Choice.

I was about to settle in front of the TV on Thursday night (which I’ve been doing a lot of lately hence the blog break), when Twitter exploded with the news of Animas discontinuing the sale of insulin pumps in the US and Canada. Customers with in-warranty pumps will be referred to Medtronic for consumables, before eventually having to choose a different brand of pump.

I knew that parent company Johnson and Johnson had been evaluating their insulin pump business for some time. I also knew that there weren’t really any exciting enhancements in the pipeline for the Animas Vibe, compared to some of the other insulin pump players in the market. Yet the news of Animas shutting up shop was still a real shock to the system.

So what does this mean for Australia? For the time being it’s business as normal, with the delivery of insulin pumps and consumables unaffected. AMSL Diabetes, distributor of the Animas Vibe insulin pump here in Australia, issued a brief statement via Facebook on Friday.

“Animas Corporation, a division of Johnson & Johnson, has announced overnight their plans to discontinue the manufacture and sale of the Animas Vibe insulin pump and exit out of the insulin pump business in the USA and Canada.

We feel that it is important that you understand that this does not affect your supply of consumables, technical support or after sales service. AMSL Diabetes is a distributor for Animas and we are continuing business as usual.”

The press release issued, however, indicates Johnson and Johnson’s intention to eventually exit the insulin pump business globally subject to consultation and timing.

When Animas does exit the market here in Australia, that leaves us with Cellnovo, Medtronic and Roche. Roche also ceased the sale of Accu Chek insulin pumps in the US earlier this year, triggering the following response from one of my contacts at Roche Diabetes Care Australia:

“I was shocked to see Animas’ announcement yesterday. Anything that reduces choice in insulin pump therapy for people is never positive.

Looking at peoples responses on social media I see that a lot of people think Medtronic and, to a lesser extent, Cellnovo are the only options left on the Australian market if Animas should ever exit here. There also seems to be a perception that, because It is no longer available in the US, Accu-Chek Combo been withdrawn globally. This perception is not accurate.

Accu-Chek Combo is manufactured in Europe and continues to be available for people with diabetes in many countries including Australia. Please be assured that Roche Diabetes Care is here to serve people needing insulin pump therapy both now and longer term both with our current tried and trusted Combo and with our exciting and innovative pipeline of products.”

While Animas have signalled their intent to (eventually) exit the insulin pump market globally, Roche have not signalled any intent of exit outside of the US. I hope, for the sake of choice, that they don’t.

I can’t say that I’ve ever felt super excited about my pump. I mean, it does it’s job. Quite nicely, I might add. However it wasn’t until I was wondering around the exhibition hall at ADS-ADEA last month that I began to appreciate why I use what I use. Looking at some of the other options on show that weren’t for me, really made me appreciate having a choice. 

I really, really don’t like seeing Medtronic eating up the market in the US, and I really do hope that the affected Animas and Roche customers will choose a replacement pump option that best suits their needs. One brand of pump should never be the only option for people with diabetes.

With Animas on the way out, Tandem’s t-slim Dexcom integrated touch screen pump would surely be a natural successor to the Vibe for Aussie distributor AMSL diabetes.

Let’s make it happen sometime before my current warranty expires in 2020…

(Choice!)

FreeStyle Libre: Questions and Answers from #DX2Melbourne

I’m back home today after a whirlwind two days spent at Abbott’s Diabetes Exchange event in Melbourne. The event was filled with such insightful and stimulating conversation, that my mind was still buzzing at 11.20pm last night when I finally crawled into bed at home.

Abbott covered my travel expenses from Perth to be there, but they did not pay for my opinions here or anywhere else. I am really grateful that Abbott are continuing these consumer conversations after last year’s DX2Sydney event, when they clearly didn’t need to. Perhaps my views are biased because I was a part of these conversations, but I am really enthusiastic about the FreeStyle Libre. My experience with it has been largely positive, and it continues to be a part time member of my diabetes toolbox.

It was fantastic to hear the Abbott team acknowledge and even encourage those little tips and tricks that people out there are already doing, even if they couldn’t technically endorse them. Like letting the sensor sit for a day after application before starting it up. Or the Rockadex patches and other adhesives that people are buying from small businesses online. I loved that they were somewhat aware of what people are doing out there in the real world.

Through my blog, through e-mails and through my circles here in Perth, I have received a great deal of feedback on the FreeStyle Libre. People either love it or hate it. Today, I thought i’d start by sharing some of the feedback I received from Abbott over the past two days. While I’m doing my best to relay what I heard and talked about, I can’t guarantee that these words are 100% accurate.

External adhesives.

Hands up if you’ve had a sensor fall off? During the days of warm weather, t-shirts and outdoor activities, that sensor is simply not sticky enough for me. Jessica Shi, Abbott’s QA and RA Manager, tells me that any external adhesive needs to be of medical grade in order for it to be officially endorsed.

Inaccuracy of the sensor when levels are high.

Ever had the Libre tell you that your blood sugar was 18mmol, while a fingerstick gave you a reading of 13mmol? There was definitely a conscensus among the room that some of us had difficulty trusting the sensor at times.

