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Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology
DOI: 10.9790/0661-1741109117 www.iosrjournals.org 110 | Page
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861, Volume 14, Issue 4, Ver. I (April 2015), PP 108-116
www.iosrjournals.org
Healthcare of Diabetes in Monitoring Patient Blood Glucose at
Remote Areas Using Cloud Technology
P.S.Jagadeesh Kumar1
, J.Ruby2
, J.Lepika3
, J.Nedumaan4
, J.Tisa5
1
Biomedical Engineering Research Centre, Nanyang Technological University, Singapore
2
Medical Professional, Department of Surgery, University of Cambridge, United Kingdom
3, 4, 5
Malco Vidyalaya Matriculation Higher Secondary School, Mettur Dam, Salem, Tamil Nadu
Abstract: The major interest of the authors in surveying cloud computing based healthcare of diabetes is to
make a thorough check in the patient’s blood glucose control at remote areas. The improvement in the
technology and combined research can bring out the best medication and diagnosis for any disease. Today, the
most challenging syndrome across the globe is diabetes mellitus. In the latest survey, the world’s 65% of the
population is suffering from either Type 1 or Type 2 diabetes mellitus. But in most of the cases, the patient’s
blood glucose level is not the same 24x7 hours and medication 24x7 hours is impossible. Thus cloud based
healthcare is the one and only solution. Also the data’s stored in the cloud can be easily retrieved and placed
quiet safe and secure with best security technique adopted. Doctors can maintain the patience history related
data set and test results through his mobile, laptop, desktop and though the patient is at remote location, he can
prescribe the medication through mail, mobile SMS based on the latest blood glucose level tested through
glucometer or nearby lab.
Keywords–Cloud Computing, Health Care, Diabetes, Analysis, Diagnosis, Literature Survey
I. INTRODUCTION
Cloud computing has been coined as an umbrella term to describe a category of sophisticated on-
demand computing services initially offered by commercial providers, such as Amazon, Google, and Microsoft.
It denotes a model on which a computing infrastructure is viewed as a “cloud,” from which businesses and
individuals access applications from anywhere in the world on demand. The main principle behind this model is
offering computing, storage, and software “as a service.” One of the biggest concerns of any healthcare provider
is minimizing or eliminating the occurrence of mistakes during treatment. The speed and accessibility of the
cloud allows every staff member working with a patient to double or triple check details again and again without
adding time to the processing. This allows for much more checks and balances. This not only helps protect
patients, which is the first priority of any provider, but also minimizes expensive lawsuits and damage to a
hospital’s reputation.
II. CLOUD COMPUTING IN HEALTH CARE
Keeping tablet computers on hand to access the cloud during operations has become more common
these days. Surgeons are expected to have a great deal of knowledge, and having access to the cloud can allow
them to quickly reference surgical texts in an electronic format as needed. It also allows running pre-operative
assessment software, communicating with other professionals, referencing medical records, or video
conferencing. Cloud computing in hospitals creates interesting possibilities for sharing information with patients
about their condition, their options, and the treatment process. They can be given the opportunity to log in and
view their details as needed or even play more of a role in their own medical care. Healthcare providers can also
use it as a way to educate current or future patients about how to stay healthy. The cost of medical care has
become one of the biggest issues. One of the ways to minimize the costs is to cut down on how much the hospital
spends to care for patients, and the cost of storing and processing information has become a significant factor. If
cloud service solutions can make a hospital work together more efficiently, and it very well can, this typically
amounts to cost savings as well.
It’s legally required for most hospitals to store images produced by ultrasounds, x-rays, CT scans,
MRIs, and other procedures for seven or more years, and then backups are needed in case the system goes down.
With all the imagery being created, this means a huge mass of storage space to archive everything. Cloud
storage provides a cost-effective, more streamlined solution for health-care providers to follow the guidelines
and regulations required. By storing information on the cloud, you open up possibilities for instant, easy sharing
between different medical professionals. Not only does this make it easier for staff within the hospital to work
together more efficiently but it also provides an option to receive a quick opinion from more qualified specialists
Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology
DOI: 10.9790/0661-1741109117 www.iosrjournals.org 111 | Page
for unique cases where experienced input is needed. Before cloud computing becomes the absolute standard;
patients, medical professionals, and government officials alike are demanding that service providers guarantee
the privacy of their information.Cloud computing is a very secure service to store data. It is a secure service
that is provided by some of the largest and most trusted companies such as Citrix, Microsoft and VMware.
Companies such as these have some of the most secure networks in the world and can be highly trusted with
sensitive information and data.
III. DIABETES MELLITUS
Diabetes mellitus is a group of diseases characterized by an elevated blood glucose level
(hyperglycemia) resulting from defects in insulin secretion, in insulin action, or both. Diabetes mellitus is not a
pathogenic entity but a group of etiologically different metabolic defects. Common symptoms of diabetes are
lethargy from marked hyperglycemia, polyuria, polydipsia, weight loss, blurred vision and susceptibility to
certain infections. Severe hyperglycemia may lead to hyperosmolar syndrome and insulin deficiency to life-
threatening ketoacidosis. Chronic hyperglycemia causes long-term damage, dysfunction and failures of various
cells, tissues and organs. Diabetes mellitus is a continuous medicated syndrome. Permanent cure of diabetes is
rare and the patient can be classified into two categories of Type 1 Diabetes and Type 2 Diabetes. The following
symptoms of diabetes are typical. However, some people with type 2 diabetes have symptoms so mild that they
go unnoticed. Early detection and treatment of diabetes can decrease the risk of developing the complications of
diabetes. Common symptoms of diabetes:
 Urinating often
 Feeling very thirsty
 Feeling very hungry - even though you are eating
 Extreme fatigue
 Blurry vision
 Cuts/bruises that are slow to heal
 Weight loss - even though you are eating more (type 1)
 Tingling, pain, or numbness in the hands/feet (type 2)
Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as
juvenile diabetes. Only 5% of people with diabetes have this form of the disease. In type 1 diabetes, the body
does not produce insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into
energy needed for daily life. With the help of insulin therapy and other treatments, even young children can learn
to manage their condition and live long, healthy lives. Diabetes is a problem with our body that causes blood
glucose (sugar) levels to rise higher than normal. This is also called hyperglycemia. Type 2 diabetes is the most
common form of diabetes. In Type 2 diabetes, the body does not use insulin properly. This is called insulin
resistance. At first, the pancreas makes extra insulin to make up for it. But, over time our pancreas isn’t able to
keep up and can’t make enough insulin to keep our blood glucose levels normal. Some people with type 2 can
control their blood glucose with healthy eating and being active. But, doctor may need to also prescribe oral
medications or insulin to help us meet our target blood glucose levels. Type 2 is treated it with lifestyle changes,
oral medications (pills), and insulin. When glucose builds up in the blood instead of going into cells, it can cause
two problems: Right away, our cells may be starved for energy. Over time, high blood glucose levels may hurt
our eyes, kidneys, nerves or heart.
