Integrated diabetes management [IDM]
requires programs that must be willing to listen to patients, but
learn from them as well.
Some would argue that this is why
integrated diabetes management is needed, as it not only collects and
transmits data, but it provides for an easy interaction between the
patient and their healthcare team. It is the healthcare team that is
doing all the date analytics and all that the patients need to do is
collect the data. This focus on data can actually make a patient
tune out even when they are getting good advice. This should not
happen under any circumstance.
The Livongo and TelCare meters are two
of many that transmit data to the cloud and also sends messages to
the patient on their meter. Now in theory these messages are meant
to help the patient better manage their diabetes. Yet these constant
messages can also be annoying. What both systems lack is a sense of
balance and perspective. Solid diabetes management is a marathon and
not a sprint. And as any marathon runner can attest, races are
filled with multiple variables. For some, the goal is to finish with
a certain time. For other runners, the goal is merely to cross the
finish line. The same is true for managing diabetes. For some, the
goal is to keep their glucose levels in a tight range, while for
others it’s just achieving an HbA1c of 7 or below. What’s
lacking in most of the IDM programs we have seen is understanding
these different patient perspectives and understanding that diabetes
management is not one size fits all.
The survey did not cover this, but one
reason patients don't download or review this data regularly is that
for the majority of patients, managing their diabetes is just one
more thing they must do each day. That, as we have said countless
times, the vast majority of patients want to live their lives with
diabetes, not for their diabetes.
Most patients want diabetes management
to fit into their life, not run their lives. If IDM is ever to take
hold, the approach must be more nuanced, more patient.
The fact is most of these programs,
instead of learning from the patient, make assumptions about the
patient. Perhaps the biggest assumption they make is that these
patients actually care what their A1c is, that they want to do all
the work to achieve good outcomes. While we wish this was true,
sadly for the vast majority of patients, this just isn’t true, not
even close.
IDM will only be impactful if it works
with the patient as a partner, not as a dictator. It should
understand the demands of diabetes management and it must learn from
the patient before offering advice. For IDM to be truly impactful,
it must not be a one size fits all approach. This will just cause
patients to tune out. Yes, there is hope for IDM, but this hope only
goes as far as IDM programs being willing to not just listen to the
patient, but learn from them as well.
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