Before we begin today it’s time for a rant. Isn’t it time to end the use of any graphic or picture that shows an old-fashioned finger stick glucose meter or a finger with a blood drop? Seriously here we are in 2020 with CGM becoming the standard for glucose measurement and we are stilling seeing these type of graphics. Why is it that everyone person who does not have diabetes believes that those of us who do have it are constantly sticking ourselves? This may have been the case years ago but today it isn’t.
First off and this is obvious to anyone who knows anything about diabetes is that even back in the old days when BGM ruled the world the majority of patients rarely tested. Heck back then and even now there is huge percentage of the patient population who doesn’t test at all. Which makes me wonder how a company like Livongo who uses an old fashioned BGM really thinks they change this dynamic, but let’s not digress just yet.
Still it really gets under our skin that all these non-diabetics think we are constantly sticking ourselves with sharp objects, when what we really want to be doing is sticking all these idiots who have no idea of what it’s like to live with diabetes with very sharp objects preferably in the groin area. These morons seem to think that insulin needles are the size of harpoons and that each time a patient injects the pain is more excruciating than the sound of fingernails being drawn across a blackboard.
While we would never claim that injecting is a pleasant experience thanks to needle technology it has become a much more bearable experience. Today’s needles are thinner, shorter and lubricated – and damn we’d like to make a joke with the lubrication, but this is a family publication – making injecting much easier.
Listen it’s bad enough that those of us with diabetes are bombarded with advice from these idiots who don’t have diabetes. A situation that has only gotten worse thanks to COVID. Yes, we know that we are at increased risk but there really isn’t much we can do about that as our diabetes isn’t going away. Like everyone else all we can do is practice social distancing, wash our hands and for those who choose to do so wear a facemask.
We keep wishing that these incredibly stupid people would spend one week living with diabetes. Even better that during this week that people who don’t have diabetes come up to them and offer unwanted uneducated advice.
The fact is we are well aware we have diabetes. Most of us don’t like this fact but we deal with it the best we can. It’s not fun but it is manageable if we chose to manage it. But it’s our choice whether and how we manage it. From the day we are diagnosed someone is telling us what to do. Frankly it’s a tiring experience a daily grind as what all of us with diabetes wants more than anything is not to have diabetes.
So to all the people who don’t have diabetes do us a big favor and follow the old adage that it’s better to be thought a fool than to open your mouth and remove all doubt. And remember that if you don’t that person with diabetes might just pull out an insulin needle and stick you in the groin.
Ok rant over and yes, we feel better.
Now that the unemployment numbers are out, the rate now stands at 14.7% a few things should be obvious. Even with the economy beginning to slowly reopen it will not be an immediate return to anything close to normal. Many of these jobs will NOT come back and it’s time everyone began to wrap their hands around that sad but true fact. For some industries such as the airlines, hospitality, entertainment and brick and mortar retailers the road back will take years.
We can’t help but wonder after seeing these numbers how consumers will manage their money moving forward. Worried about their job, if they have one, or worried about getting one, if they lost one will they hunker down and begin cutting back on essential items. As we noted yesterday most of the companies who have laid off employees have continued their health insurance. But this isn’t going to last forever as many of these “temporary” layoffs will become permanent. The same can be said about unemployment benefits which are being temporarily boosted, this will not last forever either.
Nearly every diabetes company drug and device is offering some sort of financial assistance. Many are giving their products away for free. As great as this is this too cannot last forever. Should the crisis extend to the end of 2020 and perhaps beyond at some point these programs will have to be curtailed.
The general belief is people will continue to refill their prescriptions, continue to order supplies. The area of concern among diabetes companies is new patient adds. The longer social distancing lasts the less likely it will be that people will see a physician. Even when social distancing ends one has to wonder if people will spend the money for a doctor visit. When you are worried about having enough money to pay the rent or mortgage, putting food on the table some difficult choices have to be made and physician visits while important will likely be an area that gets cut.
This is one reason we believe Insulet was very prudent with their honesty yesterday as they presented perhaps the most realistic assessment of what lies ahead. As we anticipated based on pre-market trading, they will pay a heavy price for their honesty. However this short-term pain should not reflect poorly on the company as they did the right thing.
On the flip side we cannot get away from the guidance offered by Livongo. Call us crazy, and many have, but we see this over confidence coming back to bite them. Lots of things have to go right and many of these things are beyond Livongo’s control. With the stock on fire our advice to stakeholders is take some money off the table while you can. As good as it is now nothing lasts forever. Remember what goes up also goes down and as quick as this rise has been the fall could be equally quick.
We could say the same about Dexcom only for different reasons. Like Livongo Dexcom shares have been on fire surpassing the $400 level. As much as we like Dexcom and believe that long term the COVID crisis will benefit the company it’s hard to imagine this rise continuing unabated.
The one company that may be a buy right now is Tandem. The stock while up isn’t on fire and their prospects even with COVID look good. The one caveat here would be for investor who were smart enough to buy shares back when they dipped below $50. Trading over $90 now nothing wrong with taking some money off the table.
We hate to keep saying this but there just isn’t enough data combined with too many unknown variables to make us feel comfortable with valuations.
That’s all for now. Thanks for letting us rant and a very Happy Mother’s Day to all the great Mom’s out there. And we promise Mom as much as we’d like to stick some of these idiots with an insulin needle right in the groin you said we have to be tolerant of people no matter how stupid they are.