As the Wireless Reach project manager for the Dulce Wireless Tijuana project, I attended the mHealth Forum (Foro Salud Móvil) in Mexico City last month. Among the findings we shared for this mobile health treatment program, is that it is successfully leveraging the power of mobile technology to help address the diabetes epidemic in Northern Mexico.
The forum was organized by the Ministry of Health, with around 150 national and international health experts from the government, private sector, and civil society in attendance. The conference’s mission was to identify successful mobile health strategies centered on the treatment of obesity and diabetes, two prevalent health issues in Mexico.
According to the 2012 Mexico National Nutrition Survey, 71 percent of Mexicans are obese or overweight—that’s 48.6 million people. And with diabetes as one of the top two causes of death in Mexico, the Dulce Wireless Tijuana project is working to provide a solution by empowering patients to self-monitor their diabetes through mobile devices and applications.
Under the leadership of Dr. Clemente Martínez and Dr. Cecilia Anzaldo from the Mexican Social Security Institute (IMSS), Dulce Wireless Tijuana aims to address significantly low levels of glycemic control of Type 2 diabetes patients and to improve metabolic control. It has been implemented at the IMSS Family Medical Unit #27 in Tijuana, where more than 9,000 patients were diagnosed with diabetes.
Of these patients, 300 have participated in the clinical study and were randomly placed in one of three groups: PDT (technology and education), PD (education without technology), or a control group that received standard care provided at IMSS. Patients, promotoras (community health experts), nurses, and doctors were able to access the applications and systems through 3G-enabled mobile phones, netbooks, and laptops.
The PDT group was offered:
- Health care workers who had access to confidential patient medical information through a 3G-powered database
- Automatic patient reminders created using a customized Web application and sent via SMS to health care workers
- Glucose readings that are uploaded to monitoring networks
- Videos and key educational information on diabetes self-management that could be accessed through the Internet
- Interactive surveys that monitored diabetes management, with answers sent directly to health care providers for review
- Voice and text messages sent by promotoras, nurses, and doctors
- Alerts sent to promotoras, nurses, and doctors when patients reported significantly out-of-range blood sugar levels or when patients missed tests, appointments, or classes
Preliminary results that were presented at the mHealth Forum showed reductions in the glycated hemoglobin (HbA1c), a bodily measurement of average plasma glucose concentration, of patients with poorly controlled Type 2 diabetes. At baseline, no differences were detected by the HbA1c test, but by the study’s tenth month, the PDT and PD groups showed substantial reductions compared with the control group. In other words, the groups who were offered wireless technology and education (PDT), and education without technology (PD) had less glucose in their plasma than their peers who received standard care.
It is important to recognize that the success of the Dulce Wireless Tijuana project was made possible by the shared responsibility of the following public-private partners who contribute their expertise, resources and technology: Qualcomm Wireless Reach, The International Community Foundation, The Autonomous University of Baja California’s School of Medicine, Fronteras Unidas PRO SALUD, Instituto Mexicano del Seguro Social (IMSS), Fundación Internacional de la Communidad, Iusacell, The Scripps Whittier Diabetes Institute, and Entra Health.
Final results of the study will be published in the near future. To see the project in action, watch the video here.