IV. CLOUD COMPUTING AND DIABETES MELLITUS
Cloud computing is a general term for anything that involves delivering hosted services over the
Internet. These services are broadly divided into three categories: Infrastructure-as-a-Service (IaaS), Platform-
as-a-Service (PaaS) and Software-as-a-Service (SaaS). The name cloud was inspired by the symbol that's often
used to represent the Internet in flowcharts and diagrams. Perhaps it is common that, some of our family photos
are on a desktop computer at home, others at work and still more on our phone. That's very inconvenient when
it's time to create a photo album. The same is true when diabetes data is stored in different places. By hosting all
information in one place and making it accessible anywhere, one can have a complete view of everything that
impacts their blood glucose levels, no matter where they are. Cloud computing can also help people stay more
connected to their self-care. Study has already shown that access to information over the internet can help
enhance engagement and control for people who live in remote areas where healthcare services aren't readily
available. Finally, it's been established that using an information management system can contribute to a
significant, lasting improvement in blood glucose control. Cloud computing takes that one step further by
providing immediate, anywhere access to our numbers. The general analysis and diagnosis of diabetes mellitus
is as shown in Fig.1.
Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology
DOI: 10.9790/0661-1741109117 www.iosrjournals.org 111 | Page
Fig.1 General Analysis and Diagnosis of Diabetes Mellitus
V. LITERATURE SURVEY
Yan Hu, Fangjie Lu, Israr Khan, Guohua Bai et al. [1] concluded that to accomplish the needs of
healthcare information sharing in e-health, cloud computing is a superior solution. Cloud computing is a new
technology and have good performance in storing and accessing information. Their research was mainly focused
on the implementation of SaaS cloud computing technique to share healthcare information. With the designed
prototype, could cover the current interoperability gap in e-health. The experiment results indicate that there is
much strength to use SaaS service to solve the problem such as quick development, high availability, large data
table storage, application as web service and authorized information. In the other hand, obvious drawbacks like
limitation of picture sharing and unpredictable latency are still challenges for widely using SaaS service to e-
health development for diabetes management as well.
G.Nikhita Reddy, G.J.Ugander Reddy et al. [2] presented that the major advantage of using mobile
technologies with cloud technologies is its mobility and easy sharing of the information. The cloud computing
based solutions in healthcare can help the physicians to stay in touch with their patients and examine their health
condition effectively at a low cost. There may be some concern regarding the security and other privacy issues
of data but still as every problem has a solution in the similar way these issues too can be solved. One day
utilization of cloud technologies in healthcare of analysis and diagnosis of diabetes mellitus would result in a
new era in the field of healthcare. Every section in the society can access this healthcare by implementation of
this technology. It is always remembered that cloud computing is still a developing technology, which implies
that in the future years the services it offers will be greater than our expectations or just beyond our imagination.
Yan Hu and Guohua Bai et al. [3] presented that research on applying cloud computing technology to
eHealth is in its early stages; mostresearchers have presented ideas without real-world cases validation. The
obvious features of cloud computing technology provide more reasons to adopt cloud computing in sharing and
managing health information. The main purpose of their review was to identify some challenges and feasible
cloud based solutions which can be applied in eHealth. The current review suggests that with the unique
superiority of the cloud in big data storage and processing ability, a hybrid cloud platform with mixed access
control and security protection mechanisms will be a main research area for developing citizen centered home-
based healthcare system for diabetes.
Sanjay P Ahuja, Sindhu Mani and Jesus Zambrano et al. [4] decided that the current trend of adopting
cloud computing in the medical field can improve and solve several collaborative information issues in
healthcare organizations as well as cost optimizations. Standardized cloud-based applications will bring obvious
advantages to patients, physicians, insurance companies, pharmacies, imagining centres, etc. When sharing
information across medical organizations yielding better results. Challenges such as security concerns and
interoperability will rise due to the cloud-computing model. Therefore, the adoption of the cloud is progressing
slowly. Through the implementation of best practices in the design, deployment and use of it will hopefully
generate a future growth of the cloud-based systems adoption of diabetes management, despite the obstacles.
Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology
DOI: 10.9790/0661-1741109117 www.iosrjournals.org 112 | Page
Atiya Parveen, Sobia Habib, Waseem Ahmad et al. [5] concluded that E-health cloud is the next big
buzz in healthcare sector. Cloud has the potential to transform the healthcare sector. With the use of cloud
computing in healthcare sector, it would become centralized, and as data could be shared between all the
healthcare providers on cloud, there would be collaboration as well as virtualization. With the help of cloud
computing, rural healthcare centres would efficiently use their IT infrastructure to the maximum and increase its
profits. It would also help patients to have better treatment, hospitals as well as doctors. It would also help in
carrying out research work, sharing data and analyzing it. There cannot be one deployment model or the service
model that can cater to Healthcare world.
VMware cloud solutions [6] proposed that healthcare organizations to transform the cost, quality and
delivery of patient care products and services for any syndrome including diabetes. Healthcare IT departments
are reshaped into nimble and efficient entities that can respond faster to the needs of researchers, providers,
payers and consumers while reducing infrastructure and operating costs. Any organization can think about
building for the cloud. Although true cloud computing is a standardized approach, the way each individual
organization approaches cloud computing is not. The way we approach cloud computing will depend on our
objectives. Do we want to begin with an internal private cloud or do we want to leverage public cloud services.
Kyle D. Lutes et al. [7] designed the Diabetic E-Management System seemed to be usable based on the
SUS scores and the interviews that were conducted. The SUS scores indicated that the system was usable. Most
of the participants interviewed felt that the technology was usable, yet some felt that DEMS would be useful
only if the patient was motivated to manage his/her diabetes. Furthermore, it was apparent that older diabetes
patients would not be willing to use a system like DEMS since they have been using a pencil and paper system
that they have developed over the years. The participants seemed to enjoy the overall concept of DEMS, but
DEMS still posed some shortcomings, like strict compliance rates and the inability to wirelessly integrate the
glucometer and insulin pump readings to the Pocket PC PDA. In conclusion, this research exemplified big
potential for a DEMS-like system to be commercialized and used in the real world once all the technical issues
were overcome, and the system matured, becoming well integrated with the insulin pumps and the commercially
available glucometers.
