In September 2016, the independent journalist Yutaka Hasegawa triggered a storm of criticism after writing on his blog that patients with diabetes who receive dialysis should pay the treatment themselves instead of using public #Salud insurance.
He argued that it was his "corrupt" life styles that generated the need for dialysis and that his medical expenses "would ruin Japan."
Many people connected to the Internet to criticize Hasegawa for their deceptive and abusive comment (not all #Diabetes is related to lifestyle).But he also highlighted the serious financial situation surrounding the health system of Japan, which deals with a population that is becoming more gray and a growing proportion of diabetics.
Population and expenses statistics
According to the Ministry of Health, 10 million people were "strongly suspicious" of being diabetic in 2016, compared to 6.9 million in 1997.
In addition, in a report published in July, the Ministry said that Japan has the most per capita amount of people on dialysis among the main countries, with a diabetes treatment that costs 1.2 billion dollars a year, or 4.4 per 4.4 perone hundred of all medical expenses.
According to the Japanese dialysis therapy society, 2,596.7 people per 1 million were on dialysis in the country in 2016. Dialysis costs ¥ 400,000 per patient per month, which represents "a great challenge for the medical expenses of the country", according to thereport.In this context, the government is seriously studying ways to prevent patients with diabetes from progressing to the dialysis phase.
Last month, the doctors of the National Global Health and Medicine Center in Tokyo, with the help of medical institutions and health insurance unions throughout the country, launched what they called the world's first large -scale clinical study in the world to examine whetherThe use of the Internet is effective to keep blood sugar levels at bay.
Experiment
The researchers, sponsored by the State Agreed Agreement of Japan Research and Development (AMED), have recruited 2,000 patients with type 2 diabetes who are about to receive dialysis and divided them into two groups: one equipped with an applicationSmartphone and Internet and connected medical devices, and the other without type 2 covers more than 90 percent of all patients with diabetes, experts say.
Unlike type 1 diabetes, whose cause is not known, type 2 diabetes is often associated with excess eating, obesity, lack of exercise and stress.
During the two-year study, called Prism-J, which began on January 23, users will be asked to register their health data daily, including weight, blood pressure, the type of meals they consume, the numberof steps and the amount of exercise performed, through devices connected by Bluetooth.The data will be sent to a central database and will be shared with their doctors.
They use an application for smartphones called Shichifukujin (seven fortunate gods) developed by Dr. Kazuyo Tsushita of the Integral Center for Health Sciences in the Foundation of Public Interest of Aichi Health Promotion.In a previous study conducted by the Aichi Institute and that covered almost 200 people, the users of the application showed more success in reducing blood sugar levels than those who did not use them.
functionality of the app
The application presents cartoon characters from seven gods, including Ebisu that monitor walking habits, and Daikokuten, who controls the diet.They send motivation messages adapted to each user and notify him if they relaxwith the exercise or if they begin to deviate from their weight loss plan.
In the PRISM-J study, patients will be performed by blood in their doctor's office every three months to verify their blood sugar, pressure and fat and functions and liver functions.Doctors will also review the data sent from the Internet of devices of things and give advice.
Objective of the project
The researchers said that the ¥ 1.5 billion project is intended to keep patients involved in treatment;At present, almost 4 out of 10 patients with diabetes leave therapy, citing reasons such as being busy at work or school, finding too expensive medical invoices or not feeling sick (although the disease could progress without important symptoms).
The government has set the objective that 75 percent of diabetes patients continue their treatment, which includes advice on exercise, diet and medications.
"This is an unprecedented company, in terms of the size and duration of the project," said Dr. Kohjiro Ueki, director of the Diabetes Research Center at the National Global and Medicine Health Center and the head of the study.
"Previous studies (which explored the use of the Internet of things in diabetes care) lasted a maximum of three months or six months."
Kazumi Nishikawa, director of the Division of Health Care Industries of the Ministry of Economy, Commerce and Industry, which administer intimidally with the Ministry of Health and the Ministry of Education, argued that the project is the first attempt to establish Internet from the Internet ofGadgets of things such as medical tools, not toys for health geeks and fitness.
"Doctors serve patients once a month, but they cannot administer them between visits," Nishikawa said."Usable devices and applications are useful tools to monitor patient conditions, but so far, those devices have not been reliable enough for professional use."
future of the project
The results of the PRISM-J study will be published in a respectable medical magazine in approximately two years, said Nishikawa, and pointed out that, if the Internet of things is effective in the care of diabetes, it could be incorporated into the clinical guides for treatments for treatments for treatments forbe used by doctors.
In the future, the specifications for the devices could be standardized and made public so that any manufacturer can develop them for clinical purposes.The devices could even be exported to other countries with high -risk populations, such as #rusia and China [Video], he said.
Dr. Hiroaki Kato, a guest professor at the Hollywood Digital University in Tokyo, who is an expert in digital health, said that he is everything to promote the Internet of things in medical care and praise the Prism-J project.
He said such devices will be a common tool in many medical fields, citing the success of an application to quit smoking in Japan. "It's like taking the doctor home," he said.
Challenge
The challenge is to make everyone, including patients and doctors, understand that you cannot blindly be trusted in digital health data, said Kato. "Even if the data shows that someone's heart rate has risen to 200 beats per minute, it could be just that the person has just run a marathon. "
The data alone will not tell you in what circumstances the patients were measured.Everyone should share awareness that the data has their limits.
