Revolutionising diabetes management: the You & Type 2 programme

The latest statistics reveal that 4.3 million individuals have been diagnosed with diabetes in the UK, with approximately 90% of these cases attributed to type 2 diabetes. 

Type 2 diabetes is a common condition that leads to elevated levels of sugar (glucose) in the blood, causing symptoms such as excessive thirst, frequent urination, and fatigue. The condition can also heighten the risk of developing health issues related to the eyes, feet, heart, and nerves, which can significantly impact daily life.

Compared to individuals without diabetes, those with type 2 diabetes are between two and four times more likely to suffer from heart attacks, heart failure, or strokes. This is cause for concern, especially when we consider that an estimated 1.2 million people are currently living with the condition undiagnosed.

Condition management status quo — an expensive approach

Effective management of blood glucose levels and lifestyle factors, including a healthy diet and regular exercise, can significantly reduce the risk of developing complications associated with a diabetes diagnosis. However, the traditional approach to managing the condition is both time-consuming and expensive. It has often involved clinical settings, requiring patients to travel to and from medical facilities for assessments conducted by a healthcare professional. Not only can this be inconvenient and impractical for the patients themselves, but it is also highly resource-intensive for our already overstretched and underfunded healthcare service. 

However, in recent years, the medical industry has witnessed a seismic shift towards increasingly patient-centric practices. A term that has been extensively analysed since the early 2000s, patient-centricity has been the driving force behind many technological advancements over the last two decades and represents a big step forward. 

But, with the worldwide cost of managing diabetes estimated to exceed $400 billion a year, with over two-thirds of this amount directly linked to medical expenses, this step seems long overdue. 

A positive reminder of the pandemic

However, if we are searching for silver linings, one to hold on to would be the shift in approach brought about by the COVID-19 pandemic. During a period when physical contact was limited and the UK population was confined to their homes, we learnt valuable lessons about the potential drawbacks of an over-reliance on in-person care pathways. 

It has shown that not all conditions or illnesses need physical contact with a healthcare professional for monitoring. This realisation has significant implications for the future of healthcare management in the post-pandemic years, signalling a positive move toward a world that prioritises individual empowerment and accessibility while also alleviating some of the strain on public health services.

The You & Type 2 initiative

You & Type 2 at Home was a pilot programme designed to change how individuals with type 2 diabetes manage their annual check-ups. The goal was to shift towards a more remote-first care pathway, especially during the COVID-19 pandemic, to lower in-person interactions for primary care clinicians and keep patients safe. 

The initiative was a collaborative effort involving the Health Innovation Network, South West London Integrated Care Board, Thriva, and Healthy.io. Our intuitive Thriva test kits were combined with a blood pressure monitor and a urine testing capability that enabled participants to perform their diagnostic tests at their convenience from the comfort of their own homes. This allowed them to conduct certain aspects of their annual review remotely as part of the Year of Care methodology, which is designed to offer personalised, high-quality care and support planning for individuals with long-term conditions.

The pilot programme aimed to gain a deeper understanding of the individuals who chose the remote pathway while also collecting feedback from the participants, the NHS, and the industry staff involved. The goal was for this pilot to serve as a blueprint for the future implementation of broader remote-first programmes across the country at a later stage.

“For certain individuals, remote monitoring and testing for diabetes care provides a valued alternative to face-to-face consultations. Commissioning such a pathway at population level would enable economies of scale, reducing the cost per person, making the intervention more scalable, and ultimately freeing up GP practice resources”.

Project Lead, You & Type 2, NHS South West London CCG CHRIS GUMBLE

What were the key findings?

• • Positive reception: The initiative was generally well-received, particularly by younger, digitally-savvy participants who were juggling their annual assessments around working hours. They appreciated the convenience and safety of remote monitoring.
    
    
  • Challenges: Despite the positive reception, 60% of users did not complete the tests. Many cited a preference for face-to-face interactions and discomfort with digital technologies as the primary reasons. This suggests that there is still a significant need to educate people on the benefits of adopting this type of remote-first behavioural change.

• • Supportive environment: Healthcare staff found the pathway to be acceptable and beneficial, especially with the support of a pathway coordinator and project manager. This support was crucial in effectively managing the new pathway amidst the increasing pressures in primary care.
    
    
  • Implementation success: The successful implementation of this initiative at participating GP practices underscored the pathway's potential to ease the burden on primary care services by offering a viable and sustainable alternative to in-person reviews.

Implementation insights

• Target demographics: The initiative is most suitable for working individuals who are digitally savvy and have non-complex diabetes. It was and may be less suitable for elderly individuals, those with complex health needs, or those who lack digital access.
  
  
• Coordination and management: The role of a pathway coordinator and project manager is vital in ensuring smooth implementation and user engagement. Their responsibilities encompass managing logistics, providing administrative support, and facilitating user onboarding and follow-up.

What can we learn from this pilot?

The You & Type 2 initiative represents a significant advancement in diabetes care, offering a viable improvement over traditional face-to-face reviews. While it may not be suitable for everyone, it presents a valuable option for many, alleviating primary care pressures and improving overall diabetes management with a focus on prioritising the patient.

In order for this approach to be widely adopted in the future, our industry needs to embrace a fully personalised approach. Future implementations should carefully consider the diverse needs of the diabetic population to ensure inclusivity and effectiveness.

It's important to emphasise that comprehensive user support is crucial for the success of any remote programme. Anyone interested in trialling at-home sampling should ensure that they offer educational materials and video demonstrations to help patients understand and engage with the process of regularly testing their health. At Thriva, we take pride in ensuring that our diagnostic testing kit instructions are clear and easy to follow, which helps our customers collect their samples with ease and minimises failure rates.

For our commercial partners, we are also able to customise the kit instructions to meet the needs of any programme and offer them in multiple languages. This not only improves accessibility, allowing us to cater to the diverse population of the UK, but it also fosters a sense of commitment from the patient, which in turn ensures that they are more likely to complete the sample collection process and return their sample for processing and analysis. And while we understand that as we transition to a digitally-oriented world, some individuals may require additional assistance in navigating these new digital technologies, this level of support can enhance user acceptance and improve engagement rates.

Another advantage of implementing remote-first initiatives like this at a population level is that they could lead to economies of scale, making it more cost-effective and accessible.

The partnership between Thriva Solutions and the You & Type 2 initiative demonstrates a forward-thinking approach to healthcare, emphasising convenience, safety, and comprehensive care for individuals managing type 2 diabetes. Get in touch with a member of the team today to learn more.