Diabetes Management: An Age-Old Problem That Needs A Modern-Day Solution

Evidence-Based Diabetes Management, November 2015, Volume 21, Issue SP15

Sanofi's vice president of Diabetes Integrated Care discusses the recent collaboration with Google.

Since the discovery of insulin in 1921, there has been significant progress in the diagnosis and treatment of diabetes, but clinical outcomes for people living with diabetes still remain less-than-ideal. Despite a plethora of treatments available, only half of the people with diabetes are at their target glycated hemoglobin (A1C) level,1 the standard measure for diabetes management. And, if left uncontrolled, many people experience 1 or more associated complications, including kidney disease, heart disease, strokes, blindness, and amputations, all of which come with a high price tag. In the United States alone, the annual cost of diabetes approaches $245 billion.2 Nearly two-thirds of the $176 billion of direct medical costs is for hospitalizations and medications to treat complications.3 Overall, medical costs alone are twice as high for people with diabetes than those without the disease.2

The time to address this tremendous personal and societal burden is now. Without new solutions, the problems associated with diabetes will only get worse. According to the International Diabetes Federation, by the year 2035, the number of people affected by diabetes worldwide is expected to climb to nearly 600 million, up from 400 million today.4

Despite this bleak landscape, there is hope from the positive results of numerous clinical trials showing the effectiveness of behavioral interventions, diagnostic approaches, device-drug combinations, patient communication, and self-management tools.

The elements to spark change are here now. What is needed, however, is a fundamental reshaping of how diabetes is approached both clinically and structurally, particularly the data/communications infrastructure and the basis by which products and services are paid. Diabetes care can be transformed with comprehensive and cost-effective outcomes solutions for patients, their providers, and their payers.

In short, diabetes is an age-old problem in need of modern-day solutions.

SHIFTING DIABETES MANAGEMENT FROM REACTIVE TO PROACTIVE

It’s hard to imagine that a mere 20 years ago, hardly anyone had a cell phone, let alone one that ordered and paid for a latte delivered to the office. We lost touch with friends and colleagues as the years went by. If you needed a lift to the airport, you called the local taxi service. Technology has had an astonishing impact on how we live, exponentially simplifying everyday tasks.

Why not apply the concept to diabetes care? What if patients had continuous, easy access to the vital information that could help them and their doctors manage the disease more proactively? Does the technology exist or can it be built and connected to make this possible?

Together, Sanofi and Google Life Sciences (GLS) are answering the call to improve diabetes health outcomes with a recently announced collaboration to catapult diabetes management into the 21st century. The companies are exploring how to improve diabetes care by bringing together many of the previously siloed pieces of diabetes management, including data, analytics, drug delivery and sensor devices, and health indicators such as blood glucose and A1C levels, patient-reported information, and medication regimens. In doing so, diabetes management can shift from reactive to proactive, helping people living with diabetes and their healthcare professionals stay a step ahead of complications.

COMBINING MEDICINE, DEVICES, TECHNOLOGIES, AND SERVICES TO HELP IMPROVE DIABETES MANAGEMENT

One of the fundamental problems with managing diabetes is the sheer complexity of the disease and keeping track of it. Each day, multiple times a day, people may use a variety of devices to measure their blood glucose level and take medication accordingly. With multiple variables—such as nutrition, exercise, and sleep—affecting blood glucose, adjusting the amount of medicationto avoid potentially dangerous consequences becomes essential. In simple terms, the Sanofi/GLS collaboration strives to help people living with diabetes by developing better ways to manage the disease by using technology to understand the impact of all the variables. Currently, for most people managing this disease, the approach is almost entirely analog. Food intake, blood sugar levels, and medication doses are each tracked separately and with limited real-time feedback or guidance.

Together, Sanofi and GLS will work on finding better ways to collect, analyze, and process the multiple sources of information needed to better manage the disease. The collaboration aims to improve existing technology, invent new technology, and create enhanced accessand understanding of information. Importantly, all of this technology and information needs to be useful and actionable for people living with diabetes and their healthcare professionals in the real world, with improved outcomes as the end goal.

Although the collaboration is in its infancy, patient insights and unmet needs will be vital inputs in defining functionality and features of the solutions. It is important to ensure that patient perspectives are incorporated. In the past, Sanofi conducted market research to understand payer perspectives for integrated care solutions. The team will continue doing so to ensure that the solutions offer value-added support to what payers are doing today.

Sanofi has a deep history of creating important new offerings for people living with diabetes. As a global leader in diabetes care, Sanofi believes the company has an obligation and commitment to provide integrated solutions. This collaboration will leverage Sanofi’s expertise in the treatment and biology of diabetes with the Google Life Sciences team leadership in technology to help ensure that new tools and technologies are useful in the real world. We want to help improve the patient experience, outcomes, and manage healthcare costs more effectively.

About the Author: Francois Nicolas, PhD, is vice president, Diabetes Integrated Care, Sanofi.

We believe that combining the complementary resources of Sanofi and GLS for a common ambition will positively impact disease management for people living with diabetes. Many people focused on the same problem will be able to create new, cost-effective tools and technologies that work together and work better for patients. The potential for integrated care solutions to help improve outcomes is there. With new technologies emerging to provide a more continuous and real-time view of patient health, we have an opportunity to make diabetes management simpler, more proactive and effective. References

1. Casagrandes S, Fradkin J, Saydah S, Rust KF, Cowie CC. The prevalence of meeting A1C, blood pressure, and LDL goals among people with diabetes, 1988-2010. Diabetes Care. 2013;36(8):2271-2279.

2. 2014 National Diabetes Statistics Report. CDC website. http://www.cdc.gov/diabetes/data/statistics/2014StatisticsReport.html. Accessed September 24, 2015.

3. The cost of diabetes. American Diabetes Association website. http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html. Updated June 22, 2015. Accessed September 24, 2015.

4. Diabetes atlas 2014 update. International Diabetes Federation website. http://www.idf.org/diabetesatlas.Accessed September 24, 2015.