Shark Tank winner trialling new technology to manage diabetes

Clinical pharmacist Helen Cant from Tokoroa is the winner of this year’s “shark tank” prize for her innovative trial using new technology to manage type 2 diabetes.

The Pharmaceutical Society of New Zealand recently called for applications from members who had been part of developing an innovative or collaborative service.

The top four applicants were each asked to give a 10-minute presentation to a “shark tank” panel of judges at the Society’s 2019 Conference “Towards Integrated Health” held in Auckland recently.

Helen, who gave the most successful presentation, as determined by the external ‘shark tank’ panel of judges received prize money of $2,000 from the Society towards expanding her innovative new service.

The service uses new technology to make it easier for people with Type 2 diabetes to understand their condition and make positive change to manage it.

The service has been developed and run by Helen Cant, who is a qualified pharmacist prescriber, in collaboration with a general practice and with the PHO outreach team.

Most people with diabetes measure blood glucose using a finger prick test providing a reading at a single point in time. Many people need to test four or more times daily. This is difficult to remember to do, and painful.

The Freestyle Libre flash glucose monitoring system is a sensor disc which is applied to the upper arm with a glucose-sensing filament inserted through the skin to measure glucose in the interstitial fluid continuously for 14 days. The sensor disc can hold up to 8 hours of data. It also includes a reader, which when held close to the sensor downloads the data and displays current glucose level, trend and a graph of the last 8 hours.

The information transmits to the reader through clothing, so checking blood glucose is easy and unobtrusive.

In 2018, Hauraki PHO approved Helen’s application for innovation funding to trial Freestyle Libre real-time glucose monitoring in poorly controlled Type 2 diabetes for 20 people.

The new technology ‘has already proven to have contributed to dramatic improvement in diabetes control for many of the patients who have participated in the trial so far,” explains Helen.

The real-time blood glucose measurements and graph of results provides people with increased insight into the effects of day to day activities and food choices on blood glucose and provides prescribers with in-depth information to identify problems and fine-tune medications.

The improvement in understanding of the drivers of high glucose has been very significant. People are making better food choices because they can see in real time what happens to their glucose levels. The devices put people in control of their diabetes.

Also, patients who have previously not been testing regularly are now willing to monitor their glucose because the unobtrusive “swipe” is easy and painless.

Helen would like to see the trail expanded to others with poorly controlled diabetes if more funding can be obtained.

The main barrier is cost. Each reader and each sensor are approximately $100 each and there is no PHARMAC subsidy.

Helen is now in the process of preparing a submission to PHARMAC with the results of the trial so far. She is also investigating doing a Masters degree based on a continuation of the trial.

According to Helen, approximately 10% of the adult population of Tokoroa has diabetes or prediabetes (that we know of).

Many have or will suffer from major complications e.g. renal failure, loss of vision, stroke, amputations, heart disease, neuropathy.

Good control of blood glucose very significantly reduces the likelihood of damage from diabetes.

Not only is this beneficial for the patient, it is cost-effective for the health system in preventing or delaying accessing expensive therapies like renal dialysis, cardiac stents, cataract surgery etc.

Innovative new pharmacy services were also presented at the Society’s conference by three other Shark Tank finalists.

Firstly, Vicky Chan from Unichem Pakuranga, who presented the Community Flu Fighters Pilot Project.

This initiative offered free influenza vaccinations to Asian people aged 65 or over, delivered by the accredited vaccinator pharmacists’ team from Unichem Pakuranga at organised Asian community events.

The clinics were supported by health professionals who could speak Mandarin, Cantonese, Punjabi, Hindi, Korean and other languages and were delivered at temples, churches and community centres.

Secondly, the Early Pharmacist Intervention and Care (EPIC) Pharmacy Team from Middlemore Hospital, represented by Catherine Wong and Helen Lo.

The EPIC pharmacy team provide a referral-based service to doctors, nurses and members of the multidisciplinary team in the Emergency Department (ED) and Admission Units at Middlemore Hospital, targeting patients at risk of medication-related harm at the earliest possible point during their hospital admission.

The EPIC pharmacy team provide services based on the individual needs of the patient, which may include medicines reconciliation, medicines review, facilitation of medication access and patient education.

Finally, The Better Base which was presented by Hannah O’Malley from Life Pharmacy Prices in Nelson.

The Better Base is a collaborative health promotion platform which supports people to learn about healthy, sustainable plant-based eating and take steps towards a healthier lifestyle.

As well as improving public health, The Better Base aims to improve the capability of clinicians to provide lifestyle advice for people who want to begin learning healthier habits alongside their medication plans.

Through development of a package of Lifestyle Pharmacy services, the aim is to support more pharmacists to be confident in serving their communities in a similar way in future.

The Society applauds all those members who submitted Shark Tank applications and who have taken the initiative to look at how they can work to offer innovative new pharmacy services to improve patient’s experiences and health outcomes.