No truer words

No truer words

“Once you know about it and once you are educated about it, it’s not really a problem.” These words don’t come from a respected diabetes researcher, certified diabetes educator or anyone involved in the business of diabetes. They come from Christy Findlay, director of the Peanut Gallery day care and appeared in today’s Wall Street Journal which ran two articles on diabetes today, one relating to the dramatic rise in the number of patients being diagnosed with Type 1 diabetes and the other outlining the many issues faced by parents who have a child with Type 1 diabetes in search of day care centers that can handle a child with diabetes.

Ms. Findley also noted “A lot of child-care providers aren’t comfortable with it. You hear diabetes and it scares a lot of people;” again another statement that rings true and not just for children with diabetes. In the many years that we have writing Diabetic Investor it still amazes us just how many people who work in the diabetes industry know so little about the disease and what it is like to live with diabetes. Is it any wonder that these are the same people who foolishly believe that patients will monitor their glucose levels regularly when a meter comes in pretty colors? Can anyone blame those who either have diabetes or actually get what diabetes is all about for laughing at these people and all their idiotic ideas?

For years Diabetic Investor has noted that the most effective method for improving outcomes is not better technology or even better drugs, its education. Yes better technology will certainly help but as we have noted on too many occasions even the greatest technology is worthless if the patients doesn’t use it. The same is true for medications, medications that have no chance of working if the patient doesn’t bother to use them. How many studies do we need to make people in the diabetes industry stand up and take notice, NONE. There are hundreds, if not; thousands that conclude that educated patients have a far greater chance at achieving better outcomes than those that are not educated.

The harsh reality is diabetes device and diabetes drug companies are looking for shortcuts, looking for some sort of silver bullet or magic potion that will make managing diabetes as easy as using a smartphone. It’s not like these companies don’t understand that education works, it’s just they can’t convert education into dollars. This fundamentally is the reason why industry has not yet embraced education, while there is no question that education works, there is also no clear statistical measurement that any money spent on education converts to greater sales of a particular product. The glucose monitoring market is an excellent example of this. Many years ago Roche conducted a study with three groups of patients, one was given a new meter, the second a new meter and comic book explaining the benefits of testing and the third a new meter, comic book and a meeting with a certified diabetes educator (CDE). Not surprisingly the first group barley tested at all and the last group tested most frequently, however the truly surprising result was the middle group who tested almost as frequently as the group which also meet with a CDE.

The message to Diabetic Investor was clear as a summer day; even a little education goes a long way. However, this message was lost or forgotten as since this study was done Roche has lost nearly half their business here in America.  While there are many reasons why Roche has performed so badly over these past few years one can’t help but wonder what would have happened had Roche management taken the results of their own study and actually made an effort to educate patients rather than come up with another copycat, me-too monitor.

The same can said for the insulin pump area as just last week Diabetic Investor noted the many adverse events related to insulin pump usage. While far too many of these reports are related to poor pump design or manufacturing lapses, a fair number could have been avoided had the patient received better training on how to use their pump.  Whenever Diabetic Investor reads an adverse event report that notes that the patient was attached to the pump while it was priming, a classic no-no when it comes to pumping, it tells Diabetic Investor that this patient was not properly educated. Frankly there are hundreds of adverse event reports that indicate clearly something Diabetic Investor has known for years; insulin pump companies in an attempt to boost profits are cutting back on patient training, a decision which has had disastrous results.

It’s an open question now that insulin companies are facing the prospect of generic competition whether or not they will use education as a weapon to blunt the cost advantage of generic insulin. It’s also worth considering if any of these attempts at developing and deploying an interconnected diabetes management system will achieve any measurable level of success without a corresponding increase in patient education efforts.

Diabetic Investor has said it before and will keep repeating ourselves until this is no longer true, but the most damning statistic, the one that shows the failure of diabetes industry and why education is desperately needed is that nearly two-thirds of all patients with diabetes are NOT properly controlling their diabetes. This FACT has not changed even though we have some the most advanced glucose monitors, “smart” insulin pumps, better insulin’s and longer lasting GLP-1’s. The fact is too many people in the diabetes industry have given up and have taken the attitude that only insulin using patients are worth fighting over. These folks, many of whom have no direction connection to diabetes other than the fact they happen to work at a company who happens to sell a diabetes product of some kind, haven’t bothered to do their homework or listen to those who live with diabetes 24 hours a day 365 days a year with no days off.

Thank you Ms. Findlay, director of the Peanut Gallery, for reinforcing a message that Diabetic Investor has been stating for years- “Once you know about it and once you are educated about it, it’s not really a problem.”