In year 2000, India (31.7 million) topped the world with the highest number of people with diabetes mellitus followed by China (20.8 million) with the United States (17.7 million) in second and third place respectively.

It is predicted that by 2030 diabetes mellitus may afflict up to 79.4 million individuals in India, while China (42.3 million) and the United States (30.3 million) will also see significant increases in those affected by the disease. With the steady improvements in standard of living, urban migration, and lifestyle changes this disease is quietly gaining ground.

It is predicted that by 2030 diabetes mellitus may afflict up to 79.4 million individuals in India, while China (42.3 million) and the United States (30.3 million) will also see significant increases in those affected by the disease. With the steady improvements in standard of living, urban migration, and lifestyle changes this disease is quietly gaining ground.

The risk factors that are associated with diabetes are complex and multifactorial, these include genetic factors, environmental factors and a lack of overall awareness. This is further exasperated through gender and state differences that reflect current lifestyles and diet, which is shown below. Estimates show that the prevalence of diabetes in rural populations is one-quarter that of urban population.

To tackle this growing epidemic requires a significant action from individuals and families affected by this potentially devastating disease, as well as improved awareness and framework from governmental organisations. On an individual level, the advent of the digital age across all sectors and populations of India can potentially play a significant role in motivating and management of obesity and its associated co-morbidities. Increased use of smartphones and technology can potentially reduce burden on healthcare infrastructure and also address in part the inadequate cover of specialists and paucity of readily available resources in urban and rural settings.

The progressive rise in diabetes is also beginning to affect children and adolescents. This worrying trend will ultimately cause a higher frequency of chronic long-term complications. Recent studies have reported that diabetes control in individuals worsened with longer duration of the disease (9.9±5.5 years), with neuropathy the most common complication (24%) followed by cardiovascular complications (23%), renal issues (21%), retinopathy (16%) and foot ulcers (5%). The implications for increasing the burden on the Indian healthcare system are significant. Urgent action is needed to raise awareness as well as tackle underlying factors that can cause this disease, furthermore the rise of digital health and its easy accessibility could alleviate the added pressure.

Rise of Digital applications to support disease management

Digital healthcare is undergoing a rapid growth in the management of chronic conditions. Globally there is investment of a massive scale rising from a $60 billion investment in 2013 to approx $233 billion by 2020. Although barriers still exist, these are being eradiated with greater understanding and discussion and a need to adapt such high potential applications to routine clinical/non-clinical use.

Below are grouped a series of approaches available that can provide clinical support, patient advice and motivation to achieve set goals and improve clinical outcomes. Throughout all these, management is a collaborative process where individuals and/or families gain knowledge and understand the significance of changing current behaviour. If any of these are lacking or absent then long-term success is difficult to maintain.

There is also an issue of cost with the implementation and infrastructure for the management of diabetes. The uses of these digital tools are located on computers and on mobile platforms can save time in tracking and questioning of patients adherence and activity. Secondly, they can provide confidence in the self-medication in calculating the correct dose. Thirdly they can provide motivation and ongoing individual and family support, and finally these mobile applications if used correctly by clinicians to overcame the lack of infrastructure and also advise the patient to monitor the disease in a cost-effective way without purchasing expensive equipment.

Clinical Tools

There is a growing raft of clinical tools to support diabetic patients or those at risk. These can be grouped in terms of two broad groups; the first is clinical management tools directed to support clinicians in their day-to-day role. These can form the basis to ensure that patients take their medication, using the correct dose providing confidence in self management. In addition, they can be employed to track everything through an e-log book, which is subsequently checked by the clinician.  Examples of mobile apps to support diabetes management include

  • Blood glucose e-log book
  • HEALTHeDiabetes
  • Insulin dose calculators
  • Rapid calc diabetes manager
  • Glucose monitors

The second groups of apps that can provide support for patients provide a simple explanation of diabetes; they discuss the causes and help to understand the clinical ramifications of the disease. These can enable patients and families to gain an understanding of the disease and potential risks. Examples are:

  • diabeties.org
  • http://www.diabetesindia.com
  • WebMD
  • Diabetes education
  • Healthy food/diet such as calorie king

Non- Clinical Tools

This area of mobile apps and supportive information is by far the largest available tools in the market. These include measurement of diet, physical activity, education and relaxation as well as mediation. A key component of all these is motivation, which can be supplemented by tools available on mobile apps. These are aimed not only at individuals but also at families. It is important to remember that many of these tools are lifelong partners that ensure that diabetes is adequately controlled.

Each of these tools is very subjective and it is essential that the user(s) find the app that is most suited to their needs and areas where they need the greatest support.  The plethora of apps within each of these categories offers the opportunity to shop around and try to find the best app that suits your needs.

Conclusion

 The rise of diabetes is reaching epidemic proportions in India. The improvements in standard of living coupled with an increasingly sedentary lifestyle suggest there are little positive in sight. Worryingly, diabetes is now being shown to be associated with a spectrum of complications and to be occurring at a relatively younger age within the country. With all these risk factors and startling projections there is an overall paucity of studies to understand the disease in India in more detail. However there is a growing concern through governmental task groups and rise of digital healthcare options to support obesity as well as improve lifestyle and educate about food constituents.

The rise of digital apps offers a possible beacon of hope in the growth of this disease that is affecting all sections of the population both old and young. These tools if used productively can address many of the underlying factors associated with diabetes mellitus and could produce a long term supportive solution to successfully manage the disease.