It might be, it could be

It might be, it could be

There are many who believe, including Diabetic
Investor, that patients with diabetes would be far better off if the disease
was diagnosed earlier and treated more aggressively. That we need to get away
from this treat to failure approach that only compounds the problem. As we
pointed out in several recent email alerts there are devastating consequences
when patients fail to control their diabetes.  

While many view the diabetes epidemic as healthcare
crisis, diabetes is also an economic crisis. According to the American Diabetes
Association (ADA) a male diabetic loses 11 days of work due to his diabetes
while a female diabetic loses 9 days. It is also known that for every 1%
reduction in A1C a patients saves $1,000 in healthcare costs. It is not
surprising then that corporate America is looking for programs that can help
identify which employees are at greater risk if developing diabetes. The theory
is that by identifying patients at risk of developing diabetes, the company’s could
intervene and get the patient the help they need so that they don’t develop full
blown diabetes.

A slew of companies are developing tests that
help identify patients that are at risk for developing diabetes. One such
company is Tethys Bioscience which just raised
another $25 million. According to a press release issued by the company; “Proceeds
from the financing will be used to expand commercialization of the Company’s
proprietary PreDx™ Diabetes Risk Score (DRS) product, a simple-to-administer
blood test to help clinicians identify those patients at highest risk of
developing type 2 diabetes within the next five years.”

The release also states; “While
diabetes has no cure, clinical studies have shown that it can be prevented, and
determining one’s diabetes risk is the first step in avoiding this chronic,
life-threatening disease. Clinical studies have shown that aggressive
intervention with diet and exercise alone can reduce the incidence of diabetes
by up to 60%. With the PreDx Diabetes Risk Score, clinicians can identify those
individuals with the greatest 5-year risk of diabetes conversion so they
can receive appropriate diabetes prevention regimens.”

Although Diabetic Investor does
not necessarily have a problem with these types of tests, we also live in the
real world. The basic problem we have is the same problem we have with the term
“pre-diabetes”. Diabetic Investor has seen firsthand how patients diagnosed
with “pre-diabetes” react to this news and it’s not a pretty picture. Simply
put these patients don’t take the steps necessary to avoid developing full
blown diabetes as they don’t consider “pre-diabetes” to be a problem. Try as
they might physicians have a difficult time motivation these patients to follow
a regimen that’s designed to prevent a problem that isn’t here yet. The fact is
in the real world these patients basically take the attitude that they’ll deal
with the problem IF it gets here.

Should anyone doubt this
attitude take a look at the millions of people who are overweight or smoke
cigarettes. There is clear indisputable evidence that obesity and smoking lead
to a multitude of health problems. Still we have an obesity epidemic and
millions of smokers.

While these efforts at
preventive medicine are well intentioned the fact is they don’t work all that
well in the real world. For a company like Tethys this really doesn’t matter
all that much as they are basically in a no lose situation. Should a test indicate
that a patient is at risk of developing diabetes and that patient actually
develops full blown diabetes, they can state the test was accurate. If the
patient does not develop diabetes they can state they didn’t because the
patient was properly identified and the intervention was successful. If only
life in the real world was that simple and clear cut.

A cynic just might say that it doesn’t
take a blood test to see who’s at risk of developing diabetes as all one needs
to do is look around at our increasingly obese and sedentary population.

Diabetic Investor is hardly
surprised that Tethys was able to raise more money as we predicted long ago
that the phrase “pre-diabetes” actually had more to do with money than actually
helping patients. Although there are over 24 million patients with diabetes and
that number continues to grow at epidemic rates, companies can make an even
stronger case to investors when they add in the 57 million patients who have “pre-diabetes.”
Diabetic Investor may not be the brightest blub on the Christmas Tree but
investors feel more comfortable when the target market contains over 100
million customers than just 24 million customers (16 million of whom who are
actually diagnosed).

For years the term preventive
medicine has been used as the cure for all that’s wrong with our healthcare
system. For years we’ve heard that IF we focused more on preventing diseases instead
of treating them everyone would be better off. For years we’ve heard that
preventive medicine costs a fraction of what it does to actually treat patients
diagnosed with a chronic disease such as diabetes.

The only problem is our
healthcare system is not designed around preventing diseases. Physicians are
not trained to prevent patients from developing diabetes, their trained to
treat patients with diabetes. The fact is patients don’t want to deal in what
if or what could be scenarios. In the real world patients want to know if they
have diabetes or if they don’t.

Finally Diabetic Investor finds
it somewhat ironic that anyone would believe that preventive medicine stands a
chance of being successful. All one needs to do is look at what Diabetic
Investor has been stating for years about patient education. Like preventive medicine,
it is well known that educated patients achieve better outcomes. Yet education is
still treated as the ugly sister when it comes to the diabetes dance.
Physicians are not paid to educate their patients just as they are not paid to
prevent diabetes from developing. Drug companies do not develop drugs to
prevent diabetes nor do device companies develop devices that help patients
prevent diabetes. The entire healthcare industry is built around finding new
and better ways to treat and manage diseases, not preventing them. Until this
paradigm changes preventive medicine will remain just one more pipe dream that
sounds really good but for all practical purposes doesn’t work in the real