George Hsieh and Rong-Jaye Chen et al. [8] proposed a design for a secure interoperable cloud-based
personal health record service. This design uses a self-protecting security framework that integrates access
control, confidentiality, integrity control, and authorization in an embedded and fine-grained manner. It uses the
standard CCD for storing and exchanging PHR information. The design leverages recent advancements in
attribute-based encryption and public-key based searchable encryption to support patient-controlled and fine-
grained encryption, and privacy-preserving keyword search. It also utilizes a variety of open standards to
enhance the portability and interoperability of the system, and leverage open source software packages that are
readily available for implementing these open standards. Going forward, they planned to continue with the
detailed design of the proposed system, and the implementation of a prototype system for demonstration
purpose. Further they decided to exploit emerging cryptographic schemes that can enhance the functionality,
efficiency, and usability of the encryption and key management operations such asmultiauthority ABE.
Wei-Tse Tang, Chiu-Ming Hu, and Chien-Yeh Hsu et al. [9] concluded that many factors can cause a
deviation value when subjects are taking physiological measurements. For example, blood pressure of our hands
may not being the same, so subjects must use one specific hand during the test for consistent values and ease of
the following research and comparison. In addition, for the measurements not being affected, it is necessary to
avoid talking, moving or shaking their body. It will also cause an error value if taking the measurements during
the time of 30 minutes after meal, smoke, exercise, and bathing or drinking (wine, coffee or tea).Therefore,
taking physiological measurements under an abnormal situation must be avoided. In the future, the system can
build a real-time image processing system to provide the hospital's internal medical image transmission services,
and it will also follow the transmission standard of electronic medical records which Department of Health in
Taiwan enacted. Through their cloud management system, medical image data could be transmitted to local
community clients and read by physicians. Additionally, through the Voice over Internet Protocol (VoIP)
services, physicians and consultants may easily discuss and provide patients‟ family members distance visits
service. This will further enhance the system to give out patient bedside videos and multimedia medical and
sanitary education information. To improve the services, their system will further integrate prevention health
services, provide internet browsing or download the service for people throughout the advisory by all medical
institutions and offering hygiene tips for chronic patients, or other weight control information.
Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology
DOI: 10.9790/0661-1741109117 www.iosrjournals.org 113 | Page
Carlos Oberdan Rolim, Fernando Luiz Koch, Carlos Becker Westphall et al. [10] proposed design
promotes re-usability through the use of a standard services implemented and deployed by using a Platform as a
Service (PaaS). In addition, it leverages others health-care institutions to use services through a Software as a
Service (SaaS) model without investments on hardware or software licenses. Moreover, they suggested that this
project contributes to scientific and social fields. On the scientific field, the project generates new knowledge
and applications for utility computing, cloud computing, sensor networks and mobile computing. These areas are
being extensively explored by the academic community and the developments from this project will address
some of the outstanding questions. There are many lines of research involved in this development, such as:
information systems, system modeling, networking, mobile service development, service management,
computational security and quality of service (QoS) for cloud computing based diabetic management system.
Abdullah Al-Malaise Al-Ghamdi et al. [11] proposed that the art of researches in expert system for the
purpose of diagnosis and determining the treatment of the diabetes. They introduced a new cloud computing
based expert system for diabetes treatment using Google app engine. The system is open source software, also
researchers and developers can add to it. It web-based flexible, easy to use, and guarantees the security. The
authors will develop their system in sophisticated manner and will provide a version for smart phones and IPad.
Roma Chauhan, Amit Kumar et al. [12] suggested that the e-Health Cloud represents an efficient
technology solution for several healthcare providers experiencing various concerns of increasing healthcare
delivery costs, information sharing, and scarcity of healthcare professionals. The benefits gained cannot be
suppressed by issues of trust, privacy, and security. The technical issues that must be addressed before health
care providers can fully adopt and trust the e-Health Cloud. Challenges of security and interoperability will rise
with the cloud computing model leading to the adoption of the cloud remarkably slowly. With the
implementation of best practices in the design, deployment and use of it will hopefully generate a future growth
of the cloud based systems embracement despite all of the obstacles. The paper provides an overview of the
necessity and utility of big data mining in cloud computing. Not much research has been done in the area of big
health care data mining. The future perspective of research explores management and application of healthcare
big data mining for improved decision making in healthcare.
Vishesh Ved, Vivek Tyagi, Ankur Agarwal, A. S. Pandya et al. [13] proposed a Web-based PHRS that
can store data in cloud-based architecture. The proposed system provides an avenue to store images such as
MRI, CAT, X-Ray and Medical personnel can view images with Image J viewer and diabetic related analysis. A
user case is discussed to show the functionality of the system. Future updates will focus on security and privacy
aspects.
Vassiliki Koufi, Flora Malamateniou and George Vassilacopoulos et al. [14] decided that Cloud
computing and SOA convergence can be used to meet the increased collaboration and coordination requirements
between emergency healthcare process participants by facilitating relevant information access by authorized
people where and when needed. Cloud computing was used to produce a flexible and scalable system,
supporting interoperability and execution of platform independent applications while providing secure access to
sensitive data. Their paper presents a cloud EMS system, within the context of a prototype healthcare portal,
namely Nefeli Portal. One important characteristic of the proposed system specifically calls for the integration of
EMS systems with PHRs and, possibly, other external systems since systems integration is a prerequisite for
accurate safety alerts, patient monitoring, and other recommended capabilities. Usability constitutes one of the
key features of every system and is primarily concerned with making a system easy to learn and use. On these
grounds, one of the tasks to be undertaken in the near future is system evaluation, which will be performed by
potential users in order for the usability of the system to be determined. Thus, potential weaknesses of the
system may be revealed suggesting alterations in the system design.
Nourhan Bayasi, Hani Saleh et al. [15] concluded that many methods and systems have been proposed
to target and monitor the blood glucose level of diabetic patients. Their paper has summarized the work of
Implanted Microsystem, Wireless Contact-Lens Sensor for Tear Glucose Monitoring, Hydrogel-Based
Implantable Glucose Sensor SoC and compared between them based on different metrics. As a result, they
proposed a full system level SoC for non-invasive glucose monitoring, which integrates biomedical sensor/s,
energy harvesting and power management units, low power SoC, and wireless RF transceiver.
Shaftab Ahmed, M Yasin Akhtar Raja et al. [16] proposed that Social networking activities have
created communities of users enjoying mobility and continuous connectivity in health, illness or excursion.
