Diabetes as a case study of chronic disease management with a personalized approach: the role of a structured feedback loop

As non-communicable or chronicdiseases are a growing threat to human health and economic growth, political stakeholders are aiming to identify options for improved response to the challenges of prevention and management of non-communicable diseases. This paper is intended to contribute ideas on personalizedchronicdiseasemanagement which are based on experience with one major chronicdisease, namely diabetes mellitus. Diabetes provides a pertinent case of chronicdiseasemanagement with a particular focus on patient self-management. Despite advances in diabetes therapy, many people with diabetes still fail to achieve treatment targets thus remaining at risk of complications. Personalizing the management of diabetes according to the patient's individual profile can help in improving therapy adherence and treatment outcomes. This paper suggests using a six-step cycle for personalizeddiabetes (self-)management and collaborative use of structured blood glucose data. E-health solutions can be used to improve process efficiencies and allow remote access. Decision support tools and algorithms can help doctors in making therapeutic decisions based on individual patient profiles. Available evidence about the effectiveness of the cycle's constituting elements justifies expectations that the diabetesmanagement cycle as a whole can generate medical and economic benefit