Alotaibi, Mohammed (2014) An intelligent mobile diabetes management and educational system for Saudi Arabia (SAED). (PhD thesis), Kingston University, .
Abstract
Diabetes mellitus is a common chronic disease that affects approximately 382.8 million people worldwide. Globally, the Kingdom of Saudi Arabia (KSA) has the seventh highest prevalence of diabetes, with over one-fifth of the Saudi population diagnosed with diabetes. Poor understanding and low health awareness, in parallel with lifestyle choices are considered the main components behind the increase of diabetes and diabetes-related complications in KSA. There is also a lack of diabetes speciality centres, especially in remote areas of KAS. Moreover, diabetes management becomes more complicated during the Ramadan month because people observe fasting throughout the month. The month long fasting process complicates the disease status of Saudi diabetic patients with potential complications post the fasting period. In this thesis, we present the design and development of a novel and intelligent mobile diabetes management system tailored for type 2 diabetic (T2D) patients in Saudi Arabia with the focus on the integration of educational and compliance issues, which we name as the SAED system. The system was validated in two preliminary pilots in the Kingdom, one pilot being specifically dsigned to evaluate the system for diabetic patient during Ramadan fasting month. The outcomes of the clinical pilot indicated the clear effectiveness of the SAED system in lowering the HbA1c levels. The system was tested for its performance through a randomized control trial on 20 diabetic patients for a period of six months in Kingdom of Saudi Arabia. The outcomes of the pilot study showed improvements in the HbA1c levels of patients and also significant improvements in diabetes knowledge amongst the patients. The HbA1c levels of the diabetic patients in the SAED intervention group decreased from 8.76% to 7.85%. The diabetic knowledge test outcomes of the diabetic patients in the SAED intervention group significantly improved from 46.20% to 61.10%. Further, our study also tested the SAED system on diabetic patients during the Ramadan period. This is important because fasting is observed during the Ramadan month which can significantly affect the diabetes management and diagnosis amongst the patients. The study for the Ramadan period was conducted on another 20 patients using the similar approach described above. The results from the clinical trial indicated significant reductions in the number of hypoglycaemic and hyperglycaemic events during the month of Ramadan in patients who used the SAED system. The diabetes knowledge test outcomes also significantly rose from 44.60% to 64.10%. The SAED system for diabetes management using mobile technologies in KSA has been proven to be successful in improving the diagnosis and management of diabetes amongst the patients. The SAED system offers an inexpensive, practically feasible solution for diabetes self-management in KSA. Considering the social, economic, and political conditions in KSA, the SAED system can enhance the quality of healthcare provided to patients, lead to better utilization of resources, provide timely interventions, and improve the overall quality of life of diabetic patients and their family and friends.
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