As pharma marketers continue to expand their footprint in the point of care (POC) channel – a channel where spending is growing at eight-times the rate of television spending – they are realizing not only its potential but the importance of ensuring their messaging mirrors their brand essentials as much as possible. For pharmaceutical brands, the moment of truth happens in the exam room, the “magic moment” when the physician is discussing treatment options with the patient and the prescription is being written.

We encourage pharma partners to view point-of-care as an extension of, not adjunct to, their overall marketing campaign. That’s the mindset needed to unlock the full potential of a pharma brand in the POC channel – and this channel offers lots of opportunities to do just that. First, though, consider POC’s uniqueness and develop strategies and tactics accordingly. Tried and true branding and marketing philosophies are a good place to start.

Consider the setting

We are not the same person when we are watching a television commercial in our basement during a football game as we are sitting in a waiting room in a doctor’s office or wearing a gown in the exam room. We are no longer a consumer of mass media but rather a patient thinking about our personal health. Your creative should capitalize on this environment and mindset.

Let’s look at Crohn’s disease as an example. According to the Crohn’s & Colitis Foundation of America, approximately 780,000 Americans have Crohn’s disease. TV as a medium for advertising Crohn’s treatments has become quite prevalent as of late. While this raises awareness of the condition, or can generate website traffic, given the millions of people watching television, it can be like finding a needle in haystack to reach the target patient suffering from Crohn’s disease. However, consider if that campaign had a strong pull through in physicians’ offices, and not just any physician, but IBD gastroenterologists. Brands could go much deeper with education and dialogue starters to address flare ups, treatments, compliance, etc. This setting encourages meaningful conversations between patients and physicians, and results in a direct correlation to an increase in new prescriptions.

Innovate

As marketers, we strive for a multi-channel marketing plan in which both print and digital play a vital role. The same holds true in the doctor’s office. While the educational brochure is and will remain an influential POC execution, brands have the opportunity to innovate and engage tech-savvy patients who expect innovation in the healthcare arena.

Take the use of interactive 3D anatomical models as an example. With print and TV advertising, patients are pushed a message and but aren’t really interacting with the brand. PatientPoint technology in the exam room is designed to foster interaction with touchscreens and explorations with 3D models that show inside of their body. This accessible interactive tool, also available on mobile for physicians, is unlike anything that has been offered before. Brands can extend their creative to sponsor this content, building innovative brand associations not possible through pushed mass market content.

Be helpful

Patients crave information like never before. 80% of internet users look for health information online, making medical inquiries the third most popular web-based pursuit, following only email and search engine use. Physicians, too, crave information; indeed, it is integral to providing up-to-date meaningful information. They require an endless stream of information to keep up on the latest research and treatment options. In POC, we have the ability to target and validate helpfulness and credibility, which is important since trusting content found on the web is often challenging.

Pharma can be helpful by strengthening the patient-provider relationship through its sponsorship of tools and information that help make complex medical issues easier to explain and understand (especially now that you can’t sponsor pens or hand sanitizers!).

Remember your message

Your brand need not be left at the waiting or exam room door. Pulling through your brand message to a POC execution does not need to be challenging. Assessing creative thoughtfully will help determine if it is a direct pull through or if custom content should be created. We guide our pharma partners through those decisions, helping them see how to create advertising that positions their brands while adhering to established branding guidelines. Bringing that same expertise to the POC channel will ensure the right brand message resonates with patients and physicians.

Be creative

Like other health care touchpoints, POC offers a wide variety of opportunities for creative execution. The National Health Information Awards (NHIA) program, for example, honors leading organizations in the consumer health field. The NHIA program – the most comprehensive competition of its kind – sets the standard for the industry’s educational collateral. Honorees include prestigious organizations like the American Heart Association, Mayo Clinic, March of Dimes, and Parents magazine. At PatientPoint, we’re proud that, over the past 12 years, our point-of-care programs have been recognized by the NHIA with a total of 431 awards, a great honor that brings credibility for our sponsor brands to medical professionals. Your brand can win awards here, too.

