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Diabetes app helps people self-manage better in China

Tangtang Quan could be an answer to improving diabetes health and emotional survival in China.


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Zeng Xifeng
Zeng Xifeng, creator of Tangtang Quan

Tangtang Quan (TTQ), meaning dignity in Chinese, is an app developed specifically for people with type 1 diabetes. Its founder, Zeng Xifeng, had good reason to be interested in the care and support of people with type 1 diabetes in his country.  Zeng’s daughter was born with Neonatal Diabetes Mellitus (NDM), a form of monogenic diabetes, which mirrors requirements of type 1 diabetes after the first year. With very little support, resources or information available, he believed creating Tangtang Quan could be an answer to  improving diabetes health and emotional survival. Learn about the diabetes app and how the services it provides help lessen the burden of type 1 diabetes in my interview with Zeng Xifeng.

What is Tangtang Quan?

Tangtang Quan is a social enterprise certified by China Charity Federation.  The diabetes app aims to solve many social problems in China. These include stigma associated with poor glycemic outcomes, common psychological barriers and lack of education. We provide specialized patient and family education, psychological support and blood glucose management services for type 1 diabetes. We also strive to help people realize that a better quality of life is possible if they work hard to prevent complications.

Tangtang Quan is an advocate of mobile Internet technology, wearable medical devices and innovative educational models for people in Taiwan. Our team is working hard to solve current problems that exist in the management of type 1 diabetes in China.

What does Tangtang Quan achieve that is lacking in China’s diabetes care?

Over time, I realized that people with type 1 diabetes and their families lacked the knowledge about the disease. Additionally, in China, the medical and social environment is very unfriendly to those with diabetes. We wanted to create an app to help positively change type 1 diabetes lives and give people a deeper understanding of the disease.  Our emphasis is for people with type 1 diabetes to live with more dignity and freedom.

What is the public perception of diabetes in mainland China?  Do people understand the difference between type 1 and type 2 diabetes?

The ratio between types of diabetes is unknown because type 1 diabetes in China is not officially calculated, and there is currently no official data to report on the public perception of type 1 diabetes. At present, most people are only familiar with type 2 diabetes; very few know about type 1 diabetes. Most people are not even aware of the difference between the two types.

In China, the medical and social environment is very unfriendly to people with type 1 diabetes. We wanted to create an app to help positively change their lives and give people a deeper understanding of the disease. Our emphasis is for people with type 1 diabetes to live with more dignity and freedom.

What is the result of diabetes stigma in China?

The result is that school, work, friends, marriage, family, and life have been greatly challenged. One can’t live in the sun, only in the dark corners. In addition to mental distress, type 1 diabetes also imposes a more or less financial burden on families. Of the vast majority of households, nearly half of their income is used to pay for type 1 diabetes medication. People with diabetes often feel inferior, socially isolated, and very often hide their condition. Disciplinary guidance for enrollment in colleges and universities, and opinions on the recruitment of civil servants also discriminate against people with diabetes. People with type 1 diabetes also face problems that include unstandardized treatment options and unfortunately, complications are common.

How are people with diabetes discriminated in China?

In marriage, childbirth, job hunting and other social discriminations still exist today.

Do doctors generally know how to care for a person with type 1 diabetes?

China’s vast territory still lacks a relatively systematic knowledge of type 1 diabetes education for doctors. Most doctors are not sure how to provide patients with better care. In addition, due to the problems of the Chinese medical system, doctors give patients less time to communicate. After the patient is discharged from the hospital, the doctor has little time to help. Tangtang Quan was developed to deal with these problems.

Are insulin pumps or Continuous Glucose Monitors common?  Is insulin purchased as well or government supplied?

Insulin pumps are not common in China, and continuous glucose monitoring (CGM) is not very common either. They usually consult the doctor’s advice when they buy it, but they don’t need to prescribe it. The price of insulin pumps ranges from 20,000 to 100,000 RMB (3,000-15,000 USD). The price of continuous glucose monitoring ranges from 800 to 3000 RMB (120-430 USD) a month.  Long-acting insulin is around 200 RMB (30 USD), and rapid-acting and short-acting insulin is around 60-70 RMB (10 USD).  In different regions, due to different medical insurance policies, the proportion of insulin reimbursement is also different.

What are the core functions of Tangtang Quan?

TTQ includes two key components: (1) an application freely available on Android or iOS markets and (2) a web portal (WP) accessed through any web browser. The application is designed for people to use several times a day by patients and their families. Popular features include personal diabetes diary, glucose monitoring, diet module & bolus calculator wizard, consultation with medical team, and review of patient targets, peer support communities, online education courses and more.   No matter where you are in China – you’ll always be connected to help or resources for diabetes.

How many members do you have? What is the age range?

There are 41,371 people with type 1 diabetes who use our app and we have over 20,000 registered members. Below is the age distribution of the users:

Age range Percentage
0-5 12.3%
6-15 23.6%
16-30 35.5%
31-49 23.8%
50-78 4.8%
>78 0.1%
What is TTQ’s relationship to Medtronic, World Diabetes Foundation (Novo Nordisk) and Abbott as partners?

We are Medtronic’s online distributors for insulin pump supplies. We are their only online distributors in China. We also represent after-sales service. We are also the online distributors of Novo Nordisk and the Abbott Freestyle Libre.

At the same time, we provide some diabetes education service and training courses for Medtronic, Novo Nordisk and Nordia plus other institutions to serve all types of people with diabetes and families in China.

Tangtang Quan is also cooperating with The Third Affiliated Hospital of Sun Yat-sen University, and working with the World Diabetes Foundation on a type 1 diabetes combined pregnancy research project.

How many people do you think have type 1 diabetes in China? Do you (and your medical connections) believe people die misdiagnosed?

According to surveys, there are about 4 million people with type 1 diabetes in China. Everyday, we see 20-50 patients online with type 1 diabetes, and about 20% of them are newly diagnosed.  There are indeed people, especially in areas with poor medical conditions, who die from misdiagnosis.

How does the People’s Republic of China view people with diabetes?

At present, the National government is gradually coming to realize the existence of the group of diabetes, and then will gradually proceed from their interests, from the medical insurance education and other aspects to reduce the burden on those patients. But this journey is still far away. I hope that there are more platforms like TTQ that can push institutions and push the government to accomplish this great task.

Diabetes Voice originally reported on type 1 diabetes and Tangtang Quan in an article, Worth a Shot.

 

Elizabeth Snouffer is Editor of Diabetes Voice

 

Zeng Xifeng is the founder of Tangtang Quan


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