Unmet Needs and the Future of Diabetes


Key opinion leaders discuss the unmet needs for diabetes and the future of therapy.

Dhiren Patel, PharmD, CDE, BC-ADM, BCACP: Some of the unmet needs I feel like, in 2019, will see innovation. And kind of what I see as encouraging innovation, especially from a pharmacotherapy standpoint, is that up until now we’ve had an injection barrier. And so despite all the benefits that we’ve talked about, just beyond reducing someone’s A1C [glycated hemoglobin], weight, all these other benefits that a patient gets from being on a GLP-1 [glucagon-like peptide-1] receptor agonist, at the end of the day, they’re all injectables. Whether some of them are once a day or once a week, it is still an injection piece, which I think patients are OK with. But I think there’s a lot of clinician bias, and they’re just assuming that a patient might not want to be on an injectable. But we’re going to see oral delivery of a GLP in 2019. And so I think that’s going to be a very exciting shift, where they can reap all the benefits. And this 1 barrier, that some consider a barrier, I no longer have to kind of go through that. And it’s going to be something I can give a patient a pill for and they don’t have to actually inject themselves.

My thoughts on the future of diabetes are that I think we’re shifting to a connected era in which I will have the ability to look at someone’s continuous glucose monitor. If they’re not in front of me, I will have the ability to look at patients’ blood sugar data using telehealth. We have smart connected pens that are becoming available, so I’m going to know if a patient missed a dose. I can intervene. I can look at different factors, and so these smart connected devices are going to be a big game changer, especially in rural health areas, in areas where transportation is a barrier. And as we look at some of these social determinants of health, I think they’re going to help kind of close some of these care gaps that we’ve seen, especially with diabetes.

Tripp Logan, PharmD: One of my favorite subjects is talking about unmet needs in our health care system right now. We’re in a very reactionary health care system. You have an issue, you go to the doctor, you get a prescription, it’s fixed. But that’s not how you manage chronic disease. It’s not how chronic conditions are managed and diabetes is no different.

Managing diabetes is a journey. It requires not only medications and a prescriber but a team and a support system around the patient. We pride ourselves on our pharmacies, and we’re trying to get as much education out there to encourage others to focus on the journey, not the prescription. We’ve instituted a new initiative in our pharmacies, where we’ve got community health workers in our pharmacies who are working with patients on all the social factors that go into treating diabetes.

I think this is the future of health care. I think the future of health care is helping patients longitudinally over time navigate and manage chronic conditions. The health care system is terribly hard to navigate. Most people need help. Most health care providers don’t know how to navigate the health care system. So in diabetes it’s really important because it’s a daily challenge to keep blood glucose at bay. And as you add a lot of days together, it gets into months, weeks, and years that patient, that­­ person, has people around them. They’ve got voices in their ear. They’ve got third-party payers. They’ve got different providers. They need somebody to help reconcile these things.

I think the best place to do that is in the pharmacy. Pharmacists and pharmacy staff, peers who are in the pharmacy who help those patients manage their needs and their concerns but also have access to that clinician in the pharmacy who understands blood glucose, who understands the medications, who understands the nuances of this chronic condition being diabetes and all the comorbidities that go along with it.

If we as pharmacists, and community pharmacies specifically, can help patients initiate therapy and manage therapy, and have reached their goals over time by being accessible and by being helpful to them, not only on the medication side but also on the social side, I think what we see is better control of diabetes in patients, and I think we see better health outcomes and lower overall health care costs. That to me is the most exciting thing that’s going on right now, and I think it needs to be expanded exponentially throughout our health care system right now.


Additional videos in the Insights series for 'The Cardiovascular Benefits GLP-1 Agonists' can be viewed at PharmacyTimes.com.

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