Wireless communication protocols have enabled the integration of e-healthcare solutions with the PDAs, mobile
Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology
DOI: 10.9790/0661-1741109117 www.iosrjournals.org 114 | Page
phones, IPad and laptops. While information availability and user interest is growing a number of issues require
attention. Some of them include Availability, Security, Quality of service, Fault Tolerance and Power
Management. The indigenous development of data acquisition boards for a hospital to support patient
monitoring from nursing console has been carried out. The scope of e-healthcare services will be extended to
Virtual Hospital concept to have all time connectivity through social networks.
Kyung-Soon Park, Nam-Jin Kim et al. [17] developed a PDA based personal diabetes management
system. The diabetes requires a few times of self-test and sometimes emergency tests. PDA easy to carry and
perform computing could provide more efficient and better quality medical services. The smaller size screen
than PC was overcome by visualizing abstractive and important information. The system consisted of 4 main
management menus of personal information; diet, exercise, and blood glucose, enabling the patient to self-
manage. Data input from these 4 main menus are closely engaged with each other to generate useful
information’s being instantly feedback to the patient thus would encourage continuous and persisting self-
management, eventually leading to a better regulation of blood glucose. Personal motive to using the system
could also be raised by providing the obesity and the diabetes danger index evaluated from the physical data and
the personal habit. Furthermore, the diet and exercise management are capable of prediction of weight loss to
remind the patient of the importance of self-management. Remote medical service through frequent
communication also enhances health quality by improving self-management, point-of-care, and assurance of
disease control. Future development needs to be performed for remote communication capability with hospital
personnel to widen the scope of the present system to successful mobile medicine using cloud computing.
Sepideh Poorejbari, Hamed Vahdat-Nejad et al. [18] concluded that the opportunities and challenges of
using cloud computing in healthcare sector and proposed important parameters in a cloud-based pervasive
healthcare system in more detail. In addition, a classification of different services and context types has been
suggested. Cloud computing offers potential opportunities for improving EHR adoption and provides an
altogether new generation of healthcare services. It also provides more flexibility, less expense, and more
efficiency in IT services. Cloud-based healthcare systems can create more vital solutions for preventive or
emergency care in cases such as chronic diseases like diabetes. Cloud-based pervasive healthcare is a new
paradigm in healthcare sector and has many potential and beneficial features, but there are still several problems
and challenges that need to be addressed by researchers in the future.
Myung-kyung Suh1, Jonathan Woodbridge et al. [19] developed WANDA, a three tier remote health
monitoring system and focused on increasing ease of use in order to improve patients‟ system adherence.
The developed system applies EM-based data discretization and Apriori rule learning algorithms and finds
association rules using collected sensor readings with dynamic sliding windows. They assumed that sensor
readings from patients are Gaussian mixture and quantize continuous features and applied Apriori algorithm
which efficiently finds related data using support values. The designed algorithm minimizes the number of
action items and reorganizes series of tasks for maximizing information gain.
Joseph George et al. [20] conveyed that the art researches in cloud computing and the possibility to
utilize the cloud power in diabetes treatment and research. He then introduced a new concept of Blue Circled
Cloud, which is meant for centralized management of Diabetes via cloud. It is web based, flexible and easy to
use. He also analyzed the technical aspects of the concept. Through this, if the healthcare sector can achieve
some improvements in the area of Diabetes treatment and help the diabetic patients to improve theirlifestyle.
R.P. Ambilwade, R.R. Manza et al. [21] concluded that there is a need for research in diagnosis of
diabetes which is helpful for medical practitioners and patients. Their paper discussed expert systems for both
diagnosing and treatment of diabetes. It clearly shows that, there are several expert systems developed which are
used either for diagnosis or treatment of diabetes. Majority of expert systems uses Pima Indian pregnant women
dataset for diagnosis purpose. However, some systems used the patient’s data from hospital. The methodologies
used for diagnosis/classification of diabetes are soft computing techniques like neural network, fuzzy systems.
VI. CONCLUSION
In this paper, a detailed survey been conducted on analysis and diagnosis of cloud computing based
healthcare for diabetes. It is so interesting that cloud computing though an emerging technology; found the core
of healthcare monitoring and management of all diseases and diabetes as such. Diabetes lays the foundation for
various malfunctioning of the important organs including kidney, heart, brain, liver, etc. and periodical analysis
of them is very essential. The annual heath report of various organs and periodical blood glucose level report of
the diabetic patient should make available with the doctor through cloud. Though the earlier medication of
Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology
DOI: 10.9790/0661-1741109117 www.iosrjournals.org 115 | Page
diabetes was based on paper and pen, pictorial evaluation of the patient healthcare was not possible and with
cloud computing the doctors can make the pictorial analysis as shown in Fig.2,3,4,5. By storing the diabetes
patient’s medication history in cloud, analysis and diagnosis of his timely health care can be made available to
the doctor 24x7 hours either through his mobile, IPad, Laptop or Desktop in remote areas. In-accordance with
security issue, more rigorous research is supposed to be conducted in-order to make in an efficient cloud
computing based healthcare for analysis and diagnosis of diabetes.
Fig.2 Pie Chart of blood glucose level before and after food of patient
Fig.3 Data list of blood glucose level at different time instant of patient
Fig.4 Graphical monthly blood glucose trend of patient
Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology
DOI: 10.9790/0661-1741109117 www.iosrjournals.org 116 | Page
Fig.5 Monthly log book for blood glucose level of patient
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15-16, Dubai, United Arab Emirates 2015.
[19] Myung-kyung Suh, Jonathan Woodbridge, Tannaz Moin, Mars Lan, Nabil Alshura fa, Lauren Samy, Mortazavi1
Hassan Ghasemzadeh, Alex Bui, Sheila Ahmadi, Majid Sarrafzadeh, Second Conference on Healthcare Informatics, Imaging and
Systems Biology, IEEE, 2012.
[20] Joseph George, Cloud Based Diabetes Management and Research - Blue Circled WAIMS, World Academy of Informatics and
Management Sciences, Vol 3 Issue 1, December-January 2014.
[21] R. P. Ambilwade, R. R. Manza, Bharatratna P. Gaikwad, Medical Expert Systems for Diabetes Diagnosis: A Survey, International
Journal of Advanced Research in Computer Science and Software Engineering Volume 4, Issue 11, November2014.
Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology
DOI: 10.9790/0661-1741109117 www.iosrjournals.org 117 | Page
BIOGRAPHY
CORRESPONDINGAUTHOR
P.S.Jagadeesh Kumar received his B.E degree from the University of Madras in Electrical and
Electronics Engineering discipline in the year 1999. He obtained his MBA degree in HRD
from University of Strathclyde, Glasgow, and the United Kingdom in the year 2002. He
obtained his M.E degree in 2004 with specialization in Computer Science and Engineering
from Annamalai University, Chidambaram. He further achieved his M.S Degree in Electrical
and Computer Engineering from New Jersey Institute of Technology, Newark, and the USA in
the year 2006 and his Doctorate from the University of Cambridge, United Kingdom in the
year 2013. He started his career as Assistant Professor in the Department of Electrical and
Computer Engineering, Carnegie Mellon University, Pennsylvania, United States and
continued to render his service as Associate Professor in the Department of Computer Science,
Faculty of Computer Science and Technology, University of Cambridge, Cambridge, United
Kingdom. At present, he is working as Professor at Nanyang Technological University,
Singapore for the School of Computer Science and Engineering at Biomedical Engineering
Research Centre (BMERC) as Associate Chair (Research).

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Monitoring Diabetes Patients' Blood Glucose Remotely Using Cloud Technology

  • 1. Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology DOI: 10.9790/0661-1741109117 www.iosrjournals.org 110 | Page IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861, Volume 14, Issue 4, Ver. I (April 2015), PP 108-116 www.iosrjournals.org Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology P.S.Jagadeesh Kumar1 , J.Ruby2 , J.Lepika3 , J.Nedumaan4 , J.Tisa5 1 Biomedical Engineering Research Centre, Nanyang Technological University, Singapore 2 Medical Professional, Department of Surgery, University of Cambridge, United Kingdom 3, 4, 5 Malco Vidyalaya Matriculation Higher Secondary School, Mettur Dam, Salem, Tamil Nadu Abstract: The major interest of the authors in surveying cloud computing based healthcare of diabetes is to make a thorough check in the patient’s blood glucose control at remote areas. The improvement in the technology and combined research can bring out the best medication and diagnosis for any disease. Today, the most challenging syndrome across the globe is diabetes mellitus. In the latest survey, the world’s 65% of the population is suffering from either Type 1 or Type 2 diabetes mellitus. But in most of the cases, the patient’s blood glucose level is not the same 24x7 hours and medication 24x7 hours is impossible. Thus cloud based healthcare is the one and only solution. Also the data’s stored in the cloud can be easily retrieved and placed quiet safe and secure with best security technique adopted. Doctors can maintain the patience history related data set and test results through his mobile, laptop, desktop and though the patient is at remote location, he can prescribe the medication through mail, mobile SMS based on the latest blood glucose level tested through glucometer or nearby lab. Keywords–Cloud Computing, Health Care, Diabetes, Analysis, Diagnosis, Literature Survey I. INTRODUCTION Cloud computing has been coined as an umbrella term to describe a category of sophisticated on- demand computing services initially offered by commercial providers, such as Amazon, Google, and Microsoft. It denotes a model on which a computing infrastructure is viewed as a “cloud,” from which businesses and individuals access applications from anywhere in the world on demand. The main principle behind this model is offering computing, storage, and software “as a service.” One of the biggest concerns of any healthcare provider is minimizing or eliminating the occurrence of mistakes during treatment. The speed and accessibility of the cloud allows every staff member working with a patient to double or triple check details again and again without adding time to the processing. This allows for much more checks and balances. This not only helps protect patients, which is the first priority of any provider, but also minimizes expensive lawsuits and damage to a hospital’s reputation. II. CLOUD COMPUTING IN HEALTH CARE Keeping tablet computers on hand to access the cloud during operations has become more common these days. Surgeons are expected to have a great deal of knowledge, and having access to the cloud can allow them to quickly reference surgical texts in an electronic format as needed. It also allows running pre-operative assessment software, communicating with other professionals, referencing medical records, or video conferencing. Cloud computing in hospitals creates interesting possibilities for sharing information with patients about their condition, their options, and the treatment process. They can be given the opportunity to log in and view their details as needed or even play more of a role in their own medical care. Healthcare providers can also use it as a way to educate current or future patients about how to stay healthy. The cost of medical care has become one of the biggest issues. One of the ways to minimize the costs is to cut down on how much the hospital spends to care for patients, and the cost of storing and processing information has become a significant factor. If cloud service solutions can make a hospital work together more efficiently, and it very well can, this typically amounts to cost savings as well. It’s legally required for most hospitals to store images produced by ultrasounds, x-rays, CT scans, MRIs, and other procedures for seven or more years, and then backups are needed in case the system goes down. With all the imagery being created, this means a huge mass of storage space to archive everything. Cloud storage provides a cost-effective, more streamlined solution for health-care providers to follow the guidelines and regulations required. By storing information on the cloud, you open up possibilities for instant, easy sharing between different medical professionals. Not only does this make it easier for staff within the hospital to work together more efficiently but it also provides an option to receive a quick opinion from more qualified specialists
  • 2. Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology DOI: 10.9790/0661-1741109117 www.iosrjournals.org 111 | Page for unique cases where experienced input is needed. Before cloud computing becomes the absolute standard; patients, medical professionals, and government officials alike are demanding that service providers guarantee the privacy of their information.Cloud computing is a very secure service to store data. It is a secure service that is provided by some of the largest and most trusted companies such as Citrix, Microsoft and VMware. Companies such as these have some of the most secure networks in the world and can be highly trusted with sensitive information and data. III. DIABETES MELLITUS Diabetes mellitus is a group of diseases characterized by an elevated blood glucose level (hyperglycemia) resulting from defects in insulin secretion, in insulin action, or both. Diabetes mellitus is not a pathogenic entity but a group of etiologically different metabolic defects. Common symptoms of diabetes are lethargy from marked hyperglycemia, polyuria, polydipsia, weight loss, blurred vision and susceptibility to certain infections. Severe