This content originally appeared on diaTribe. Republished with permission.
By Adeline Jasinski
New virtual care assistants have been shown to help many people overcome these feelings and benefit diabetes management.
Diabetes and depression are both serious health conditions worldwide, and they often occur together. People with diabetes are two to three times more likely than others to develop depression, and people with depression are at high risk of developing type 2 diabetes. These conditions can lead to worsening health outcomes, which is why researchers are looking at new ways to help people manage diabetes and depression.
What is depression?
According to the American Psychiatric Association, depression is a medical illness that affects how people think, feel, and act. People with depression may feel sad or irritable, experience a decrease in pleasure, and lose interest in things they once enjoyed. They may have other symptoms such as:
Feelings of guilt or worthlessness
Fatigue or loss of energy
Suicidal thought or thoughts about death
Changes in weight, activity, or sleep habits
Slowed movement or speech
It is normal to feel sad and tired sometimes, or to have trouble concentrating occasionally. However, unlike people who are simply feeling sad or who are experiencing grief over a tragic life event, people with depression experience these symptoms for more than two weeks and exhibit different behaviors from their normal behavior or personality.
Diabetes and depression are often linked
Depression is associated with diabetes and other chronic conditions such as high blood pressure, heart disease, and arthritis. This relationship may be caused by shared underlying biological processes for depression and chronic diseases, or by unhealthy behaviors such as smoking, alcohol use, and physical inactivity, which are common in people with diabetes. Whatever the reason, the link between diabetes and depression is well established.
Depression compounds problems with diabetes self-care, including going to appointments and medication adherence. Struggling with medication adherence means they have trouble taking their medication at the right time, dosage, and frequency. Not taking medication according to the prescribed schedule can lead to worsening of the condition and increased complications and mortality.
According to Emily del Conte, a registered dietitian and certified diabetes care and education specialist at Evolution, “Taking medications is part of self-care. When a patient has depression, all self-care activities become harder.” Researchers are looking into ways to help people with both depression and diabetes stick to a medication routine to improve their overall health.
Can a virtual assistant help?
Several studies have explored using technology to help people with a variety of conditions take their medication regularly. Past studies have looked at whether voice and text messages can help patients improve medication adherence. More recent work has focused on the use of virtual assistants to offer health advice to patients in a variety of situations.
Virtual assistants are app-based platforms that rely on a chatbot, or a computer program designed to simulate conversation with human users, especially over the internet. Patients can use the virtual assistant to access medical information, and the virtual assistant can remind users about medications and appointments, as well as assess their adherence. Virtual assistants have been used to support pregnant women and new mothers, as well as people with cancer, chronic pain, coronary heart disease, coronary artery disease, and breast cancer.
One recent study found that people with type 2 diabetes who used app-based mobile health interventions were able to improve their glucose management. Another study found that people with type 2 diabetes and depression who used a microelectronic monitoring device known as a “Medication Event Monitoring System” improved their adherence to both oral glucose-lowering medications and antidepressants. These studies show the potential for technology to help people with both diabetes and depression improve medication adherence.
A new study assessed whether a virtual assistant that provides medication reminders can help people with type 2 diabetes and depression. The study followed people with a diagnosis of both conditions who already had poor medication adherence, defined as taking their medication as directed less than 80% of the time. For nine months, participants used the virtual assistant, which reminded them to take their medication and to attend upcoming appointments. It also provided each person with a weekly summary of their medication adherence.
The study used A1C levels to measure diabetes progression and a patient health questionnaire to measure the severity of depression and treatment response. To assess participants’ use of the virtual assistant, the program tracked how many times every day each person interacted with it. Clinicians interviewed participants at the three-month and nine-month marks to determine how useful the virtual assistant was overall and, more specifically, in improving medication adherence.
Participants who used the virtual assistant improved their health outcomes in several ways:
Improved medication adherence: 77% of participants demonstrated positive medication adherence, though all had poor adherence at the start of the trial
Improved A1C levels: average level changed from 7.6% to 7.3%
Improved depression: questionnaire scores changed from 13.2 to 8.6, signaling a significant decrease in symptoms of depression
In addition, interviews with participants showed that they found the virtual assistant useful. All participants used it daily and found that it covered their medication reminder needs, and 70% agreed with the idea of continuing to use it after the study concluded.
Can a virtual assistant help with your medication adherence?
If you have type 2 diabetes, depression, or both, you can use technology to help with your medication adherence. There are a variety of apps for diabetes available, and many of them are free. Here are some options, each with a brief description:
MySugr: This app is great for counting carbs and tracking your glucose levels, and you can easily share your data with your doctor. You can also use it to set reminders.
Glucose Buddy Diabetes Tracker: You can use this app to log data about your food intake, glucose levels, and medication use. You can also scan food labels and follow the app’s free diabetes education plan.
Diabetes Tracker by MyNetDiary: This app lets you track current medications, insulin use, your food and water intake, weight, exercise, and more. You can also set goals, search receipts, and see an overview of your personal health statistics.
Take a minute to search for apps on your smartphone or tablet and see which one appeals to you or ask your healthcare provider for recommendations.
However, not everyone has a smartphone or tablet, and not everyone wants to use an app to manage their diabetes. Even if you choose not to use an app, you can still use the findings of this study to improve your medication adherence. Set a timer and keep a manual log of when you take your medication to demonstrate your accountability. Del Conte also suggests setting reminders on your phone, keeping your medication in sight on the counter, and using a pill box. If you have a close friend or family member willing to help, ask them to check in daily or weekly to see how you are doing. Sometimes, the knowledge that someone will be following up is enough to push you to take your medication or go to your scheduled appointment.
If you are interested in trying out a diabetes app or other virtual care tools, see: