Diabetes monitoring through digital health: perspectives on care optimization

Diabetes mellitus (DM) represents an important risk factor for diseases, with impact on morbidity and mortality in the Brazilian population. Comprehensive care of people with diabetes is a great challenge in all levels of healthcare. Digital care coupled with Primary Health Care (PHC) strategies has become an appealing alternative. This study aimed to analyze characteristics of a population within a diabetes care pathway and to investigate associations between digital monitoring and reduction in levels of glycated hemoglobin (HbA1c). This is a longitudinal study with 88 working adults within the diabetes care pathway of a digital PHC service. All data came from patients’ medical records, from March 2022 to December 2023. A multilevel model was described considering 117 HbA1c measurements over time as a fixed effect. Also, the intraclass correlation coefficient (ICC) was calculated to quantify the proportion of clinical and total variance. A survival analysis with changes in HbA1c levels was performed using Kaplan–Meier survival curves with log-rank test. The digital monitoring of DM within a diabetes care pathway, via digital health services, led to reductions in HbA1c levels over time. A significant difference was observed between the first and last measurements (7.3% and 6.4%, respectively; p < 0.05). The study provides a type of diabetes care that can contribute to the health and disease control and demonstrates the strength of digital PHC for monitoring diabetic patients and should help PHC decision-makers and researchers to better understand how to improve diabetic patient management services using digital health.