Battle Between Diabetes Patient & ADA Chief Highlights Gulf Between Progress & Available Resources

Recently, Amy Tenderich, who writes the popular blog Diabetes Mine.com got into a tiff with the head of the American Diabetes Association (Dr. Richard Kahn) over some comments he made regarding the value of diabetes technology.  After reviewing his speech, presented at the Diabetes Technology Society annual meeting, and speaking with someone who attended Kahn’s lecture, she said:

“[T]he keynote speech by Richard Kahn, Chief Scientific Officer of the American Diabetes Association, who came across as ‘dismissing the technology that in particular people with Type 1 diabetes use to keep healthy -- insulin pumps and glucose monitors,’ a number of influential attendees tell me.”

Tenderich went on to suggest that Kahn seemed less like a champion for diabetes patients, “but rather like a chief advocate for health insurance payers -- trying to drive down their own costs by denying support for new technology, in particular at the expense of Type 1 diabetics.”

Tenderich’s post ignited a firestorm of protest from the diabetes blogging community.  When he became aware of the Tenderich’s post, Kahn wrote an e-mail her, which said, in part:

“Rather than serve to incite your viewers in a fashion unfair to me and the ADA, perhaps you should have a discussion on the actual ideas and concepts in the talk?”

The Key Questions: How Should Consumers Evaluate New Technologies & Who Should Pay?

Tenderich’s post prompted a lot of commentary about this issue on her blog.  Many backed her, while others suggested that diabetes patients and advocates should reconsider the role of technology in their care.  Kevin McMahon, who writes Challenge Diabetes.com, a blog focusing on the “gap between technology and outcomes” said:

“My take on Kahn's talk is that we need to stop throwing new gadgets at patients and expect to improve outcomes. We need to stop pushing the notion of simply 'test more and you'll do better'. We need to come up with better ways of individualizing care than just inviting the patient to a Tuesday night support/educational class at the hospital (which is incredibly inconvenient for most people). . . . It takes more than just a new device, a new website or a new book targeting the patient who is already tuned into intensive management.  The diabetes challenge is to address a far wider spectrum than the readers of this blog. Further, I believe that Dr. Kahn understood exactly who he was talking to and that was a group of technology zealots who don't always consider the average patient. In order for diabetes technologists to be relevant going forward, Dr. Kahn's speech put the industry and its cadre of quasi-independent researchers on notice that biased and poorly done research cannot be tolerated any longer.”

With medical costs rising and resources dwindling, how should we be evaluating technology?  Can we afford to pay for every new medical gadget (or pill)?  What information can we give consumers (who are being asked to take control of their care) seeking to understand which new medical tools are worth the effort? 

I’d love to hear your ideas on this issue and perceptions of the ongoing argument between Tenderich and Kahn.