aint no sunshine when she’s gone

bathroom

attending the medtronic diabetes advocates forum came with everything you would expect: great big hunks of information, meaningful connections, the forging of new friendships, open discussion, action plans, boats of laughter, and down-right exhaustion.

coming home from the weekend, i said to my partner, jesse, “that was a lot of diabetes.”

feeling slightly bent out of shape from returning to a diabetes job after a diabetes weekend got me thinking about a conversation with chuck on the first evening about his job in global coverage with medtronic.

he candidly told me about his recent visit to japan. he said that in order for most people with diabetes to be covered for an insulin pump, they must see their doctor every month. he went on to explain that all pump supplies are funneled through the doctor’s office.

at first i was stunned by this. every month and seemingly no autonomy to order as you please? how could they live like that i wondered.

but as the conversation between him and scott e continued, my mind wandered. i wanted to ask so many more questions.

what if that much doctor time actually worked to their benefit? what if they liked seeing a care professional twelve times a year because it helped them foster better management habits? what if not having to order your own supplies, but rather JUST pick them up made it simpler?

by this point, my head was exploding.

i had to ask about metrics, about the data. was this method working? could we benefit from more covered visits IF a person would elect to have them? could management improve if the extra task of ordering supplies wasn’t in our hands as patients?

i asked chuck if pump-wearing PWDs in japan have better A1Cs. and his answer was ‘well, we don’t know.’

if my brains were not scattered about the floor already, they certainly were by now.

being a big idea person, i started conjuring up things that could happen for all people with diabetes if we only knew how this model affected management. ideas were going off in my head like bottle rockets. one after the other. i knew that cultural and lifestyle differences would make for excellent confounding factors, but i couldn’t let it stop me from dreaming.

the structure for collecting data was already there. medtronic was already there. they were in japan, making an impact, talking with patients and healthcare providers. but they were not collecting the results.

this conversation kept creeping into my mind throughout the forum and since being back home.

i know that being around diabetes more helps me remember to check more, to bolus more, to count carbs.. slower. i also know that being around people with diabetes is exhausting because it is tiring to be so much more on my diabetes game.

i can’t say if seeing my doctor more often would improve my health ‘outcomes’, or do anything other than annoy me to bits. but i can say that if i knew that evidence showed that seeing your doctor more often improved management, i would sure as hell jump on the bandwagon.

so in the spirit of asking, medtronic, please start collecting.

for all people with diabetes. lets figure out best practices and get them covered by all insurance.

we need healthy empowered people in this world

chop chop.

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9 thoughts on “aint no sunshine when she’s gone

    • That is unfortunate, and saddening. Was she upset about the stigma, when you spoke with her? I wonder how her child felt about it and about being at FFL, where diabetes gives you mega cool points.

  1. Great thoughts… I think monthly visits would help. But that is hard for people for sure. I have never matched my pregnancy numbers and I know the frequent visits made me fine tune and motivated me to achieve good control. Plus I got to know my team better.

    • Thank you for reading Michelle! I can’t say I am not a little worried about being able to control my levels tightly enough when that time rolls around. I like the IDEA of monthly visits, but the idea of actually taking time off work to go makes me cringe just a little. I am glad that it worked for you and helped. Have you written your story about it? It could serve as a case study for evidence of improved ‘outcomes’ (I hate that word). Thank you for sharing!

  2. My brain doesn’t even know how to start thinking about all this. Wow! Data is so important. I know that IDF is pushing all countries to begin to collect data. It’s a huge undertaking, but oh so important for the big picture!

  3. It would certainly be interesting to know whether or not this practice has a statistically significant impact on a1cs. I can see why it would.

    I wonder how Japanese diabetics see this practice. Does it feel instructive to them? If it doesn’t, why not? Could it be that Japanese norms and values has led to a different doctor-patient relationship than what’s common amongst US diabetics? If so, what can we – both patients and doctors – learn from them?

    Then there’s the question of whether or not the cost outweighs the benefits (and a plethora of other questions).

    It’s certainly intellectually stimulating to think about.

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