How digital technology is helping lessen the global rise of diabetes

Cutting costs

New models of wellness and care are necessary to address this human crisis and bring costs down to sustainable levels. Innovation in a single area – be that technology, analytics, payment models, government regulation or care delivery models – is not enough.

Cooperative efforts are needed to develop scalable technologies and make them widely available, align stakeholder incentives for data sharing, build environments that support healthy lifestyles, and reshape the way consumers think about their health.

Technology will enable smarter cities and smarter choices...

Globally, people with diabetes are generally clustered in urban areas. Better artificial intelligence, cheap, ubiquitous sensors, and cloud or fog computing create new possibilities for creating environments that support healthy behaviors.

For example, as cities grow smarter, switching between driverless cars, mass transit and manual transport (walking, bike shares) may become seamless.

Health care applications can already use sensor-enabled activity trackers to provide well-timed incentives to nudge healthy behaviors for consumers who want to set themselves activity targets.

But by combining these trackers with electronic health records, this technology could be leveraged to support people at risk of diabetes or obesity, by suggesting changes such as such as walking the few blocks to a bus stop or biking. Such small changes, made across a lifetime, can mean the difference between active, healthy aging and a middle-to-late life filled with chronic diseases.

…But only if it rapidly moves beyond early adopters

Rapid adoption of technologies across socioeconomic groups is crucial for improving chronic disease outcomes, curbing costs and addressing existing health disparities.

For the last decade, diabetes prevalence has been rising most rapidly in low and middle-income countries. People are leaving rural areas for urban life and sedentary work, exacerbating the growing prevalence of diabetes in places such as India, Southeast Asia and parts of Africa. Observational studies indicate that sitting for long periods of time can double the risk of type 2 diabetes and cardiovascular disease. Designing workspaces and workdays around opportunities for physical movement could improve workers’ health, concentration and performance.

Additionally, even in a relatively wealthy country like the United States, 73% of people don’t own an activity-tracking device of any kind[1]. The key to circumventing the next digital divide, and addressing health disparities, is to make rapid technology adoption possible – even for economically challenged populations. Bringing telemedicine and inexpensive sensors to countries with low diagnosis rates could improve quality of life and reduce overall costs through early treatment. Rapidly disseminating affordable technologies could enable low and middle-income countries to address the proliferation of metabolic disease drivers, improve diagnosis rates, contain costs and keep their workforce healthy without slowing growth.

Sweeten the deal for sharing the burden

Misaligned incentives for health care payers, providers and consumers hinder the management of diseases like obesity and diabetes:

• Those responsible for paying health care in countries which rely heavily on private insurance are reluctant to fund programs in which competitors are likely future beneficiaries through reduced long-term costs of care. This perception thrives where most people change insurers as much as they change jobs. Even in countries with a central and government funded payer, immediate-term cost pressures can be a blocker to funding.
• Providers have traditionally been incentivized by the immediate quality of service they provide or, more recently, the effectiveness of treatments, rather than by improving overall long-term health of their consumers.
• And consumers may need additional incentives to provide the kind of data that enables individualized, holistic care plans. This is particularly true of older adults, who are more likely to report having privacy concerns.

Healthy bodies need healthier fuel

For much of the world, the availability of healthy food is tied to economic status: the more money a person has, the greater the access to healthy options. Western diets, overflowing with calorific possibilities, are heavily meat and saturated fat-based, increasing the risk for early death, Parkinson’s and Alzheimer’s disease. Fresh fruit and vegetables, the base on which most government-led food pyramids are built, receive considerably less monetary support (i.e., subsidies) than crops used as animal feed or ingredients for heavily processed food. The narrow window of ripeness for such foods also makes them difficult to transport and store cheaply.

There are enormous opportunities to bring technology and big data approaches to global food production and supply chain management, to shape policies that encourage sensible eating habits, to address resource-intensive food production and to increase access to healthy food worldwide.

• Eating behaviors could be nudged towards healthier choices with data-informed changes to the types of food available, by lowering barriers to access and changing how portions are presented.
• Meat protein, which is resource intensive to produce, untenable to farm in some areas and ethically fraught in others, is today being successfully grown in the lab.
• 3-D printing technologies can also create palatable, healthy meals from raw materials easy to transport and store. Increasing access to quality, palatable food helps shift people away from a lifetime of dietary mistakes often ending in glucose intolerance or diabetes.

The future of healthcare

Health care should be more than disease-focused provision: to really address diabetes and obesity it needs to become a patient-centric, on-demand, around-the-clock endeavor.

Additionally, wellness, prevention and care have to be scalable but also tailored to a specific market: cultural issues, ethnicity and regional differences in resources will all determine whether a particular model is successful.

What is certain is that there is no time to waste. Every year that diabetes goes unchecked sees health care costs rise, and both individuals and economies suffer. Diabetes is here, and swift action needs to be taken to address it:

• Payers need to look to the long-term social costs, not the short-term financials.
• Providers need to incentivize prevention at the same time as developing new treatments.
• Consumers need to realize that there is a problem – and that the power to avoid this often lifestyle-related disease can lie primarily with them.