Pharma marketers who apply their marketing prowess to POC will reap the full rewards of a channel that offers unparalleled opportunities for deepening relationships with patients and providers, and for delivering the right message at the right time. The best POC program is seamless with TV, print, sponsorships, detailing, and other pharma marketing tools, and takes into account the touchpoint’s unique needs and opportunities.

The Point of Care Communications Council (POC3), an industry association dedicated to advocating for the effective use of the point of care (POC) channel to advance health and healthcare outcomes, recently held its annual meeting in New York to discuss how to elevate healthcare at the POC. Whether we come from clinical, marketing, patient education, or analytics disciplines, we all have the same concern: How to better engage patients using their physical presence at the POC as a core part of their patient journey. Healthcare providers and marketers must “compete” for patients’ attention as digital technology envelops their lives. And, while pharma in general has been conservative about employing new innovations, we understand the need to be part of this (r)evolution and are actively working to adopt new technologies in order to better engage patients both at the POC as well as at other points across their patient journey.

Marketers can target patients along the patient journey, from pre-visit symptom inquiry to post-visit condition research, including those moments of truth in the physician’s office, engaging with them at each critical decision point. POC marketers are leveraging digital technologies to match the individual preferences of their schedules, lifestyles, and preferences for consuming information.

2016 saw a breakthrough of healthcare-compliant technologies. Geo-fencing, with ads and patient education being sent to mobile devices within a highly defined geographic area in and around physician offices, gained traction. Studies show that 50% of patients in the physician’s waiting room use mobile devices[1] and 18% are accessing healthcare information[1], underscoring the value of this immersive moment. Highly specific condition- and/or specialty-related information is often targeted within the office, while geo-fences are extended to broader geographic areas for the delivery of information around conditions affecting larger patient populations.

Targeting messages to desktop and mobile devices complements marketing at the POC by enabling more touchpoints along the patient journey. In particular, contextual, page-level programmatic targeting enables marketers to provide patients with educational content or advertising that is contextually relevant, regardless of whether the information appears on a dedicated health website or via another premium site, including online newspapers and other information sources. This contextual marketing enables marketers to expand their reach and provide patients valuable information whether the patient is in the initial stages of researching symptoms or is educating themselves about a specific condition post-diagnosis.

As we move into 2017, we can expect that healthcare marketers will be designing marketing plans which employ a more comprehensive multichannel approach – evolving from planning models that can often be outdated. This includes relevant and engaging waiting room television programming, interactive exam room tablets, and mobile marketing which combine to mobilize the patient from disease awareness to treatment. Surveys have shown that patients wish to manage their healthcare online[2], enabling the opportunity to engage them more often in-between physician visits. The trend spans all age groups, including 53% of seniors, age 65 or older, who note that they use health technology “at least a few times a month” to manage their health[3].

We anticipate that telehealth will gain prominence as a POC channel. Telehealth is currently poised to realize exponential growth, with a projected jump from 800,000 virtual consults in 2015 to 7 million by 2018[4], reaching a market size of $38B[5]. Supported by changes in legislation and Medicare billing, physicians will use telehealth platforms to see more patients. At the same time, patients appear ready for virtual consults, with recent data showing 80% of patients are open to telemedicine[6]. Marketers will leverage virtual waiting rooms and virtual exam rooms to enrich the patient experience with patient education, brand information and other health-related content.

Innovative virtual reality (VR) applications will continue to develop to both promote patient education and as a clinical tool. While VR is in its initial stage, data show 96% of physicians expressing an opinion that VR engagement can be more valuable than websites and other clinical tools. Other experts forecast VR to be a $150 billion industry by 2020[7]. The VR opportunity to explore patient and provider education through richly immersive therapeutic and behavioral visualizations and enhanced anatomical modeling further supports the trend toward increasingly meaningful and deeply relevant education for patients.

Overall,the POC segment continues to grow at a faster pace than overall DTC spending[8], which itself is firmly back on the rise supporting a steady flow of major drug introductions[9]. The customizable power of POC advertising addresses the trend toward personalized medicine, resulting in more customized communications to targeted patient populations. At the same time, more patients are engaging in healthcare due to an increased prevalence of chronic conditions, an aging population, and greater access to care, placing health and wellness at the top of mind.

