Bengaluru-based endocrinologist Dr Abhijit Bhograj uses an IoT sensor and app to make diabetes treatment more effective.

Treatment with a deeper understanding of elevated blood sugar levels is set to make a huge difference to diabetics with breakthrough technology. Bengaluru-based endocrinologist Dr Abhijit Bhograj uses this technology, comprising a cloud-connected sensor and app that generates data on a patient’s condition and response to triggers, and enables more accurate treatment.

India is a ticking time bomb with nearly half of the world’s diabetics. A shocking 72 million Indians are diabetic and the number is expected to touch 100 million by 2030. At epidemic proportions, and with just around 600 endocrinologists in the country, diabetes will be a major stumbling block disrupting lives and hampering productivity, if left unchecked. 

“The fact that we did not have enough understanding of our patients bothered me. Often, we treated patients based on one blood test. This is just not enough data to base a treatment plan on. There are many factors that lead to high blood sugar levels. Sleep, food, stress, lifestyle, obesity, hereditary and medications are some of them. Ideally, a doctor needs a deep understanding on how a person has fared on these parameters in terms of their impact on the blood sugar levels over a period of time. It is impractical to conduct multiple tests every day for a fortnight to arrive at this conclusion. So often, doctors treat diabetics with insufficient data, merely on guesswork. The treatment therefore does not result in optimum benefit to the patients,” says Dr Abhijit Bhograj.

This led him to embark on a quest to harness digital technology to research and gather data that will help in efficient treatment of the disease. Dr Abhijit uses a sensor with a filament that is impaled on a patient’s arm. The sensor’s subcutaneous filament takes a reading of the patient’s blood sugar level every 15 minutes over two weeks. During this time, the app, to be downloaded on the patient’s phone, analyses data generated by the sensor. This internet-based system that connects the sensor and the app yields valuable data on the patient’s blood sugar levels and the different triggers that cause spikes.

“For a detailed profile, a doctor should interact with a patient for at least an hour at every consultation. Also, the patient should get their blood sugar levels checked many times through the day at strategic times, such as after a meal or some physical activity that have a bearing. Now, this is impossible. This tech involvement gives me all the data I need to understand the patient’s condition. It tells me the causes of high blood sugar levels such as particular food groups or specific conditions such as stress. I tailor the treatment plan accordingly. In many cases, I have brought down the blood sugar levels by up to 30 per cent through diet modifications only, and no medication. The medication administered with this knowledge is efficient too,” explains Dr Abhijit.

Given the lack of time and historic data, diabetes is treated merely by fasting and post-prandial tests or HbA1c condition. With many factors causing elevated levels, this technology arms the doctor with insight into the causes, enabling a customized treatment plan that yields optimum results. 

How it works

• A sensor with a filament is taped to the patient’s arm above the elbow. The filament is subcutaneously-impaled.
• The sensor analyses the blood sugar level from the interstitial fluid every 15 minutes ie 96 readings in a day. It has a chip that stores the data.
• The sensor is connected to an app that the patient has to download onto their smart phone. The sensor and app are connected through the internet.
• The app analyses data generated by the sensor.  
• The data is stored on the cloud. The doctor retrieves this and gets a detailed picture on what causes spikes in the patient’s blood sugar levels. The advice, thus given, covers activity, diet and medication, specific to the patient’s condition. This leads to better outcome. Sometimes, just lifestyle modifications will bring the sugar levels within normal range, making medication unnecessary.

What impact does this have?

• Improves glucose control. Reduces medication when not needed. Around 30% reduction in blood sugar levels seen with no medication in many cases.
• Treatment of diabetes will be based on patterns and not one test. This enables customized and more intelligent care.
• Effect of all categories of food consumed is known. Advice is based on this intelligence, not guesswork.
• With this data, more variants of diabetes are being discovered, beyond Type I and II. Medication based on diagnosis aided by this accurate data is more effective.
• It is possible to predict the onset of diabetes. Pre-diabetes risk factors emerge, are analysed and with just lifestyle management onset of diabetes is prevented. 
• Over time, the voluminous data generated will be useful. It can be analysed to identify patterns for more effective treatment.

The way forward

“Even today, we treat diabetes with just one test. All this will change with this technology. Diabetes care in the world will change. We will learn more about diabetes, its triggers, and ways to manage it better,” says Dr Abhijit Bhograj. 

Given the endless possibilities of big data analysis, Artificial Intelligence and digital healthcare, it is breakthrough tech applications such as this that can make a huge difference to people’s lives. An enormous amount of time and productivity is lost due to ill health caused by elevated sugar levels across the world. This technology will create a healthier and more productive society.

This story was originally published on The News Minute and is reprinted here with permission. It can be viewed here.