Diabetes Spatial Care Paths, Leading Edge HbA1c Testing, Facilitation Thresholds, Proactive-Preemptive Strategic Intelligence, and Unmanned Aerial Vehicles in Limited-Resource Countries

Abstract In limited-resource settings, prediabetes and diabetes care demand efficient Spatial Care Paths and effective geospatial optimization of medical services upstream to avoid the economic penalties of untold patient complications downstream. Clever HbA1c technologies placed at the leading edge of primary care in health care small-world networks will improve patient care where multifactorial impediments are identified by facilitation thresholds. We illustrate how to formulate facilitation thresholds and then actuate changes that will solve problems generating the threshold phenomena. It is no longer a question of whether point-of-care HbA1c should be used, in view of numerous studies showing its benefits that we summarize, but instead one of how to effectively design, implement, integrate, and optimize strategies that serve underserved populations. In parallel, professional oversight for HbA1c interferences and variants accompanied by laboratory evaluation will help optimize diagnosis and monitoring. Aerial drones, which currently are used to deliver blood, vaccines, and drugs to inaccessible rural settings, could transport specimens for detailed HbA1c evaluations. By taking advantage of strategic intelligence and moving to primary care, the flow of knowledge emanating directly from patients will help public health nurses, primary care staff, and multidisciplinary physicians, some working via telemedicine, to proactively and preemptively reduce diabetes complications by means of evidence-based, cost-effective decision making closer to patient homes. Innovative monitoring and treatment will fulfill expectations for high-quality efficient personalized care, even self-monitoring essential to the management of a chronic condition, thus transforming standards of care to appropriately embrace and empower point-of-care culture.