Tackling Type 2 Diabetes: Try Integrated Virtual Care

With Mark Heyman, PhD, and Amy Hess-Fischl, MS, RD, CDE, LDN

Chances are, if you have type 2 diabetes (T2D), you are left to manage this condition on your own. An occasional visit to your doctor is just not sufficient to keep you on track and aware of any changes that might make your management easier, better, more effective. Therefore, any approach that provides you with ongoing support and insights may help reduce the potential for long-term complications.1

Sleek chrome glucose testing kit by One Drop introduces a visually appealing option for anyone with type 2 diabetes.When blood glucose falls out of range, virtual coaches are alerted to respond with personalized behavior changes based on real-time data, a useful option for people with type 2 diabetes.

Contemplating A Virtual Coaching Program: What to Consider

Just as Weight Watchers groups have proven very effective in helping many people manage their weight, diabetes care programs have sprung up to meet the needs of the growing number of individuals who receive a diagnosis of type 2 diabetes. In fact, there are more than 8000 diabetes management apps available.2

In sorting through these apps, you may want to select a service that goes beyond just carb counting or glucose checks to address the psychosocial aspects of diabetes self-care. While monitoring blood sugar in people with type 2 diabetes remains controversial,3 providing personalized action steps and recommended changes based on your own behaviors affords you the best chance of having a favorable impact on blood sugar control.1,4

“[One Drop is not the first formal program to offer health coaching, Livongo may be the one who can claim that, and MySugr also has a similar setup offering unlimited strips for under $40 but One Drop is a nice addition,” says Amy Hess-Fischl, MS, RD, CDE, LDN, program coordinator for the Teen and Adolescent Diabetes Transition Program at the Kovler Diabetes Center at the University of Chicago, in Illinois.

Virtual Capabilities in Diabetes Self-Management

Diabetes self-care programs have sprung up to fill this growing need for ongoing, informed professional lifestyle guidance intended to elicit sustained behavioral change. These apps, particularly three prominent services: Livongo, SugrIQ, and One Drop, are structured to increase awareness and provide personal strategies to people with diabetes, to ultimately reduce diabetes-related outcomes in the long-term and better glucose control day-to-day.

“While it is not typical for people with type 2 diabetes to check their blood glucose as commonly as those with type 2 diabetes, taking this approach serves to inform these patients how their behaviors and food choices are impacting their health,” says Mark Heyman, PhD, CDE, vice president of clinical operations and innovation at One Drop.  

One Drop is the first integrated glucose management program to “draw on artificial intelligence-informed data collection, facilitated by the only Bluetooth-enabled glucose meter, and boasts a mobile app that is the only virtual coaching program to earn recognition by the American Diabetes Association,” Dr. Heyman tells EndocrineWeb.

“The coaches might be considered ‘care extenders’, filling in between doctor visits, and available in real time,” he says.  

These virtual coaching services address common treatment barriers in individuals with T2D by providing support informed by real-time, data-driven, personalized coaching aimed to reduce hemoglobin A1c based on glucose readings.

One Drop currently works on the widest range of available technology-driven apps: FitBit, Apple HealthKit, Google Fit, DexCom, InPen (Companion Medical), and most recently the Apple Watch.5

Research Raises Limits on Benefits of In-App Coaching

To provide some clinical data on the reliability of a mobile coaching program to improve glucose control, the makers of One Dose sponsored a 12-week study to evaluate the effectiveness of the One Drop program.6  The study was conducted by Evidation Health, a technology-based company specializing in assessing integrated device-driven behavioral programs; the authors declined to comment.

The impact of professional coaching was evaluated by measuring the self-care outcomes of 146 people who have had a diagnosis of diabetes for 4 to 18 years—they were mostly women (71%) and White (75% and 25% Black or Hispanic); the average age of participants was 52 years.6

Results of this study support “a clinically meaningful and significant reduction in [hemoglobin] A1c,” particularly among the most active users and those with a higher A1c level at the start,” by increasing access to education and personalized virtual coaching,6 according to the authors.

“Regardless of the program (or app) chosen, giving patients options regarding where they can get glucose testing strips, education, and ongoing support is crucial for success in self-managing diabetes,” Ms. Hess-Fischel tells EndocrineWeb. “The more patients have control over this, the more likely they will be able to adhere to goals.”

A Closer Look at the One Drop App-Based Program

To address patients’ common barriers to care, the One Drop program is supported by clinically trained, personal digital coaching who are all certified diabetes educators (which is also the case with their two main competitors) and whose responses to clients are informed by our fully integrated technology, Dr. Heyman says.

 “All the data gathered through our app does two things: It provides activated decision support for people with type 2 diabetes by reacting to real-time blood glucose levels,” he says. The artificial intelligence-driven app generates data backed by population-based learning and individual actions in order to inform and recommend individualized behavior changes.

These programs work by recording blood sugar levels in-range, and when the blood sugar falls out of range, activates alerts to the coaching team who then offers data-informed tips and suggested changes so the patient can gain a greater understanding of problematic actions and effective ways to self-correct.6-8

The One Drop app includes features such as a food library, medication reminders, and a personal coaching chat section Coaches send messages with links to useful articles, PDF files that illustrate recommended changes, infographics that visually depict points that may be easier to understand than static numbers, according to Dr. Heyman.

“We provide encouragement on a daily basis so individuals have supportive accounting in the moment to interpret and respond to their data give them the education to develop skills and provide them with behavior-based information,” says Dr. Heyman, including:

  • Reminders to check blood sugar and interpret results and trends
  • How to Prepare Healthy Recipes
  • Insights on Healthy Carbs
  • Strategies to help overcome common obstacles

“In the moment, what we’ve seen is that individuals changed their behavior and when they haven’t and/or their hemoglobin A1c hasn’t decreased sufficiently, we might recommend that they return to their physician to be evaluated for possible barriers and to review their medications, to foster better outcomes,” Dr. Heyman told EndocrineWeb.

What Is Coming Next In the Virtual App Coaching Sphere?

One Drop is currently developing a two-month weight loss program, Revive, that is based on the National Diabetes Education Program, PreventT2 curriculum,9  and will include a Bluetooth-integrated digital weight scale so the data can be collected, recorded, and shared with the health coaches, but also makes the process effortless and provides a bit of accountability. 

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A1c Control for Type 2 Diabetes Patients

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