Helpful findings

• When prescribing a blood glucose meter, doctors will discuss the price with their patients, instruct the patients regarding meal schedule, the test schedule and the target levels.
• According to Vox, doctors learn from colleagues, specialty society meetings and medical device companies about new medical procedures.
• In Canada, doctors are often busy so they don't have time to learn about new medical products themselves, which is why they rely on pharmaceutical representatives.
• The recently introduced Physician Payments Sunshine Act requires medical device and equipment companies to report physician compensations, which improves financial connection transparency.
• During the diabetes testing process, the doctor will perform one of the following three tests: [1] the fasting glucose test, [2] the oral glucose tolerance, or [3] the A1c blood test.

Research strategy

Key findings

•  According to our findings, diabetes patients turn to discussion forums to explore options for blood glucose meters, as they value the experience of other patients.
• A patient at the TU Diabetes patient discussion forum references a study where she found information on products that prompted her to switch to Freestyle Lite after trying Verio and Dexcom products because of Feestyle Lite's accuracy.
• According to a review by a Canadian mother and her son diagnosed with Type 1 diabetes, they switched to a continuous glucose monitor because they were getting up every three hours during the night to check his blood sugar levels, and the new monitor does it automatically, alerting them with an alarm if there is a problem.
•  Accuracy appears to be a motivating factor for patients switching brands, according to some patient commentary, such as a slightly dated (July 2017) discussion at TU Diabetes. 
•  Ease of use and convenience are factors that may sway some diabetes patients in Canada to switch from one brand to another, such as seniors.
• Some patients state that challenges in keeping them on the continuous glucose monitor because their insurance no longer covers the device, which costs roughly $4,000 per year is one of the barriers to acquiring a blood glucose meter
• According to a 2018 CARP (Canadian Association for Retired Persons) member survey, which noted "unaffordability of test strips and the pain of testing as two of the major barriers to regular glucose monitoring."

RESEARCH STRATEGY

WHERE AND HOW EXISTING PATIENTS LEARN ABOUT PRODUCTS

•  Patient discussion forums appear to be one place patients turn to explore options for blood glucose meters, as they value the experience of other patients.
• A patient at the TU Diabetes patient discussion forum references a study where she got information on products that prompted her to switch to Freestyle Lite after trying Verio and Dexcom products because of its accuracy.
• While not a Canadian forum, the Discussions section of the American Diabetes Association also suggests that patients rely on each other for information on glucose monitoring products to purchase.

MOTIVATIONS

• The severity of the patient's diabetes may have an effect on which product they choose.
• A Canadian mother and her son, who has Type 1 diabetes, switched to a continuous glucose monitor because they were getting up every three hours during the night to check his blood sugar levels, and the new monitor does it automatically, alerting them with an alarm if there is a problem.
•  Accuracy appears to be a motivating factor for patients switching brands, according to some patient commentary, such as a slightly dated (July 2017) discussion at TU Diabetes.
•  Ease of use and convenience are factors that may sway some diabetes patients in Canada to switch from one brand to another, such as seniors.
• Charlene Lavergne, a Canadian senior who has lived with diabetes for 40 years, switched to the FreeStyle Libre because of its convenience and lack of pain.

BARRIERS

• The aforementioned Canadian mother and son are facing challenges in keeping him on the continuous glucose monitor because her insurance no longer covers the device, which costs roughly $4,000 per year.
• Pain may be another factor that influences a patient's decision to use one glucose monitoring product over another, according to a 2018 CARP (Canadian Association for Retired Persons) member survey, which noted "unaffordability of test strips and the pain of testing as two of the major barriers to regular glucose monitoring."

RESEARCH STRATEGY

FLASH GLUCOSE MONITORING FEATURE

•  Flash glucose monitoring feature entails tracking historical glucose readings. Flash glucose monitoring has an exceptional capability to measure glucose after every defined moment in interstitial fluid through a tiny filament that is put under the skin and positioned by a small adhesive pad. Glucose levels are displayed on demand when the sensor is waved over, or "flashed", with a hand-held scanner.
• Glucose level data, in this monitoring technology, is measured, captured, and stored automatically and continuously. This feature is very important for both patients and their doctors, so that they can see patterns over time and make adjustments to lifestyle, diet or treatment, when needed.
• The FreeStyle Libre system was the first-ever flash glucose monitoring system that was created by Abbott and authorized for sale by Health Canada in 2017. This system covered by a majority of private health insurance companies.
• Users of the flash glucose monitoring system can also share their comprehensive readings digitally with their doctors and use the information to better manage their lifestyles. 

VOICE FUNCTIONS — TALKING FEATURE

• The extra large screen and talking functions of the blood glucose meter make it easy for users to know their readings.
• Patients have reviewed and recommended that the voice functions, especially the talking feature, is useful and important for older patients with eyesight problems. This feature will help them know their readings easily. Also, this talking meter is more reliable.

ALERT FEATURE- CONTINUOUS GLUCOSE MONITORING (CGM) DEVICES

• CGM measures glucose levels in the fluid surrounding the cells (interstitial fluid).
• These glucose readings are sent from the “transmitter” to a “receiver” which displays the current glucose level, as well as the glucose trends so that you can take action as needed.
• The Alert feature of CGMs will notify the patients when their glucose is low and when their glucose is above the target range (which allows the patient to take corrective action earlier). In addition, Rate of Change Alerts notify the patient if their blood sugar is dropping or rising quickly. Alerts offer safety and peace of mind for persons living with diabetes and their families.

PAIN AND DISCOMFORT MINIMIZATION FEATURE

• Flash and CGM Glucose monitoring system measure glucose levels of the intestinal fluid with the help of sensors that replace of the pokes demanded by the more conventional fingerstick blood glucose meter.
• Based on research, a fear of pain and needles, and the inconvenience of the self-monitoring process are obstacles in good blood glucose control. The Flash and CGM glucose monitoring systems addresses these obstacles.
• For patients who prioritize reduction in finger pricks, they would focus on a system such as Dexcom that is approved to replace fingerstick glucose checks for treating lows and correcting highs.
• This is very helpful for the patients as the demands of frequent BG checks can wear them out.
• This feature is important for both patients and doctor as once the doctor ascertains that this is a pain point for the patient in monitoring their blood glucose, they would recommend this option for the patients, resulting in better care and treatment.
•  Danny, a Canadian senior who has lived with diabetes for 6 years, switched to the FreeStyle Libre as that provided an alternate option to measure glucose levels without the pain. He did this on the recommendation of his endocrinologist.

REMOTE VIEWING OF GLUCOSE DATA

• The feature of remote viewing enables the patient to remotely share their glucose readings in real-time with other people with a spouse or family member who is outside of the communication range of the system, or even in a different location.
• This is a compulsory feature for parents of children with Type 1 as the kids are not able to reliably recognize their low sugars and take action on them. Parents can remotely view their daughter’s glucose data while she’s in the middle of a hockey game, or their son’s data while he’s over a friend’s house.
• This feature is important for both the patient and the doctor. With this feature, the doctor can remotely view the patient's data in real-time and timely intervene for any changes. This feature will help kids who are diabetic to readily share their data with parents/family members.

RESEARCH STRATEGY