The Future of Diabetes Prevention and Management

Dennis P. Scanlon, PhD: I’m getting the signal that we need to wrap up this discussion. I have the feeling we could probably go on for another couple of hours, but what I want to do is give each of you an opportunity for some last closing thoughts. Dr Gabbay?

Robert Gabbay, MD, PhD, FACP: I think this has been a great discussion, and I do agree that we could talk for quite a long time, more. I think key themes are, now that we know that diabetes prevention works, how do we get it to the most people? And I think digital solutions is a large part of that—being able to scale. I think that although it’s not for everybody, having groups and the group dynamic can be very effective. And having diabetes educators at the forefront of that, I think, is key.

I really do believe that we’re at this point where continuous glucose monitoring (CGM) is going to be a lot more ubiquitous. It will be an effective tool to be able to manage patients. There will be patients, where just that added information is enough for them, but then there will be those that will need that as a tool, along with other data that can be leveraged from their smartphones. And so, I think technology is going to influence diabetes in a dramatic way in the next 2 or 3 years. And I think we’ll see a big, big change.

Mary Ann Hodorowicz, RDN, MBA, CDE: I’m going to make this really simple. I’m looking at the AAAs, like AAAs in car safety, right? You can belong to AAA. Affordable, accessible, appropriate. Those are the 3 key words here, whether it’s medication for people with diabetes, devices, CGM, insulin pumps, apps, or digital technology. It has to be affordable, easily accessible, and appropriate (meaning individualized for that patient). So, even though we have a bioidentical drug and the formulary requires “A,” “A” doesn’t work, necessarily, for a particular patient. And that’s where we get into the conundrum of affordability and population health. So, affordable, accessible, appropriate—I think that’s what the key is going to be for population health and better care of individual patients.

Dennis P. Scanlon, PhD: AAA—I like it. Dr Kaufman?

Neal Kaufman, MD: I think we’re at a very exciting time. A paradigm shift, I think, is happening. We’ve got consumerism, where individuals are taking more control and responsibility for many things (including their health and healthcare). We’ve got technology being able to deliver something in-the-moment. You have it in your pocket at all times. We’ve got the concept of population health, and the concept of value-based care coming into a healthcare system that wasn’t set up that way. So, all of those things are coming together. The patient is at the center, and we always think of what’s most important and what their needs are. We, as healthcare providers, payers, employers, and health systems, will make it so that we will help patients to have those outcomes that they need. With all of that coming together, we have the opportunity to make major changes at the population health level, as well as the personal health level.

Dennis P. Scanlon, PhD: And somehow, the payer has the last word here.

Neal Kaufman, MD: Always.

Kenneth Snow, MD, MBA: That would be appropriate. With all of this going on, it really drives the fact that, more than ever, we need adequate data to be able to make decisions on all these opportunities that are now available. Which ones are actually of benefit for patients? How do we improve the lives of our patients? And for outcomes, how can we make that data available for physicians and other healthcare providers, so that right decisions can be made?

Dennis P. Scanlon, PhD: I want to thank you all for joining me in this discussion. On behalf of our panel, we thank you for joining us for this AJMC^® Peer Exchange^®.