Diabetes care is taking on a new meaning, helped in large part by the COVID-19 pandemic, as well as other factors.
Now, for retailers, the diabetes category also entails educating people, especially the newly diagnosed, about blood glucose monitoring, nutrition and other important topics. Pharmacy staff are engaging with consumers and manufacturers are introducing innovative products and systems that can help stores capitalize on the growing need for managing the condition.
According to the Centers for Disease Control and Prevention in its 2020 National Diabetes Statistics Report, 34.2 million people of all ages, or 10.5% of the U.S. population, had diabetes in 2018. Also, 1.5 million new cases of diabetes were diagnosed. The report also estimated that 88 million adults aged 18 years old or older had prediabetes in 2018.
Not only are more people being diagnosed with diabetes, but the way they are connecting with healthcare providers is changing. “Unsurprisingly, the most important trend in diabetes management is related to COVID-19,” said Elaine Anderson, global head of marketing at Ascensia Diabetes Care. “Many people with diabetes have seen their regular face-to-face meetings with physicians, dietitians and educators postponed or moved to telephone or video calls.”
People with diabetes are using digital tools to get remote coaching for diabetes management, share their blood glucose data from their blood glucose meters or their continuous glucose monitoring, or CGM, systems, and get personalized recommendations. “Although this was related to COVID-19, we expect that this trend will continue,” Anderson said.
Since many people with diabetes see their pharmacists more frequently than their clinicians, retailers play a key role in helping people manage their diabetes. Now that consumers are hesitant to visit stores during the pandemic, retailers and pharmacies have an opportunity to provide more services using technology. For example, pharmacists can leverage digital tools for remote monitoring of patients and identify trends or needed behavior modification.
With this in mind, Ascensia is enhancing its digital solutions to support diabetes management. The company, which is based in Switzerland and has U.S. headquarters in Parsippany, N.J., recently announced a partnership with Visiquate to develop a digital diabetes management platform. The new platform will integrate with Ascensia’s existing devices and apps to data capture, and will provide the ability to deliver analytics for individuals, health plans, diabetes educators and providers through various dashboards.
Diabetes in a pandemic
The COVID-19 pandemic added another challenge for retail pharmacies. Many had to make such operational changes as adding curbside pickup and delivery. “It speaks volumes to the tenacity, adaptability and creativity of our pharmacy partners,” said Casey Pflieger, director of retail sales at Owen Mumford, based in Marietta, Ga. “Despite the bleak side of this pandemic, community pharmacies are rapidly evolving and taking their place center stage. It is an exciting time for the industry.”
Also, according to the CDC, the percentage of adults with diabetes increased with age, reaching 26.8% among those aged 65 years and older. This age group tends to fill more than one prescription, and some pharmacies are implementing medication synchronization, or med sync, as a way to improve efficiencies and increase medication adherence. Med sync is a system of software and other components that help pharmacies conduct a comprehensive review with consumers who can then pick up all their prescriptions in one visit per month. The system helps streamline operations, decrease abandoned prescriptions and increase medication adherence.
“Most importantly, these programs make life easier for patients,” Pflieger said. “With a condition as complex as diabetes, anything that can be done to make treatment easier, safer or more convenient can have a profound impact on quality of life and patient compliance.”
Owen Mumford, which makes injection therapy solutions like Unifine Pentips pen needles, introduced Unifine SafeControl, its first safety pen needle, this summer. Company officials said it is an elegant, easy-to-use solution that provides greater control of the injection process for users. “We also engaged with pharmacists to better understand the financial challenges they are facing with current solutions in the market,” Pflieger said. “The result, a product that better meets the needs of the end user and has attractive pricing to satisfy the needs of our pharmacy customers.”
There’s an app for that
The pandemic also sped up certain trends, such as the consumerization of health care. “People are more proactively seeking and using what they perceive to be trustworthy, relevant information and technology to make better-informed decisions with their HCPs and on their own,” said Stacy Burch, vice president of marketing and commercial excellence at U.S. Diabetes Care at BD Medical in Franklin Lakes, N.J. “COVID-19 has accelerated the need for more virtual engagement.” BD manufactures pen needles, insulin syringes and other products.
Burch said that the CDC has made certain recommendations for pharmacy staff during the COVID-19 pandemic. “Pharmacists who are providing patients with chronic disease management services, medication management services and other services that do not require face-to-face encounters should make every effort to use telephone, telehealth or telepharmacy strategies,” according to the CDC recommendations updated in May.
One way to do this is with an app. According to a March 2019 study in Frontiers in Endocrinology, people who have Type 1 or Type 2 diabetes and who used diabetes apps had higher scores in self-management, which was calculated by summing up scores for factors including diet, exercise, blood glucose testing, foot care and smoking. “Recommending a well-suited diabetes care app may be important,” Burch said.
To that end, BD Medical is providing pharmacy customers with tools and resources that facilitate patient engagement to meet patients where they are, whether face-to-face or remotely. The company offers the BD Diabetes Care App, designed to support positive diabetes self-care behavior. The app uses artificial intelligence with content in English and Spanish, including recipes, data logging, how-to videos and personalized tips for self-management.
