IPN 2022 November

Improving Diabetes Care Through Technology

Written by Mary Feeley Clinical Nurse Specialist Diabetes Integrated Care, North Tipperary/East Limerick

Technology is evolving at a fast pace & has become an integral part of diabetes care in Ireland today. Healthcare providers & diabetes patients are harnessing the benefits of a wide variety of technologies such as:

• connected blood glucose meters,

• data sharing platforms,

• telehealth,

• remote monitoring,

• continuous glucose monitors,

• insulin pumps,

• smart phone apps to help improve clinical outcomes.

In general practice & the community setting diabetes technology can be utilised to improve health outcomes. This will be enhanced when the person using is well-informed & actively engaged with the technology. For our patients with Diabetes, we want to ensure the latest technology & best treatment options are available to them, so quality of life will be enhanced & clinical outcomes will improve. As health care professionals we want to make informed better care decisions, feel less stress & be able to cope with providing required care to our clients with this chronic condition.

At its core, diabetes is a behavioural challenge, as diabetes management is dependent on the initiation and maintenance of a complex series of behaviours of both the person with diabetes and their healthcare professionals. Although technological and pharmacological advancements are vital, a new medication or device can only influence outcomes if appropriately prescribed by a healthcare professional and used as prescribed by the person with diabetes.

As a nursing profession we need to reframe how we interact with & care for our clients in a digital world. The sheer volume of health & wellness applications, mobile & social media apps (e.g., wearables, online communities) & virtual healthcare (e.g., telemedicine, virtual consultations) available to patients today is impressive.

All this may seem antithetical towards the traditional nursing role - having a therapeutic relationship

in physical interaction - but patients are increasingly informed, empowered & connected to the internet, they demand a varied, personalised, self-management healthcare system that fits their varied & busy lifestyle.

Nursing requires a cultural shift. Too often, support for nursing technology to enhance care can be poorly configured, resourced or not up graded in response to practice and societal trends. We need to revisit cultural interpretations of how technology can complement nursing practices & processes, rather than seeing technology as competition or adversaries. Collaboration with technology developers, providers & all users is essential to ensure success. Amidst technology, nurses can incorporate practical know-how with empathic understanding and technical knowledge to provide human and sensitive care. Practicing respect, actively listening, committing to taking the time to sit with patients, and establishing trust and transparency will balance the presence of technology while advocating safe, quality care.

The theory of technologic capability as caring in nursing illuminates the cohabitation of technology and caring with three key nursing processes:

1. Technological understanding: competent use of technology in treating and caring for the patient as a coparticipant.

2. Mutual design: the nurse and patient agree on diabetes a care plan.

3. Participative engagement: shared activities in implementing the care plan and evaluating the patient’s response and outcomes.

People living with diabetes can feel like they are participants in a lifelong science experiment. Needing to track what they eat and then measure the food’s effect on their blood sugar levels. If you take insulin, you must

administer the correct amount to compensate for the number of carbs you’ve eaten. If you exercise, this needs to be factor in as well. A variety of technologies and devices exist that can help manage all of this — and it can make a big difference to a person living with diabetes by targeting blood glucose control, medication adherence, weight loss, and enhancing quality of life. Technologies for diabetes are intended to support people with diabetes in their therapy and such technologies must also be accepted and used by them. It is therefore important to know the attitudes, wishes, and needs of patients so that new technologies and digital offerings can be developed to suit them.

Digital diabetes products such as connected devices & digital applications, can provide a more seamless & continuous care for people with diabetes, with the potential to achieve better care efficiency & outcomes.

Technology in practice: A Real- World Example

There are a wide range of devices and supporting Apps available. One such device with a supporting App is an example of digital Diabetes technology that can be utilized in general practice is the OneTouch Reveal ® web application. It enables health care professionals to monitor patient progress, offer remote consultations, and allow more effective and informed treatment

decisions between patients and the health care professional The OneTouch Reveal app aggregates data from a OneTouch Verio Reflect ® blood glucose meter and provides analytics to help patients and health care professionals visualise glycaemic trends and patterns, enabling more informed treatment and lifestyle decisions. The app also allows patients and health care professionals to stay connected.

The everyday use of technology empowers people with Diabetes to manage their blood sugar and easily connects them with their Diabetes Care Support team. An Easy-to-use interconnected diabetes management system changes the way patients see their blood sugar readings and enables nurses, doctors, family, and friends to help them manage their diabetes.

It’s up to us!

Irish Health care professionals need to accelerate the digital health transformation, allowing us to become digitally enabled professionals. How do we do this, we invest in informatic education, practice & research. We also need to upskill in data science & other digital health topics to allow emerging technologies develop that are appropriate & safe for nursing practices & patient care. We need to invest in and lead digital health developments, collaborate with others to deliver & develop digital tools that we as health care professionals, patients, and the public need.