As it continues to evolve and expand, the POC channel will remain a highly effective and measurable tool for pharma brand marketers. The return on marketing investment at the POC, whether measuring new prescriptions, conversions, or adherence rates, continues to perform exceptionally well relative to other forms of promotion[9] and with digital innovation, the ability to impact the broader patient journey is greater than ever.

Editor’s Note: On Nov. 16, 2016, ContextMedia, the leading healthcare decision platform, announced that it will acquire AccentHealth, which provides best-in-class patient education at the point of care. Click here to read the full news release.

References

1 Accent Health Consumer Connections Panel, 2013

2 https://newsroom.accenture.com/industries/health-public-service/most-patients-want-to-self-manage-healthcare-online-accenture-survey-finds.htm

3 https://www.accenture.com/t20160829T222305__w__/us-en/_acnmedia/PDF-29/Accenture-Silver-Surfers-Continue-to-Make-Waves.pdf

4 http://blog.evisit.com/36-telemedicine-statistics-know

5 http://www.theihcc.com/en/communities/health_access_alternatives/2015-another-unstoppable-year-for-telehealth_i7gjbohl.html

6 http://www.healthitoutcomes.com/doc/of-patients-open-to-telemedicine-0001

7 http://www.aha.org/research/reports/tw/15jan-tw-telehealth.pdf

8 Digi-Capital Forecast, 2015, Confideo Labs Survey 2014 (AH presentation)

9 http://www.zsassociates.com/~/media/files/publications/public/zs-point-of-care-research-executive-summary.ashx

10 http://www.fiercepharma.com/dtc-advertising/pharma-s-dtc-ad-spending-soars-past-5b-2015

The patient as the consumer. You’ve heard this one before. Additionally, you’ve probably read about how you, as a healthcare marketer, need to view patients through that lens from now on. But how do you actually turn that insight into action? Before answering that question, we should be asking ourselves how accurate the “consumer” label is.

Why consumer?

Tremendous improvements are changing the healthcare landscape to make it more consumer-driven. Since 1990, average life expectancy in this country has increased from 71.8 to 76.4 years for men, and 77.8 to 81.2 years for women. Meanwhile, the uninsured rate in that same period has dropped from 13.9% to 9.1%. The number of physician visits is increasing at a rate faster than the increase in the population of the US.

As a result, patients are spending more than ever, which is one of the primary reasons we, as healthcare marketers, now call them “consumers.” This trend will likely continue: health spending in 1990 accounted for 12.2% of our GDP; today, it accounts for 17.5% of our GDP, and this is expected to grow to 34% by 2040.

Is the label ‘consumer’ accurate?

The physician/patient relationship has also changed dramatically, as has the manner in which patients seek information. Calling them “consumers” makes marketers feel they have a handle on delivering this information. However, patients now seek to share in the decision-making around treatment options, and are no longer just taking orders in the exam room. We cannot underestimate the importance of the physician in these decisions. Removing “patient” from our language can do that, because it takes the physician out of the equation.

Additionally, the “consumer” label oversimplifies the complexity of decision-making for patients, and the extent to which they seek input. Patients want to know more than they find in the retail emails they receive. Today, 72% of patients seek information about their healthcare online, 60% turn to friends and family, and 24% get support from others with the same condition. Yes, patients want to make informed decisions, but demand more than a web search or advertising message.

In the past, I’ve promoted the use of the term “Well-Connected Doctor.” As a counterpoint, I’d like to propose that we also adopt the term “Engaged Patient”. Health decisions require more input than almost any other decision we make, and we should treat the individuals who we hope to reach with respect.

How to reach the ‘Engaged Patient’

Back to the original questions: How do we as healthcare marketers, best approach the needs of the Engaged Patient?

