Abstract

Remote continuous data monitoring and personalized data-driven approach for managing diabetes in a virtual and physical setting

Author(s): Milena Caccelli*, Yousef Said, Joena Mojado, Carolyn Palsky, Ali Hashemi & Ihsan Almarzooqi

Many factors have contributed to the global increase of Diabetes Mellitus (DM) and metabolic disorders worldwide. In the United Arab Emirates (UAE), the International rapid urbanization and socioeconomic development has led to an increased prevalence of diabetes, reaching 16.3%. In line with global patterns, adherence to recommended diabetes management in the UAE remains a challenge with low compliance. Clinical inertia, ineffective health system programs, lack of performance based reimbursement models, and outdated communication tools for physicians and patients are responsible for diabetes treatment failure over many years. Single-biomarker remote monitoring strategies, such as glucose monitoring, have demonstrated reduced medical spending due to lower mean glucose values.

The GluCare care model encompasses two components, a physical component and a continuous digital monitoring component termed Remote Continuous Data Monitoring (RCDM) as a standard methodology of care for patients with diabetes. Continuous real-time monitoring and analysis of numerous parameters, under the responsibility of the primary caregiver, such as glucose, sleep patterns, dietary choices, activity, weight, amongst others, allow for data-driven actionable insights by the care team.

Methods: A retrospective and observational 3 month study of the GluCare model of care was conducted. Primary and secondary outcomes were described. In addition, food logging and patient interactions and their correlations with the primary and secondary outcomes were analysed.

Results: Initial data (n=22) indicate that patient engagement via the GluCare model lead to significant improvement in HbA1c (-2.14% point, p=0.00013) and other metabolic parameters such as LDL-cholesterol (-17.25%, p=0.0071), body mass index (-4.55%, p=0.0003), triglycerides (-18.52%, p=0.0165) and uric acid (-20.4%, p=0.0052) within 90 days of program initiation.

Conclusion: These initial findings suggest that management of diabetes under the GluCare model of care has the potential to significantly improve diabetes outcomes.

Abbreviations: RCDM: Remote Continuous Data Monitoring; HbA1c: Glycosylated Hemoglobin; DM: Diabetes Mellitus; UAE: United Arab Emirates; IDF: International Diabetes Federation; CGM: Continuous Blood Glucose Monitor; BGM: Blood Glucose Monitor; EMR: Electronic Medical Record; NHANES: National Health and Nutrition Examination Survey; NAFLD: Nonalcoholic Fatty Liver Disease; NASH: Nonalcoholic Steatohepatitis; BG: Blood Glucose; HR: Heart Rate; HRV: Heart Rate Variability; RR: Respiratory Rate; BP: Blood Pressure; TIR: Time In Range; TG: Triglycerides; ALT: Liver Transaminase; hsCRP: High-Sensitivity C-Reactive Protein; LADA: Latent Autoimmune Diabetes in Adults; SPD: Steps Per Day; DPP: Diabetes Prevention Program.