Metrics that Matter to Patients

Kim Kelly, PharmD, BCPS, FCCP, CDTC, CPC, CEC
August 21 , 2018 03:01 AM

Does Time-in-Range Matter? Perspectives from People with Diabetes on the Success of Current Therapies and the Drivers of Improved Outcomes

Runge AS, et al. Clinical Diabetes 2017;36(2);112

What were the findings (excepted from the Abstract & Article)?

A1C is currently the metric of choice for assessing the efficacy of new diabetes products, guiding health care providers’ choice of medications, and supporting regulatory approval and reimbursement policies. Although A1C has proven useful for predicting the long-term risk of complications from hyperglycemia, it cannot assess a therapy’s ability to deliver important short-term outcomes that affect patients’ day-to-day experiences. The authors designed and conducted this study through an online survey. Participants were members of the dQ&A (San Francisco, Calif.) Patient Panel, a proprietary research panel of people with type 1 or type 2 diabetes. Panel members are invited to respond to quarterly market research tracking surveys and occasional one-time or single-topic surveys. After assessing patient perspectives on the success of current diabetes therapies and the factors that have the greatest impact on daily life, they show that time-in-range is a crucial outcome for people with diabetes and that current therapies are falling short on this metric. They also show that patients feel significant stress and worry, and they believe they are falling short in diet, exercise, and weight maintenance. In addition, they believe diet and exercise and in-range blood glucose are the biggest drivers of improved diabetes management and mindset. Together, these findings support the need for therapies that improve outcomes including and beyond A1C.

Why is this important?

The primary objective of this study was to evaluate patient perspectives on the success of current diabetes therapies, the factors having the greatest impact on daily life, and the drivers of improved diabetes management and mindset. Results from the survey collectively suggest the need for diabetes treatment development and regulation that more expansively evaluate what matters to patients and that better align outcomes with patient challenges and priorities. These results underscore the need to consider the full spectrum of patients’ daily glycemia rather than simply the 3-month average, as measured by A1C. Of outcomes that can be used to assess diabetes therapies, time-in-range was the highest-ranking one believed to have a “big impact” on daily life by all groups (57% of Type 1 patients, 45% of Type 2 taking insulin, and 41% of Type 2 not taking insulin), second only to food choices in all instances. Have you been using time-in-range to assess your patients? With new CGM technologies available it may make sense to evaluated how patients feel and connect it with their time-in-range data.

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