Digital Therapeutic Sparks Improvement in Diabetes Across Demographic Lines

A new report shows people in different racial and ethnic groups appear to gain similar benefits from a digital therapeutic designed to treat type 2 diabetes (T2D). The study showed engagement with the software led to improvement in blood glucose levels across demographic groups.

The finding is significant because a wealth of previous research shows that people in minority racial and ethnic groups are more likely to have diabetes and are at a higher risk of severe outcomes from the disease. The report was published in Applied Sciences.

This study’s investigators wrote that 37.3 million people in the United States have diabetes and that they account for a total annual economic burden of $327 billion. However, that burden is spread disproportionately across the population, they noted.

“Health care disparities associated with significant racial/ethnic groups have been observed in T2D and obesity, including impairments in diagnosis, out-of-range glycemia, and development of diabetes-related complications due to low socioeconomic status, living in rural communities, reduced access to care, and a lack of health education,” they wrote.

Among the most recent developments in diabetes care has been the creation of digital tools and therapeutics that can help patients manage their disease. Such tools include sensors and monitors that can help track patient data and offer real-time alerts, as well as educational and coaching content.

The authors wanted to see how well a digital therapeutic platform would perform across different racial and ethnic groups. In particular, they wondered if the disparities seen broadly in diabetes outcomes would persist among users of the digital therapeutic or whether the tool might offer a means to help close the gap. They retrospectively analyzed a cohort of 1000 people with T2D who used Dario Health’s digital therapeutic in a real-world setting over 12 months. The cohort included 736 White patients and 264 patients who identified as racial and/or ethnic minorities. Females made up most of both cohorts, and 55% of people in both groups either did not use insulin or declined to specify whether they used insulin. Participants were only included if they took at least 3 blood glucose readings in both the first and the last months of the study period.

At the start of the pilot period, the participants had an average blood glucose level in excess of 180 mg/dL, putting them in a “high-risk” category, and there were no observed differences between the 2 groups. By month 12, the White participants had reduced their blood glucose by an average of 14% and those in other racial and ethnic categories had reduced their blood glucose by 15%, on average.

The investigators also constructed models designed to predict average blood glucose number and frequency of blood glucose measurements the user conducted. Those findings suggested that engagement with the digital therapeutic tended to lead to positive blood glucose results. Again, those results did not vary significantly between the racial and ethnic groups studies.

The investigators said their findings show that patients who are motivated to use a digital therapeutic like Dario are likely to see improvement and that that improvement appears to cut across demographic lines.

“The study highlights the necessity for future research to focus on disparities in various aspects of living with diabetes,” they wrote, “and to investigate actionable digital strategies that promote in-range glycemia, reduce hyperglycemia, and encourage diabetes self-management engagement by comparing results for diabetes care, technology use, and outcomes among different populations along expanded periods of time.”

Reference

Gershoni T, Ritholz MD, Horwitz DL, Manejwala O, Donaldson-Pitter T, Fundoiano-Hershcovitz Y. Glycemic management by a digital therapeutic platform across racial/ethnic groups: a retrospective cohort study. Appl Sci. Published online December 29, 2022. doi:10.3390/app13010431