Diabetes is one of the most common chronic diseases in our country. No less than 1 in 14 Dutch people has it. Diabetic patients should always be alert to their blood sugar levels and have to leave a lot behind. Through e-health solutions, patients gain more insight into their blood sugar levels. Trins van der Linden, diabetes nurse at the Jan van Goyen Medical Center, can monitor patients remotely in this way.

Diabetes
'Diabetes used to be called diabetes mellitus. It is a disease in which the body can no longer balance blood sugar, causing too much sugar in the blood. This is because the body has too little of the hormone insulin. And the body often no longer responds well to insulin. Or it doesn't make any insulin at all. Insulin regulates blood sugar, so that's very important.' 

e-health
'At Jan van Goyen we want to help diabetes patients as best as possible to get their blood sugar levels under control. Contact once every three months is sometimes not enough. For example, if I indicate during a check-up that the patient should inject more during breakfast, it may turn out after the next check-up that this was not enough, but then you are already three months further. That is why we have been working with e-health programs for several years now: I can monitor patients' blood sugar levels online at any time. Every two weeks I have a telephone appointment with the patient to discuss the results. Ideal for people who work and have busy lives. Then they don't have to come by all the time.'

How does it work?
'When a patient comes to us, I ask him or her for permission to check the blood sugar level via an e-health program. This usually concerns type 1 diabetes patients. When the patient gives their approval, they can download an app. Then there are two ways to get the data. In the first, the patient measures his blood sugar level via a finger prick. The values are passed on to the app via a bluetooth connection, after which I can view the data.
The second group of patients works with sensors that are placed on and in their skin and that continuously measure the blood sugar level. This creates a continuous curve for 24 hours, which is visible via the e-health program. I can follow those people live, in real time. For example, I can see their blood sugar values, average glucose and patterns.'

It is not the case that everyone is continuously monitored. Patients are only followed when they email or call that things are not going well. Then I can watch the curve online and we can discuss by phone which adjustments they can make. I also consult the curve during a telephone appointment or during consultation hours.

Fast growth
'At the moment, about 50 patients use the e-health option. This group is growing very quickly. Recently I can also follow women with gestational diabetes. They no longer have to email their results every week. There is a separate program for this, because they only have to measure their blood sugar levels during pregnancy. The patients who use it are all super enthusiastic. I therefore expect that the number of e-health users with us will have doubled by the end of 2019.' 

Knowing more? Please contact the internal medicine department.