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Focus Diabetes

Process & technology innovation need to be employed in structured care

• Personalized Diabetes Management supports improved diabetes therapy outcomes

Berlin, Germany (October 1, 2012) – Diabetes is a silent chronic disease in the beginning, but if not treated appropriately it deteriorates over time. Due to its secondary complications diabetes can be reckoned as dangerous. It requires healthcare professionals’ and patients’ continuous attention and therapy adaptation to optimally manage the condition to delay or even prevent the sequelae to arise. At the 2nd international scientific media symposium Focus Diabetes: Patients. Perspectives. Progress., facilitated by Roche Diabetes Care on the occasion of the 48th annual meeting of the European Association for the Study of Diabetes (EASD) in Berlin, renowned key opinion leaders discussed most recent approaches to personalize diabetes management and optimally manage glycemic control with the support of latest technological innovations. There was consensus amongst the experts about the fact that the presented concepts are able to substantially facilitate therapy decisions and are easy to implement into daily routines. This is in addition emphasized by current study results which demonstrate that the structured management of glycemic patterns in combination with data visualization can support enhanced doctor-patient collaboration, and can lead to patient motivation to better adherence and improved therapy outcomes1.

Diabetes, as many other chronic diseases, is complex and difficult to manage as it is often accompanied by secondary complications and multi-morbidities. Instable glycemic control and especially post-prandial hyperglycemic events are considered to be decisive risk factors leading to short- and long-term complications such as cardiovascular diseases like heart attack or stroke but also neuropathy, retinopathy or renal disease. “We are strongly convinced that a personalization of diabetes management integrating structured self-monitoring of blood glucose as well as the comprehensive treatment of individual glucose patterns, involving data management solutions in a collaborative manner between doctors and patients, can help optimize therapy and enhance standards of diabetes care”, states Luc Vierstraete, Global Head of Roche Diabetes Care at the beginning of the event. “Latest scientific evidence demonstrates that a structured approach to diabetes management supports healthcare professionals and people with diabetes alike and helps to improve therapy outcomes2. And now it is crucial to implement such promising approaches into daily practice.”

Despite the advances that were achieved in diabetes management over the last couple of years, many people with diabetes are still failing in reaching their glycemic targets and adhering to their recommended therapy regimens. Moreover, current research shows that in many cases necessary therapy changes such as the initiation of insulin therapy are still made too late – despite the availability of the tools required to appropriately manage the disease. This is concretely demonstrated by the Australian example introduced by Dr. David Norman O’Neal, Senior Endocrinologist at St. Vincent’s Hospital and Associate Professor at the University of Melbourne, Australia, who is one of the leading investigators of the Stepping Up study3. Based on his everyday experience he advocates a structured diabetes management approach especially when it comes to blood glucose monitoring and insulin initiation and titration. 

A European key opinion leader working group recently issued an expert opinion paper4 proposing a more personalized approach to diabetes management in the form of a six-step cycle. “One size does not fit all, hence we need to develop individual targets for our patients taking into account their clinical context as well as their personal history”, states Professor Antonio Ceriello, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) in Barcelona, Spain. The six-step cycle4 involves structured self-monitoring of blood glucose as a guide for selecting the adequate therapy to prescribe, combining it with patient self-management and a feedback loop to ensure that people with diabetes stay motivated. In addition   and according to a new algorithm, patients are assigned a phenotype cluster according to different factors including age, duration of diabetes, comorbidities, type and prevalence of daily blood glucose levels. According to Prof. Ceriello the value of the cycle for the general practice lies in its combination of efficiency-enhancing aspects and the potential to improve both, quality of and access to optimal diabetes care.

Technology in terms of innovative medical devices plays a fundamental role in transferring such new approaches into daily practice.  “Especially when it comes to insulin treated people with diabetes, functionalities such as automated bolus advisors can significantly support the personalized diabetes management approach, help to improve glycemic control and facilitate daily therapy management” states Dr. Ralph Ziegler, Diabetologist in Münster, Germany and one of the investigators of the ABACUS5 study. “The results from a recent survey6 underpin that use of the bolus advisor in the Accu-Chek® Aviva Expert system contributes to reduced fear of hypoglycemia, increased confidence in bolus calculation, improved ability to reach glycemic targets and eventually supports also therapy adherence and overall well-being”, explains Dr. Ziegler.

