Recently, we gathered in Mexico City to announce the final results of the Qualcomm Wireless Reach-supported Dulce Wireless Tijuana (DWT) mobile health study in Tijuana, Mexico that were also published in the Diabetes Technology & Therapeutics journal.
Distinguished speakers at the event included Salvador Blasco, vice president of Business Development and Mexico Country Manager for Qualcomm; Gabriela Manriquez, senior director of Government Affairs for Qualcomm; Dr. Maria Cecilia Anzaldo from the Mexican Institute of Social Security’s (IMSS); and Dr. Adriana Carolina Vargas from the School of Medicine and Psychology of the Autonomous University of Baja California (UABC) — two well-known public institutions in Mexico.
Non-communicable diseases, such as diabetes, are the leading cause of death worldwide. The problem is particularly acute in Mexico which has the highest percentage of people between the ages of 20 and 79 with diabetes. The International Diabetes Federation estimates that type 2 diabetes will affect nearly 20 percent of Mexico’s adult population by 2035 and will account for 23 percent of the IMSS budget by 2030.
Clearly, innovative interventions are needed.
DWT was a multi-sector study that examined how a chronic care model based on the Project Dulce approach of peer educators, together with 3G wireless internet access, can be used to educate and empower underserved communities to more effectively monitor and control diabetes.
The program convened a binational group of stakeholders, led by the International Community Foundation (ICF), which included IMSS, UABC, Fronteras Unidas Pro Salud, Scripps Whittier Diabetes Institute, Entra Health Systems and lusacell to provide education, medical and technical assistance, community outreach, management, evaluation and funding.
In the study, a total of 301 patients with poorly controlled type 2 diabetes participated and were randomly assigned to one of three groups: control group, Project Dulce clinical intervention (PD), and Project Dulce clinical and 3G technology intervention (PD-TE).
The group with the technology intervention used 3G mobile devices to send their glucose readings to their promotoras (community health experts), nurses and doctors for regular monitoring as well as to receive reminders of appointments and other information they needed to manage their diabetes. They also had access to educational materials on diabetes self-management.
In order to measure how well the patients’ diabetes is controlled, the health care providers conducted a glycated hemoglobin A1c (HbA1c) test, which provides an average of the patient’s blood sugar control over the past 2 to 3 months. When a patient’s diabetes is not controlled their blood sugar is too high and their HbA1c test will be higher.
The study’s final results indicate a significantly greater reduction in absolute levels of HbA1c in the PD-TE and PD groups; these groups also exhibited significant improvement in diabetes knowledge, compared with the control group. These positive study results suggest that integrating peer-led education, nurse coordination and 3G wireless technology is an effective approach for improving diabetes outcomes in high-risk populations.
These outcomes show the potential impact mobile health solutions offer to combat the public health problem addressed in the framework of the National Strategy for Prevention and Control of Overweight, Obesity and Diabetes launched by the Ministry of Health as part of Mexico’s National Development Plan 2013-2018.