Transcription:
Latest Technologies for Better Diabetes Management

Bill Klaproth (Host): Smart technology has become a useful tool in diabetes care and management. Here to talk about different technologies currently being used to manage diabetes is Dr. K. K. Rajamani. Dr. Rajamani, thank you so much for being out with us. What's the most popular way right now people monitor and manage their diabetes?

Dr. K. K. Rajamani (Guest): Currently, Bill I think most people just use a standard blood glucose monitor that tells them what their blood sugar is, with no connectivity to any device or to a smartphone or the web. So, this is the most common way that most people manage their diabetes.

Bill: And now, what are some of the new diabetes products, tools and gadgets that are assisting people in self-managing their diabetes? You mentioned connectivity. Tell us what are some of these new technologies.

Dr. Rajamani: There are several areas that have grown over the last few years. Probably the most important way is how blood glucose data is shared and tracked. People with diabetes need to monitor their nutrition, they need to monitor their activity and also they can monitor their blood glucose levels, and different ways to monitor diabetes. In the nutrition level, you have several apps that you can get on a smartphone that track your carbohydrate intake and also the amount of calories that you can eat.

So, you can track this easily by keeping a track on the smartphone. Even if you're not very knowledgeable about calories and carbs, there are ways to try to figure out how many calories and carbs there are in each meal that you eat. So, this can be easily done by tracking using an app on your phone to tell you how many calories and carbs that you have. The biggest breakthrough, however, is probably how blood glucose data, which really monitors how well you're doing minute to minute and day to day is tracked.

That's allowed us to keep a track of this, not just for the patient, but also for the patient to understand what their trends are. So, there are apps on smartphones to do this and there are also apps that you can upload on your computer, or you can do them on any device that you have anywhere that you are in the world. So, this is probably the biggest innovation that's happened in diabetes care over the last few years.

Bill: I could see where smart technology would certainly assist someone in keeping track of the monitoring. It's nice to have an electronic log of all of that right there at your fingertips. So, for a diabetic who is interested in smart technology, where should they start?

Dr. Rajamani: I think the simplest way to see is with your current glucose meter that a patient with diabetes has, can they upload it to a smartphone or to a log book which is electronic? That you can do by just using software that comes sometimes with the meter that you have right in your house and you can log on your data right on to the internet and load it up onto the internet and you can view your blood glucose data and an electronic log.

So, once it's on an electronic format, now you can share that with your provider, with your physician or whoever is looking after you, or your friends or family, if you wanted to. So, they can now see this blood glucose data. One limitation of that is that it's all retrospective data. So, it's telling you what your blood glucose was yesterday or the day before or what happened to you. That's the downside of it. It's not real time. Some of the glucose sensors that are out there right now, these are glucose sensor devices that go under the skin, allow you to track your glucose level in real time. So, what happens is that you can now see what your glucose level is right on your own smartphone and, using a smartphone, potentially could share it with others anywhere in the world, really, so that anyone in the whole world can know what your glucose level is at that particular time.

So, this allows you to, for example, if a person with diabetes is having a low blood sugar, someone somewhere in the world can know that you have low blood glucose, and if you're really unconscious or somewhere out in the field, using GPS technology to track you down and find out where you are and bring assistance to you. So, this is really changing how diabetes could be delivered by using monitoring devices to monitor blood glucose. The diabetes log books which a patient used to maintain have now moved to the electronic format and that now is going to be moving to a continuous glucose monitoring format so you can use this data in real time to help patients with diabetes.

Bill: So, this almost sounds like this smart technology is becoming the norm in diabetes monitoring and management.

Dr. Rajamani: I think it's probably not the norm yet. Many people are not yet linked to smart technologies. Many people don't have smartphones. Many people are not so savvy about technology. They don't have devices or know how to use computers.

But, as time changes, this will become the norm in managing diabetes. Most doctor's offices don't yet have technology to monitor glucose from patients. Patients still bring in their log books and these are dog-eared log books they bring in to their doctor's offices. And, really, in practical terms, doctors have very little time to look at each page in that log book.

So, the smart technology will allow doctors in their offices to analyze blood glucose data and even possibly signal to doctors what to do with that blood glucose data. So, it'll change the way diabetes care will be delivered in the future.

Bill: So, this helps physicians as well. So, physicians and patients can benefit from smart technology.

Dr. Rajamani: That's correct. Physicians, if they have the ability to do so, can upload patients' blood glucose data--this is the retrospective data that we talked about--right in their own offices, and have devices then show this on their computer screen in real time with the patient sitting right by them so they know where a patient is having high blood sugars, the low blood sugars and help patients to understand these blood sugars more effectively. They can also help them to use medication to treat this--the appropriate medication at the correct time--for them to really take control of their diabetes more effectively.

Bill: So, are most physicians at this point recommending smart technology, do you think?

Dr. Rajamani: Actually, I would say "no" right now. That's probably because in the physician community, also just like in the general public, does not have broad acceptance and knowledge of smartphone technology. But, I think that'll also change as more and more people use their own smartphones for their own health and they find that variable technology or technology that helps you to monitor your heart rate, your blood pressure, your sleep, these are things that benefit you. So, why will it not benefit everyone else? I think that's a transition that has to happen at some time.

Bill: So, if someone listening has diabetes and they are interested in smart technology and their physician isn't yet prepared to use it, would you recommend them to just kind of look for apps on their own on their smartphone?

Dr. Rajamani: I think to some extent, many people already do that. When they have a smartphone, they find apps that may help them look after their own personal health. As you know, there are apps out there that monitor your heart rate. There are apps that monitor your sleep. There are apps that monitor your wakefulness, your mindfulness.

So, there are a lots of apps to monitor different aspects of your health, how many steps you walk, how much you run, what's your calorie use. But, these have not found broad applicability in a physician's office. People use this to diagnose their own problems. The other day I had a friend of ours who actually diagnosed himself to find that he had an irregular heartbeat and he took it to his doctor using his smartphone and they found that he actually had a condition called "atrial fibrillation", which potentially is a disease with consequences.

So, I think it can change the way that people and doctors interact by bringing forth patients to be more conscious about how their bodies work and function. It's not just in the case of heartrate but, more specifically, in patients with diabetes, what their blood sugars are doing minute-to-minute.

Bill: That's an amazing story and a great example of how technology can benefit someone. Dr. Rajamani, why should someone choose Rochester Regional for their diabetes care?

Dr. Rajamani: Rochester Regional is probably one of the premier centers in the upstate area for care of patients with diabetes. They are just bringing technology to the forefront. I think it brings people--people who actually look after patients--to the forefront to help patients deal with day to day are of their diabetes. The people who I work with are probably the most compassionate and caring people and some of the most knowledgeable people that I've worked with. So, I think that's where Rochester Regional really brings care and connectivity to patients with diabetes.

Bill: Dr. Rajamani, thank you so much for your time today. You're listening to Rock Your Health Radio with Rochester Regional Health. For more information, you can go to www.rochesterregional.com. That's www.rochesterregional.com. I'm Bill Klaproth. Thanks for listening.