hyperglycemia may lead to hyperosmolar syndrome and insulin deficiency to life- threatening ketoacidosis. Chronic hyperglycemia causes long-term damage, dysfunction and failures of various cells, tissues and organs. Diabetes mellitus is a continuous medicated syndrome. Permanent cure of diabetes is rare and the patient can be classified into two categories of Type 1 Diabetes and Type 2 Diabetes. The following symptoms of diabetes are typical. However, some people with type 2 diabetes have symptoms so mild that they go unnoticed. Early detection and treatment of diabetes can decrease the risk of developing the complications of diabetes. Common symptoms of diabetes:  Urinating often  Feeling very thirsty  Feeling very hungry - even though you are eating  Extreme fatigue  Blurry vision  Cuts/bruises that are slow to heal  Weight loss - even though you are eating more (type 1)  Tingling, pain, or numbness in the hands/feet (type 2) Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. Only 5% of people with diabetes have this form of the disease. In type 1 diabetes, the body does not produce insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. With the help of insulin therapy and other treatments, even young children can learn to manage their condition and live long, healthy lives. Diabetes is a problem with our body that causes blood glucose (sugar) levels to rise higher than normal. This is also called hyperglycemia. Type 2 diabetes is the most common form of diabetes. In Type 2 diabetes, the body does not use insulin properly. This is called insulin resistance. At first, the pancreas makes extra insulin to make up for it. But, over time our pancreas isn’t able to keep up and can’t make enough insulin to keep our blood glucose levels normal. Some people with type 2 can control their blood glucose with healthy eating and being active. But, doctor may need to also prescribe oral medications or insulin to help us meet our target blood glucose levels. Type 2 is treated it with lifestyle changes, oral medications (pills), and insulin. When glucose builds up in the blood instead of going into cells, it can cause two problems: Right away, our cells may be starved for energy. Over time, high blood glucose levels may hurt our eyes, kidneys, nerves or heart. IV. CLOUD COMPUTING AND DIABETES MELLITUS Cloud computing is a general term for anything that involves delivering hosted services over the Internet. These services are broadly divided into three categories: Infrastructure-as-a-Service (IaaS), Platform- as-a-Service (PaaS) and Software-as-a-Service (SaaS). The name cloud was inspired by the symbol that's often used to represent the Internet in flowcharts and diagrams. Perhaps it is common that, some of our family photos are on a desktop computer at home, others at work and still more on our phone. That's very inconvenient when it's time to create a photo album. The same is true when diabetes data is stored in different places. By hosting all information in one place and making it accessible anywhere, one can have a complete view of everything that impacts their blood glucose levels, no matter where they are. Cloud computing can also help people stay more connected to their self-care. Study has already shown that access to information over the internet can help enhance engagement and control for people who live in remote areas where healthcare services aren't readily available. Finally, it's been established that using an information management system can contribute to a significant, lasting improvement in blood glucose control. Cloud computing takes that one step further by providing immediate, anywhere access to our numbers. The general analysis and diagnosis of diabetes mellitus is as shown in Fig.1.
  • 3. Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology DOI: 10.9790/0661-1741109117 www.iosrjournals.org 111 | Page Fig.1 General Analysis and Diagnosis of Diabetes Mellitus V. LITERATURE SURVEY Yan Hu, Fangjie Lu, Israr Khan, Guohua Bai et al. [1] concluded that to accomplish the needs of healthcare information sharing in e-health, cloud computing is a superior solution. Cloud computing is a new technology and have good performance in storing and accessing information. Their research was mainly focused on the implementation of SaaS cloud computing technique to share healthcare information. With the designed prototype, could cover the current interoperability gap in e-health. The experiment results indicate that there is much strength to use SaaS service to solve the problem such as quick development, high availability, large data table storage, application as web service and authorized information. In the other hand, obvious drawbacks like limitation of picture sharing and unpredictable latency are still challenges for widely using SaaS service to e- health development for diabetes management as well. G.Nikhita Reddy, G.J.Ugander Reddy et al. [2] presented that the major advantage of using mobile technologies with cloud technologies is its mobility and easy sharing of the information. The cloud computing based solutions in healthcare can help the physicians to stay in touch with their patients and examine their health condition effectively at a low cost. There may be some concern regarding the security and other privacy issues of data but still as every problem has a solution in the similar way these issues too can be solved. One day utilization of cloud technologies in healthcare of analysis and diagnosis of diabetes mellitus would result in a new era in the field of healthcare. Every section in the society can access this healthcare by implementation of this technology. It is always remembered that cloud computing is still a developing technology, which implies that in the future years the services it offers will be greater than our expectations or just beyond our imagination. Yan Hu and Guohua Bai et al. [3] presented that research on applying cloud computing technology to eHealth is in its early stages; mostresearchers have presented ideas without real-world cases validation. The obvious features of cloud computing technology provide more reasons to adopt cloud computing in sharing and managing health information. The main purpose of their review was to identify some challenges and feasible cloud based solutions which can be applied in eHealth. The current review suggests that with the unique superiority of the cloud in big data storage and processing ability, a hybrid cloud platform with mixed access control and security protection mechanisms will be a main research area for developing citizen centered home- based healthcare system for diabetes. Sanjay P Ahuja, Sindhu Mani and Jesus Zambrano et al. [4] decided that the current trend of adopting cloud computing in the medical field can improve and solve several collaborative information issues in healthcare organizations as well as cost optimizations. Standardized cloud-based applications will bring obvious advantages to patients, physicians, insurance companies, pharmacies, imagining centres, etc. When sharing information across medical organizations yielding better results. Challenges such as security concerns and interoperability will rise due to the cloud-computing model. Therefore, the adoption of the cloud is progressing slowly. Through the implementation of best practices in the design, deployment and use of it will hopefully generate a future growth of the cloud-based systems adoption of diabetes management, despite the obstacles.
