An Integrated Framework for Social Contribution of Diabetes Self-care

Management Application

Zul Indra, Liza Trisnawati and Luluk Elvitaria

Departement of Informatics Engineering, Abdurrab University, Pekanbaru, Indonesia

Keywords:

Diabetes Mellitus, Diabetes Self-care Management (DSCM), Web Application.

Abstract:

Diabetes mellitus (DM) has becoming a critical health problem due to number of mortality. This disease will

affect the entire life of diabetic with its biological, psychological and social effects. However, there is no

known cure for this chronic disease. Diabetics can only reduce the complications that arise by taking certain

measures such to keep the blood glucose levels as close to normal as possible. The goal to keep the blood

glucose levels as close to normal requires the involvement of diabetics by diabetes self-care management

(DSCM). However, successful treatment for diabetics is not only depending on patient’s role in the care of

their diabetes but also requires family support. This research proposes an integrated DSCM application which

is enriched of social contribution feature since the DSCM application which accommodates the involvement of

diabetics’ family (social contribution) is still scarce. This proposed DSCM is aimed to allow family member

of diabetics to encourage them to keep their blood glucose levels as close to normal and enabling the doctors

to be actively involved in helping diabetics in managing their lifestyle.

1 INTRODUCTION

Diabetes mellitus (DM) has becoming a critical health

problem due to number of mortality. In 2011, the

International Diabetes Federation (IDF) claimed that

every year 4 million people die of diabetes with an av-

erage of one person dying every 7 seconds (Alrahbi,

2014). It has been estimated that 382 million people

in the world had DM, with more than 90% of them are

type 2 diabetic (Thojampa, 2019). In addition, based

on The World Health Organization report, the number

of people with diabetes has risen from 108 million to

422 million in just 34 years. This number of is ex-

pected to increase to about 439 million in 2030, where

69% of this number is estimated to occur in develop-

ing countries (Shaw et al., 2010). Therefore in 2014,

the World Health Organization (WHO) declared that

diabetes is one of most serious disease and a costly

health condition around the world(Association et al.,

2014).

As a chronic disease, diabetics will experience

various complications in their daily lives. This dis-

ease will affects the entire life of diabetic with its

biological, psychological and social effects (Mankan

et al., 2017). As an example, diabetics have a greater

risk of cardiovascular disease, eye or kidney disease,

and even reduced life expectancy compared to normal

people. In terms of psychological problems, sufferers

will experience a loss of life pleasure because they

lose the conﬁdence to live independently and become

discouraged in living life. Furthermore, they have to

maintain a planned care throughout their lives and re-

ceive professional help from time to time.

Unfortunately, to date, there is no cure for this

chronic disease. Diabetics can only reduce the com-

plications that arise by taking certain measures such

to keep the blood glucose levels as close to normal as

possible (Syaifuddin and Anbananthen, 2013). Effec-

tive control of diabetes depends on self- monitoring

and self-care activities such as blood glucose moni-

toring, appropriate diet and nutrition, exercise regi-

men and medication administration strategies. Also,

individuals have to keep track of their overall health

record a holistic approach instead of only monitoring

their blood glucose reading.

However, the goal to keep the blood glucose lev-

els as close to normal cannot be achieved without in-

volvement of patients in the management plan. This

involvement occurs through diabetes self-care man-

agement (DSCM) with patients assuming an indepen-

dent role in the care of their diabetes. In addition,

successful treatment for diabetics is not only depend

on patients role in the care of their diabetes but also

requires family support a good relationship with the

Indra, Z., Trisnawati, L. and Elvitaria, L.

An Integrated Framework for Social Contribution of Diabetes Self-care Management Application.

DOI: 10.5220/0009106100680073

In Proceedings of the Second International Conference on Science, Engineering and Technology (ICoSET 2019), pages 68-73

ISBN: 978-989-758-463-3

diabetes care team, including open communication

and easy access to care, is essential for success (Sil-

verstein, 2014). This research proposes an integrated

personal health record which allow family member of

diabetics to contribute in order to keep the blood glu-

cose levels of diabetics as normal as possible.

