July 30, 2018
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Despite advances, type 1 diabetes community seeks more options for management

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Two new national surveys conducted by The Harris Poll suggest most endocrinologists and adults with type 1 diabetes want more options to help them better manage the disease, even as new advances continue to change the disease landscape, according to a summary of the survey data released by the American Association of Clinical Endocrinologists.

The T1D Unmet Needs surveys examined the support, management and treatment of the disease and why it is important to continue prioritizing and advancing innovation to help patients achieve better outcomes. More than 70% of endocrinologists and adults with type 1 diabetes surveyed stated that recent advances in type 1 diabetes give them hope that there will eventually be a cure, yet an overwhelming majority agreed that more advances are currently needed to help improve the lives of those with the disease. The surveys were supported by Lexicon Pharmaceuticals and Sanofi U.S.

“Over the past 5 years, the type 1 diabetes landscape has vastly evolved,” George Grunberger, MD, FACP, FACE, chairman at Grunberger Diabetes Institute in Bloomfield Hills, Michigan, said in a press release. “With new technology, genetic research and testing and finger-stick-free monitoring devices, it’s truly an exciting and unprecedented time in health care, and in diabetes in particular. However, the data from these surveys are an important reminder that there is still a lot of work to be done to meet the needs of the type 1 diabetes community.”

As Endocrine Today recently reported, the FDA approved several new developments in diabetes technology in the past 2 years, including a factory-calibrated, finger-stick-free continuous glucose monitor (FreeStyle Libre Flash, Abbott), a new stand-alone, smartphone-only CGM (Guardian Connect, Medtronic), a “smart” insulin pen that keeps track of dosing (InPen, Companion Medical) and the first artificial pancreas (MiniMed 670G, Medtronic). The pace of new approvals, according to experts, may signal a new era in diabetes technology.

Among all respondents, 73% of endocrinologists and adults with type 1 diabetes reported that recent advances in the diabetes space give them hope for a cure; however, 87% of adults with type 1 diabetes and 93% of endocrinologists agreed with a survey statement that more advances are needed to improve the lives of those with type 1 diabetes.

Disease burden

Among adults with type 1 diabetes, 88% reported that living with the disease adds stress to their lives, 57% avoid going out to eat and 49% avoid social gatherings with family and friends because of their disease. Additionally, 58% of adults with type 1 diabetes reported struggling with keeping their blood glucose within recommended range, whereas 48% reported difficulties achieving individualized target HbA1c levels. Among respondents with type 1 diabetes, 77% reported wanting a medication to better help them stay in their target glucose range, whereas 93% of endocrinologists reported wanting to do more to help their patients manage the disease.

“These findings highlight the ongoing need to provide support to adults living with type 1 diabetes,” Rachele Berria, MD, PhD, head of U.S. diabetes medical affairs at Sanofi, said in the release. “We have collaborated with AACE and Lexicon Pharmaceuticals to ensure these unmet needs are brought to the forefront in the hopes that increased awareness will help to transform care for people living with type 1 diabetes.”

Sharing knowledge with patients

Ninety-nine percent of endocrinologists reported knowledge about noninsulin pathways, but only 45% of adults with type 1 diabetes knew about them, according to the survey results. Additionally, 32% of endocrinologists reported that the hybrid closed-loop system, also known as the artificial pancreas, could have the greatest potential for positive impact on patients with type 1 diabetes, yet 28% of respondents with the disease did not report knowledge about that advancement, according to the survey results.

Pablo Lapuerta, MD, executive vice president and chief medical officer at Lexicon, said the findings represent an opportunity to enhance education and “cross-share” information about innovation that might ultimately improve type 1 diabetes care and outcomes.

“Lexicon and our partners at Sanofi are committed to bettering the lives of the millions of people around the world living with diabetes,” Lapuerta said in the release. “We understand that living with type 1 diabetes is an everyday challenge and through our collaboration with AACE, we hope to call attention to the unresolved needs of the type 1 diabetes community, specifically.”

Despite the recent technology advances, adults with diabetes must be able to understand it and afford it, Anne L. Peters, MD, professor of clinical medicine at Keck School of Medicine at the University of Southern California, Los Angeles, told Endocrine Today in a recent interview.

“I spend half my time in east LA, where most people don’t have access to this technology and can’t even use insulin pens,” Peters said. “You can’t forget that the majority of people with type 1 diabetes aren’t higher socioeconomic status, access-to-all-the-stuff people. They’re people in primary care practices all over the country. Not everyone has a smartphone. Not everyone is numeric. Not everyone can do this stuff. No matter what, the goal is to make these advances available to everybody.” 

Grunberger said physicians should ensure they are working in partnership with their patients to review new research that might address both therapeutic and disease management challenges. – by Regina Schaffer

Disclosure: Lexicon Pharmaceuticals and Sanofi U.S. supported the surveys.