1. Offer Authentic Value to the Patient. The Engaged Patient reads about conditions, seeks communities for support, and has conversations at the dinner table about their health. More than any other group, the Engaged Patient doesn’t want to be sold to. To deliver on the unprecedented desire to present the Engaged Patient with reliable information, we need to accept that there is no easy route to build this trust, and find creative ways to include them in all the relevant inputs.
2. Leverage Technology. It is our job to understand the complexity with which they seek information, and present it in a meaningful way to patients and physicians. From point-of-care platforms that place us in the exam room during the consultation to online support groups to shared experiences, it is critical to align on messaging across channels, and generate relevant content on a consistent basis.
3. Address the Rising Health Care Costs by Investing in Outcomes. As marketers, reaching the Engaged Patient is different from reaching other consumers, because patients are subject to a system that does not make it easy to understand pricing, or why costs continue to rise. For healthcare marketers, by identifying health outcomes as a KPI, this means a greater life-time value for each of the patients we can impact.

Republished with permission. Click here to read the original posting on MediaPost.

Editor’s Note: On Nov. 16, 2016, ContextMedia, the leading healthcare decision platform, announced that it will acquire AccentHealth, which provides best-in-class patient education at the point of care. Click here to read the full news release.

In the past year, news stories have featured multiple outsider challenges to “the Establishment.” Traditional authority faces threats of being upended. Moreover, the challengers seem to have emerged with tsunami-like force, seemingly out of nowhere. Technology makes it easier for like-minded individuals to find each other and collectively demand changes that may shake up the status quo. Since branding uses messaging to reinforce an organization’s or product’s “reason for being,” it is worth looking at what potential shake-ups could mean for the industry.

This is particularly important for advertising agencies serving healthcare and pharma, sectors that have recently faced their own heightened public scrutiny. Turing Pharmaceuticals’ Martin Shkreli became the poster boy for corporate greed. Mylan’s EpiPen price increase owned the headlines this summer, and renewed focus on perception of co-pay programs across patients, payers, and physicians. The US Treasury Department blocked Pfizer’s plans to buy Allergan, an acquisition that would have drastically reduced Pfizer’s American tax exposure. And despite the fact that Bill Gates calls the US’s drug-pricing system “better than most,” there is a growing narrative that suggests companies are putting their money into communications to push profits over patient-saving innovations. But do these discussions truly challenge the $21 billion-plus advertising spend of America’s pharma industry?

The conversation may be intensifying due to societal changes, but there have been periodic calls to ban pharmaceutical advertising since Merck ran the first DTC ad in 1981. (A ban would likely be unconstitutional under the First Amendment.) Calls for increased regulations have been considered, as well. The Responsibility in Drug Advertising Act, introduced in February 2016 by Connecticut Congresswoman Rosa DeLauro and Comptroller Kevin Lembo, would place a three-year moratorium on any ads for newly approved prescription drugs. Minnesota Senator Al Franken introduced similar legislation, the Protecting Americans from Drug Marketing Act, which would lead the IRS to stop drug companies from deducting marketing costs of direct-to-consumer (DTC) advertising.

So what’s really going on? Reinhard Angelmar, emeritus professor at INSEAD and an expert on pharma marketing, says criticisms of pharmaceutical advertising are misplaced. “The call for a DTC advertising ban is a desperate attempt to slow down the erosion of organized medicine by tackling the pharmaceutical industry,” Professor Angelmar told Havas Tonic. “The timing is well chosen. It fits the current debate around high drug prices, while diverting attention away from the high price of healthcare.”

Angelmar sees multiple factors eroding the traditional sources of physician power. Web and mobile technologies have increased consumer access to medical information through online sites and digital apps. In addition, Angelmar points to ACA-related price pressures on both patients and doctors, which have led to consumers demanding a greater say in medical decisions. Finally, Angelmar focuses on the expanding sector of nontraditional healthcare providers, including pharmacy-based clinics and nurses, as well as “third-party payers who convert independent physician-entrepreneurs to contracted agents and salaried employees.”

Where does that leave Big Pharma? Or the advertising agencies that service it? Or the media that carry the communications? From Professor Angelmar’s perspective, pharma brands and their marketing partners need to be more proactive in reaching out to multiple constituents. Angelmar believes that doctors and payers, as well as patients, can (and should) be courted as natural allies of DTC: “Develop a plan to improve the perceived value of DTC among physicians,” he says. “What do third-party payers think about DTC? Ensure that they perceive the value of DTC.”

