People living with diabetes will tell you it’s a full-time job understanding how their body will respond to different foods and how stress, exercise, environmental factors and even routine daily activities cause them to readjust their insulin and glucose intake multiple times a day.
And for children living with this condition, their caretakers must think about all of these things and learn their insulin needs for them.
Now layer on top of this the expense of living with this autoimmune disease. The diabetes research foundation JDRF estimates adults with Type 1 diabetes spend about $20,000 a year managing their condition.
Fortunately, the number and quality of options for diabetics has increased dramatically. Today’s diabetics can lead healthier, fuller lives thanks to new user-friendly, affordable and discrete devices that have been developed to assist them with daily self-care routines and needs.
The reasoning behind the advances in delivery and monitoring equipment can be distilled into two words: improving compliance. As the number of people diagnosed with diabetes has risen each year, compliance has headed in the opposite direction. Diabetics describe the older methods as being cumbersome, painful, complicated and unreliable at times.
Hearing this, manufacturers have been delving into how they can remediate these issues. The answer, they discovered, is technology. The result has been the introduction of cutting-edge tech, such as closed loop systems, smaller and more accurate continuous glucose monitors, smart devices and faster-acting insulins. What’s more, during the next few years, as costs come down and nano technology enables the hardware to be miniaturized, more advancements are expected.
Challenges and issues
Insulin pump therapy has historically been expensive and difficult to access, said Bret Christensen, chief commercial officer at Acton, Mass.-based Insulet. To address this, Insulet’s products are available at the pharmacy, which means most customers pay less than $50 per month with no commitment, and they can get their pump supplies at the same place they get their insulin. “It’s more convenient and more affordable than the Durable Medical Equipment benefit, which is how all other insulin pumps are covered by payers,” he said.
Many patients, Christensen noted, are struggling with the burden of diabetes, explaining that daily tasks, such as checking blood sugars and delivering insulin, can be overwhelming, not to mention diminish a person’s quality of life. “Pharmacy organizations and pharmacists are in a unique position to help identify patients who need help with their diabetes care and create more awareness of technologies, such as continuous glucose monitoring and insulin pumps available through the pharmacy,” he said.
Christensen added that “evidence suggests these technologies can improve outcomes and lessen the burden of diabetes. With medication adherence as one of the primary roles of a pharmacist, they stand to play a critical part in the healthcare continuum.”
Advanced in monitoring
Blood glucose monitoring, or BGM, has been used for decades and remains an important tool in diabetes management, but BGM has its limitations, said Chris Scoggins, vice president of commercial operations and marketing at Abbott’s Diabetes Care Business, based in Abbott Park, Ill. “BGM requires painful fingersticks and can only provide point-in-time information,” he said. “High and low blood glucose fluctuations can often go undetected — even when people are performing multiple daily fingersticks.”
Continuous glucose monitoring systems were designed to address these issues and have been life changing for millions of people. Advancements in CGM technology have led to next-generation devices that are more accurate, discreet, easier to use and connected to apps with compatible smartphones.
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“CGM allows people living with diabetes to automatically track their glucose levels day and night,” Scoggins said. “Through a smartphone app or reader, people can see where their glucose values have been, where they are now and where they are going through use of trend arrows.”
Emory Anderson, president and CEO of Intuity Medical, located in Fremont, Calif., pointed out that people with diabetes have been frustrated with options to date and the disruption it presents to everyday life. Given the limited innovation with BGM, patients are clamoring for something much simpler, Anderson said.