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With digital care, diabetes should be neither costly nor deadly
Blood glucose community testing, telemedicine and artificial intelligence (AI)-assisted clinical decision support can be used to improve the reach and availability of our limited physicians.
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An official of the Healthcare and Social Security Agency (BPJS Kesehatan) shows the state health insurer's mobile application that enables people to access health services and control payments through cellular phones. (Antara/Aloysius Jarot Nugroho)
The International Diabetes Foundation has estimated that more than 10 million people live with diabetes in Indonesia.
However, the national Basic Health Survey from 2018 reported that less than 4 million of the diabetic patients have been diagnosed. This is an alarming situation since unmanaged diabetes often leads to complications that are irreversible and costly.
Diabetes prevalence is expected to increase even more along with the growing aging population, sedentary lifestyles and insufficient intervention programs. As the conventional diabetes system dictates, the Puskesmas (community health centers) are mandated to screen all high-risk diabetes patients in their jurisdiction. Unfortunately, many Puskesmas are understaffed, underfunded and overburdened.
Indonesian society has a relatively low level of health literacy, especially among those who are uneducated and poor. Most diabetic patients seek treatment just too late, when irreversible complications have arisen.
Many patients seeking medical help have already progressed to having strokes, heart disease, kidney failure or diabetic feet, leading to high morbidity and mortality. In 2018, treatment of these complications cost the national health insurance (JKN) Rp 15 trillion (more than US$1 billion).
Diabetes complications are often caused by ineffective therapy. Successful therapy by controlling fasting blood sugar is today only achieved by 2.5 percent of patients. There are challenges in access to, capacity, capability and affordability of health care to provide behavioral change counseling, patient-health provider feedback and laboratory tests. Those are the main obstacles to scaling up the program.
Innovation and technology in the healthcare system may overcome the challenges mentioned above. Blood glucose community testing, telemedicine and artificial intelligence (AI)-assisted clinical decision support can be used to improve the reach and availability of our limited physicians.
