So much for IDM and Type 2

So much for IDM and Type 2

We hate to say we told you so but we did. We don’t mean to gloat but it’s about time all these companies that have those way cool whiz bang cloud enabled toys which are supposed to help patients manage their diabetes more effectively wake up and smell the coffee. All along we have noted that interconnected diabetes management (IDM) had lots of potential but little hard data that proved it worked for patients with Type 2 diabetes.

These companies consistently cite empirical evidence or use “self-reported” data to prove that their whiz bang way cool cloud enabled toy works but to date we have yet to see any hard evidence. We have yet to see one “clinical” study that concluded these toys help patients with Type 2 diabetes.

Per a study published in the respected peer-reviewed JAMA Internal Medicine in patients with non-insulin-treated type 2 diabetes (T2D), self-monitoring of blood glucose (SMBG) failed to improve 1-year glycemic control and health-related quality of life (HRQOL) compared with patients who did not perform SMBG. The researchers noted;

“Incorporating technology into self-management activities has been touted as potentially transformative for patients, and to date some smaller studies support this notion. However, our findings do not. It is possible that the enhancement of SMBG with one-way messaging back to the patient does not adequately engage patients.”

Let’s be very clear here THIS IS A VERY BIG DEAL on multiple levels. First many of these companies have astronomical valuations based largely on the belief they can help patients with Type 2 diabetes. Which as me note consistently is the largest patient population. Second this study also supports our contention that the reason these patients do not test or do not test regularly is the number has no value. Even when these patients got coaching with the number it didn’t change anything. Third and most importantly it points to the difficulty facing all the newcomers to our wacky world folks like Apple, Google and Amazon all whom are making the deep dive into diabetes.

When it comes to helping patients with Type 2 diabetes those who do not use insulin the problem isn’t and never will be giving them more toys to play with. The problem as and will always be getting these patients to be medication adherent. This is why we favor systems like the Intarcia micro-pump as it solves the biggest problem facing patients with Type 2 diabetes.
It’s about time everyone begins to recognize that patients don’t respond well to programs which attempt to change their behavior. That it will take more than a way cool toy to accomplish this difficult, if not impossible task. Patients with Type 2 diabetes are PEOPLE fist and diabetics second. Yes, this is getting redundant but it must be repeated; there is little incentive for these patients to become more engaged with their diabetes management. They do not pay lower premiums when they do well, their co-payments do not decrease nor is their deductible lowered.

These patients are being TOLD what to do based on the false premise that patients see a benefit to all this extra work. We have long contended and will continue to contend that IDM increases the patient’s workload when patients want their workload lightened. That the only way these patients will do all the heavy lifting is when there is something in it for them and that isn’t a lower HbA1c. Patients do not see or feel a lower HbA1c. But they sure as heck feel it every time they walk into their pharmacy and dish out their hard-earned dollars. They feel it every time they look at their paychecks and see how much their health insurance costs.

What these patients want more than anything is to NOT have diabetes in lieu of that they would like their diabetes management made simple, to not have to think about it. This is exactly what the Intarcia micro-pump does, once instated its game over, no pills to take, no glucose to measure. This system makes their diabetes management what they want it to be, an afterthought.

What must change most for all these companies even the big boys and girls who are new to the diabetes sandbox is to get with the program. To understand that this is not about the toys in the sandbox. This is not about way cool whiz bang cloud enabled. That even when coaching is readily available it will fall on deaf ears unless the patient gets something out of the deal. What really needs to change is the patient experience, diabetes management shouldn’t be a grinding task.

Most of all patients should be rewarded with more than a nice thank you. That if these companies really are intent on changing behavior then it’s time for them to put their money where their mouths are. We always say that when it comes to our wacky world it’s all about money, who spends it, who makes it and who saves it.

Unfortunately, the money is never directed at the right person; THE PATIENT. Sure, these companies and their executives make money. Investors sometimes make money. But what about the patient? Isn’t about time that these patients are rewarded for all their hard work? Isn’t about time they get something tangible, something that really matters to them, that impacts them in a positive way?

As Momma Kliff used to say; “It’s very noble to believe that people really care about their health, that they want to live long and healthy lives. When the truth is for most people, the masses, they care about their pocketbook more.”