out an alert if the person falls (iTraq) or wanders outside of a prescribed area (TRAX). Some, such as AngelSense, even allow caregivers to listen in remotely and monitor what is going on, or communicate with the wearer if necessary.
Remote monitoring, especially of glucose readings and medication, can provide invaluable data for your doctor and other diabetes team members.
Doctors talking to other doctors
Coordination of care is an important aspect of diabetes management, and telehealth options can help ensure all the health professionals in your life are on the same page. For example, your doctor may send lab results, X-rays, or other exam information digitally to a specialist, or teleconference with a specialist. This can reduce the amount of time your doctor spends waiting for a specialist input and can eliminate the need to travel to specialist appointments in person.
Personal health records
Your personal health record (PHR) is a secure, private electronic application where you can manage and maintain your own personal medical record. It can be as simple or as detailed as you wish, but should at the very least contain the basics, such as your age and birthdate, a list of medications you’re taking, conditions you’ve been diagnosed with, and any allergies you may have.
If you have diabetes, your PHR is also a good place to record and track things like your glucose numbers and reactions to medication adjustments. In case of an emergency, it’s an easy way to let emergency personnel know about your health. Your PHR can also be handy if you see multiple doctors or other health care providers.
Personal health apps
Like remote monitoring, personal health apps can be very useful tools for helping manage your diabetes. Personal health apps can make it easier to:
- Record your vital signs
- Calculate calories or carbs, and track what you’re eating
- Set medication reminders, so your meds stay on schedule
- Keep track of your physical activity
All of these are important tasks for people managing diabetes, and you may find the following apps useful:
- iBP Blood Pressure (iOs / Android): In addition to blood pressure, also lets you store glucose readings.
- SmartBP Smart Blood Pressure (iOs / Android): Tracks blood pressure, heart rate, and weight.
- Blood Pressure Monitor (iOs only): Tracks vital signs, lets you record medications, and more
- Fitbit (iOs / Android): More than a fitness tracker, it’s a lifestyle tracker.
- Lose It! Calorie Counter (iOs / Android): A calorie counter and weight loss app.
- MyFitnessPal (iOs / Android): A diet and fitness tracker.
- Medisafe Medication Reminder (iOs / Android): Simple medication tracker and reminder.
- Leap Fitness Step Counter (Android only): A simple step counter for tracking your daily activity.
- 8fit (iOs / Android): Tailored exercise and diet plans.
Resources You May Find Helpful
- American Diabetes Association (ADA): Part of their mission is to provide education and services to improve the lives of all people affected by diabetes.
- Diabetes UK: The UK version of the ADA; offers some information, education, and online programs that the ADA does not, such as the Low Carb Program.
- Juvenile Diabetes Research Fund (JDRF): An organization focused on Type 1 diabetes (T1D), with a mission to cure, prevent and treat T1D.
- The American Dental Association: Provides information on diabetes and oral health, including why good oral health is particularly important for people with diabetes, and what you can do to keep your mouth healthy.
- Physicians Committee for Responsible Medicine: Information on preventing and managing diabetes through plant-based eating.
- Newcastle University: Provides cutting-edge research into reversing Type 2 diabetes through diet.
- Centers for Disease Control and Prevention (CDC), Diabetes UK: Information on and support for dealing diabetes burnout.
The Bottom Line
While it isn’t robust enough to replace conventional primary care, the telehealth field is rapidly expanding, allowing greater access to care than ever before. This is particularly important for people with diabetes, who must coordinate their care with a variety of professionals across fields.
Managing diabetes can be stressful, time consuming, and difficult. Keeping on top of all the things you might need to track, such as glucose readings, diet, exercise, and medications, can sometimes feel like a full-time job. Taking advantage of the new generation of devices that can monitor, record, and send data directly to your doctor or other members of your care team can make diabetes management easier. And the growing selection of apps for tracking lifestyle challenges, like your diet or your exercise regimen, can give you powerful tools for taking control of these aspects of your life.