These are good points, and there is evidence that DTC has a real value. For instance, health economist Austin Frakt, in a March 2016 New York Times The Upshot Blog, pointed to multiple studies that demonstrate positive healthcare outcomes generated directly by DTC, ranging from better-informed consumers to better patient care. One study about DTC antidepressants showed that when patients “requested a specific drug, 90% received appropriate care, but not all of it involved drugs.”

Havas Tonic’s learning from a multi-month healthcare panel it ran in 2015 supports these points. Paul Klein, Managing Director of Havas Tonic, says, “Polling consumers about their attitudes toward DTC advertising, we found the most receptive audiences for such marketing were more – not less – informed about healthcare, media, and marketing. The study seems to negate the assertion that advertising exploits vulnerable consumers.”

In fact, the poll suggests that the most engaged audience for such messaging (i.e., “Requestors”) is a sophisticated group. And compared to those polled who feel negatively about DTC (i.e., “Non-Requestors”), this group expressed a sense of empowerment around their healthcare decisions. Take their relationships with doctors. Says Klein, “Compared to Non-Requestors, Requestors expressed feeling far more engaged with their physicians and were conscious about maintaining a patient-doctor dialogue.” This makes sense: The Requestor, after all, is bringing an informed request to their doctor. It is up to the doctor whether or not to grant it.

A compelling aspect of Requestors is their attention to societal values. Pharma brands should take note: Their most engaged customers prioritize companies with a social conscience. For Requestors, this means demonstrating a propensity for innovation. For instance, a company might stress the research as well as the innovation behind the treatments it brings to market. Pfizer’s “Before It Became a Medicine” is one such effort. Consumers care about a brand’s overall societal imprint, and will lean in to companies that work to establish that they are truly keeping the patient top of mind in their efforts. But pharma needs to be careful – if every pharma company comes out with a personal story about why they pursued innovation, the messages will quickly become duplicative and dissonant. We’re already seeing this in consumer perception of patient-assistance programs – if the drugs weren’t so expensive, then there wouldn’t need to be financial assistance.

There are challenges to DTC advertising that need to be taken seriously. Addressing them starts with recognizing that today’s DTC advertising audiences are not mindlessly consuming products. They are thinking carefully about what they purchase, and from which companies they purchase. The most powerful branding for them will acknowledge their hunger for innovation, as well as social consciousness. Equally important, pharma brands (and their marketing partners) have to be more imaginative in thinking about allies, from patients to doctors to payers.

Part 3: The Medications

A few months ago, I went for a blood test and found out my A1C was over 10%. This, combined with an unexplained weight loss of about 30 pounds, lead doctors to the obvious conclusion that I had joined the ranks of about 30 million Americans who had diabetes. At this point, the two major questions were which type of diabetes, and how can I treat it? Because it came on suddenly and quite severely, my doctors suspected type 1. I, knowing my diet and physical activity regime over the last 30 years, suspected type 2.

As diabetes is very complex, it’s more than just taking medication every day to treat this disease. There is a great deal a patient has to know about diet, exercise, devices, drug interactions, dosing, and testing. As there was so much to take in, I decided to detail my experience as a newly diagnosed diabetic and the challenges I have faced, having spent so much of my time on the marketing side, to now be on the patient side. In this article, I detail my experience with diabetes medications and why I chose the ones I did. My final article in this series will deal with the overall consumer experience.

Upon getting my diagnosis, my doctor prescribed me two things, insulin shots 3 times a day, with meals, and Glimepiride (Amaryl). I was surprised not to receive Metformin, as I heard this was usually a first line treatment, but was told that Glimepiride was secondary to Metformin in history and lack of side effects. For my other prescription, I was given Humalog quick acting insulin, along with a very quick primer on how to use it and instructions on self-dosing.

For reference, my numbers at this meeting were awful. My A1C was around 12%, which equates to a blood sugar around 300 mg/dL. My cholesterol was also awful, with a total of 327 mg/dL. My LDL was 228 mg/dL and my triglycerides were 206 mg/dL. Other endocrine numbers were also terrible but those were the most alarming to me, especially since all of these readings were normal at a physical almost a year earlier.