2 LITERATURE REVIEW

DSCM can be deﬁned as implementing actual per-

formance for self-care activities for those who suffer

from diabetes to manage their condition (Gharaibeh

et al., 2017). The main purposes of DSCM manage-

ment is to the glucose levels as close to normal as

possible by doing diet, performing physical activities,

monitoring blood glucose level, using of medications,

another self-care actions. The workings of DSCM is

to modify health behaviour by making changes to the

daily plan, if necessary, in accordance with the treat-

ment regimen and completion of self-care activities

such as following a regular diet and exercise plan,

independent monitoring of blood glucose levels, and

taking medication according to prescription (Khairnar

et al., 2019).

Nowadays, DSCM is considered a critical part of

diabetes management and has an important role in

helping diabetics to control the glycaemic and prevent

complications (Funnell, 2009). Furthermore, several

research has shown that DSCM can improve the qual-

ity of life of diabetics and contributed in prevent-

ing and lessening the severity of complications (Lorig

et al., 2009).

During the last ﬁve years, there are several re-

searches that have been done to develop DSCM ap-

plication. In 2014, an integrated model for cognitive

behavioural therapy for DSCM was proposed (Alanzi

et al., 2014). This proposed DSCM was intended

to implemented cognitive behavioural therapy for di-

abetics by using smartphone technology. In 2016,

another work for DSCM was performed by utilizing

the digital engagement concept (Burford et al., 2016).

This research attempted to empower the diabetics by

inviting them to participate in various digital activi-

ties for the management of their health condition. The

second work for DSCM research in 2016 was carried

out by developing an application which is called by

DiaHealth (Islam et al., 2016).

Based on the review of these several related

works, it can be inferred that there are many e-health

applications for diabetes management systems avail-

able, but most of these systems only focus on glucose

measurement levels and have not accommodated the

involvement of diabetics’ family (social contribution).

Therefore, this research proposes an integrated per-

sonal health record which is enriched of social contri-

bution feature. This feature is aimed to allow family

member of diabetics to encourage them to keep their

blood glucose levels as close to normal. Furthermore,

this proposed DSCM is enabling the doctors to be ac-

tively involved in helping diabetics in managing their

lifestyle.

3 SYSTEM REQUIREMENT

The DSCM application that is created is a web-based

application because it tends to be more ﬂexible. Web-

based applications can be accessed through various

devices and various operating systems such as via

smartphones or tablets and others including smart

watches. It doesn’t matter whether users use Win-

dows, Linux, iOS, Mac OS, Blackberry, Android or

other devices; users can still use it only with a web

browser. Users simply open a web browser (for ex-

ample Firefox or Google Chrome) which then points

that web browser to the DSCM application URL to

use this DSCM application.

In addition, users can also access this applica-

tion through all the devices they have without hav-

ing to install it ﬁrst on each of these devices. This

of course will make it easier for users who tend to

have multiple devices at once or change devices fre-

quently. As for the website interface, DSCM appli-

cation uses a bootstrap framework which is known as

one of the best website front-end framework. By us-

ing this bootstrap framework, the DSCM application

becomes more responsive and can adjust its appear-

ance according to the devices that access it. How-

ever, to use this website-based application, users do

not need hardware with strong speciﬁcations because

all applications are placed on the server side rather

than on the client side.

4 FEATURE OF PROPOSED

DSCM APPLICATION

Based on literature study that has been conducted, this

DSCM application is designed to have 5 main mod-

ules namely personal health record, knowledge base

and extraction, intelligent suggestion, notiﬁcation and

reminder and social contribution.

As seen in the ﬁgure 2, the DSCM application is

divided into two levels of users, namely the level of

diabetics and social (family members and internists)

who have different access rights. Diabetic Users will

An Integrated Framework for Social Contribution of Diabetes Self-care Management Application

Figure 1: Module of Proposed DSCM

Figure 2: Context Diagram of Proposed DSCM

be given the right to access the blood sugar level data

input features, input insulin data, input exercise data

and obtain a proﬁle of their health records. In addition

they will also be given a notiﬁcation to remind them

to routinely check (input) blood sugar level data, diet

advice and also advice on physical activity. For social

level user, they will be given access to the health pro-

ﬁle of diabetics, get notiﬁcations from the system and

provide encouragement so that diabetics can manage

their lifestyle. Moreover by using this DSCM, it is

expected the internist can get a health picture of the

patient real time and provide better treatment.

