About 10 days ago, the annual meeting of the Diabetes Technology Society took place right here in my SF Bay Area neighborhood. Over 800 scientists, engineers, and doctors from government, industry, academia, and clinical practice gathered for this annual consortium on what's new in everything from non-invasive glucose monitoring to nanotechnology to the artificial pancreas project.
Just as last year, I had hoped to cover this event live, but was put off by the exorbitant entry fee -- the organizers do not grant affordable media access, *sigh* You can read a summary of the presentations over at the ChildrenWithDiabetes website.
But what apparently really shook the walls this year was the keynote speech by Richard Kahn, Chief Scientific Officer of the American Diabetes Association, who came across as "dismissing the technology that in particular people with Type 1 diabetes use to keep healthy -- insulin pumps and glucose monitors," a number of influential attendees tell me.
I use the phrase "came across" on purpose, because you won't see any direct hits if you read the "very vanilla" published script of Kahn's speech (you can download it HERE). But his demeanor and the many asides he made during his talk "stunned" everyone in the room -- all people who've devoted their careers and lives to diabetes technology.
In the cryptic speech, Kahn's point seemed to be that no randomized control trial has ever shown the actual benefits of using insulin pumps (A1c, glycemic variability reduction), and the same goes for fingerstick monitoring of Type 2's on oral medications. What the audience heard was Kahn "calling into question the cost-effectiveness of all diabetes technology." Note that nowhere in his speech does even mention the terms "Type 1" or "Type 2." Looks like we've got some lumping going on here, of all PWDs into one big bucket -- from the ADA itself?!
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"To sum up a half-hour talk in one sentence, (Kahn) essentially said that if you want to keep patients with diabetes healthy, just have them take their meds on time," Jeff Hitchcock, director of ChildrenWithDiabetes tells me. "I think he has no sense of what living with Type 1 diabetes is all about, and the tremendous impact that technology has had on the patients, and their families."
Renowned industry consultant Kelly Close, who covers the DTS conference every year with her research team, was -- in a word -- blown away: "As a patient, I literally felt like I'd been run over by a bus. It was very threatening... I'm worried about what this guy is whispering in the ears of lobbyists in Washington, DC."
It is frightening that someone like Kahn, who in his position with the ADA is arguably the most visible spokesperson for diabetes in this country, would deliver a speech essentially dissing the value of new diabetes technologies -- and at the country's top gathering of D-tech experts, no less!
See the patient discussion thread on Kahn's remarks at the ADA Message Board (of all places :)
Another attendee, who preferred to remain anonymous, explained it to me this way: "I think (Kahn) was sending pre-emptive strikes, saying I'm not sold on this... He's skeptical about CGM, he doesn't like the data on insulin pumps... He's been pushing this message in the Type 2 world for a while, but hasn't tread into the Type 1 arena —- but now he has in a pretty aggressive way."
Kahn is a savvy professional communicator. He speaks for the ADA, which supposedly speaks for us, the Diabetes Community. Is this the type of advocacy we want?
Think of the ramifications. If the ADA comes out with an official position that there's no value in using an insulin pump, or a CGM system, or even a fingerstick meter if you're a Type 2 not on insulin, the Powers That Be will listen. Insurance providers are already resistant enough to covering our preventative needs. (They'd rather defer until we're older and develop severe complications, which will then become Medicare's problem)
I for one believe we need to speak out here, before Kahn's view becomes the ADA party line and insurance providers stop covering insulin pumps altogether. Kelly Close and I plan to draft some kind of patient petition to protest, which I hope to post here asap. Stay tuned.
Thank goodness for blogs and social media, btw. This type of thing has gone on behind closed doors for far too long. Let the patient community have a voice on the relative value of the technology we use to manage our condition. I bet the ADA will get an earful!