June 7, 2022 Bill McElnea, VP of Population Health & Lillian Piz, Manager of Population Health

Key Takeaways from two Diabetes Conferences Shields Health Solutions Attended

Two big diabetes clinical conferences – the American Association of Clinical Endocrinology (AACE) Annual Meeting and the American Diabetes Association’s (ADA) Annual Clinical Conference – took place in May and, Shields Health Solutions was proud to be in attendance for both.

Endocrinologists, practitioners, and fellows from across the country convened for the AACE Annual Meeting to lead and participate in state-of-the-art lectures on clinical and technological developments in Endocrinology and Diabetes. This year marked ShieldsRx’s inaugural attendance at AACE with an accepted abstract and poster: “Impact of a Pharmacy Liaison-Managed Care Model within a Health-System on Clinical and Economic Outcomes in Patients with Diabetes.” The abstract was presented during an e-poster session on Saturday, May 14th, by Lillian Piz, Manager of Population Health. It provided an observational analysis of the ShieldsRx Pharmacy Liaison-Managed Care Model at Baystate Health in two Endocrinology clinics which were associated with positive outcomes related to medication access and adherence as well as HbA1c reduction.

Two core diabetes care themes discussed during the last day of the conference included the ever-increasing adoption and ongoing advancement of diabetes technology and the growing utilization of SGLT2s, particularly at the intersection of diabetes and heart failure treatment.

A high-level review of the AACE 2021 Advanced Diabetes Technology Guideline, presented by Dr. Sandra L. Weber from Prisma Health System University of South Carolina School of Medicine, revealed how encouraging the adoption of continuous glucose monitors and insulin pumps continues to be critical in helping patients achieve successful diabetes self-management. The importance of monitoring a patient’s Time in Range (TIR) – referring to the percentage of time when blood sugars are safely between hyper and hypoglycemic levels – was a highlight of the discussion and was presented as the key to preventing hypoglycemic events in particular.

On the topic of increased prescribing of SGLT2s over the past few years, Dr. Roma Gianchandani from Cedars Sinai Health System, Dr. Neda Rasouli from the University of Colorado, and Dr. Kristen Kulasa from the  University of California San Diego Health discussed a range of considerations through their respective presentations on “Use of SGLT2 Inhibitors in the Inpatient Setting”, “The Efficacy and Risks of SGLT2 Inhibitors”, and “Collaboration with Non-Endocrinologists using SGLT2 Inhibitors for Non-Diabetes Indications” (namely, heart failure). It seems that with a deeper understanding of the effects and benefits of SGLT2 use, there is an opportunity to enhance patient care across specialties.

The American Diabetes Association’s Annual Clinical Conference is the ADA’s largest clinically focused event each year and brings together diabetes practitioners, researchers, nutritionists, pharmacists, technology manufacturers, and other experts from all over the world.  This year’s conference had a theme of “Resilience & Reframing Diabetes Care” and featured various presentations and panels on topics ranging from telehealth, food insecurity, medication management, motivation, mental health, and health equity.

A big theme of the conference was how to inspire sustained behavioral change among high-risk diabetes patients. Dr. Jan Kavookjian from Auburn University’s Harrison School of Pharmacy led a half-day workshop on motivational interviewing techniques where she presented strategies for addressing patient ambivalence and resistance to change. Another presentation from Dr. Joshua Brown of Atrium Health dealt with the challenges of inspiring change via telehealth and proven methods practitioners can use to position telehealth appointments for greater success.

The second workstream of this year’s conference was health equity, the importance of screening patients for Social Determinants of Health and mental health.  Dr. Richard White of the Mayo Clinic presented on the impact that discriminatory zoning practices in the 1930s and 40s still have on health inequities today, and cited research showing how diabetes disproportionately impacts minority communities.  Sarah Stotz, an Assistant Professor at the Colorado School of Public Health, discussed the prevalence of food insecurity among diabetes patients in the U.S. (as high as 22% among insulin-dependent patients) while providing a range of resources clinics can use to address this widespread challenge.  Finally, Kathryn Kreisler and Allison Lewinski from Duke University hosted a valuable workshop on ways to screen for depression in diabetes patients, who are two to three times as likely to be afflicted by it than people without diabetes.

One issue the diabetes clinical community is still grappling with is how to provide more real-time support and guidance to patients. While there is broad consensus that the Covid epidemic has accelerated the availability of convenient telehealth support, lower relative reimbursement rates for telehealth care are a continuous barrier to scaling such services. This may be where ShieldsRx Care Coach model can fill an urgent need, given the program’s encouraging clinical impact to date and independence from the sometimes-unpredictable world of telehealth billing.

Both conferences proved to be worthwhile events for ShieldsRx participation this year – great forums for us to communicate our impact in diabetes and valuable opportunities to learn how health systems are innovating in this space.