A “Flash” in the pan or the real thing

A “Flash” in the pan or the real thing

One thing that can be counted with consistency in the diabetes device world is the quest to build a better mouse trap, even when there is no real need for a better mouse trap. The glucose monitoring arena is a perfect example of this phenomenon. After years of innovation the fundamental fact remains that patient still don’t test their glucose levels as frequently as they should. Alternate site testing, smaller sample sizes, faster test results and of course meters that come in pretty colors have resulted in virtually no increase average testing frequency. Yet this hasn’t stopped companies from coming up with ever more creative ways to try and reverse this situation.

Now never mind that the most effective tool for increasing average testing frequency is patient education, something that most everyone knows but no company has ever embraced. Nope it’s far easier to sit in a meeting and impress the powers that be with some new way cool technology than it is to say; “Hey guys if we spent a fraction of our budget on educating our patients it would do far more effective at increasing strip usage than spending what we do on some new way cool technology that most patients could care less about and quite frankly only a fraction will ever use.” The simple fact is technology is cool and education is not.

This is why Diabetic Investor is getting a good laugh from the latest “technology” in glucose monitoring which just so happens is being touted by our friends at Abbott (NYSE:ABT). Abbott has been working on something called Flash which is basically a hybrid of a conventional glucose monitor and continuous glucose monitor. The company has also come up with a fancy new term to promote this new system, Ambulatory Glucose Profile (AGP), which according to the company’s web site “provides a comprehensive view of the patient’s changing glucose levels over time, thus allowing the clinician to see patterns and adjust therapy accordingly.” Now before we go any further it should be noted that patients and clinicians need another new term to learn about as much as they need another meter on the market.

Granted Diabetic Investor may not be the sharpest knife in the drawer but doesn’t a CGM provide this exact same information. Is this not why CGM has become a valuable tool in diabetes management? Isn’t this the reason why more and more physicians and diabetes educators are recommending that their patients start using a CGM? Is it not true that CGM while still imperfect has become a critical tool in the quest to develop a true closed loop insulin delivery system? Has not the introduction of CGM given patients and physicians a better understanding of how to more effectively manage diabetes? Put more bluntly is there really a need for this new system?

To understand just how flawed this approach is Diabetic Investor came across an interesting article on the Irish Times web site. According to the article:

“Nearly 40 per cent of diabetes patients surveyed across Europe cited forgetting as the chief reason why they do not monitor.

Tired of testing (33 per cent), inconvenience (21 per cent) and pain (16 per cent) were also cited by patients who do not monitor themselves properly.

Small wonder then that 67 per cent of those with type 2 diabetes and 60 per cent of those with type 1 diabetes report diabetes monitoring that falls below the recommended levels.”

Notice how pain, the factor most frequently cited by the so-called experts is the least mentioned reason why patients don’t test. Now we hate to brag here but hasn’t Diabetic Investor been saying this exact same thing since the dawn of time. Haven’t we said over and over that the reason most patients don’t test regularly is they don’t value the information provided by the test. Believe us when we tell you but 40% of patients would not forget to test if they felt this information was of value, 33% wouldn’t get tired of testing if this information helped them better manage their diabetes and  21% would put up with the inconvenience if they understood how this information directly impacts their individual situation.

This is not to say the reasons cited by patients are not valid and that education alone will increase average testing frequency. Diabetic Investor has said it a thousand times; managing diabetes is not easy it’s a 24x7x365 job with no days off. This is what almost every BGM company fails to grasp. They fail to understand that most patients aren’t like the people who are advising them. Truth be told one of the biggest problems these companies have is they pay way too much attention to researchers, so-called diabetes thought leaders and bloggers who aren’t like a normal patient with diabetes. These people are already engaged with their diabetes and understand what’s necessary to properly manage their diabetes. Put simply these people get it.

Yet in the real world, a place where many of these people don’t reside, the majority of patients aren’t engaged with their diabetes and quite frankly don’t get it. The fact is these people want to live their lives with their diabetes and NOT for their diabetes. They want simple solutions that fit into their daily routines, solutions that don’t add to their already complicated lives. They know that diabetes is serious disease but most have never been given even the smallest amount of education on how to better manage it. They are constantly being told what to do and feel they have little direct control over their diabetes.

This is prime reason why this new system, should it ever reach the market, really has no chance of being commercially successful. It also doesn’t help any that there are products already on the market that not only do the same thing but do it better. To Diabetic Investor the Flash is the classic example of how companies fall in love with technology and fail to consider whether this whiz band way cool technology is even needed. Just because something can be done does not mean it should be done, a fact that is lost on most glucose monitoring companies. Companies who have failed to learn in spite of overwhelming evidence that more technology does nothing to increase strip usage.

To fully grasp the difference between useful technology and the Flash take a look at the Pogo system from Intuity Medical. This all in one device while not revolutionary does make life easier for the patient; it fits into their lives and does not make their lives even more complex. Just ask any patient who’s fumbled around looking for the vial of test strips, lancing device and meter. The Pogo contains all this in one nice easy to use package that requires little if any training to use properly. Most importantly it does what the patient wants it do, it provides a test result.

Again this is something that most BGM companies just don’t get. The majority of patients could care less if their meter has a 500 test memory, makes bolus calculations, calculates average mean glucose or comes in every color in the rainbow. What most patients want is simplicity a meter that delivers a test result, all these other whiz bang features are nice but honestly only a handful of patients ever use them.

These facts won’t stop our friends at Abbott from touting this new system especially since it has some new way cool terminology to talk about. Yet to Diabetic Investor this new Flash is just that a flash in the pan that will never amount to much and certainly won’t be commercially successful.