All-in-all these research results are able to show that personalizing diabetes management can help in improving therapy efficiency and effectiveness as well as adherence and medical outcomes. “Such algorithms and a structured approach to diabetes management will facilitate decision processes for healthcare professionals and patients. Moreover, the already available scientific evidence of the six-step cycles elements are promising in terms of generating medical and also economic benefits for healthcare systems” concludes Prof. Ceriello. 

Sources 

1. Weissmann, J, et al.,Improving Process Quality and Medical Outcome of Diabetes Treatment with Information Management: the Physician’s Perspective. Results from the Multicenter Observational VISION Study &  Brotons, C. et al, Benefits of a Blood Glucose Data Reader Device in the Management of Type 2 Diabetes Mellitus: Primary Care Nurses Perspective, Poster presentations at Advanced Technologies & Treatments for Diabetes (ATTD) 5th International Conference, February 8–11, 2012
2. Polonsky WH. et al. Structured SMBG significantly reduces HbA1c levels in poorly-controlled, non-insulin treated type 2 Diabetes: Results from the STeP Study.Diabetes Care February 2011 34:262-267; doi:10.2337/dc10-1732
3. Stepping Up study: Structured Glucose Monitoring & Insulin Titration, study design presented by Dr. David O’Neal, Roche Diabetes Care symposium, 48th EASD, Berlin 2012
4. Ceriello, A. et al. Diabetes as a case study of chronic disease managementwith a personalized approach: The role of a structured feedback loop. Diabetes Res Clin Pract(2012), http://dx.doi.org/10.1016/j.diabres.2012.07.005  
5. Ziegler, R.; Cavan, D. Presentation of ABACUS baseline results, Roche Diabetes Care symposium, 48th EASD, Berlin 2012
6. Barnard KD, Parkin CG, Young A, Ashraf M: Use of an automated bolus calculator reduces fear of hypoglycemia and improves confidene in dosage accuracy in patients with type 1 diabetes mellitus treated with multiple daily insulin injections. J Diab Sci Tech 2012, 6(1):144-149.

About Focus Diabetes: Patients. Perspectives. Progress.

To support advancement of optimal diabetes management and structures of care, Roche Diabetes Care has initiated a high-level scientific media symposium series titled “Focus Diabetes: Patients. Perspectives. Progress.” that takes place at an annual frequency.

The event series serves as a platform to discuss in-depth scientific insights as well as the latest developments in diabetes management with internationally renowned experts. It addresses topics such as challenges in efficient diabetes management faced by patients, healthcare professionals, health insurances and payers as well as current clinical study findings. Besides providing exclusive insights and a professional setting for discussions, the symposium series offers participants the opportunity to directly liaise with the experts.

About Roche

Headquartered in Basel, Switzerland, Roche is a leader in research-focused healthcare with combined strengths in pharmaceuticals and diagnostics. Roche is the world’s largest biotech company with truly differentiated medicines in oncology, virology, inflammation, metabolism and CNS. Roche is also the world leader in in-vitro diagnostics, tissue-based cancer diagnostics and a pioneer in diabetes management. Roche’s personalized healthcare strategy aims at providing medicines and diagnostic tools that enable tangible improvements in the health, quality of life and survival of patients. In 2011, Roche had over 80,000 employees worldwide and invested over 8 billion Swiss francs in R&D. The Group posted sales of 42.5 billion Swiss francs. Genentech, United States, is a wholly owned member of the Roche Group. Roche has a majority stake in Chugai Pharmaceutical, Japan. For more information: www.roche.com.

About Roche Diabetes Care

Roche Diabetes Care is a pioneer in the development of blood glucose monitoring systems and a global leader for diabetes management systems and services. For more than 35 years, the Accu-Chek brand has been dedicated to enabling people with diabetes to live life as normally and actively as possible as well as to empowering healthcare professionals to manage their patients’ condition in an optimal way. Today, the Accu-Chek portfolio offers people with diabetes and healthcare professionals innovative products and impactful solutions for convenient, efficient and effective diabetes management, spanning from blood glucose monitoring through information management to insulin delivery. The Accu-Chek brand encompasses blood glucose meters, insulin delivery systems, lancing devices, data management systems and education programs – leading to an improved medical outcome.

For more information please visit www.accu-chek.com

Roche Diabetes Care, 01.10.2012 (tB).