ESPE Yearbook of Paediatric Endocrinology

Brief summary: This commentary focuses on the barriers and opportunities of digital systems with regards to diabetes care in resource-limited settings. It highlights the importance of developing context-specific and cost-effective models of efficient, integrated, and organised diabetes care delivery.

This commentary builds on a more general article on the potential of digital health interventions (1). It focuses on the opportunities for better diabetes care at the patient level. Indeed, with a recent increase in capacity in paediatric diabetes in low- and middle-income countries, the number of patients diagnosed with diabetes has increased exponentially. Challenges in patient management that can be potentially addressed by digital health include (but are not limited to) travel distances from rural areas to the medical center, review of blood glucoses, and patient-specialist interaction for emergencies. Indeed, during the COVID-19 epidemic, pediatric endocrinologists have learned to offer both virtual and in-person visits to maintain patient care while reducing physical contact.

The potential of digital health is not limited to direct patient care. Digital health also plays a major role in the training of health professionals through programs that include a e-learning component (see 11.3) or live, interactive presentations with experts from around the world such as the PEDAF program (https://e-pedaf.org/site/). Virtual registries such as the SWEET project are increasingly integrating countries from low-, middle- and high-income countries to successfully reach commonly agreed goals and bridge ‘social and cultural differences among countries, differences in clinical governance, and lack of structured networks of interested parties’ (www.sweet-project.org). However, in many instances, work remains to be done to ensure proper access to internet as well as to offer computer education to families, with an emphasis on gender equity, as women are much less likely than men to use mobile internet or to own a smartphone.

Reference: 1. Kaboré SS, Ngangue P, Soubeiga D, Barro A, Pilabré AH, Bationo N, Pafadnam Y, Drabo KM, Hien H, Savadogo GBL. Barriers and facilitators for the sustainability of digital health interventions in low and middle-income countries: A systematic review. Front Digit Health 2022; 4:1014375. DOI: 10.3389/fdgth.2022.1014375.