CCS Consumer Insights Report

CCS collaborated with an independent market research firm to survey more than 1,500 individuals living with diabetes to understand their CGM or Insulin Pump experience.

Misconceptions and Fragmentation: The State of Diabetes Care in America From GLP-1 Hype to Insufficient Education and Coaching, People Living with Diabetes Speak Out

Executive Summary Diabetes is more prevalent than ever among people from all backgrounds and circumstances. With the rising burdens of disease clashing with shrinking access to traditional healthcare resources, people with diabetes need innovative options for getting the proactive, holistic, person-centered care they need to thrive. To discover more about how people living with diabetes view their current care and what they want from the future, CCS collaborated with independent market research firm PureSpectrum to survey more than 1,500 individuals living with the condition who have been prescribed either a Continuous Glucose Monitor or Insulin Pump in the United States.

The findings revealed the following major themes:

GLP-1 therapy is highly sought after but may not be fully understood

People with diabetes tend to view GLP-1 weight loss drugs (GLP-1s), such as Ozempic, as an all-in-one solution for their metabolic health, with 57% of individuals stating that they think GLP-1 weight loss drugs alone may be a silver bullet for helping achieve their health goals. However, these results indicate people living with diabetes may not be fully aware of how these medications need to be integrated into a holistic care plan to best manage metabolic health. Half of people with diabetes only see their doctor three times a year or fewer, which may contribute to the fact that more than a third of respondents (36%) felt they did not have enough information when first diagnosed with their condition. People with diabetes largely feel that they aren’t getting the clinical support and engagement they know is necessary to improve their health. A majority (94%) believe that suppliers are a critical member of the care team and would like more active engagement with supply companies, including education and coaching. These findings indicate that survey respondents are eager to engage with different members of the care continuum — including medical suppliers — to get the support they need to stay healthy and successfully manage their chronic disease.

Lapses in clinician communication leave people with diabetes feeling isolated and unsure

Healthcare consumers living with diabetes are open to innovative relationships to augment care

Introduction

Diabetes is one of the most common chronic conditions among residents of the United States, with more than 38.4 million people living with the disease. A further 97.6 million — or close to a third of the population — meet the criteria for prediabetes, significantly raising their risks of becoming one of the 1.2 million new cases diagnosed every year. 1 A large proportion of these people come from communities facing a variety of socioeconomic challenges, including those with lower incomes, those in historically underserved racial and ethnic groups, and those living in remote rural regions or challenging inner-city environments.

14.5% of American Indian/ Alaska Native people, 12.1% of Black (non- Hispanic) people, and 11.7% of Hispanic people have diabetes 2

12.1% of people with incomes less than 100% of the federal poverty line have diabetes 2

12.1% of people with less than a high school education have diabetes 2

Meeting the scope and scale of the need for comprehensive diabetes care is daunting for a healthcare system facing financial and operational pressures from every angle. It’s also a relentless, complex challenge for the individuals and families directly affected by this life-altering chronic condition. But people with diabetes aren’t giving up hope — and they are certainly not giving up on their expectations for proactive, holistic, and personalized care. In fact, people with diabetes are more educated and empowered than ever, and they are increasingly demanding equitable, affordable access to the latest treatment options, whether in person or delivered by digitally enabled care teams that are deeply responsive to their unique needs. Meeting expectations and satisfying the needs of people with diabetes will require healthcare providers, health plans, suppliers, and other members of the care continuum to collaborate on shared solutions that prioritize preventive, person-centered strategies for educating and engaging individuals from all segments of society.

Hype over GLP-1s may be creating false hopes for people with diabetes

The majority of people with diabetes are now aware of GLP-1s, a class of medication indicated for blood sugar control that often produces notable weight loss as part of the process. More than half (57%) have discussed these medications with their doctor, and of that group, 71% have been prescribed or recommended a prescription.

