Impartial Online Tool IDs ‘Best Fit’ Devices for Diabetes Patients

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A new online tool aims to help patients with insulin-treated diabetes and their health care providers to identify the best diabetes technology based on individual needs and preferences.

The “Device Finder” tool is a new feature of the DiabetesWise website, www.diabeteswise.org, which is funded by the Leona M. and Harry B. Helmsley Charitable Trust with no industry contributions. It is intended for use by patients with either type 1 diabetes or insulin-treated type 2 diabetes and by endocrinologists and primary care clinicians in their discussions with patients.

The main DiabetesWise site was launched in June 2019 by a team led by Stanford (Calif.) University psychologist Korey K. Hood, PhD; this team included endocrinologists, psychologists, diabetes care and education specialists, nurses, and patients. The information provided in it was based on work from the past several years in examining human variables that influence diabetes technology uptake, Hood said in an interview.

“We realized there wasn’t really a great resource for people to actually compare different devices and understand what might fit their lifestyle and priorities. You had to go to a device manufacturer to get that information, and … that’s probably a little bit biased,” said Hood, who is professor of pediatrics and psychiatry & behavioral sciences at Stanford.

The site offers a quick “Check Up” that asks patients about what devices they’re currently using, how they feel they’re handling their diabetes management, and about their priorities regarding devices. The new “Device Finder” tool provides information about different combinations of insulin pumps, continuous glucose monitors (CGMs), injections, and fingerstick glucose meters. The site also features resources for patients on speaking with their doctors, costs and health insurance, coping with COVID-19, and “wisdom” with patient narratives. Patients can download reports to share with their clinicians.

Asked to comment, diabetes technology expert David Ahn, MD, program director of the Allen Diabetes Center, Hoag Health, Newport Beach, Calif., said, “I love that DiabetesWise.org offers patients a way to compare and contrast different products all in one place that is not directly influenced or funded by a specific manufacturer or industry in general. I especially appreciate the patient stories and how they each arrived at their current devices.”

However, Ahn also noted, “when talking to my patients, I feel like having a personal discussion can lead to a better sense of their desires and preferences than a website that is just following an algorithm. … The challenge with any resource like this is fully appreciating the nuances of each individual and device since choosing a device or combination of devices can be more of an art than a science.”

Nonetheless, he said that the site may be “a good starting place to learn key concepts and product details” for newly diagnosed patients and nonspecialist clinicians.

Indeed, Hood said, “It’s not perfect. We will revise it as we get more data.” The team is currently following about 500 patients with type 1 and type 2 diabetes, most of them not in specialty care and not initially using advanced devices (pumps/CGMs) to see how they’re engaging with the site and whether they adopt new technologies. “We were pretty encouraged that, in the first month, people were reaching out to their providers to get a prescription. I think we’re generating the awareness that we thought we would.”

Unfortunately, the COVID-19 pandemic has had a negative impact. “We queried people, [and] about half had lost some portion of employment and with that was tied their access to benefits and health insurance. We saw a dip in how much people could actually access. We’ll report that when we have all the data.”

Pending funding, Hood said the team also hopes to create a clinician-facing version of the site. “We won’t forget about endocrinologists, but really we’re interested in making it a tool that primary care clinicians and even pharmacists can use to help with the engagement and uptake of diabetes devices because the rate of use of these diabetes devices in adults with type 1 who aren’t in specialty care is pretty low. So we’re trying to reach the groups that will have a bigger impact.”

In addition to his work on DiabetesWise, Hood is a consultant for Cecelia Health. Ahn is a consultant for Senseonics and Eli Lilly and on the speaker’s bureau for Lilly.

This article originally appeared on MDedge.com, part of the Medscape Professional Network.

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