The downside of big data
Yesterday we wrote about how big data has the potential to transform not just the management of diabetes but the business of diabetes. Yet there is a flip side to this story. As much as interconnected diabetes management (IDM) can help a patient there is a downside here. The downside comes from the perspective of what we like to call the average patient with diabetes.
Diabetic Investor has always divided the diabetes world into three distinct patient categories. About 10% of the market we call Uber users, these patients are actively engaged with their diabetes management. Put simply they get it. On the other end of the spectrum about 20% of the market these patients will never get it and quite frankly they could care less. Yet in the middle or about 70% of the market are patients who know that diabetes is serious disease and they know they have to do something about it. However they do not want to live their lives for their diabetes they want to live their lives with their diabetes. The want diabetes management to fit into their lives and not run their lives.
It is this middle group of patients who would benefit immensely from IDM, yet they also the same group who could tune out from IDM. One of the most misunderstood aspects of diabetes is that many seem to believe that patients understand the benefits of properly controlling their diabetes. That they are willing to put in the work to make this happen. As we have said many times diabetes management is a job, a job where the patient does not get a day off. The reality is the majority of patients just don’t want to put in the effort, not because they don’t necessarily see the benefits rather they have real lives to live. As we have said before they are not living their lives for their diabetes, to these people it’s just one more thing in their lives they have to deal with.
This is why Diabetic Investor believes so strongly in KISS, keep it short and stupid. That technology should be deigned to make diabetes management simpler not more complex. That a patient should not need an advanced engineering degree to operate a system. Nor should they need another degree in advanced mathematics to understand and interrupt all the data being generated by these way cool whiz bang devices.
Here are just a few examples of what we’re talking about – once-weekly GLP-1’s, implantable continuous glucose sensors and implantable drug delivery i.e. Intarcia. As everyone knows Diabetic Investor sees GLP-1 as one of the best options for patients. These products do not require the patient to check their glucose levels, there are no calculations that involve insulin on board, duration of action, carb intake and target glucose. Being a fixed dose product the patient simply dials out the dose and injects. That’s it. Now that there are three once-weekly options all with simple to use pen delivery systems the so-called pain of injecting happens just 52 times per year. The GLP-1 category will get another boost when once-monthly options come to market.
Several companies are working on implantable continuous sensors, sensors which can remain in the body for a year delivering readings to a patient’s smartphone. So far we have yet to see a system that is ready for prime time but we love the concept. Anyone who used a CGM knows the value of the data these systems provide. It’s not an understatement to say that the data from CGM is transformative. However the downside of CGM is yet another device worn on the body, another system that has to swap out every 7 days or so. Think about how this market would explode if a patient could walk into their doctors office, have a CGM injected into their body and have the readings delivered to their smartphone.
Even better is the Intarcia implantable exenatide pump. We cannot think of a more elegant solution to the problem of therapy compliance. Unlike insulin which is lethal drug, exenatide is not lethal. Yes the pump has to be implanted but once in the body the patient doesn’t do a damn thing. Now we may not be the sharpest knife in the drawer but we cannot imagine a simpler solution.
All of these systems are examples of when it comes to diabetes management less is more. That the dumber the system the better. It’s time that everyone in this wacky world wakes up to the fact that the majority of patients with diabetes are NOT Uber patients. That they are normal everyday folk who have diabetes. That these patients have lives to live and their diabetes management is NOT the centerpiece of their lives. That these patients will tune out if they overloaded with data or asked to perform too many tasks.
Now here is a warning to every company in this wacky world – companies like Apple, Google, Facebook plus many other tech giants get this. This is why they are investing heavily into many of the smaller less well-known companies. They understand if advanced technology is truly to be transformative it must make life easier not more complex. That the goal of advanced technology is to make diabetes management stupid, something that doesn’t require the patient to think about their diabetes management.
The fact is many of what we like to call the old guard just don’t get this. They cannot depart from the past. Yet the fact is if they don’t change they are toast, companies like Apple or Google will clean their clocks and not give it a second thought.
Change is coming and by our way of thinking cannot get here soon enough.