Bruce Passingham, Abbott’s Scientific Affairs Manager, told us he’s interested in hearing about each individual’s circumstances. There might be other conditions or medications that could be affecting results. He also touched on hydration as well, which is a no brainer for me when my levels are a little stubborn.

The biggest takeaway here is to make sure you call customer service. I am so surprised at the number of people who tell me that they haven’t bothered to. All of my issues have been resolved through customer service, and a few bloggers in the room praised the express shipping of replacement sensors.

When will we see the Libre funded by the Australian government?

Earlier this year, the Department of Health was seeking submissions from consumers to potentially get the FreeStyle Libre funded through the National Diabetes Services Scheme. It’s currently a bit of a watch this space…

Are there any plans to add alarms to alert users of dropping blood glucose levels?

In reference to the likes of Dexcom and Medtronic, Abbott have reminded us that their product is not a Continuous Glucose Monitor. It is a replacement for finger sticks.

How many people will an automated insulin delivery system actually reach?

Recent headlines out of the US have surrounded the partnership between Abbott and Bigfoot Biomedical, makers of an automated insulin delivery system. “Next generation” FreeStyle Libre sensors will supply glucose data, which Bigfoot’s system will use to automatically deliver insulin and regulate glucose levels.

My question to the team was around how many people the end product will actually reach. I was told that this next-gen Libre sensor can also be paired with a Bluetooth enabled insulin pen, which will provide smart dosing advice for those on Multiple Daily Injections. Abbott expect that their product will reach a greater number of people through the options for people with type 1 on Multiple Daily Injections, and those with type 2 diabetes.

Obviously, don’t expect to see anything like this to hit Australian shores for a long, long time…

This doesn’t even begin to scratch the surface of a very stimulating two days of diabetes conversation, and I’ll have more to follow in the coming days. You can also keep an eye on these bloggers who were in attendance, for their perspectives on the event.

Further disclosures: Abbott supplied me with a new FreeStyle Libre reader, two sensors, and a lovely goodie bag with some pens, paper and a few other bits of branded stationery. I was put up in a room at the Blackman Hotel in Melbourne for one night. I was also fed and watered across the duration of the event.

Feeding the D-Tech Frenzy

Growing up, many of the appliances in our house had longevity. When an item malfunctioned for the first time, there was a pretty good chance that it could be fixed. When the VCR began spitting tape out of our videos, the handyman came out and put some new parts into it. When our second hand Windows 98 computer got stuck in Safe Mode, my Aunty’s computer guy came over and fixed the belt inside the box.

When a beloved household item came the the end of it’s life, I watched Mum and Dad mourn over how well it had served them and how hard it would be to replace. As those items were eventually replaced, we noticed that they all had one thing in common. They never lasted nearly as long as their predecessors. I can’t begin to count how many kettles, washing machines, printers, televisions and computers we’ve gone through since the originals packed up.

We live in a very consumeristic society. Nothing is designed to last anymore. Today’s innovations will likely become enhanced or obsolete in a few year’s time, and the attitude seems to be to throw it away. Everything has to be brand new. Sure, things are far cheaper than they once were, but we probably spend just as much on replacing defunct items.  It’s hard not to feel that we as consumers, have fed this frenzy to a degree.

It’s hard not to feel that diabetes technology is heading this way, as well.

No sooner than the Dexcom G5 Continuous Glucose Monitor was released, I was already reading about plans for a Dexcom G6. No sooner than the Medtronic MiniMed 640G insulin pump had begun rolling out, I was already hearing about plans for the hybrid closed loop 670G. Tandem recently rolled out an upgrade of their t-slim insulin pump. Bigfoot Biomedical, which have a closed loop system in development, recently announced a partnership with Abbott that will utilise data from a “next gen” FreeStyle Libre system. We even have confirmation of Apple entering the market. 

Technology is the hot topic of the town in the diabetes community – and rightfully so. Who doesn’t get excited about all of the advancements in the pipeline that will improve the treatment of diabetes and the quality of our lives? Who wouldn’t get excited about a shiny new device, just like we do with our smartphones and tablets and cars? Diabetes is monotonous, so I’ll certainly appreciate anything that makes it a little more exciting.

Call me a hypocrite writing this, because I am an enthused user of diabetes technology. I am a privileged person. I get excited over a shiny new gadget, and I am grateful that the tech is an option for me.

But I kind of feel that we, as consumers, have fed this technology-focussed frenzy to a degree.

When looking at the bigger picture, it doesn’t feel like an actual cure for type 1 diabetes is even on the horizon. It’s beginning to feel like these advancements are no longer a solution, but rather a pathway to the next enhancement or product.

If my social media feeds are anything to go by, people are crying out over the skyrocketing prices of insulin, and access to basic healthcare. Then I look at all of these advancements, and I wonder just how many people the end product will actually reach.

Dad showed me an article in the paper yesterday, of promising research on insulin producing cells, or something like it. I dismissed it instantly, citing that I’d likely never hear of it again as I have with many other developments that qualify closer to a “cure” status.

I wonder why we aren’t questioning companies on the feasibility of these advancements. I wonder why we aren’t holding companies to greater accountability for their actions. I wonder if we are throwing enough support behind research into potential diabetes cures. I wonder if we, as the consumers, are taking full advantage of our ability to drive the agenda.

I wonder if we have lost sight of curing diabetes.