79% have inquired about GLP-1s to help them manage their diabetes

53% are also interested in the weight loss possibilities

43% believe GLP-1s can assist with cardiovascular health risks

While the drugs have been shown to both improve glycemic and metabolic health as well as produce benefits of weight loss, they should be used in conjunction with lifestyle and long-term support to maximize and sustain results. However, a majority of respondents (57%) view these weight loss medications as the only thing they need to achieve their health goals. Respondents identifying as male (63%), those living in urban areas (67%), and those on commercial insurance (63%) were among the most likely to believe this statement. Those beliefs can be problematic for people living with diabetes, especially since multiple studies 3 have indicated that users can regain an average of two-thirds of the weight lost after discontinuing the medication and may also see their cardiovascular health markers revert back to their original state.

“GLP-1 drugs hold great potential to help tackle the obesity and diabetes epidemics plaguing Americans, and it’s critical that the healthcare ecosystem ensures access to these medications for those who need them most. However, they’re not a silver bullet. “To make the most of the benefits, we need to ensure they are fully integrated into holistic, personalized efforts to improve self- management and lifestyle decisions that can lead to sustainable weight loss and improved cardiovascular and metabolic health.” Dr. Angela Fitch Founder and Chief Medical Officer of knownwell, a weight-inclusive healthcare company that offers holistic, evidence-based care and a member of CCS’ Scientific Advisory Council

Lackluster communication and infrequent contact lead to avoidable gaps in care

Unfortunately, not every person receives the level of care they need to fully understand the role of GLP-1s in diabetes care or to receive the holistic support and guidance required to maximize the long-term impact of these medications. A worsening shortage of primary care providers and specialists is reducing the ability to receive diabetes care in many communities, while social determinants of health (SDOH) can compound challenges with access and affordability. As a result, a large proportion of people with diabetes only interact with their healthcare providers a few times a year. For many, this can leave worrying gaps in their ability to manage their health.

50% of people only see their doctor three times per year or fewer, including 3% who don’t see a doctor at all

67% report getting the majority of their diabetes-related care from a primary care provider

42% (nearly half) report that their doctor is their only point of contact for diabetes care

72% have additional comorbidities to manage, which can complicate their care

It’s no wonder that more than a third of participants feel underprepared to manage their diabetes when diagnosed or that 82% of people who have experienced a life-threatening, diabetes-related emergency feel the crisis could have been prevented with closer clinical management of their condition.

People with diabetes making less than $50,000 per year were the least likely to feel they had enough information about their condition when first diagnosed to manage it effectively. They were also the least likely to report receiving care from any organization other than their doctor.

“Primary care providers and diabetes-related specialists are doing a heroic job at managing the unprecedented demand for diabetes care, but they cannot — and should not — be responsible for all of it alone. We need additional experienced players on the field to amplify their efforts in creative, coordinated, and engaging ways that reach people where they are.”

Dr. Arti Masturzo Chief Medical Officer at CCS

People with diabetes are eager to change the equation and integrate new solutions into their daily routines, including trying the newest options in weight management and working closely with different stakeholders to supplement their diabetes knowledge and self-management skills. For example, nearly three-quarters (71%) believe any organization that touches their diabetes care should be engaging with them in between doctor visits to avoid dangerous gaps in care that can lead to potentially devastating complications such as lower extremity amputations, eye problems, or kidney disease.

Harnessing new opportunities to close care gaps and enhance engagement

Personalized education, continuous coaching, and effective engagement are the solutions to the significant problems facing people seeking high-quality diabetes care.

While many health plans, device manufacturers, and digital lifestyle programs have launched new initiatives in recent years, people with diabetes are increasingly discerning about who they work with.