  • 4. Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology DOI: 10.9790/0661-1741109117 www.iosrjournals.org 112 | Page Atiya Parveen, Sobia Habib, Waseem Ahmad et al. [5] concluded that E-health cloud is the next big buzz in healthcare sector. Cloud has the potential to transform the healthcare sector. With the use of cloud computing in healthcare sector, it would become centralized, and as data could be shared between all the healthcare providers on cloud, there would be collaboration as well as virtualization. With the help of cloud computing, rural healthcare centres would efficiently use their IT infrastructure to the maximum and increase its profits. It would also help patients to have better treatment, hospitals as well as doctors. It would also help in carrying out research work, sharing data and analyzing it. There cannot be one deployment model or the service model that can cater to Healthcare world. VMware cloud solutions [6] proposed that healthcare organizations to transform the cost, quality and delivery of patient care products and services for any syndrome including diabetes. Healthcare IT departments are reshaped into nimble and efficient entities that can respond faster to the needs of researchers, providers, payers and consumers while reducing infrastructure and operating costs. Any organization can think about building for the cloud. Although true cloud computing is a standardized approach, the way each individual organization approaches cloud computing is not. The way we approach cloud computing will depend on our objectives. Do we want to begin with an internal private cloud or do we want to leverage public cloud services. Kyle D. Lutes et al. [7] designed the Diabetic E-Management System seemed to be usable based on the SUS scores and the interviews that were conducted. The SUS scores indicated that the system was usable. Most of the participants interviewed felt that the technology was usable, yet some felt that DEMS would be useful only if the patient was motivated to manage his/her diabetes. Furthermore, it was apparent that older diabetes patients would not be willing to use a system like DEMS since they have been using a pencil and paper system that they have developed over the years. The participants seemed to enjoy the overall concept of DEMS, but DEMS still posed some shortcomings, like strict compliance rates and the inability to wirelessly integrate the glucometer and insulin pump readings to the Pocket PC PDA. In conclusion, this research exemplified big potential for a DEMS-like system to be commercialized and used in the real world once all the technical issues were overcome, and the system matured, becoming well integrated with the insulin pumps and the commercially available glucometers. George Hsieh and Rong-Jaye Chen et al. [8] proposed a design for a secure interoperable cloud-based personal health record service. This design uses a self-protecting security framework that integrates access control, confidentiality, integrity control, and authorization in an embedded and fine-grained manner. It uses the standard CCD for storing and exchanging PHR information. The design leverages recent advancements in attribute-based encryption and public-key based searchable encryption to support patient-controlled and fine- grained encryption, and privacy-preserving keyword search. It also utilizes a variety of open standards to enhance the portability and interoperability of the system, and leverage open source software packages that are readily available for implementing these open standards. Going forward, they planned to continue with the detailed design of the proposed system, and the implementation of a prototype system for demonstration purpose. Further they decided to exploit emerging cryptographic schemes that can enhance the functionality, efficiency, and usability of the encryption and key management operations such asmultiauthority ABE. Wei-Tse Tang, Chiu-Ming Hu, and Chien-Yeh Hsu et al. [9] concluded that many factors can cause a deviation value when subjects are taking physiological measurements. For example, blood pressure of our hands may not being the same, so subjects must use one specific hand during the test for consistent values and ease of the following research and comparison. In addition, for the measurements not being affected, it is necessary to avoid talking, moving or shaking their body. It will also cause an error value if taking the measurements during the time of 30 minutes after meal, smoke, exercise, and bathing or drinking (wine, coffee or tea).Therefore, taking physiological measurements under an abnormal situation must be avoided. In the future, the system can build a real-time image processing system to provide the hospital's internal medical image transmission services, and it will also follow the transmission standard of electronic medical records which Department of Health in Taiwan enacted. Through their cloud management system, medical image data could be transmitted to local community clients and read by physicians. Additionally, through the Voice over Internet Protocol (VoIP) services, physicians and consultants may easily discuss and provide patients‟ family members distance visits service. This will further enhance the system to give out patient bedside videos and multimedia medical and sanitary education information. To improve the services, their system will further integrate prevention health services, provide internet browsing or download the service for people throughout the advisory by all medical institutions and offering hygiene tips for chronic patients, or other weight control information.
  • 5. Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology DOI: 10.9790/0661-1741109117 www.iosrjournals.org 113 | Page Carlos Oberdan Rolim, Fernando Luiz Koch, Carlos Becker Westphall et al. [10] proposed design promotes re-usability through the use of a standard services implemented and deployed by using a Platform as a Service (PaaS). In addition, it leverages others health-care institutions to use services through a Software as a Service (SaaS) model without investments on hardware or software licenses. Moreover, they suggested that this project contributes to scientific and social fields. On the scientific field, the project generates new knowledge and applications for utility computing, cloud computing, sensor networks and mobile computing. These areas are being extensively explored by the academic community and the developments from this project will address some of the outstanding questions. There are many lines of research involved in this development, such as: information systems, system modeling, networking, mobile service development, service management, computational security and quality of service (QoS) for cloud computing based diabetic management system. Abdullah Al-Malaise Al-Ghamdi et al. [11] proposed that the art of researches in expert system for the purpose of diagnosis and determining the treatment of the diabetes. They introduced a new cloud computing based expert system for diabetes treatment using Google app engine. The system is open source software, also researchers and developers can add to it. It web-based flexible, easy to use, and guarantees the security. The authors will develop their system in sophisticated manner and will provide a version for smart phones and IPad. Roma Chauhan, Amit Kumar et al. [12] suggested that the e-Health Cloud represents an efficient technology solution for several healthcare providers experiencing various concerns of increasing healthcare delivery costs, information sharing, and scarcity of healthcare professionals. The benefits gained cannot be suppressed by issues of trust, privacy, and security. The technical issues that must be addressed before health care providers can fully adopt and trust the e-Health Cloud. Challenges of security and interoperability will rise with the cloud computing model leading to the adoption of the cloud remarkably slowly. With the implementation of best practices in the design, deployment and use of it will hopefully generate a future growth of the cloud based systems embracement despite all of the obstacles. The paper provides an overview of the necessity and utility of big data mining in cloud computing. Not much research has been done in the area of big health care data mining. The future perspective of research explores management and application of healthcare big data mining for improved decision making in healthcare. Vishesh Ved, Vivek Tyagi, Ankur Agarwal, A. S. Pandya et al. [13] proposed a Web-based PHRS that can store data in cloud-based architecture. The proposed system provides an avenue to store images such as MRI, CAT, X-Ray and Medical personnel can view images with Image J viewer and diabetic related analysis. A user case is discussed to show the functionality of the system. Future updates will focus on security and privacy aspects. Vassiliki Koufi, Flora Malamateniou and George Vassilacopoulos et al. [14] decided that Cloud computing and SOA convergence can be used to meet the increased collaboration and coordination requirements between emergency healthcare process participants by facilitating relevant information access by authorized people where and when needed. Cloud computing was used to produce a flexible and scalable system, supporting interoperability and execution of platform independent applications while providing secure access to sensitive data. Their paper presents a cloud EMS system, within the context of a prototype healthcare portal, namely