The insulin glargine dilemma: an opportunity for the diabetes community?

Excerpt

It has happened again. Once more, the patient is left alone; once again, physicians are caught between the conflicting forces of suspicion and company interest, emotions and experience, traditions and personal relationships with industry representatives, colleagues and scientific associations. The scientific associations are expected to help their members navigate through stormy waters in an impartial manner, even in the absence of definitive scientific evidence. Shareholders lose confidence and money. The company loses trust, image—and money. Its management is on the defensive. This is a lose-lose situation for all concerned, including the authors of a paper that required more post hoc analyses than there were original hypotheses [1]. The conclusion? There is more than an insulin glargine dilemma; there is a fundamental breakdown in the interaction between the players in healthcare. The issue at stake goes beyond insulin analogues or diabetes—it is healthcare in general. We believe that this dilemma has offered us the opportunity to rethink and reorganise some of the relationships in the field, and thereby to achieve better patient care and safety. …