My instructions were to take the Glimepiride twice a day and take the Humalog twice a day, with 1 unit of insulin for every 40 points of blood sugar over 140 I was getting. Early on, most of my readings were in the 240 range, which equated to 3 units of insulin 3 times per day. The Glimepiride was easy, just a small pill, twice a day, no side-effects. My endocrinologist told me I’d see results pretty quickly if it worked, but I saw almost nothing from the pill alone. A few days later, once I mustered up the nerve to do the injections, I added the insulin to my regimen.

This immediately started to bear fruit, not only reducing my average blood sugar to the low 200s over the next few weeks but controlling my spikes. After a high carb meal, I could hit over 300; but now my spike would usually stay down in the 250 or less range. While this was an improvement, it was still way too high for me.

As far as taking the insulin, the hardest part was doing the injection. My instructions weren’t great and sticking a needle in your own stomach goes against every instinct you have, so it was a hard mental barrier to overcome. The Humalog pen, however, made it much easier than this otherwise would have been. Choosing an insulin dose was incredibly simple, physically injecting and administering the medication was quite simple, and with the insulin not needing refrigeration, it was a matter of keeping it out of heat and direct light, as well as making sure I had the proper equipment.

The needles given to me were Becton Dickinson ultra-thin micro-needles. Supposedly, they are some of the smallest needles on the market and, as my nurse told me, were lubricated to make injection/removal simple and painless. For the most part, this was true. If I could muster up the nerve, the injections were pretty easy, removal was always quick, and there was only occasional some redness or marks at the injection site.

I never really noticed many side effects from either medication or the physical injections, except for an occasional sting when the medicine was being administered. There occasionally may be some small bleeding if I came in at the wrong angle or a sting like getting pricked at the wrong spot if I hit a nerve, but the mental part was much harder than the physical part. I attribute that a lot to the quality of the penlike injection device and the quality of the needles as I don’t know how I could make it through this if I needed individual needles, syringes, and vials as previous diabetics would.

Adding an additional treatment option

While this was starting to move my numbers, I still wasn’t happy with the progress I was making so I requested my doctor add Metformin to my treatment plan. I was told that it could cause stomach discomfort but discounted that as I rarely experience digestive side effects from medication that is prone to cause those, but I erred significantly here. Firstly, I was prescribed 4 XR 500mg pills, 2 each twice a day. The pills are massive horse pills, so they physically aren’t the easiest to take. But the side effects made the experience much worse. At two a day, I experienced mild and occasional discomfort, but three (taken two in the morning and one at night) made things much worse. Frequent diarrhea, stomach pains, and overall discomfort became fairly common. Once I increased to four, it became almost unbearable as it went from an inconvenience to a real impediment in living my daily life.

If I was seeing major results, it would have made the effects more palatable, but I only saw maybe a 20-30 point drop in my already high blood sugar range during this time, to the 180s to low 200s on average. Because the side effect risk with Metformin, other than the stomach issues, was very low, as was the cost, I elected to remain on the medication but wanted to find an additional treatment option to hopefully reduce or replace my reliance on these medications.

I examined many type 1 medications, which are few and far between, as I was told it was likely type 1 early in my journey. Upon finding out a few weeks later that it was type 2, that opened up my world of medication options. I was looking at several, including Actos, Januvia, and Invokana, as I was adamant that I did not want to take any more injections. However, the potential side effects I read on many of these medications was enough to frighten me off, as was the cost on several of them. After further research and seeing that by body did react to insulin, I decided to go with a long-term insulin. I felt it would be the most effective, have the least side effects, and possibly replace one of my other injections so it wouldn’t really be adding to my troubles.

After examining my options, I tried to decide between Toujeo and Tresiba, the two newest on the market. Toujeo had a long-history as a somewhat newer version of Lantus. However, you needed a fairly strict dosing schedule on this insulin. Secondly, the discount program was less than stellar (more on this in my next article). Lastly, the patient reviews I read on Drugs.com for it were really poor, with lots of adverse reactions. While I know that people who have bad experiences are much more likely to post than those with good, I found there to be enough ratings to be of significance and they rated poorly compared to similar products.

