Digital Health from a Healthcare Perspective (Part 9)
The Second Part: Tapping into the Challenges of Diabetes and Lifestyle Management, Health2Sync
Wellness and Exercise therapy, Medical devices, Wearable, Clinical Doctor, Disease management and Patient monitoring, Japan, Medical communication, Digital Therapeutics (DTx)
Diabetes Care Enters a New Era Through Collaboration with CGM
Improving lifestyles, such as diet and exercise, is essential for treating diabetes. In recent years, there has been an increasing number of attempts to intervene in lifestyle improvement by linking personal health records (hereafter PHR) with daily diabetes care and lifestyle through smartphone-based apps. In the previous part, I introduced the health support app “Health2Sync” and the “Health2Sync Platform,” a cloud service that can be managed by medical institutions to solve health issues for people with diabetes and other chronic diseases and pre-diabetic lifestyle-related diseases (pre-symptomatic disease group). In the second part, I explain how the linking with continuous glucose monitoring (CGM) could dramatically change the management of blood glucose in diabetes.
“Health2Sync Patient Management Platform” Source: Health2Sync
Blood Glucose Control in Diabetes Mellitus has Moved from HbA1c to SMBG to CGM
Until now, “HbA1c (hemoglobin A1c)” has been widely used in diabetes treatment as an indicator of blood glucose control. HbA1c reflects the average blood glucose level over the past two to three months; however, it does not provide an accurate picture of the state of blood glucose variability. Self-monitoring of blood glucose (SMBG) using a blood glucose meter also makes it difficult to monitor blood glucose fluctuations, as it is a spot measurement of blood glucose levels once to four times a day. In recent years, continuous glucose monitoring (CGM) has become more widespread, allowing patients to visualize blood glucose fluctuations in real time. In 2019, the international consensus on 'Guidelines for blood glucose control by CGM' was published. 1)
Enables a Comprehensive Understanding of Blood Glucose Variability
With the widespread use of CGM, the importance of understanding blood glucose trends and regular blood glucose monitoring has been attracting attention. New blood glucose control indicators have recently emerged, such as ‘Time in Range (TIR)’ and ‘Ambulatory Glucose Profile (AGP).’ TIR is the percentage of blood glucose meeting the target range (70~180 mg/dL), and the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) recommend a treatment target value of “TIR of 70% or more.” 1)
AGP is a graphical representation of blood glucose fluctuation with five analysis curves.
Since September 2021, the CGM of Abbott Japan LLC products can be linked to “Health2Sync.” Users can view blood glucose fluctuations such as TIR and AGP, blood glucose trends, diet, exercise, and medication all in one “Health2Sync” application. It will make it possible to relate more real-time blood glucose movements to everyday life information.
The Expansion of Health Insurance Coverage is also a Tailwind
In response to these new measurement methods and guidelines, the intermittently scanned continuous glucose monitoring (isCGM), which can easily measure blood glucose levels by simply holding the machine over a patch attached to the arm.
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