Wake up call – Again
One would suspect that if someone is hit in the head with a baseball bat often enough that eventually they will get the point. This unfortunately not the case when it comes to diabetes education. Despite a growing body of evidence that diabetes education is one the most effective tools in helping patients control their diabetes, education continues to be treated as the ugly sister. Instead physicians and drug companies have become fixated on pushing more pills without educating the patient what other steps they can take to help control their diabetes.
Further evidence of this came yesterday from the online edition of the Annals of Internal Medicine when they published “Mortality Trends in Men and Women with Diabetes, 1971-2000”. What the study found was women with diabetes are dying at higher rates today than they were three decades ago. A surprising result when you consider that the study also found that men with diabetes experienced the opposite outcome and are actually living longer than three decades ago. The authors of the study concluded “Progress in reducing mortality rates among persons with diabetes has been limited to men. Diabetes continues to greatly increase the risk for mortality, particularly among women.”
The question is why?
In an accompanying editorial Nanette K Wenger, MD attempts to answer that question scientifically. Dr. Wenger’s premise is that disparities exist in how women are treated compared to men. While there is some evidence of this Dr. Wenger fails to mention one of the simpler approaches to improving outcomes; better education for all patients. Dr. Wenger concludes by stating “We lack an evidence-based comprehensive strategy for improving cardiovascular outcomes in diabetic women. Until we do, a prudent clinical approach involves 2 steps. First, we must recognize that diabetic women are at excess risk for developing CHD. Second, we must take an aggressive, guideline-based approach to CHD risk factor management.”
Diabetic Investor does not necessarily disagree with Dr. Wegner’s conclusion; however, her recommendations are all too typical of how physicians look at the problem. Today physicians can choose from nine different drugs to treat diabetes, these drugs can be used alone or in combination. Patients have access to several tools that can help them more effectively manage their diabetes. The internet has opened doors previously closed to patients who can now research diabetes instantly. Still more than 70% of patients with diabetes are not achieving adequate control and now we have evidence that women with diabetes are no better off today than they were 30 years ago. Just how many times does the diabetes establishment have to be hit in the head with a baseball bat to understand people with diabetes need more than new drugs and fancy tools?
Later on this week the American Diabetes Association will be holding their annual Scientific Sessions in Diabetic Investor’s hometown of Chicago. This year’s show will surly be dominated by the Avandia controversy and which direction physicians should go with patients who were taking the drug. Several companies will reveal data on promising new therapy options. And if the past is any guide we’re likely to have a surprise or two. What makes this all ironic is that the simplest and most cost effective tool for helping patients manage their diabetes will hardly receive a mention.
The real fact is if all the companies involved in the diabetes industry would stand up and make diabetes education a priority issue their bottom lines would also improve. Studies have shown even with a small amount of education patients are more compliant with their therapy regimen and check their glucose levels more frequently. Still drug and device companies do little when it comes to making patient education a priority. Diabetic Investor has said it before the problem isn’t that these companies do not see the benefit of patient education; rather they cannot directly tie better education to their individual product lines. This makes it difficult to justify the additional capital required as companies have shareholders to answer too and quarterly numbers to hit. Everyone appears to be waiting for the other guy to make a move before jumping in.
Meanwhile each day brings more evidence that the current state of affairs isn’t getting the job done and the millions of patients with diabetes are paying a heavy price. It’s time to bring out the heavy hitters and for the industry to use their collective power to make diabetes education a priority. With diabetes, pre-diabetes and obesity growing at epidemic rates there is more than enough patients to go around so that everyone will benefit financially. The time for excuses is over.