They would prefer an entity that understands the lived experience of a person with diabetes and is a trusted point of contact that is already integrated into the diabetes care journey. For example, many respondents shared that medical suppliers are among their first choices for engaging with additional support and services. 94% are likely or very likely to consistently engage with their suppliers around diabetes self-management and care 89% of survey respondents believe diabetes suppliers truly understand what it’s like to live with diabetes 86% would trust diabetes suppliers with more of their health needs. Of that group:

66% would trust their supplier with health coaching

63% would trust their supplier with assistance with SDOH

54% would be interested in more educational support surrounding their condition

48% would trust their supplier to provide telehealth

“The survey found that people living with diabetes clearly are ready and willing to try new approaches to managing their health and preventing long-term complications. It’s time to take advantage of what the broader care continuum has to offer. Diabetes medical suppliers have the experience and the bandwidth to utilize their real time data and collaborate with peers to create a more cohesive care plan – and best of all, they already have the consumer trust and pre-existing relationships that are essential for seeing the positive results we are all striving for.”

Deb Galloway National Health Plan Executive and a member of CCS’ Scientific Advisory Council

Key takeaways

FOR PROVIDERS

With over half of people with diabetes (57%) hoping to rely on GLP-1s alone for improving their metabolic and cardiovascular health, primary care providers and specialists alike will need to focus on offering education on the role of these medications as part of a holistic care plan that includes sustainable lifestyle changes and personal medical devices to monitor key diabetes-related metrics. To supplement their bandwidth for these conversations and ensure that coaching occurs between infrequent office visits, providers can leverage trusted and established relationships with healthcare ecosystem partners — such as device suppliers — to provide education, support, and coaching.

FOR HEALTH PLANS

The large number of respondents who believe more healthcare stakeholders should be involved in their care (71%) confirms that health plans are on the right track with their strategy of partnering across the industry to expand their services and offerings. Integrating diabetes supply companies into these partnerships could be particularly effective for augmenting existing coaching and educational resources, especially with the significant number of participants (86%) who have expressed a preference for stronger relationships with these entities.

FOR CONSUMERS AND CAREGIVERS

Diabetes care is becoming more proactive, personalized, and comprehensive as new relationships are formed between healthcare stakeholders. However, consumers and caregivers can only maximize the benefits of these arrangements if they truly engage in the coaching and education offered by trusted sources. Being open to receiving support from entities like medical supply companies — and actively advocating for more of these options with providers and health plans — will be essential for architecting an innovative, accessible, and effective diabetes management ecosystem.

Conclusion In a rapidly evolving environment filled with significant operational pressures and clinical challenges, understanding what people with diabetes expect from their caregivers is the first step toward closing care gaps and extending holistic chronic condition management in an equitable and accessible manner. While emerging therapies like GLP-1s are a promising part of the solution, stakeholders will need to do more than rely on medications to stem the tide of diabetes across the United States. Traditional entities like health plans and providers will need to listen to what people with diabetes are asking for: a way to leverage their established relationships with suppliers and other members of the care team to enhance communication, receive coaching and advice, and stay on track with their health between visits. With consumer expectations rising alongside the number of diagnoses, numerous opportunities exist to infuse innovation into the diabetes management process and create a more holistic, proactive, and effective ecosystem for keeping communities healthier and more satisfied with their care.

Footnotes

1. https://diabetes.org/about-diabetes/statistics/about-diabetes 2. https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html 3. https://pubmed.ncbi.nlm.nih.gov/35441470/ https://jamanetwork.com/journals/jama/fullarticle/2812936

CCS is a leading chronic care management company, providing clinical solutions and home-delivered medical supplies for those living with chronic conditions, particularly diabetes. The company works specifically with health plans, providers, and employers to defragment the patient journey by combining all of the following into one seamless platform experience: medical devices, pharmaceuticals and clinical education, and coaching services. To holistically support individuals living with diabetes, CCS has advanced its AI-based machine learning and large language models to support the identification and timely engagement of high-risk members before serious adherence issues arise. CCS supports 180,000+ people living in the United States and delivers more than 1.2 million orders directly to their homes each year. After serving individuals for 30 years, CCS has the relationships, experience, and data in place to create a new era of home-based, proactive chronic care management. To learn more about CCS, please visit CCSMed.com.

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