Saturday, November 19, 2005

State of Diabetes Care Today

I arrived home yesterday to watch television, and was horrified at what a commercial market diabetes has become. I had no sooner turned on the TV when a commercial for some meter (I think it was for Abbott's FreeStyle Flash) appeared. Does anyone else besides me find the commercials for blood glucose meters and test strips to be completely stupid, and even worse, unpersuasive? Persuading consumers, after all, is the whole point of advertising.

To begin with, as a patient with type 1 for the past 30 years, I automatically dismiss all claims of being "virtually pain-free" because such claims are completely baseless, akin to claims of "new and improved" diswashing liquid. There may be some study conducted by the company to "prove" their claims, but they are meaningless nevertheless. Interestingly, recall that "virtually pain-free" was the same claim that was used back around 1986 or so when I got my very first meter, and at the time, the typical lancet was at least 25 gauge, not the ever-smaller 30 or even 33 gauge variety widely sold today. Even so, today's lancets hurt far more than injections ever did. Also, smaller isn't always better. My callused fingers need the bigger gauge or I cannot possibly get any blood.

Also, is anyone else troubled by the fact that when the so-called diabetic patient in these commercials or print ads test their blood sugar, they are ALWAYS in the normal range? If someone's blood sugar is always normal, then they aren't diabetic, so why bother showing this? Why not show a figure of 376 mg/dL or 43 mg/dL? At least that might appear more realistic to many of the people these companies are trying to sell their meters and strips to. Furthermore, it sends the wrong signal to patients that their test results should always fall into the normal range, and if its not normal, then they are failures. Is it any wonder most people with diabetes don't test enough?

Personally, I don't test to smile about how close to normal it is, that by itself is not a reason to waste a $1.00 test strip or inflict pain on myself. I often test to determine how far from euglycemia (higher or lower) my blood glucose levels actually are so I can determine what action is required (whether I need more insulin or I need to eat)!


Johnboy said...

Scott, my guess is that Diabetes Management programs are not designed for people like you (or me for that matter).

As for the commercials, I agree that they have much less impact than "word of mouth" or "professional reccomendation." My nurse turned me onto Freestyle products, and I liked them so much that I became an advocate and even purchased the stock, which I owned until they were bought out by Abbott. The commercials did nothing for me but confirm what I already knew; however, if I had not tried the product, I would have dismissed it as meaningless hype.

Good luck with your strips order! Out of curiousity, how large was your previous order??

Scott S said...

You are probably right about disease management programs not being for people like us. However, the statistics cited in The Wall Street Journal suggest they don't really save money for insurers, either. I suspect this is because the programs don't address the heart of the issue, namely motivating patients who don't properly care for themselves to do so, which is a phychological issue, not an education issue! Someday the insurance industry will get that.

BTW, I received my strips without any problem. My insurance company indicated that they compared my order with my A1c, and did not even question it! I guess they realized that strips are the cost for a lower A1c!

Kassie said...

I hear you on the pain free thing!

Meter ads strike me as odd. And it depresses me that there are enough people with diabetes out there to warrent spending $$ on tv ads.

Scott S said...

True .... but at least get to know who they are marketing to. It seems to me they have two markets for testing supplies: the enormous "noncompliant" type 2 market who test, according to recent studies, an average of only 4x per week, or the "heavy" users, which are people who are in excellent control of their condition and use about 10-15 test strips per day.

Guess which market is more profitable? Why, then, are they targeting the 15 million recently diagnosed patients (who are primarily type 2 and not on any meds to treat their condition).

Simple math suggests that the "heavy" user market is far more profitable. Light users will use about 240,000,000 test strips this year, while heavy users (estimated to be roughly 2 million type 1 and type 2 patients who maintain good control) will use roughly 448,000,000 test strips assuming they use an average of 14 per day. While the latter market is small by comparison, they are much more profitable!

I should be in advertising, but perhaps I am applying too much common sense here!