Nefeli Portal. One important characteristic of the proposed system specifically calls for the integration of EMS systems with PHRs and, possibly, other external systems since systems integration is a prerequisite for accurate safety alerts, patient monitoring, and other recommended capabilities. Usability constitutes one of the key features of every system and is primarily concerned with making a system easy to learn and use. On these grounds, one of the tasks to be undertaken in the near future is system evaluation, which will be performed by potential users in order for the usability of the system to be determined. Thus, potential weaknesses of the system may be revealed suggesting alterations in the system design. Nourhan Bayasi, Hani Saleh et al. [15] concluded that many methods and systems have been proposed to target and monitor the blood glucose level of diabetic patients. Their paper has summarized the work of Implanted Microsystem, Wireless Contact-Lens Sensor for Tear Glucose Monitoring, Hydrogel-Based Implantable Glucose Sensor SoC and compared between them based on different metrics. As a result, they proposed a full system level SoC for non-invasive glucose monitoring, which integrates biomedical sensor/s, energy harvesting and power management units, low power SoC, and wireless RF transceiver. Shaftab Ahmed, M Yasin Akhtar Raja et al. [16] proposed that Social networking activities have created communities of users enjoying mobility and continuous connectivity in health, illness or excursion. Wireless communication protocols have enabled the integration of e-healthcare solutions with the PDAs, mobile
  • 6. Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology DOI: 10.9790/0661-1741109117 www.iosrjournals.org 114 | Page phones, IPad and laptops. While information availability and user interest is growing a number of issues require attention. Some of them include Availability, Security, Quality of service, Fault Tolerance and Power Management. The indigenous development of data acquisition boards for a hospital to support patient monitoring from nursing console has been carried out. The scope of e-healthcare services will be extended to Virtual Hospital concept to have all time connectivity through social networks. Kyung-Soon Park, Nam-Jin Kim et al. [17] developed a PDA based personal diabetes management system. The diabetes requires a few times of self-test and sometimes emergency tests. PDA easy to carry and perform computing could provide more efficient and better quality medical services. The smaller size screen than PC was overcome by visualizing abstractive and important information. The system consisted of 4 main management menus of personal information; diet, exercise, and blood glucose, enabling the patient to self- manage. Data input from these 4 main menus are closely engaged with each other to generate useful information’s being instantly feedback to the patient thus would encourage continuous and persisting self- management, eventually leading to a better regulation of blood glucose. Personal motive to using the system could also be raised by providing the obesity and the diabetes danger index evaluated from the physical data and the personal habit. Furthermore, the diet and exercise management are capable of prediction of weight loss to remind the patient of the importance of self-management. Remote medical service through frequent communication also enhances health quality by improving self-management, point-of-care, and assurance of disease control. Future development needs to be performed for remote communication capability with hospital personnel to widen the scope of the present system to successful mobile medicine using cloud computing. Sepideh Poorejbari, Hamed Vahdat-Nejad et al. [18] concluded that the opportunities and challenges of using cloud computing in healthcare sector and proposed important parameters in a cloud-based pervasive healthcare system in more detail. In addition, a classification of different services and context types has been suggested. Cloud computing offers potential opportunities for improving EHR adoption and provides an altogether new generation of healthcare services. It also provides more flexibility, less expense, and more efficiency in IT services. Cloud-based healthcare systems can create more vital solutions for preventive or emergency care in cases such as chronic diseases like diabetes. Cloud-based pervasive healthcare is a new paradigm in healthcare sector and has many potential and beneficial features, but there are still several problems and challenges that need to be addressed by researchers in the future. Myung-kyung Suh1, Jonathan Woodbridge et al. [19] developed WANDA, a three tier remote health monitoring system and focused on increasing ease of use in order to improve patients‟ system adherence. The developed system applies EM-based data discretization and Apriori rule learning algorithms and finds association rules using collected sensor readings with dynamic sliding windows. They assumed that sensor readings from patients are Gaussian mixture and quantize continuous features and applied Apriori algorithm which efficiently finds related data using support values. The designed algorithm minimizes the number of action items and reorganizes series of tasks for maximizing information gain. Joseph George et al. [20] conveyed that the art researches in cloud computing and the possibility to utilize the cloud power in diabetes treatment and research. He then introduced a new concept of Blue Circled Cloud, which is meant for centralized management of Diabetes via cloud. It is web based, flexible and easy to use. He also analyzed the technical aspects of the concept. Through this, if the healthcare sector can achieve some improvements in the area of Diabetes treatment and help the diabetic patients to improve theirlifestyle. R.P. Ambilwade, R.R. Manza et al. [21] concluded that there is a need for research in diagnosis of diabetes which is helpful for medical practitioners and patients. Their paper discussed expert systems for both diagnosing and treatment of diabetes. It clearly shows that, there are several expert systems developed which are used either for diagnosis or treatment of diabetes. Majority of expert systems uses Pima Indian pregnant women dataset for diagnosis purpose. However, some systems used the patient’s data from hospital. The methodologies used for diagnosis/classification of diabetes are soft computing techniques like neural network, fuzzy systems. VI. CONCLUSION In this paper, a detailed survey been conducted on analysis and diagnosis of cloud computing based healthcare for diabetes. It is so interesting that cloud computing though an emerging technology; found the core of healthcare monitoring and management of all diseases and diabetes as such. Diabetes lays the foundation for various malfunctioning of the important organs including kidney, heart, brain, liver, etc. and periodical analysis of them is very essential. The annual heath report of various organs and periodical blood glucose level report of the diabetic patient should make available with the doctor through cloud. Though the earlier medication of
  • 7. Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology DOI: 10.9790/0661-1741109117 www.iosrjournals.org 115 | Page diabetes was based on paper and pen, pictorial evaluation of the patient healthcare was not possible and with cloud computing the doctors can make the pictorial analysis as shown in Fig.2,3,4,5. By storing the diabetes patient’s medication history in cloud, analysis and diagnosis of his timely health care can be made available to the doctor 24x7 hours either through his mobile, IPad, Laptop or Desktop in remote areas. In-accordance with security issue, more rigorous research is supposed to be conducted in-order to make in an efficient cloud computing based healthcare for analysis and diagnosis of diabetes. Fig.2 Pie Chart of blood glucose level before and after food of patient Fig.3 Data list of blood glucose level at different time instant of patient Fig.4 Graphical monthly blood glucose trend of patient
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  • 9. Healthcare of Diabetes in Monitoring Patient Blood Glucose at Remote Areas Using Cloud Technology DOI: 10.9790/0661-1741109117 www.iosrjournals.org 117 | Page BIOGRAPHY CORRESPONDINGAUTHOR P.S.Jagadeesh Kumar received his B.E degree from the University of Madras in Electrical and Electronics Engineering discipline in the year 1999. He obtained his MBA degree in HRD from University of Strathclyde, Glasgow, and the United Kingdom in the year 2002. He obtained his M.E degree in 2004 with specialization in Computer Science and Engineering from Annamalai University, Chidambaram. He further achieved his M.S Degree in Electrical and Computer Engineering from New Jersey Institute of Technology, Newark, and the USA in the year 2006 and his Doctorate from the University of Cambridge, United Kingdom in the year 2013. He started his career as Assistant Professor in the Department of Electrical and Computer Engineering, Carnegie Mellon University, Pennsylvania, United States and continued to render his service as Associate Professor in the Department of Computer Science, Faculty of Computer Science and Technology, University of Cambridge, Cambridge, United Kingdom. At present, he is working as Professor at Nanyang Technological University, Singapore for the School of Computer Science and Engineering at Biomedical Engineering Research Centre (BMERC) as Associate Chair (Research).