In part 2 of this Exclusive Interview, Keith Campbell talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about the diabetes care advancements he has seen over the years and the changes he finds exciting.
Having been an instrumental change in the way pharmacists practice pharmacy, Professor Emeritus R. Keith Campbell, RPh, MBA, CDE, FASHP, FAPhA, FAADE, is the former Associate Dean and Distinguished Professor in Diabetes Care/Pharmacotherapy at the Washington State University College of Pharmacy in Pullman, Washington.
Transcript of this video segment:
Steve Freed: You have diabetes. When you started, things were a little bit different. We only had one oral drug for diabetes at that time. So, you’ve been around longer than most of people I have been talking to. You have seen a lot of changes. What has excited you the most…If you have to put 5 things that have had the most major changes in the field of diabetes, what would those things be?
Keith Campbell: I’d have to start with the development of insulins and cleaner, better insulins that work more physiologically. And a close second is self-monitoring blood glucose and I actually started in 1978. Ames actually brought out their first glucometer in 1979 and that really made a world of difference, in terms of knowing where your blood sugars were, what affected them getting high or getting low and that made it a lot easier to manage. When I come to a meeting like this and we see all of the products that are coming out as continuous glucose monitors, it’s pretty phenomenal. I’m really excited today, but some of the products that I saw that are smaller and easier to insert, less calibration and last a longer period of time. With the insulin pump, it makes it pretty easier if you know where you are, how much insulin to take, and what to do if your blood sugars are getting too low. We actually have one that is being promoted a lot here – Medtronic 670, that is kind of a smart pump along with their continuous glucose monitor that slows your insulin release if your blood sugars are going down, and increases if it is going up. They call it a closed loop type of system. A lot of excitement about that and who it is for. I think we’re going to get it better for blood glucose monitoring that more type two patients. I liked the Libre system when it comes out for patients. You put it on your arm. You can swipe it and it will tell you your blood sugar whenever you want it. It lasts for 14 days and I’m pretty excited that that’s going to really help promote more people with diabetes to monitor more often. There’s two things. Sorry, I am so verbose. The third thing is the A1C test, even though it’s not perfect, it gave people some numbers and the ADA did, you know, know your cholesterol, know your blood pressure and know your glucose numbers. The A1C number really helps people see if they’re taking pretty good care of themselves over a period of time and I think that’s had a lot of influence. Nutrition issues are something that have been so crazy my entire life. Here’s what you can eat and here’s what you can’t eat, and then came to the conclusion that if you know your blood sugar levels and you think and you eat healthy, avoid whites, avoid salt, avoid refined sugar and refined flour, and eat more fiber. Another area that I think is going to explode is the microbiome and what happens to the bacteria and viruses and other critters that are in our gut. I think that’s going to just explode in the next few years. There’s always lots going on with diabetes. The last and very important thing is education. Identifying patients early, motivating them to take care of themselves and then educating them in a way where they take charge of their own condition. Lot of things for kids…it was pretty nasty. I started on a 22-gauge, 1-inch needle and only injected it halfway and they were a little on the painful side. The lancets have gotten smaller, so it’s much easier to manage diabetes if you get into the healthcare system and I’m kind of concerned about that because a lot of people don’t always get into it and they don’t always get educated or they don’t follow the standards of care, so they could get much better outcomes and especially the prediabetes where we’ve got millions of them that are going to get it. We can identify them and get them in for exercise and better nutrition and on some medications. We could really improve the outcomes of care.