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03/22/2021

New tools, approaches to diabetes care help patients thrive

As the number of patients with diabetes continues to grow, companies are developing solutions for managing the disease state that can help make living with it easier.
David Salazar
Managing Editor
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Diabetes management is undergoing something of a revolution.

With 34 million Americans afflicted with diabetes and who have developed a self-care mindset that has only increased with the pandemic, suppliers of products targeted toward diabetic patients — from glucose monitors and pen needles to compression socks and nutrition — increasingly are offering and bringing new ways of managing diabetes to the fore, as well as helping retailers cater to diabetic patients throughout the store.

Managing a Complex Condition
As one of the tentpoles of diabetes management, glucose monitoring also can be a longstanding pain point for diabetic patients. Sticking fingers multiple times daily to keep track of blood sugar levels has been the industry standard. Yet, as connected health’s profile grows, well-known names in the category are looking to get smart about both glucose monitoring and injection.

“In many areas of chronic condition management like diabetes, medical innovations are making it easier for patients to connect remotely with doctors,” a spokesperson for Abbott Laboratories said.

Over the past several years, this has taken many forms, including cell-enabled monitors that relay information to healthcare providers or even app-paired monitors that allow for smartphone management — many of which still require the finger stick. The next evolution in smart diabetes management are continuous glucose monitoring systems paired with digital tools.

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For Abbott, that solution is the Freestyle Libre, a CGM offering that also includes an app and cloud-based data management system to connect patients, caregivers and physicians to enable remote monitoring and easier management. This particularly has been useful as COVID-19 has led to fewer in-person provider visits.

“By providing continuous glucose data, users can make informed decisions about their food intake, exercise and medication to better manage their diabetes,” the Abbott spokesperson said. “During the pandemic, as telehealth and remote monitoring have proved vital, the FreeStyle Libre helped doctors access their patients’ glucose data remotely to help inform treatment.”

Monitoring is not the only element looking to get smart. In late February, Eli Lilly announced a collaboration with digital health solution provider Welldoc to join Lilly’s in-development connected insulin solutions to Welldoc’s BlueStar app. The partnership is aimed at making insulin dosing more accurate. “Today, less than half of people who use insulins are achieving their target A1C goals,” said Marie Schiller, vice president of product development for connected care and insulins at Eli Lilly. “We want to simplify the experience of using insulin by integrating our medicines with the most innovative technology available.”

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Outside of connected solutions, suppliers are rolling out products focused on ensuring patient safety with insulin injections. UltiMed, which makes the UltiCare line of pen needles, has debuted the UltiCare safety pen needles, which conceal the needle before and after use to prevent accidental needle stick injury. Compatible with most diabetes pen injector devices, the product also offers an audible cue to indicate when the needle has penetrated the skin and the safety mechanism has been activated.

A Whole-Store Approach
Beyond the baseline management of diabetes via insulin injections and constant monitoring of blood glucose levels, various additional products exist that can help diabetic patients thrive while keeping their condition in check.

“Reducing carb intake and eating satisfying foods rich in nutrients is a lifestyle change that has the greatest effect on regulating blood sugar levels and getting Type 2 diabetes under control.”
—Colette Heimowitz, vice president of nutrition and education, Simply Good Foods

A critical area of the store that many forget is integral to keeping diabetes under control is one that also is central to the retail offerings of almost all retailer pharmacy operators — food. The American Diabetes Association, in its 2021 Standards of Medical Care, noted that a reduced-carbohydrate diet is one that has seen the most evidence when it comes to improving blood glucose levels. Additionally, a recent meta-analysis of 23 studies published in the journal BMJ found that when compared with a low-fat diet, lower carbohydrate diets for six months saw higher rates of remission than those on low-fat diets.

Colette Heimowitz, vice president of nutrition and education at Simply Good Foods, said that in these studies, participants’ carb intake ranged from 10% to 25% of daily calorie intake — in line with Atkins 20, Atkins 40 and Atkins 100.

“This great news if your customer is already living a lower carb lifestyle or considering it as a way to manage Type 2 diabetes,” Heimowitz said. “Reducing carb intake and eating satisfying foods rich in nutrients is a lifestyle change that has the greatest effect on regulating blood sugar levels and getting Type 2 diabetes under control.”

