Call to Action: Exodus of Diabetes Tech Support in New Mexico
Jessica Kirk MSN, RN, CPN, CDE
New Mexico is in a technology support crisis. In the last month, we have lost local representation from two pump companies, as our state was absorbed by larger service areas. This blog is a review of the technology patterns and resources in the last few years, as well as a call to action so that as a diabetes community we make sure to get involved, stay informed on diabetes technology, offer choices to our patients, and be the support that our patients need to have successful health outcome with their device choice.
The downfall of technology in our community began late 2011 when Animas decided to “gray out” the New Mexico territory, leaving our patients with two companies as their insulin pump choices. Animas still existed but provided no representation or support in the state, therefore, the consensus among providers and educators was that it was no longer a viable option for patients.
By the fall of 2012 we were introduced to a new insulin pump option for patients, the Tandem t:slim insulin pump, yet we still had no local representation. Therefore, the choice for patients was still limited.
Fast forward to the beginning of 2014 where we had local representation from four insulin pump companies: Insulet, Medtronic, Roche, and Tandem. We also had local representation for standalone Dexcom continuous glucose monitoring (CGM). Asante Snap was another insulin pump option on the market and Animas was still on the market as well, however, we did not have local representation for these two companies. 2014 was a great year for both local support in New Mexico and as a plethora of device choices for patients. Patients and providers had growing resources and tools at their hands!
Now we are in 2018. Much has changed since 2014 and not necessarily for the best for our community. The insulin pump device market lost three companies that are no longer in the pump business (Animas, Roche, Asante Snap). Recently Tandem and Insulet dissolved local New Mexico support and we are down to one pump company offering local support which is Medtronic. We also have local support for Dexcom and Abbott Freestyle Libre CGM. We should be flourishing in choices and local support but instead we are in a critical shortage of device representation.
Let this critical time in the New Mexico diabetes community serve as a call to action for CDEs in our community. The first question is why are companies leaving New Mexico? The second question is what can we do about it as CDEs? Our responsibility as educators is to ensure we are delivering quality, individualized patient care (including device choice), excellent training, education, follow-up, and management for our patients.
New Mexico continuing to lose local support falls on diabetes care teams in this state. It is our job and our responsibility to be experts in all device options for our patients and to offer these devices to our patients. Removing choice in diabetes care options is a disservice to our patients. Competition drives innovation. Without business, tech companies are left with one option: pull out of New Mexico leaving diabetes care teams and our patients with no support. Even in the absence of local support, our patients have a right to be given all of the device options on the market. It is ultimately up to the patient to make the informed decision on what therapy fits them best for the management of their diabetes. When a patient has a say in their care they are more successful! As CDEs it is our responsibility to inform the patient of their options and our job to be their support and educator for the device they choose. We must offer the patient a supportive environment for their choice.
The NCBDE (National Certifying Board of Diabetes Educators) describe a certified diabetes educator as, “a health professional who possesses comprehensive knowledge of and experience in diabetes prevention, prediabetes, and diabetes management. The CDE® educates, supports, and advocates for people affected by diabetes, addressing the stages of diabetes throughout the lifespan” (What is a Certified Diabetes Educator, 2018). Having comprehensive knowledge and experience in diabetes includes diabetes technology. The healthcare sphere is quickly changing and diabetes management now includes much more than lifestyle modification education. We must embrace our role in this quickly changing environment. It is our obligation to our patients to keep up with emerging therapies and educate ourselves. We must utilize our skills as diabetes experts in the ever-growing world of diabetes technology. Providers and patients rely on our expertise. We must remember that we as health professionals must not sit back and let technology bypass us. Technology is not going away, we must embrace it and use it to help our patients achieve positive diabetes health outcomes.
CALL TO ACTION: I challenge you to respond, start a discussion, share your thoughts, and most importantly get involved in this very serious matter that is occurring in our community. I ask you to be the comprehensive CDE and health professional that our community needs. If we expect local support from companies then we first must give them support in the community and offer their choice to our patients.
Here is a link to AADE’s Professional Practice Paper on Insulin Pump Therapy With and Without Sensor Integration. It was designed to help educators in their daily practice on working with individuals who want to initiate pump therapy. https://www.diabeteseducator.org/practice/educator-tools/ipt-resources
References
What is a Certified Diabetes Educator? (2018). Retrieved from https://www.ncbde.org/certification_info/what-is-a-cde/
AADE Practice Paper on Insulin Pump Therapy With and Without Sensor Integration. (2018). Retrieved from https://www.diabeteseducator.org/practice/educator-tools/ipt-resources
Device Company Contacts
Tandem:
Kim Stocking KStocking@tandemdiabetes.com
Megan Pinter MPinter@tandemdiabetes.com
Elizabeth Neely-Perkins eneelyperkins@tandemdiabetes.com
Omnipod:
Lindsay Brown lbrown@insulet.com
Dawn Cutler dcutler@insulet.com
Dexcom:
Jon Konvalinka jon.konvalinka@dexcom.com
Abbott:
Buford, Billy S bill.buford@abbott.com
Medtronic:
Filutze, Vickie vickie.j.filutze@medtronic.com
Buckner, Jennifer jennifer.l.buckner@medtronic.com