Video transcript
We've seen a proliferation over the last few years of social media with a variety of outlets with a plethora of content, some of which is excellent and some of which is maybe less than optimal. What I’d really like to know is how can we best leverage and utilise what is potentially a really important and useful tool to improve healthcare delivery and the management of people with chronic conditions, and in particular, people with type 2 diabetes or diabetes in general? Hello. My name is Marc Evans and I'm a clinical diabetologist based in Cardiff, Wales, in the UK. A lot of my research interests have been focused around pharmacoepidemiology, real-world evidence generation and analysis, and health economic evaluations. In terms of some of the things that we don't really know, that I'd really like to know about managing diabetes, there are a few of those that have always been vexatious questions. Firstly, should really metformin be the first-line therapy of choice for all? We've seen so much data in terms of cardio, renal and metabolic outcomes with other drugs, in particular the SGLT2 inhibitors, and guidelines, particularly the ESC guidance, would imply that if a patient has coexisting CKD or heart failure then an SGLT2 inhibitor, really based on Level 1A evidence, should be our first-line therapy choice. From an economic perspective, what is the best value for money first-line therapy choice for people with type 2 diabetes. The second thing I'd like to know is linked to that sort of question. How do we identify patients from very basic, simple phenotypic characteristics that we'd all be able to access on a day-to-day basis in our routine practise to ensure that patients get the right medicine at the right time to deliver the best outcomes for themselves? Namely, how can we leverage very simple, easy-to-measure parameters into this world of precision medicine to optimise outcome and optimise therapy utilisation? Another thing that I think is becoming increasingly important for us to understand from a health economic perspective is how do we understand the true value of drugs with multiple therapy indications across potentially different disease areas? Examples in diabetes of course are the SGLT2 inhibitors, whereby we have label indication for heart failure with preserved and reduced ejection fraction, CKD in people with and without type 2 diabetes, and also for glucose lowering and metabolic control. How can we fully understand the value of such an agent in routine clinical practise from a health economic perspective? Similarly, the drug semaglutide, which has label indication for obesity, type 2 diabetes management, and potentially Alzheimer's disease, and fatty liver, how, based on such a wide range of therapy indications and potential outcome benefits, can we fully and truly appreciate the value of such a therapy choice to our entire healthcare system? Something else that I found really puzzling, and I think we could really do with a solution for, is how do we best leverage social media in terms of delivering diabetes care, and not just diabetes care, and not just diabetes care, but in general healthcare and chronic condition management. We've seen a proliferation over the last few years of social media with a variety of outlets with a plethora of content, some of which is excellent and some of which is maybe less than optimal. What I'd really like to know is how can we best leverage and utilise what is potentially a really important and useful tool to improve healthcare delivery and the management of people with chronic conditions, and in particular, people with type 2 diabetes or diabetes in general? In connection with the digital evolution that we're experiencing at the moment, one of the things going forward in the future, finally, that I'd really like to get a handle on and understand more clearly, is how can we implement AI-based technology in our clinical practise to ensure that we can move into the next era of diabetes and chronic disease management as effectively as we possibly can?