By Shahd Husein/GluShahd
In June, researchers, industry representatives, and stakeholders gathered at the American Diabetes Association’s 78th Annual Scientific Sessions in Orlando, Florida to share the latest in diabetes prevention, care, and management. The T1D Exchange team was there, presenting on a variety of diabetes-related topics, from glucagon use among people living with diabetes to Medicare coverage for insulin pump therapy.
Each year, the Scientific Sessions provides an opportunity to gauge what’s on the forefront of the minds of diabetes researchers. Alicia McAuliffe-Fogarty, PhD, T1D Exchange’s Vice President of Patient-Centered Research, said this year’s conference showed that it was an exciting time to be working on and presenting type 1 diabetes research.
“This year at the conference, there was a greater emphasis on type 1 diabetes,” she said.
Here is a recap of this year’s presentations from T1D Exchange’s Patient-Centered Research team (you can click the links below to see our PCR-related tweets from the ADA meeting):
1. We presented results showing that people with type 1 diabetes who used half-unit insulin pens experienced less anxiety about their blood sugar levels. It appears that half unit pens allow users to feel they can dose more precisely. Bottom line: providers should consider different treatment solutions like half unit pens to help persons with type 1 diabetes to achieve narrower blood glucose targets.
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2. T1D Exchange researchers teamed up with Zealand Pharma to examine the perceptions that people with type 1 diabetes have about glucagon rescue kits. The study showed that glucagon rescue kits were, in fact, underutilized to treat hypoglycemia, a condition marked by very low blood sugar levels. The main reasons cited were: 1) inadequate glucagon prescriptions and education from providers, 2) unclear and confusing kit instructions, and 3) difficulty of use.
3. Our team surveyed Glu users to measure the quality of glucose management when using continuous glucose monitors (CGMs). Results show that although people who used CGMs still experienced episodes of low blood sugar when using their devices, they were more satisfied with their blood sugar management with insulin treatment, likely because they more often met recommended targets. In addition, we found that blood sugar levels were not associated with work productivity or activity impairment, in contrast to previous reports that included people with type 1 and type 2 diabetes.
4. Medicare recipients must go through multiple hurdles to receive coverage for insulin pump treatment and the supplies needed to manage type 1 diabetes. We asked adults living with type 1 diabetes about insulin pump coverage in relation to Medicare policies. Approximately 50 percent of those surveyed experienced problems with coverage.
The majority of those surveyed cited the high costs of pumps and supplies as barriers to access. Other issues cited included the long wait time to receive delayed supplies and the requirement by Medicare to visit the doctor every 90 days. As results of these issues, more than a third of people with type 1 diabetes reported changing their pump behaviors. In many cases, this led to adverse outcomes, such as higher blood sugar and infection. This study adds more to the growing pool of evidence to support the need for easier access and better coverage of insulin pump therapy under the Medicare program.
5. We asked both providers and patients who used insulin pumps to tell us about the challenges associated with pump therapy. Patients said that they stopped using insulin pumps because they experienced elevated blood sugar levels with pump therapy. Meanwhile, providers attributed lack of pump use to high out of pocket costs and lack of insurance coverage. The discrepancy in response points to the need for better patient-provider communication and a more tailored approach to an individual’s treatment.
It is clear from these studies that while better technology and therapies are vital for improving management of type 1 diabetes, patient input is a key part of the process of improving care, as well.
“Our research is showing that the patient perspective can help in managing diabetes,” McAuliffe-Fogarty says. “There is a growing conversation around the psychosocial factors that impact diabetes and people’s choices to try and access therapies.”