Advanced glucose monitoring technologies strengthen telemedicine for Canadians with diabetes and their health-care providers
Next year will mark the 100th anniversary of the discovery of insulin – a revolutionary scientific achievement that has forever changed the lives of people with diabetes. This milestone will be a moment of Canadian pride, as insulin was co-discovered by Canada’s Frederick Banting.
Since that breakthrough a century ago, significant advances have been made in diabetes treatment and management. Progress has frequently been driven by transformational technologies that help individuals better understand their blood sugar levels and optimize their use of insulin. And these new technological tools, along with the emergence of “telemedicine,” are proving particularly valuable during the COVID-19 pandemic.
People with diabetes often rely on regular, usually face-to-face, contact with physicians, diabetes educators and other specialists to help them manage the disease. With the pandemic and the lockdowns putting most in-person visits beyond reach, health-care professionals and their patients have had to adapt.
“The pandemic has meant a lot of growing pains for our team, our patients and their families,” says Dr. Jeremy Gilbert, a Toronto endocrinologist and associate professor at the University of Toronto. “In my practice, we have been vigilant about helping patients to successfully manage their diabetes, despite the challenges.”
The challenges mean clinical consultations have had to be done remotely – with provider and patient connected by phone or by two-way videoconferencing through the Ontario Telemedicine Network, says Dr. Gilbert.
Meanwhile, new digital technologies for diabetes management have made the transition to telemedicine much easier and have demonstrated their benefits, he adds. He points to continuous glucose monitoring (CGM) devices that produce detailed data related to glycemic control and allow sharing of the data with the health-care provider.
“These new devices have been life-altering for many patients and a true game-changer for my practice,” he says.
The patient’s perspective: Empowered by data
Rebecca Redmond has experienced the benefits of CGM devices, including in her interactions with her health-care providers during the pandemic. Based in London, Ontario, Ms. Redmond uses a CGM device, the Dexcom G6, to manage her type 1 diabetes. It monitors her sugars on a continuous basis and tells her when she needs to address either a low or high glucose scenario.
“One of the features I love is the CLARITY app, which allows me to upload glucose data gathered over a week, a month or longer, and then view the data in easy-to-read graphs,” says Ms. Redmond. “This data not only empowers me to make the best self-care decisions, but the app also allows me to share this data with my physicians.”
Ms. Redmond describes a telephone visit she recently had with her endocrinologist. “We could look at the same reports on my glucose levels, at the same time. It made our discussions 100 per cent more productive; using all the graphs, she was able to advise me on how to adjust my insulin doses to achieve better control.”
Ms. Redmond is an active public commentator on many aspects of living with diabetes, including telling her personal story through her blog, at deadpancreasanxiety.com. She says the fact that she is a distant cousin of Frederick Banting is part of the inspiration for her advocacy.
One of her goals is to tell the story of how CGM technology has given her unprecedented control over her diabetes after more than 20 years of inadequate management. She is also promoting the need to expand affordable market access to these digital tools.
“Providing access to these devices through private insurance and government programs will reduce the human costs and the dollar costs in the health-care system by reducing the complications of mismanaged diabetes down the road,” says Ms. Redmond.
Dr. Gilbert agrees that providing access to CGM technologies is very important, as is the need to continue to embrace telemedicine overall.
“The speed with which we have had to change in response to the pandemic has highlighted the value of digital health care delivery to people with diabetes, especially those taking insulin,” he says.
“CGM has become the standard of care in my practice. These new technologies are necessary and valuable, and I believe it is right that patients have access to them. It’s going to help us move toward even stronger telemedicine.”
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