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Bayer HealthCare supports individualized diabetes treatment

What people with diabetes do really need

• A patient-oriented approach is pivotal of successful blood glucose therapy

Berlin, Germany (October 1, 2012) – Bayer HealthCare is stressing the need to help health care professionals and people with diabetes to make better decisions for effective diabetes management. At a media round table organized on the occasion of the 48th Annual Meeting of the European Association for the Study of Diabetes (EASD) in Berlin, Germany, a group of international experts came to the conclusion that a patient-focused approach combined with modern blood glucose monitoring systems of the next generation is pivotal of a successful future diabetes therapy. They agreed that standardized guidelines and accuracy norms for blood glucose monitoring systems are essential, however, each therapy might be individual to human behavior and constituency as many patients are still failing, for example, to reach HbA1c goals.

The current guidelines and expert recommendations highlight the role of self-monitoring of blood glucose in diabetes management and emphasize that education is necessary to ensure that people feel confident about managing their disease. A successful diabetes management needs to combine the benefits of both modern technology and individualized therapy. High performance blood glucose monitoring systems are as important as advanced care delivery. A recent study, for example, has proven evidence that many patients with type 2 diabetes are unable to accurately estimate their blood glucose values.(1) Bayer HealthCare, therefore, fosters the cooperation with diabetes experts, nurses, and health care professionals and actively supports the exchange of knowledge and experience through excellence-oriented networks.”

Current guidelines in diabetes management

Professor Oliver Schnell, expert of the Diabetes Research Group at the Helmholtz Center in Munich, Germany, gave an overview of the current guidelines in diabetes management. Since 2009, when the first global recommendation for self-monitoring of blood glucose (SMBG) was presented by the International Diabetes Federation (IDF)(2), SMBG has been recommended as a key element in personalized diabetes therapy as it defines the individual dosage of insulin based on measured blood glucose level and a meal’s carbohydrates. In non-insulin treated patients, it provides information on hypoglycemia, glucose excursions due to intercurrent illness, and changes in medication or lifestyle.(3)

A number of studies figured out that the evidence for a benefit of SMBG both in insulin-treated and non-insulin treated patients with diabetes is increasing.(4) Experts agree that structured approaches of SMBG also support early treatment modification.(5) According to them, there is a clear need to incorporate an educational and a therapeutic component.(6) As all patients have individual needs and perform differently in the monitoring process, individualized SMBG and treatment strategies are required that take into account clinical characteristics like duration of diabetes, risk of hypoglycemia, and comorbidities. This personal training may enhance therapy outcome as it contributes to a better selection of treatments based on individual response and patient learning.

Improving personal treatment through advanced care delivery

Professor Kari Harno from the Department of Health and Social Management at the University of Eastern Finland spoke about diabetes self-management tools for patients and presented first results of an EU-wide e-health study.(7) In self-management tools, distinction is made between educational tools that help instruct patients and technological tools which enable them to capture, review, receive personalized decision support, and respond to measured data.(8) To apply appropriate treatment and make the necessary adjustments, patients may depend on e-health tools for reporting measurement data. The recent study examined mobile terminal-based applications, used for example with a mobile phone that provides data analysis to support individualized self-management of diabetes. The devices may then supply patients with automatic feedback on personal health records created from the entered data, or lead them to educational modules.

Understanding the patients’ needs

Proper education is always important to ensure that people with diabetes can feel confident about managing the disease. Building on more than forty years of experience, Bayer HealthCare actively fosters the personal approach of gaining know-how through exchange platforms and excellence-oriented networks. With its support for the “Young Leaders in Diabetes Programme” of the International Diabetes Federation, Bayer is part of a key plan to enhance the lives of young people living with diabetes by honoring innovative projects in diabetes management all over the world. At the media roundtable, Alexander Leon Silverstein, President of the “Young Leaders in Diabetes Programme” from the UK, spoke from the perspective of a person who is living with the metabolic disorder and gave an update on current Young Leaders’ projects. He pointed out that cultural habits influence patients’ behavior and affect the individual therapy outcome as well. Therefore, sharing experience and best practice between experts and patients of different regions or ages can be highly beneficial for a successful diabetes therapy in the future.

