In our latest episode of The Hard Things About Healthcare, we spoke with Dr. Halis Kaan Akturk, an endocrinologist at the Barbara Davis Center for Diabetes and an Associate Professor of Medicine at the University of Colorado. Dr. Akturk is deeply involved in both patient care and clinical research, making him uniquely qualified to discuss how emerging technologies, thoughtful data use, and patient-centered strategies are reshaping how we manage type 1 diabetes (T1D).
A Personal Mission: A Career Inspired by Family
For Dr. Akturk, the quest to improve T1D management isn’t just professional—it’s rooted in a personal experience. While still in medical school, he helped care for his uncle, who was losing his eyesight, kidneys, and limbs to diabetes complications at a time when advanced treatments and tools simply didn’t exist:
“I witnessed that he was losing his eyesight, his kidneys, and some amputations related to diabetes… There were no diabetes technologies at that time… That motivated me to make an impact for people living with type 1 diabetes in the future.”
This firsthand exposure to the real costs of inadequate care spurred Dr. Akturk to dedicate his career to ensuring patients today don’t have to face diabetes without the right tools and support.
From Fingersticks to AID Systems: How Technology Transforms Lives
Over the past decade, the landscape of diabetes management has evolved at breakneck speed. Today, Continuous Glucose Monitors (CGMs) deliver real-time glucose readings, and Automated Insulin Delivery (AID) systems use those readings to adjust insulin in ways that were once unimaginable. For patients, this means fewer unpredictable spikes and drops, more stable blood sugars, better sleep, and a noticeable drop in stress around daily care.
Dr. Akturk highlighted the game-changing nature of these developments:
“Now we are using no-calibration CGMs and small insulin pumps that interact with CGM systems, delivering insulin automatically. These technologies increase people’s confidence in life, quality of sleep, and quality of life.”
But these breakthroughs aren’t plug-and-play solutions. Success hinges on understanding each patient’s unique situation—tailoring the technology to their habits, routines, and lifestyles. The best device for one person may not be the best for another, which is why flexibility and patient education are key.
Early Adoption of CGMs: Setting the Stage for Long-Term Success
Among all the advances, one stands out as a foundational step: starting CGM use early. In Dr. Akturk’s research, patients who began using CGMs within the first six months of diagnosis experienced significantly better outcomes over a seven-year period than those who waited or never used one at all:
“We saw that people starting the CGM in the first six months did significantly better over seven years compared to those who started later or never used one at all.”
This isn’t just about having nice data points—it’s about preventing long-term complications and reducing day-to-day burdens. By introducing CGMs early, patients gain a clearer understanding of their glucose patterns from the start, building confidence and knowledge that pays dividends over time.
Data Overload: How to Turn Information into Insights
If there’s one area that’s both a blessing and a challenge, it’s data. Twenty years ago, clinicians struggled with too little information—relying on a handful of fingerstick readings to guide treatment. Today, CGMs and pumps provide a constant stream of numbers, charts, and metrics. While more data sounds great, too much can be overwhelming.
“20 years ago, we were complaining we didn’t have any data at all. Now we’re complaining we have so much data, what can we do?” Dr. Akturk observed.
The key is knowing where to look. Time-in-range metrics, patterns of highs and lows, and mealtime insulin use are more actionable than a sprawling 80-page download. By focusing on meaningful metrics, clinicians can quickly identify problem areas—perhaps nighttime highs or exercise-induced lows—and guide patients in making targeted adjustments.
Overcoming Insurance Hurdles: The Hidden Challenge
While technology and data can transform care, the practical realities of insurance approvals often slow progress. Even when a clinician knows a particular device or medication could help, prior authorizations and bureaucratic back-and-forths can derail a patient’s access:
“You have to convince the insurance that the patient needs this medication… It’s a confirmation back and forth and it takes a lot of time and a lot of money from everybody.”
For many clinicians, navigating insurance feels like a second job. Nevertheless, Dr. Akturk and his team persist, sometimes turning to alternative devices or research participation as workarounds. These efforts ensure patients aren’t stuck with suboptimal tools simply because insurance processes haven’t caught up with current standards of care.
Remote Care: Expanding Access with Caveats
The surge in telemedicine—particularly after COVID-19—means patients living hours away from a specialized clinic don’t need to make the long drive to get expert guidance. Remote visits streamline follow-ups and help keep patients engaged. But technical hiccups remain. Getting patients to share CGM and pump data before an appointment is often trickier than it sounds. Without that data, virtual visits lose much of their value. Still, the convenience and reach of telehealth have permanently changed the way diabetes care is delivered, extending top-tier expertise well beyond urban centers.
Education is Non-Negotiable: Tools Need Skilled Users
As beneficial as CGMs and AID systems are, they aren’t substitutes for understanding how to manage diabetes. Patients and providers must learn how to interpret the data, know when to adjust settings, and recognize that technology only works as well as the person using it:
“It’s like driving a car; just turning on the radio won’t make you go faster… You need to know what to do when you are high or low and what to change.”
Effective education remains the backbone of successful long-term management, ensuring that these systems truly empower patients rather than overwhelm them.
The Road Ahead: A More Empowered Future
With dedicated clinicians like Dr. Akturk at the helm, the future of diabetes care looks more promising than ever. By embracing the right technologies early, zeroing in on the most relevant data points, working around insurance barriers, and investing in patient education, we can continue to reduce the daily burden of T1D.
For more insights into the challenges shaping healthcare innovation and how providers are overcoming them, subscribe to Honey Health and stay tuned for future episodes with renowned healthcare professionals.
Commenti