Tuesday, July 2, 2013

Different types of patients

This week I have gotten a chance to think about different areas of Novo that I would like to learn more about, as there are many many departments with different responsibilities. One of these areas is the Call Center where Novo employers receive phone calls from patients, physicians, nurses who are all taking or providing the company’s drug. They might be calling for various reasons including adverse effects, dosage questions, administration questions, etc. I am excited to see how the employee responds to these questions as there are tight protocols of what people can and can’t say regarding the drug to help prohibit off-labeling. This connects to another department called Safety where their name objective is to ensure that patients remain safe and healthy throughout trials as well as using the drug. Nurses are also seen in this area as well, but it is my impression that they only have contact with the investigators during trials and not directly the patients.

Working here is causing me to think about patients and what patients mean to me as a future health care provider. Questions I have begun to ask myself here are what type of patient do I see myself thriving with? The one who is newly diagnosed coming in wetting the bed and screaming at the prospect of having to check blood sugars? The patient who is coming in routinely to a clinic after 10 years of having diabetes and deciding that they just can’t do it anymore and are rebelling from their condition? Or the patient who I don’t know, Subject ID xxxx, who is risking their health to try a new drug to potentially make leaps and bounds for future drug technology and therefore many other patients? I didn’t realize that drug companies, especially the Strategic Scientific Communications department I am in really don’t have much interaction with patients. I’m glad I’m getting this experience now, away from the patient, to see that I probably like being with the patient more. There is something about being able to look into a newly diagnosed child and say, “hey look, I take insulin too, and I’m doing just great and we are going to get you feeling a lot better” that might make me feel more fulfilled than thinking of these people as mere numbers.  But anyways, these are just wheel churning daydreaming thoughts that I randomly think about as the corporate life day goes on.

Working here has also made me learn more and appreciate Type 2 Diabetes. I used to detest it. Honestly, because lots of people would assume that I have it, so I usually get immediately territorial and judgmental of them and their ignorance and lack of knowledge. Therefore, I developed this preconceived notion of all T2D people as the ones who make me have to defend myself. When you live with type 1 sometimes it’s very easy to live with the mindset that type 1 is the only type of diabetes that exists. However, working here has reminded me that type 2 actually encompasses about 95% of all people living with diabetes which means that there is only an astonishingly low 5% living with type 1. So now I feel like a hypocrite because as much as I blame others for not knowing a clue about type 1, I’ve realized I don’t know that much about type 2. The key difference between the two types of diabetes is that in type 1 the only way to treat it is by administering insulin, but in type 2 you can use multiple drugs that all have different mechanisms of action such as sulfonylureas such as metformin to help release insulin from beta cells or alpha-glucosidase inhibitors that work to slow down the digestion of glucose and therefore lower blood sugars. And then there’s of course, Victoza, made by Novo that acts as a human glucagon- like peptide that works to secrete insulin when blood sugars are only elevated to reduce low blood sugars and also doubles to increase meal satiety and causing weight reduction. As there are many more ways to reach a patient with type 2, there are more drugs, more competition for drug companies, but then more options for patients. As other lifestyle and socioeconomic influences are all incorporated into life with type 2 diabetes, this can pose to be very convenient for patients. Sometimes I feel like I can barely get a grasp on technology advances to therapy in type 1, so incorporating type 2 into that as well has been overwhelming, but it’s important to stay educated, informed, and considerate of different patients and therapies.

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