“The BD Diabetes Care App can reinforce and supplement what patients learn in the physician office or pharmacy,” said Claire Levine, associate director of strategic customer marketing at BD Medical — Diabetes Care. “Connecting patients with diabetes to trusted support beyond the pharmacy, in a consumer-friendly format, can be an opportunity for pharmacists to add value to patient interactions.”
Bluetooth and Blood Glucose Meters
Connected health that allows for sharing health data with a healthcare provider through digital or wireless means is gaining momentum not just because of COVID-19 and social distancing, but because consumers in general have been relying on technology to help them manage their own health.
Trividia Health offers the True line of blood glucose monitors, test strips and other products. Through a partnership with Mellitus Health, which provides software for diabetes care professionals who manage insulin therapy, Trividia Health will offer a solution to help improve diabetes care through pharmacies and pharmacy-based clinics. In general, patients bring their glucose meter to the pharmacy or store clinic, and the solution, which will integrate Mellitus Health’s FDA-cleared Insulin Insights software, analyzes the glucose meter data and generates an insulin dosing recommendation for their healthcare professional, who can accept or edit the suggested change.
“It’s a new program that allows retail pharmacies to be the access point of data,” said Michael Schlanger, director of channel marketing at Trividia Health. The Fort Lauderdale, Fla.-based company offers a full portfolio of products that cover all aspects of diabetes care, from testing and monitoring to nutrition and skin care. In addition to implementing new high-tech solutions, a best practice for retailers is to display the full diabetes set with products that cover the gamut of needs, Schlanger said.
People with diabetes, especially those who are newly diagnosed, might not realize they need the array of products. Trividia also has launched an educational campaign, Meet Lance, which features a character named Lance who is diagnosed with diabetes. The brochure walks readers through test strips, choosing the right meter and other details of diabetes care.
There also has been innovation in other such areas as glucose monitoring. “Continuous glucose monitors are arguably the most important and critical innovation in diabetes care in quite some time,” said Marc Taub, divisional vice president of technical operations at Abbott Diabetes Care, with U.S. headquarters in Abbott Park, Ill. “CGMs measure glucose levels without a fingerstick and provide users with actionable information to make informed decisions about their health painlessly and conveniently.”
Glucose levels change minute by minute for individuals who live with diabetes, Taub said, so round-the-clock glucose monitoring is critical. “Traditional glucose monitoring involves painful fingersticks multiple times a day and, because of this, many people did not test their glucose levels as often as they should,” he said. “If left unchecked, this can cause serious health complications.”
Earlier this year, Abbott announced it had received Food and Drug Administration clearance for its FreeStyle Libre 2 system. It is worn on the back of the upper arm for up to 14 days and measures glucose every minute to help users and their healthcare providers make informed treatment decisions. With a one-second scan using a handheld reader, users can see their glucose reading, trend arrow and eight-hour history. The system also alerts users when glucose levels are too high or too low without scanning.
Abbott is working with several strategic partners to integrate technologies to make diabetes care easier. For example, Abbott and Tandem Diabetes Care recently finalized an agreement to develop and commercialize integrated diabetes solutions that combine Abbott’s CGM technology with Tandem’s insulin delivery systems to provide more options for people to manage their diabetes.
“Abbott is committed to continuing to innovate its technologies to ensure those living with diabetes are equipped with the best tools to manage the condition,” Taub said.
Other category leaders also are working on new products and services. Eli Lilly is developing two platforms that will integrate connected insulin delivery devices, software and analytics. The components are designed to analyze glucose trends in response to insulin doses and people’s behaviors to equip people with diabetes and healthcare providers with actionable insights to help with diabetes management. “We believe that with the insights backed by data, we can help people with diabetes change their behaviors,” said Azam Khan, chief data insights officer for connected care and insulins at Eli Lilly. “Our goal is to help people with diabetes reduce their A1C and spend more time in the target glucose range.”
Nutrition Is Important, Too
While it might not be as flashy as the hottest new technology, nutrition is an important segment in diabetes care. Pamela Heyward, president of SOS Life Sciences, developed Glucose SOS Rapid Glucose Recovery when two of her daughters, who have diabetes, were suffering from severe hypoglycemia, or low blood sugar. Glucose SOS, which is fine powdered glucose that is absorbed more quickly than candy, soda or juice, dissolves faster than tablets. “I invented it out of necessity,” Heyward said.
Glucose SOS, available in several food, drug and mass chains, often is displayed in the pharmacy section with other diabetes-related products. Some even set up a counter display in November for National Diabetes Month. Retailers have been very supportive of the new product. “One buyer said he doesn’t have diabetes, but he loved the flavor,” Heyward said. Glucose SOS is available in fruit medley, green apple crisp, kiwi strawberry, and original sweet and tangy.
From advanced digital communications to fun flavors of glucose, the diabetes category is seeing much change, said Owen Mumford’s Pflieger. “Within diabetes care, innovation is happening all around us, all the time.”