Towards Developing Online Compliance Index for Self-Monitoring of Blood Glucose in Diabetes Management

Self-monitoring of blood glucose (SMBG) is a key component of modern therapy for diabetes mellitus in which the patients and their informal health carers can play a major role. In this paper, a rule-based decision support module is proposed towards developing online compliance index for SMBG in diabetes management in patients who are administering daily subcutaneous insulin injections. The proposed decision-support application is developed and embedded in a mobile health (mHealth) scenario in which the patients' data are collected over a distance and stored in a remote disease management hub for further processing and monitoring purposes. The decision support module utilizes the collected evidences of the day-to-day SMBG and historical data to generate a personalized online compliance index. Patient's attributes relevant to SMBG are categorized into four main groups, (i) glycemic-control attributes, (ii) lifestyle attributes, (iii) mood and well-being attributes, and (iv) complication prevention attributes. A functional prototype of the proposed system is developed and its end-to-end functionality is tested successfully. The proposed system is expected to improve patients' follow up through prioritizing delivery of healthcare services based on their compliance index, especially in situations where available caregivers are insufficient to meet the demand for health care services.