Highlights from the American Diabetes Association’s (ADA) 78th Scientific Sessions
I had the pleasure of attending the ADA’s 78th Scientific Sessions in Orlando, Florida, June 22-26, where we presented two posters co-authored by our CEO, Ken Tomaszewski, one of which was selected for a moderated session. The posters highlighted results from a study exploring the perceptions of control held by people with Type 2 diabetes and healthcare providers who treat patients with this condition.
Attending the ADA’s Scientific Sessions was a wonderful opportunity to gain a deeper understanding of the current trends and areas of interest and research in diabetes. There is, of course, a great deal of information about the medical treatment of diabetes with new clinical trial data being presented. Having a background in health services research, I was particularly interested in the sessions focusing on areas outside of pharmacology.
I was struck by how many presentations touched on topics such as diabetes prevention, cost of diabetes, technology, and the social determinants of healthcare. The amount of information was overwhelming, but fortunately, many presenters offered the opportunity to take photographs of their slides, thus allowing an opportunity to take time to further digest what I learned. Looking back at those images and my notes, a few key points really stand out to me.
Although the staggering cost of chronic care was not new to me, I was surprised to learn that 1 in 4 healthcare dollars in the US goes to treat people with diabetes, making it the costliest condition in our healthcare system. The high cost of diabetes management often results in non-adherence to medication, resulting in increased healthcare use and medical costs. Not only is this an issue for patients on Medicare, but it is increasingly becoming an issue for those on high deductible healthcare plans.
I also found one perspective on the treatment of diabetes to be very enlightening. Type 2 diabetes is currently “treated-to-failure”, following a complex journey of treatments that often results in frustration for the patient, their families, and their healthcare providers. The presenter suggested that using a cancer model for diabetes care would result in more frequent interactions with patients when first diagnosed, potentially allowing for greater opportunities for diabetes remission, a concept that is less than 10 years old.
Usage of online and mobile apps to manage healthcare is on the rise and can be very helpful for diabetes self-management. Although apps can make life easier by leveraging technology to reduce the mental burden required to effectively manage glucose and insulin, apps can be of varying quality, often untested, and as with other medical devices, can potentially pose safety or security concerns. Despite these concerns, most were optimistic about the value of these technologies and that their use will only increase in the future.
Probably what affected me most was hearing the experiences of those with diabetes and how managing the disease must be considered in a much larger social context. I keep finding myself coming back to one message. When we plant lettuce and it doesn’t do well, we don’t blame the lettuce, but rather look to other factors such as lack of sun, or water, or fertilizer. However, in diabetes care, it is very common to blame patients for their lack of success in managing their condition or their behavior without understanding the bigger picture. New interventions are being explored in understanding and addressing the social determinants of healthcare to better understand patients’ finances, relationships, beliefs/values, and behavioral health needs.
I look forward to leveraging my new-found perspectives in continuing to help our clients design high quality diabetes research studies.