Simply Good Foods is the parent company of Atkins, which offers bars, shakes and treats tailored to consumers on reduced-
carbohydrate diets.

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Even patients who are focused on their nutrition occasionally can experience low blood sugar and require something to quickly get their blood sugar back to a safe baseline. A longtime staple for low blood sugar episodes has been glucose tablets.

Pamela Hayward founded Glucose SOS when trying to help her daughters with Type 1 diabetes recover from low blood sugar episodes because the tablets they were taking took time to metabolize, and getting the correct dosage can require some trial and error.

Her goal was to develop something that would work quickly and offer more convenience than a tube or bottle of glucose tablets. Glucose SOS is sold in boxes of six 15-g pouches of powdered glucose that is absorbed sublingually.

“It’s a maintenance tool to keep your blood sugar up. Once it comes in contact with saliva, it dissolves and it’s absorbed into the buccal mucosa, going directly into the bloodstream, so it works super fast,” Hayward said. The product comes in four flavors — fruit medley, green apple crisp, kiwi strawberry, and original sweet and tangy — and is free of additives, artificial colors and flavors, and preservatives. The product, which meets ADA guidelines for combating hypoglycemia with its packet size, is serving as the starting point for other products, including the forthcoming glucose melts, which like the powder are absorbed sublingually once they melt.

“Managing your blood sugar levels is the most important thing,” Hayward said. “You want to give people with diabetes choices of something that tastes good and is convenient. The goal is to help them be as healthy as they can be and give them choices so they’re not grabbing candy bars or products that might not be the best for them.”

Blood sugar dips are not the only potential complication that can occur when managing diabetes. Patients also are at increased risk for foot problems that can result from poor circulation, which leads many to turn to compression socks to help improve circulation and reduce swelling in the feet and legs.

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Like Hayward at Glucose SOS, Michelle Moran has come to market with a product meant to improve upon a category staple with Skineez, compression socks that also aim to hydrate the skin. Developed in partnership with orthopedic surgeon Dr. David Jaofsky, Skineez are infused with apricot kernel oil, retinol, rosehip oil, shea butter, vitamin A and vitamin E.

“The creams usually sit next to conventional (drying) compression and diabetic socks,” Moran said. “Now there is a solution where these ingredients are included inside the product.” She also said that Skineez uses micro-capsule technology to embed the ingredients into the fabric of the sock. The hydrating benefits are meant to last for 10 washes, after which Moran said users can apply Skineez Garment Spray to reinfuse the socks.

Education and Merchandising
Diabetes is an area in which retail pharmacies successfully can leverage their not-so-
secret weapon — the pharmacist — to educate customers on their assortment and recommend products throughout the store.

To do so, though, they have to know what options exist, which is why Abbott has focused on supporting education grants for pharmacy continuing education.

“To date, Abbott has provided educational grant support for pharmacists who continue education via programs with the American Pharmacists Association, Pharmacy Times, Medscape, the ADA and the American Association of Diabetes Educators,” the Abbott spokesperson said. “In addition to national and online programs, Abbott provides live peer-to-peer training sessions for pharmacists and webinars on the clinical application of FreeStyle Libre and CGM report interpretation, using the Ambulatory Glucose Profile, a standardized one-page report that visually summarizes glucose trend data.

Diet and nutrition also offer an opportunity for guidance. “Now more than ever, [pharmacists] can play a key role in helping individuals navigate the diabetic aisles near the pharmacy,” Heimowitz said. “The evolving research showing how effective low carb diets are in managing Type 2 diabetes should help pharmacists feel confident when recommending low sugar and low carb products, such as low sugar, low carb bars, shakes, meals and treats, to customers.”

In terms of educational merchandising, Skineez’s Moran said that the company focuses on making sure its packaging includes educational information about compression socks and the ingredients they are infused with and has developed displays that it ships with the products.

“These displays have educational and product information printed on the back of the display — in sight of the pharmacists,” she said. “We do this to help educate the pharmacists about the product benefits Skineez delivers. The more knowledge the pharmacist has about the product, the easier it is for them to recommend.” dsn

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