Sad but true

Sad but true

According to an article published last week in the New Mexico Business Weekly:

Ries Robinson, president and CEO of InLight Solutions Inc., has worked for nearly 18 years to take his breakthrough photonics technology to market

While working at Sandia National Laboratories and the University of New Mexico’s School of Medicine, Robinson, an engineer and physician, developed a way to measure and monitor glucose levels in patients with a flash of light.

That led to a commercial venture in 1993 to build Robinson’s original concept into a “platform technology” with broad applications, including noninvasive glucose monitoring, diabetes detection, three-dimensional fingerprint scans and intoxication tests.”

Yes the search for the Holy Grail of glucose monitoring, a non-invasive glucose monitor, has been going on for nearly 18 years. And just where do we stand today after 18 years of effort and millions invested? Not one step closer to actually having an FDA approved, commercially viable non-invasive glucose monitor on the market.

Yet even after 18 years and millions invested (more like wasted), companies remain convinced that a non-invasive glucose monitor will revolutionize diabetes management. These people remain convinced that the reason patients do not monitor their glucose levels on a regular basis can be directly linked to the “pain” of the notorious finger prick. The theory is if you remove the “pain” factor all of sudden patients will begin monitoring their glucose levels with reckless abandon.

Perhaps it’s just a coincidence but the effort to develop a non-invasive glucose monitor began shortly before Diabetic Investor began publishing. One could say we have actually grown up together.  Yet unlike the dreamers who believe non-invasive glucose monitoring is the answer, Diabetic Investor has always lived in the real world. And while it would be nice to have a non-invasive system, this is not the Holy Grail everyone seems to think it is.

From the beginning Diabetic Investor has stated and continues to state that the reason patients do not test their glucose on regular basis is they don’t understand what the test results mean or how to translate these results so they can better manage their diabetes. Take for example a Type 2 patient taking 500mg of metformin three times per day, not an uncommon treatment regimen. Why in the world would this patient test their glucose levels at all? Will the test results have any impact on their therapy regimen; will they take only two doses of metformin instead of three?

Or what about a patient who take Lantus once a day and supplements their therapy with metformin, another common therapy regimen for a Type 2 patient- will glucose monitoring change anything?

Diabetic Investor once noted that you could give away testing supplies for free and patients like the ones described above would still not test regularly. It would not matter if that test was performed non-invasively or with any of the existing monitors on the market today.

What many in the glucose monitoring space have never understood is how patients live their lives in the real world. Rather than actually understand how their customers are really using their products or why they aren’t using them, these people prefer to live in the Ivory Tower world and believe patients will test because their physician tells them they should or because the ADA says they should. They falsely believed that the reason patients did not test regularly was directly linked to the so-called “pain factor”.

These same people learned nothing from the move towards alternate site testing. Back when alternate site testing was first introduced these Ivory Tower residents believed this would revolutionize glucose monitoring and testing frequency would dramatically improve. Companies’ aggressively touted systems which were virtually pain free believing patients would buy into this fantasy. As it turned out alternate site testing was nothing more than a marketing ploy as data clearly shows testing frequency barely moved.

Is it any wonder that today the BGM market is in complete disarray? Rather than actually help patients understand why testing is important and teach patients how to use this information so they can better manage their diabetes, companies instead wasted millions on developing sophisticated technology that only a handful of patients use.

Diabetic Investor sees this trend continuing only now instead of developing more sophisticated glucose monitors companies are investing heavily into mobile technology and apps. The theory is patients will use these apps to better manage their diabetes and ultimately test more frequently.  A theory which is doomed to fail just as alternate site testing failed to increase testing frequency.

Think for a moment about the patients described earlier in this post, will they now begin to test because they have a cool diabetes app on their iPhone. And let’s say they did go through all the work necessary to use these cool apps. We say work because as cool as these apps are and as great as the information they provide is, the patient must enter a mountain of data before they can learn anything. As it stands today the only monitor that actually seamlessly communicates with an app is the iBGStar, made by AgaMatrix for Sanofi-Aventis (NYSE:SNY). Since the iBGStar is still undergoing review at the FDA, that means patients must manually enter their glucose readings into the app which adds yet another step to the process.

But the glucose reading is just one piece of information required by these very cool apps. Looking over a host of apps currently available and actually talking to real patients Diabetic Investor has concluded that these very cool apps do little more than to add to the burden of diabetes management rather than making diabetes management easier. Most patients who live in the real world and who aren’t spending every waking moment on their iPhones, face the same problem as they did with their existing glucose monitor- just what does all this data mean and how can they use it to more effectively manage their diabetes.

The simple fact is for the majority of patients no app, Twitter feed, Facebook page or other form of social media gives them what they need most- a better understanding of their diabetes and what  they can do to more effectively manage their diabetes. Or put more simply technology is not a substitute for some good old fashioned diabetes education.

It amazes Diabetic Investor that companies continue to invest millions in technology when numerous studies have proven that the most effective method at improving outcomes is education. Even more amazing is that educated patients are more compliant with their therapy regimen and monitor their glucose on a regular basis. Put another way, this means that an educated patient uses more of the drugs and devices made by the same companies who are now investing millions in apps and social media. Whereas there is no evidence that an app or social media is good for business, there is an abundance of evidence that shows that educated patients are very good for business.

Now Diabetic Investor may not be the sharpest knife in the drawer or the brightest blub on the Christmas tree but one just might think that these companies who are investing millions in apps and social media would demand some return on their investment. That they would perhaps like to sell more insulin or test strips, that they would seek proven methods for increasing sales and building brand equity.

Yes we know these apps are way cool and that social media does play a role but there is no hard evidence that either of these technologies sell one more vial of insulin or get the patient to monitor their glucose on a regular basis. The only proven method for producing both better patient outcomes and increased sales is education.

The truly sad part is that technology like apps or social media have the potential to be important tools that help the patient more effectively manage their diabetes. An educated patient would ultimately incorporate these tools into their diabetes management as they would understand how to use this information. Or as David Sarnoff wrote; “We are too prone to make technological instruments the scapegoats for the sins of those who wield them. The products of modern science are in themselves good or bad; it is the way they are used that determine their value.”