Living in a digital world

Digitising diabetes

One of the most important ways for those who suffer from diabetes to maintain their health is to consistently test their blood sugar levels. In the past, this has involved people with diabetes having to carry significant amounts of kit with them to perform finger prick tests up to five times a day. New developments in technology, however, have since made it a lot easier to keep glucose levels in check. 

Flash monitors or continuous glucose monitors (CGM) use a sensor – a small device which can be attached to a user’s arm or stomach to record how much glucose is in the fluid underneath the skin. The results will show on a ‘reader’ or via a smartphone app. 

If a patient has a CGM, the sensor will send results to their phone every few minutes. With a flash monitor, they will need to scan the sensor with their phone to see any results. 

“There’s an app on your phone and you link it up to a sensor via Bluetooth,” explains Max Rossiter, a 24-year-old who suffers from type 1 diabetes and uses the Abbott Freestyle Libre 2 – currently the only type of flash monitor.   

“You can program it, so it provides you with alarms if your glucose goes too high or too low. Obviously, these days everyone has their phones around them all the time and it’s so useful to interact with your diabetes on an intimate level.” 

Guidance published by NICE in April 2022 stated that everyone in England with type 1 diabetes will be offered the opportunity to have a flash glucose monitor. 

Furthermore, NHS Digital now offers free digital resources for those suffering from the condition. My Type 1 Diabetes offers “tailored advice and information created by NHS experts and people living with type 1 diabetes”. Participants will be able to access information, videos, articles and online courses. Alongside all adults living with type 1 diabetes, the programme is also available for friends, family and carers. It does not require a referral from a healthcare professional. 

What’s app?

Launched in late-2018, the NHS App is the most downloaded free app in England, with a sharp increase of users from 200,000 in January 2020 to 16 million in September 2021. This rise was largely attributed to the coronavirus pandemic as well as the introduction of Covid-19 vaccination records needed to travel and enter large venues.

“The NHS App played a central role in the fight against Covid-19, helping to enable international travel and access to major events,” says Simon Bolton, interim chief executive at NHS Digital. “It has also changed the way millions of adults in England access healthcare services in the three years since its launch, with people using the NHS app to book GP appointments, order repeat prescriptions, access the NHS Covid Pass service and register organ donation decisions.” 

Users are also able to access their medical records, conduct health assessments, arrange and conduct video appointments with healthcare professionals and nominate a pharmacy to collect electronic prescriptions (see boxout). Services have proved to be popular. Indeed, from June to September 2021 app users have ordered almost 3.2 million repeat prescriptions and booked more than 268,000 appointments, according to NHS data. 

“These huge numbers show we are already putting health services directly into the hands of the public,” says Professor Jonathan Benger, digital citizen portfolio lead at NHS England. “That offers us a great opportunity to use these channels to reduce demand on frontline services, give patients access to quicker and more effective care at their fingertips and save the health and care system time and money.”

An improvement for everyone? 

Of course, a digital transition is not welcomed by all demographics. In fact, research published by Lloyds Consumer Digital Index in 2019 showed that 55 per cent of over 65s lack at least one essential digital skill and 53 per cent of over 65s still have none of the foundational digital skills they need.  

As a result, fears many older people will be excluded from vital services as they transition to smartphone applications are growing.

“The need for apps is spreading across society and in many cases, it is impossible to access the same level of service unless you download the required app on a smartphone,” says Dennis Reed from the over-60s campaign group, Silver Voices. 

“There are often no alternatives publicised, and you are made to feel like a dinosaur if you refuse to embrace the app culture.”  

From March 2023, patients should also be able to access their hospital appointments via the NHS app, something Dennis is worried will further exclude older people who are not as confident when it comes to using technology. 

“The drive towards apps excludes many older people and is clear age discrimination. Many older people do not own smart phones, or if they do, only use them for phone calls. Many of us also struggle with the keen eyesight and dexterity required to manipulate small screens.” 

Pharmacy staff can be on hand to help elderly customers who may struggle using the necessary technology by initiating conversations or putting up displays around the store. Health campaigns are also a key opportunity to spark discussions. In particular, Get Online Week which takes place annually every October with the aim of improving digital access and skills.