I found this not to be the case for Tresiba. The fact that it would work for almost two days gave me some comfort as I was still figuring out my dosing and medication needs so that flexibility was something I valued. I could get it at a very reasonable cost while I tried it out so the financial investment wasn’t terrible. Lastly, the user experiences and clinical trial results for it were very favorable. Therefore, I had no problem anxiously asking my doctor to try Tresiba.

Upon starting Tresiba, about a month after my initial diagnosis, the hardest thing I found about it was the actual purchase (more on this next article). Taking the medication was very similar to the Humalog, with a similar device. However, I found, for whatever reason, it was even easier to take. The injections were simpler and less painful, the needle went in more easily (despite it being the same needle), and the medication caused less of a reaction. The pens also kept a long time, for about 45 days rather than the 30 days as with other pens. For someone like myself, who was put on a very low dose (8 units, even lower than the recommended 10 unit start dose), this allowed me to use the entire pen before expiration, saving me both inconvenience and money.

I was told the Tresiba could take nearly a week to work but within 3 days, my numbers fell substantially. I was getting my first readings in the normal range at that point, well enough that I could both dial back on the Metformin and no longer needed the quick-acting Humalog. Instead of getting in the upper 180s as I was prior to this prescription, I was getting most of my pre-meal readings around 120, with my spikes only going up to around 170 or so. For medical purposes, within a week of Tresiba, I was getting readings akin to what a healthy person would get.

All that was left was to fine tune my medicinal treatment and diet plan. Shortly after starting Tresiba, I spent ten days in Germany on a long-planned vacation. With a diet heavy on beer and pretzels, I was quite nervous what would happen to me, yet I only spiked to over 200 if I was REALLY bad with my diet. I would also come down to normal readings by the next morning and almost never experienced low blood sugar.

Long-term planning

Once I returned home, I was able to normalize my schedule and found even better results. I switched to taking my Metformin to one pill in the morning and two in the evening, from two pills twice a day. Suddenly the unbearable stomach issues I had from taking four pills were nullified almost that day. Furthermore, my waking blood sugar was down from its prior readings of 120-140 to around 90-110. I was so pleased with these results that I quit the Glimepiride entirely without any adverse results about a month later.

Keeping myself only on the 8 units of Tresiba for about two months and 1500 mg of Metformin XR for about a month, I went in for a followup blood test. I figured my A1C would be way down, based on my blood sugar monitor readings and that my diet was better so my cholesterol would be down. However, I was shocked when my results came in. My A1C, which was measured in late July at around 12%, was down all the way to 6.6%, which was pretty much within normal range. I expected improvement, but not that much.

Even more shocking was what happened to my cholesterol. When I took my initial test, my doctor wanted to put me on a statin immediately but I wanted to see what treating the diabetes would do. He approved this line of treatment but said not to expect a significant improvement. Therefore, he was shocked to see most of my numbers were cut nearly in half. Total cholesterol down to 167 mg/dL. Triglycerides down to 113 mg/dL. LDL down to 88 mg/dL. All of these numbers were improvements beyond my best hopes, despite mediocre commitment to diet and exercise. Furthermore, the significant 30 pound weight loss I obtained from diabetes has been maintained.

For now, I am maintaining my treatment of 8 units of Tresiba every morning and 1500 mgs XR of Metformin. I am thrilled with the results and finding that, thanks to the medications I am on, just three months after a terrible diagnosis, I am able to live my life much as before while keeping my numbers in a normal range. Other than annoying side effects from the Metformin, I have very little issues from my treatments. I don’t workout nearly enough and I am not strict about my diet, although I try to avoid high carb sides and desserts, as well as eat smaller portions than before, yet I have still achieved and maintained successful numbers with very few troublesome spikes. I have kept my weight lower; my vitals and cardiovascular numbers have improved considerably. While injecting myself every day is an annoyance, it’s not a major problem. I am still hoping for a longer-lasting insulin so I can cut my dosing, but I am comfortable that maintaining this treatment plan and nothing else can lead me to a long, healthy life – something I never thought I’d be able to write a few months back.