In exhibit hall displays and conference room conversations at the American Diabetes Association's 73rd Scientific Sessions recently, there was a common theme spread throughout many discussions:
We have choices.
Whether it's the latest gadgets like glucose meters, insulin pumps, or continuous glucose monitors (CGMs), or different types of medications, options exist and we are fortunate enough right now to be able to tailor our D-Lives how we'd like in many respects.
For this month's Diabetes Social Media (DSMA) Blog Carnival, we are asked to ponder our D-Device Choices and what goes into those decisions.
Regardless of which type of diabetes you have — Type 1, Type 2, or Type 3 (aka Type Awesome or caregiver) — you probably use one or more diabetes devices on a daily basis. How do you select the diabetes devices you use? To others looking into new or replacement devices, what would be your best advice to someone shopping around?
Now, this D-tech topic is close to our hearts here at the 'Mine -- what with our DiabetesMine Design Challenge that kicked off D-innovation crowdsourcing, and our current Innovation Summits that push for better-designed options to manage our diabetes.
We are currently conducting a big ONLINE SURVEY about how PWDs use and feel about their diabetes tools, so please take a few moments to fill that out so that we can share our sentiments with health & medical decision-makers in an organized way.
And now, on to my own personal thoughts on the topic of choices...
When it comes to insulin pumps, I've been using the same brand for most of the 12 years I've been pumping. Many years ago, another pump did catch my eye. It offered a food database and had a built-in glucose meter unlike the model I was using, so I made the switch... to my later dismay. Not happy with the choice after a year or so, I went back to the original brand and have remained a loyal customer.
The same goes for CGMs and glucose meters -- I happen to be a "creature of habit"-type guy, so not looking to change just for the sake of trying the latest and greatest on the market.
It's a little different with fingerstick meters, however. Since most of them achieve roughly the same level of accuracy, I typically look at style and how a meter fits into my case. Or how the back light works in a movie theater and the number of averages kept in the database. So there I'm more swayed by aesthetics, for sure.
But my personal preferences aren't what I want to talk about in this post. Instead, I want to look at the simple fact that we do have choices, and what it might mean if those choices were limited and we were forced to use a device or medication against our will.
Although the vendors at the big ADA conference were touting the choices they're offering, many side conversations on the expo floor and at evening gatherings touched on the ugly reality of healthcare reimbursement reform, and how that may play out negatively for patients and manufacturers alike. If we're not willing to step up and speak up about this issue together, we may find ourselves practically erasing all the exciting news and innovations being presented at the Scientific Sessions.
You may remember our recent report on meter accuracy that discussed the July 1-effective changes in diabetes supplies covered by Medicare. This impacts all of us in the D-Community because the private insurance market typically follows suit on what Medicare has done.
"The government is trying to take away your choice," one Pharma rep told me during a conversation about those upcoming Medicare changes. "We believe in choice, but the government isn't listening to industry. They see us selfishly pushing a product, and so our voice is being listened to less and less."
That conversation stuck with me.
It's on us. As people with diabetes, as patient advocates, as individuals who just want what's the best for our own health. We shouldn't be forced to use low-quality devices simply because they cost less and can be used as a talking point for politicians to say how much money they're saving -- on the wrong thing, tools that outta be improving our health!
Obviously Pharma is in the business to make money on products, so they have their own agenda, but it's also not in anyone's interest to push no-name brand meters from overseas on patients that often don't even have an 800-number to call if there's a question or concern.
It worries me that this "lowest common denominator" i.e. cheapo approach could be applied to insulin pumps, CGMs, oral and injectible medications, and even lab tests and medical procedures. Some say the sweeping changes coming are "Bad for Doctors, Awful for Patients."
Many on Medicare have already been told they must either switch brands of glucose meters and strips, or face paying for everything out of their own pockets (not a realistic choice for many!). And this may just be the beginning...
What can we do?
I suppose we have to talk to our lawmakers and policy-makers, to let them know that while cost is an important consideration, quality must be assured. Luckily there are some national initiatives aimed at pushing back, like the Campaign for Quality and Community Campaigns for Quality Care.
We're not experts on healthcare policy or reform by any means, but we know what's right and wrong, and we know what we need to manage our diabetes well. As much as I'm a creature of habit in choosing my D-Supplies, having a choice is super important because I'll always do better using a tool that fits my lifestyle and health habits.
And the idea of being limited to low-cost, one-size-fits-all treatments not only makes me mad, it also scares me to death.
This post is our June entry in the DSMA Blog Carnival. If you'd like to participate or see the other posts in the carnival, visit DSMA here.