When you’re on a journey, quality tools matter. My kids will never know what it’s like to get lost on a road trip and fumble through a cluttered glove compartment in search of a tattered paper map. Today, the GPS function living in our phones has made getting lost virtually impossible. Not only does my GPS know me and my personal preferences, such as defaulting to take the most fuel-efficient route or avoid tolls, but it also leverages an impossibly large amount of data, from traffic patterns to street closures, to get me to my chosen destination.
As healthcare providers we must strive to be the GPS for every individual on their health journey – combining insights gleaned from health data with personal preferences so that all individuals feel seen, heard, and empowered to address their healthcare needs.
Healthcare providers need to customize diabetes care based on an individual’s lifestyle
Unfortunately, the one size fits all approach that has been popularized by many digital health point solutions – particularly in diabetes care – exaggerates outcomes and downplays the difficulty that patients face in sticking to unrealistic lifestyle changes making long-term outcomes elusive. Some programs misleadingly tout their ability to “reverse” diabetes, even though some patients may still be on diabetes medication like Metformin and major scientific organizations agree that only “remission,” not “reversal” is possible. According to a joint consensus statement from the ADA, Endocrine Society, European Association for Study of Diabetes and others, remission in T2D is defined as A1c < 6.5 for at least three months without any diabetes medications (including Metformin).
These monolithic programs are also concerning because they seemingly neglect the multifactorial drivers of an individual’s health and variation in clinical condition. For example, the type, quantity, timing, and combinations of foods we eat directly influence insulin levels in the body. Medications and insulin used to treat diabetes can also negatively affect insulin sensitivity. Therefore, dietary recommendations and prescriptions must be tailored for a given individual, which contrasts with a solution focused solely on diet-based recommendations.
Given the reality of how diet and medications address diabetes differently, I believe in data-driven personalized solutions to manage an individual’s risk factors and chronic conditions. This is important as chronic conditions do not exist in isolation. More than 40% of adults in the U.S. have two or more chronic conditions, according to the CDC. It’s imperative that we spend the time and effort to create holistic and realistic solutions that meet patients where they are.
A study1 by Teladoc Health found people with both diabetes and hypertension who used the company’s chronic care integrated platform saw sustained clinically significant reduction in blood pressure after only four weeks and experienced further improvements after using the program for twelve weeks. They also showed better improvements in HbA1c, a clinical metric that reflects blood glucose control.
Studies show significant benefits from whole-person care, especially for diseases like diabetes
As a provider, I’ve also seen first-hand the direct linkage between an individual’s physical and mental health. People with diabetes are 2 to 3 times more likely to have depression than people without diabetes, according to the CDC.
Mental health conditions including depression and anxiety are often associated with chronic conditions such as diabetes, hypertension, heart disease and cancer. It’s why I believe so strongly that whole-person care is uniquely positioned to address these issues and support patients when and where they need it the most. And we see examples every day with employers such as Graco, who implemented a whole-person care approach and saw an additional 0.6% reduction in A1c among members enrolled in a mental health program compared to those not enrolled in mental health.
Social and environmental factors account for 50-60% of health2, and we also address these critical determinants of health for individuals living with diabetes. I find that there are key attributes of a whole-person care model that target more inclusive, equitable, and sustainable outcomes. These include providing cellular-connected devices, real-time digital and human wellness coaching and support in both English and Spanish, and easy to understand health content. Last month, a Teladoc Health study showed that all members were able to benefit from their remote monitoring diabetes program including targeted education and coaching, regardless of socioeconomic and educational status. These tools have helped us expand access where it’s needed most, with approximately 55% of Teladoc Health’s active chronic care solution users living in vulnerable or underserved communities.
Every day, Teladoc Health gets to enable better outcomes and create greater value as we turn the data gathered across millions of health journeys into actionable insights for consumers, clinicians, and clients with a whole person approach, customized to meet individuals wherever they are in their health journey.
An individual living with diabetes doesn’t need a one-size-fits-all approach to care. They need a GPS, a model that is dynamic and optimizes as the journey continues and makes the destination attainable.
To continue reading about multi-program chronic condition solutions that amplify outcomes click here.
About the author
Dr. Vidya Raman-Tangella is responsible for leading the clinical vision at Teladoc Health, working cross-functionally to improve health outcomes for our members, and ensuring we deliver the best-possible quality care when and where it’s needed.
1. Dzubur E, Yu J, James R, Hoffman J, Shah B. Effects of Program Enrollment in a Digital Multiple Health Behavior Change Intervention on Clinical Outcomes: A 12-month Study. Annals of Behavioral Medicine, Volume 56, Issue Supplement_1, April 2022,Page S481.