Innovation for further personalization

Improved accuracy in self-monitoring of blood glucose can provide benefits for both patients and health care professionals. More precise measurements are likely to empower patients to self-manage their diabetes and may favor appropriate therapeutic changes as part of an effective diabetes management program. Therefore, Bayer HealthCare offers next generation devices that meet high accuracy standards and additionally provide technical features for individual therapy decisions. Its new Contour® XT and Contour® Next USB meters and the new Contour® Next sensors have been designed for patients with basic needs as well as for patients with more advanced needs, particularly those who test frequently. Both systems are affected by many common interfering substances, show good stability over a wide range of temperatures, and are easy to handle. Their No Coding® technology automatically calibrates the meter, thereby eliminating errors due to miscoding. The new systems are easy to teach, learn, and use and give patients the confidence they need to take over control and make better decisions.

Research suggests that 71 percent of people with diabetes make decisions about their diabetes management, including insulin dosing, without testing their blood glucose. Other patients believe that they know what their blood glucose level is and use these perceptions to make decisions about their self-care practices. Bern Harrison from Bayer HealthCare’s diabetes research and development group in Mishawaka, USA presented a recent study(9) assessing the difference between self-reported, estimated blood glucose values and blood glucose values as measured on a blood glucose monitoring meter. Nearly half (46 percent) of subjects estimated blood glucose values that were more than ±15 mg/dL of actual glucose values <75 mg/dL or more than ±20 percent of actual glucose values ≥75 mg/dL (based on current ISO accuracy criteria); 58 percent estimated blood glucose values that were not accurate based on more stringent accuracy criteria (within ±15 mg/dL or ±15 percent at glucose concentrations <100 and ≥100 mg/dL, respectively). These findings suggest the importance of regular blood glucose testing rather than estimation of blood glucose values to help people with diabetes to make better informed decisions for effective diabetes management.

About Bayer HealthCare

The Bayer Group is a global enterprise with core competencies in the fields of health care, agriculture and high-tech materials. Bayer HealthCare, a subgroup of Bayer AG with annual sales of EUR 17.2 billion (2011), is one of the world’s leading, innovative companies in the healthcare and medical products industry and is based in Leverkusen, Germany. The company combines the global activities of the Animal Health, Consumer Care, Medical Care and Pharmaceuticals divisions. Bayer HealthCare’s aim is to discover, develop, manufacture and market products that will improve human and animal health worldwide. Bayer HealthCare has a global workforce of 55,700 employees (Dec 31, 2011) and is represented in more than 100 countries.

More information at www.healthcare.bayer.com

Sources 

1. Edelman S, Pettus J, Greer J, Stenger P, Schachner H, Dunne N, Parkes JL, Pardo S; Impact on Diabetes Behaviors: Knowing Versus Guessing Blood Glucose Values; poster presented at the 48th annual meeting of the European Association for the Study of Diabetes (EASD), Berlin, Germany, 1-5 Oct, 2012.
2. IDF. Guideline Self-Monitoring of Blood Glucose in Non-Insulin Treated Type 2 Diabetes. Available at: http://www.idf.org/guidelines/self-monitoring, 2009.
3. Ibd.
4. Klonoff DC, Blonde L, Cembrowski G, et al. Consensus report: the current role of self-monitoring of blood glucose in non-insulin-treated type 2 diabetes. J Diabetes Sci Technol 2011;5:1529-1548
5. Schnell O, Alawi H, Battelino T, Ceriello A, Diem P, Felton AM, Grzeszczak W, Harno K, Kempler P,   Satman I, Vergès B. The Role of Self-Monitoring of Blood Glucose in Glucagon-Like Peptide-1-Based   Treatment Approaches: A European Expert Recommendation, Journal of Diabetes Science and Technology, May 2012, Volume 6, Issue 3: pages 665–673.
6. Polonsky WH, Fisher L, Schikman CH, et al. Structured self-monitoring of blood glucose significantly   reduces A1C levels in poorly controlled, noninsulin-treated type 2 diabetes: results from the Structured Testing Program study. Diabetes Care 2011;34:262-267
7. Mobile Sipoo substudy on IMB-model application, May 2012.
8. Adler-Milstein J. & Linden A. (2009). The use and evaluation of IT in chronic disease management. In: Handbook of Research on Information Technology Management and Clinical Data Administration in   Healthcare. Vol. 1, ed. A. Dwiwedi, pp. 1-18. Medical information science reference, Hershey, NY.
9. Edelman S, Pettus J, Greer J, Stenger P, Schachner H, Dunne N, Parkes JL, Pardo S; Impact on Diabetes Behaviors: Knowing Versus Guessing Blood Glucose Values; poster presented at the 48th annual meeting of the European Association for the Study of Diabetes (EASD), Berlin, Germany, 1-5 Oct, 2012.

Bayer HealthCare, 01.10.2012 (tB).