It’s like chicken soup

It’s like chicken soup

Back in the day when her boys were under the weather Momma Kliff would make her outstanding chicken soup. Asked if chicken soup would help Momma responded, “It can’t hurt.” We thought of Mom today after reading a story about whether patients with diabetes should use pot. Now that pot is legal this is a legitimate question and we think the answer is HELL YES.

Listen we have no idea if getting stoned will lead to better outcomes but given what a patient has to go through each day, we’re with Momma Kliff on this one as it certainly couldn’t hurt.

Frankly we think its time the industry party a little as it just might make them think out of the box a little and actually come up with something different. Instead of coming out with yet another way cool whiz bang cloud enabled toy or another drug that does the same thing as all the other drugs perhaps getting stoned will loosen the reins a little. Perhaps it would make these buttoned downed executives realize that it’s not about the toys in the toy chest or the drugs in the medicine cabinet.

Yesterday during an interview, we noted that there are 15 yes 15 different “smart” pen companies. There are 3 established insulin pump companies with more on the way. We have 5 count them 5 long-acting insulin’s and 4 versions of short-acting insulin, 5 actually when you count Afrezza. There are 3 long-acting GLP-1’s 3 SGLT2’s and the list goes on.

As we also noted during this conversation with all these toys and all these drugs one fact hasn’t changed since the day, we began publishing Diabetic Investor – the majority of patients are not under good control so therefore it makes perfect sense that we continue to do the same thing over and over again. Isn’t this the definition of insanity performing the same behavior over and over again yet expecting a different result.

We won’t get on our soap box and explain that until the patient has skin in the game, until outcomes matters to the PATIENT nothing much will change. We hate to point out the obvious but, in this business, that’s becoming essential but there is one common characteristic for every patient that is under good control and it does not matter whether they are Type 1 or Type 2. It does not matter how they treat their diabetes either.

What matters is they are engaged with their diabetes management, they have the want to.

Before the advent of interconnected diabetes management (IDM), which truth be told is just disease management with better technology, we ranted about patient education. That study after study proved what we already knew education is the most effective tool to achieve better patient outcomes. Yet we also ranted that as effective as education is it was and sadly still is the least used tool in the tool box.

This is one of the biggest issues facing every effort in IDM. These systems are very good at gathering the data, analyzing it and then giving the patient advice. They are great at giving the patient the how to manage their diabetes more effectively. What they suck at is they don’t do anything that gives the motivation to want to manage their diabetes.

Think about this just for a moment and not from a clinical perspective but from an everyday perspective. The vast majority of patients understand that diabetes is a serious chronic condition, they are not stupid. These patients are also very receptive to advice. However, what none of the IDM companies have figured out is these people do not live their lives for their diabetes. They would like diabetes management to be stupid something they do without having to think.

We have been strong supporters of the Intracia exenatide micropump for one simple reason because once inserted in the patient’s body it makes their diabetes management stupid. No glucose monitoring, no pills to take, no shots no nothing. This is the same reason each version of GLP-1 has been more successful than the previous version, we have gone from twice daily injections to once daily to now once-weekly.

In theory a real closed loop insulin delivery system is equally stupid. This is the true beauty of a such a system as it’s the system that does all thinking. Yes, the patient has some work to do but that work with a real closed system is mechanical in nature, setting up the system. For once set up the system does the rest.

The G6 and Libre are also examples of stupid. Once on the patient’s body the patient doesn’t do a damn thing, no calibrations no thinking. With the G6 anyway the data gets sent to a smartphone which then can be analyzed. There is still some heavy lifting as it is up to the patient to understand the data and then if need be act upon it but with insulin dosing algorithms that job is becoming easier.

To put this in terms a diabetes executive can understand think about all those damn meetings you are forced to attend. You know the one’s we’re talking about the meetings with lots of fancy slides, which invariably leads to another meeting with even cooler slides which in turn leads to yet another meeting. This in turn leads to deliberation and ultimately a decision that yes white towel paper is just fine for the executive restroom.

So here is our suggestion before the next meeting send your admin out to the local pot dispensary. (And remember they don’t take credit cards only cash, so you’ll need to jump through several hoops to get the cash.) Put the pot in the center of the conference table and have at it. (And don’t forget the munchies for once everyone is good and stoned everyone will be hungry.) Ok once when all good and stoned the meeting can begin with a simple question – What can we do today to make diabetes management stupid?

And to quote our favorite greenskeeper Carl Spackler;

“This is a hybrid. This is a cross, ah, of Bluegrass, Kentucky Bluegrass, Featherbed Bent, and Northern California Sensemilia. The amazing stuff about this is, that you can play 36 holes on it in the afternoon, take it home and just get stoned to the bejeezus-belt that night on this stuff.”