As with most segments of HME today, there is much uncertainty surrounding the future of the diabetes market with competitive bidding around the corner and a push for less ex-pensive products.

Although providers will have to wait to see how this affects the market, they can be certain of one thing: Diabetes is growing at an alarming rate, and the need for diabetic supplies will only increase in the coming years.

The American Diabetes Association estimates that in the United States, 24 million people, or 8 percent of the population, have diabetes.

Every day, approximately 4,110 people are diagnosed with diabetes, the association says, warning that if present trends continue, one in three Americans born in 2000 will develop diabetes in their lifetime. The vast majority of these cases are type 2 diabetes, which is attributed to lifestyle. “Unfortunately, the diabetes market is growing because of the population's obesity, lack of exercise, eating habits and poor compliance,” says Frank Suess, president of West Palm Beach, Fla.-based Pharma Supply. “It's positive for the business, but not the population.”

And even though the medical community knows that proper testing and control of blood sugar can help patients prevent serious complications such as kidney disease or amputations, getting patients to comply with testing and treatment continues to be a challenge, says Cathy Pereira, manager of national accounts and government relations for Ft. Lauderdale, Fla.-based Home Diagnostics.

“Since diabetes develops over time, people don't feel the impact of the disease until complications such as blindness begin to occur, and oftentimes these complications cannot be reversed,” she says.

The good news is that home medical equipment providers can play an important role in helping to prevent these complications by educating patients on the disease and providing supplies that will help in- crease compliance.

“There's a big emphasis on preventative medicine,” says Edward Letko, managing director of New York-based US Diagnostics. “That's why I see this market growing, and I have a very hopeful future for this market.”

Easy Does It

For patients with diabetes, many advancements are making the disease more manageable and increasing patient compliance. For instance, blood glucose meters have become more reliable, faster, smaller, require less blood and are easier to use, says Pereira.

In fact, one of the biggest needs for diabetic patients are products that are easy to use and read, providers and manufacturers say.

“Manufacturers are building products that are more and more feature-rich, but are harder to understand at the patient level,” says Carolyn Hughes, director of sales and marketing for Scotts Valley, Calif.-based Palco Labs. “The majority of newly diagnosed diabetes patients are senior citizens. These people have trouble reading and understanding technically convoluted instructions that use terms they were never familiar with in the first place.”

Because many patients with diabetes have vision problems, large, easy-to-read display screens on glucometers are in high demand. “The [most frequent] request we've always gotten is for a larger display size,” says Raul Lopez, director of operations for Miami Lakes, Fla.-based provider BayShore Dura Medical. This is not only limited to a screen with giant letters but it could also be a meter that gives a nice-sized printout, he notes.

Talking meters that have come out in recent years also help those with poor vision by announcing the results, Suess says. In addition, the meters prompt patients on how to use the device, simplifying the process for them.

No-coding technology in blood glucose meters is another new innovation that simplifies the testing process for the patient by automatically detecting what type of testing strip is being used, Pereira says.

For people that require more intensive management, primarily those with type 1 diabetes, integrated therapies help patients more easily monitor and control their blood sugar, says Claudia Graham, vice president of global therapy access for Medtronic, Northridge, Calif.

One recent development is continuous glucose sensing combined with insulin pumps, she notes. These devices allow patients to monitor their blood sugar levels all day so they can see what happens between blood sticks, then adjust insulin levels as necessary. For example, the system will show the patient what their blood sugar levels were while they were asleep, something they could not otherwise test.

Less Pain, More Gain

Manufacturers also are spending more time and resources developing products that reduce pain for patients, says Palco's Hughes.

While most meters on the market today require smaller amounts of blood for testing — which makes it less painful to get the sample — the lancing devices themselves are being refined to minimize discomfort.

For lancing devices, the major factors that affect pain are the velocity and angle of the needle, how deep the needle goes into the skin and how clean the edges of the needle are, Hughes explains. If, for example, the needle is pitted, it's going to hurt more and create bruises, she says.

Although strides have been made in this area in recent years, it is important for providers to choose quality products because some of the lower-quality lancets and lancing devices on the market can inflict more pain than necessary, she says.

Alternate site testing is another new trend in lancing devices that reduces discomfort.