4.1 Personal Health Record

In this proposed DSCM application, the Personal

Health Record Module consists of two main parts,

namely data input section and the health proﬁle of

diabetics section. There are several data which is

inputted by users into personal health records such

as blood sugar levels, insulin intake, exercise activi-

ties and diet activities. All these records of data will

be processed by the Knowledge Base and Extraction

module and then delivered to diabetics in the form of

suggestions.

Figure 3: Homescreen of Proposed DSCM

DSCM application will give suggestion to diabet-

ics regarding physical activity and a better and appro-

priate diet in order to maintain their blood sugar levels

as close to normal. All data that has been inputted by

the diabetic user will be displayed by this DSCM ap-

plication on the health proﬁle display page so that the

related users, diabetics and family members of the in-

ternist, can monitor the patient’s health condition real

time.

Figure 4: Proﬁle of Diabetic

Figure 5: Graph Representation for Glucose and Blood

Pressure Level

4.2 Knowledge Base and Extraction

This module has a task to process raw data which

are inputted by users where concepts of data min-

ing and machine learning are utilized in this mod-

ule. So that the presence of the Knowledge Base and

ICoSET 2019 - The Second International Conference on Science, Engineering and Technology

Extraction module makes this DSCM application be-

come smarter as this DSCM will adjust itself, in terms

of giving advice and notiﬁcations, according to the

health proﬁle of each user. For example, based on the

results of the blood sugar level record the DSCM ap-

plication will look at the blood sugar level trend of

diabetics then analyse the causes of elevated or de-

creased blood sugar levels.

The results of this analysis will be displayed and

can be accessed by the user in personal health record

module. In addition, the results of this analysis will be

further processed in the intelligent suggestion module

to be able to provide more suitable treatments related

to diet, physical activity and so on.

4.3 Intelligent Suggestion

As explained in the knowledge base and extraction

module, this developed DSCM application will intel-

ligently provide advice according to the health proﬁle

of each diabetic. Thus the advice which is delivered

will be more in accordance. For example, based on

the results of the analysis that has been carried out

in the knowledge base and extraction, users will get

advice about physical activity and diet control that is

more in line with their habits in order to make it easier

for them to keep their blood sugar levels normal.

Figure 6: Sample of Intelligent Suggestion

4.4 Notiﬁcation and Reminder

This module is an important module in the DSCM

application that has the task of giving reminders to

users. Patients will be reminded to record their health

data such as their blood sugar level and regular phys-

ical activity. Due to diabetics are tend to forget or

lazy to record their health data because they consider

this troublesome. This module will routinely check

whether the patient has recorded their health data. If

diabetics have not yet recorded the data, the DSCM

application through this module will send notiﬁca-

tions to users in order to remind diabetics to imme-

diately record their health data.

4.5 Social Contribution

As explained earlier, another factor in the success of

treating diabetics is the contribution of family mem-

bers. This module is intended to be a medium for

Figure 7: Sample of Intelligent Suggestion

Figure 8: Adding of Reminder Notiﬁcation

Figure 9: Reminder Data

family members and doctors to be actively involved in

helping diabetics in managing their lifestyle. Through

this module, they can easily monitor the health condi-

tions of diabetic real time and encourage them to be

able to regulate their lifestyle such as reminding them

to check their blood sugar levels, follow a healthy

diet, and do physical activities and so on.

Figure 10: List of Social Contributor

5 CONCLUSIONS

Successful treatment for diabetics is not only depend

on patients role in the care of their diabetes but also

requires family support to encourage them to keep the

blood glucose levels of diabetics as normal as possi-

ble. This research proposes an integrated DSCM ap-

plication which allow family member of diabetics to

An Integrated Framework for Social Contribution of Diabetes Self-care Management Application

Figure 11: Form of Social Contributor Registration

encourage them to manage their lifestyle and enabling

the doctors to be actively involved in helping diabet-

ics real time. This research is still in the initial stages

in terms of identifying what modules are needed in

the development of DSCM applications. Further re-

search needs to be carried out to ﬁnd out how much

the inﬂuence of proposed DSCM application in order

to ease the treatment of diabetics.

Figure 12: Approval for Social Contributor

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An Integrated Framework for Social Contribution of Diabetes Self-care Management Application