The Diabetes Landscape
Delivered March 7, 2020. Contributor: Careka S.
Goals
To obtain information about the global diabetes landscape and the "Time in Range" (TIR) concept including general overview, doctors and patients perspectives, evolution of diabetes, devices used for TIR, perspective and barriers of TIR and companies that are promoting TIR.
Early Findings
Overview
- Globally, people die from diabetes frequently (every 7 seconds) and half of them are younger than 60 years old, according to International Diabetes Federation statistics. Annually, this amounts to 4 million patients.
- The prevalence of diabetes globally is "8.8% of the world population in 2017" (i.e. 424.9 million) and will increase to 9.9% by 2045 (628.6 million people).
- Globally, it affects mostly people who fall in the 40 – 59 years age range and especially in countries ranked as low and middle income.
- Diabetes is currently one of the leading causes of death and presents complications for kidney failure (>50%), cardiovascular disease, neuropathy as well as amputations.
- The Pacific and Middle Eastern islands tend to have the "highest prevalence of diabetes".
Evolution
Doctors' perspective
- Indian doctors currently disagree with some aspects of the global guidelines in treating diabetes such as "relaxing the long-term blood sugar target
". Concerns stem from the fact that for several decades, the principle was to use a measure of HbA1c of 6.5%
to determine that someone was diabetic and this has now been increased to "HbA1c level between 7% and 8%
" which was traditionally 6.5 to 7%
for patients who are diagnosed with type 2 diabetes.
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The "Time in Range" concept is considered to be more useful for diabetics given the clarity it presents in the glucose range and target time to aim for. It can also be used as a short-term diagnostic tool.
Proposed next steps:
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As the initial research briefly touched on an overview of global diabetes, its evolution, doctors' perspective and the "Time in Range" concept, we recommend continuing our research with the following: 1) provide a detailed overview of diabetes globally including its evolution, prevalence for men versus women, persons most affected by it, challenges in low and middle-income countries and current and future treatment for diabetes, 2) provide an overview of doctors' perspective in treating diabetes globally including their motivations/interests in treating patients, frustrations/concerns, and challenges in treating diabetes, 3) provide an overview of patients' perspective on living with diabetes including their frustrations, support, motivations, interest in new medications, proud moments in treatment (e.g. when "in range") and 4) provide a detailed overview of the "time in range" concept including doctors' confidence/feedback (positive and negative), devices used to measure it, companies currently promoting time in range and its use in making a diagnosis.
In addition to this, we propose further research to 1) provide an overview of the patients perspective of the of "time in range" concept, ease of use/understanding of use, and indications of their use of glucose monitoring device (i.e. whether is an increase/decrease in use), 2) identify 3 of the top manufacturers of constant glucose monitoring devices globally. For each, we will provide One: the name, Two: the website link, Three: why it was chosen as top, and Four: a description of the company, and 3) provide the competitive landscape of the top 3 manufacturers of constant glucose monitoring devices to include their target market, pricing, products/services, value proposition, and their competitive advantages.