The unanswered question

The unanswered question

Later this week the diabetes world will gather once again in steamy New Orleans for the annual American Association of Diabetes Educators (AADE) conference.  Given the move towards interconnected diabetes management (IDM) it will be interesting to see how these educators respond to so simple questions; “Is it possible that a patient with diabetes can have too much information? Will data overload get in the way of better diabetes management?” Simply put will all this information do the opposite of what’s intended, instead of having a patient tune in will they tune out instead.

With the explosion of wearable devices and the many glucose monitors connected to the cloud gathering the information isn’t the problem. The problem remains pretty simple; converting this data into actionable information. Some would argue this isn’t really a problem as all this data will analyzed by a third party, i.e. a Certified Diabetes Educator, who in turn will help the patient understand and act on it. Still the question is even with the help of a CDE will patients tune out.

We ask this because of the very nature of diabetes management and the many different therapy options followed by patients. Unlike insulin using patients who can see an immediate impact on the advice given by a CDE, the impact for non-insulin patients takes time to be seen. Unlike insulin using patients who can make quick adjustments to how much and when they take their insulin, non-insulin patients lack this control. They cannot without a doctors intervention change and/or add medications to their therapy regimen.

Another equally important issue is making sure a patient actually follows the advice given by a CDE or physician. We hate to belabor a point yet a huge obstacle to better patient outcomes is a patient actually being compliant with their therapy regimen. It really doesn’t matter how good the advice the patient is getting nor does it matter that this advice is backed up by data, what matters is the patient taking action actually following this advice.

Looking into the future Diabetic Investor can envision patients using IDM completely tuning out. Perhaps the best way to think about this is to look at our increasing dependence on mobile technology. Let’s face facts given the choice between taking away their smartphones or going without food most people would rather not eat. Think about the last time you went 24 hours without getting a text message, email or call on your smartphone. Now try and imagine what it must be like for a patient with diabetes who in addition to text messages from family, friends and co-workers is being bombarded with even more messages telling them how they should be managing their diabetes.

Yes we know that these messages are well intentioned yet the fact remains patients just might get tired of being constantly reminded they have diabetes. This is especially true when you consider that good diabetes management is 24x7x365 job with no days off and the results of all this work don’t always payoff. Solid diabetes management is not like weight loss where a patient can see they are making progress.,

This being the case it’s easy to see why patients just might tune out. They just might believe that yes it’s nice to have help but as well intentioned as this help is it’s just too much work. That all this work isn’t being rewarded in a tangible way. That’s a real problem as the reward, i.e. a lower HbA1c, takes time to be seen and let’s be honest in today’s instant gratification society patients don’t like waiting around for results.

As everyone knows we’re big believers in the potential of IDM yet as much as we see the promise of IDM there are obstacles that need to be acknowledged and overcome.