Diabetes: Perspectives From
Three Patient Segments

By Dave Jacobson, Ph.D., Senior Vice President, GfK Market Measures

According to recent Roper U.S. Diabetes Patient Market Study findings, diabetes today has a new, younger face across all ethnicities and is emerging fast from all demographics. As seen in the chart below, the statistics are troubling. In 2007, as in prior years, 97 percent of the newly diagnosed were Type 2 diabetes patients.



As a result of these findings, several questions come to mind: Where are these patients coming from? How many have been living with conditions that put them on the road to diabetes? How can we reach Latino diabetes patients or those of African-American heritage who are undiagnosed?

To provide answers, GfK Market Measures’ Roper Global Diabetes Group examined the patient dynamics of three critical U.S. diabetes market segments – pre-diabetes patients, Latino diabetes patients and African-American diabetes patients. Since 1989, the Roper U.S. Diabetes Patient Market Study from GfK Market Measures has probed the dynamics of diabetes patients’ attitudes and behaviors. Based on feedback from diagnosed patients, the intelligence gleaned from the study has been used to assess changes in therapy and monitoring practices, patient perceptions, demographics and brand usage. This article identifies several key findings from each patient market perspective gleaned from the following studies: the 2007 U.S. Pre-Diabetes Patient Market Study, the 2005 Latino Diabetes Patient Market Study and the 2007 U.S. Diabetes Patient Market Study.

Profile of the Pre-Diabetes Market Segment

The pre-diabetes patient segment, comprising both diagnosed and undiagnosed pre-diabetes patients, includes 77 million adults. The diagnosed patients (nearly 23 million adults) are classified as such because a health care professional informed them that they have a pre-diabetic condition, which includes high blood sugar, impaired glucose tolerance, insulin resistance, borderline diabetes, risk for developing diabetes, mild or slight diabetes and pre-diabetes. Those who were termed “undiagnosed” (54 million adults) were patients who had not yet received a diagnosis of pre-diabetic condition but were told by a health care provider they had various diabetes risk factors.



Obesity, a family history of diabetes, high blood pressure and cholesterol problems are widely prevalent among pre-diabetes patients. According to the Centers for Disease Control, obesity in the United States is growing and is a major risk factor for diabetes. According to the National Diabetes Education Program, without intervention, pre-diabetes patients will progress to Type 2 diabetes at a rate of 10 percent per year.

The average age for diagnosed pre-diabetes patients is 45 years and approximately 48 years for undiagnosed patients, compared to 52.5 years for newly diagnosed Type 2 patients. This suggests there is ample time for preventive measures to be put into effect before a pre-diabetes condition results in Type 2 diabetes.

With respect to gender, the Roper studies indicated that the diagnosed pre-diabetes population is more likely to be female, who are traditionally better patients, in that they are more health-conscious, more conscientious about regularly visiting their health care professional and are often even more proactive in taking care of their health.

Attacking pre-diabetes should be viewed as an opportunity for pharmaceutical companies and manufacturers of blood glucose meters and nutriceutical products to educate physicians and patients about new treatments for pre-diabetes and to promote a more aggressive approach to diabetes prevention. This has the potential to reshape the diabetes paradigm.

Profile of the Latino Diabetes Patient Market Segment

The Latino diabetes patient population of 2.2 million patients represented 16.6 percent of all diabetes patients in the 2005 Roper study – a share that is disproportionate to Latinos’ proportion in the overall population. Latino patients tend to be younger, less educated and less affluent, less likely to have health insurance or to be in good control of their condition. Nearly 80 percent of Latinos have an immediate family member with the condition.

One of the main segmentation tools we employed in the study was acculturation level. Respondents proficient in English only are designated as “assimilated” and those proficient in both languages are “acculturated.” Spanish proficiency alone is designated as “unacculturated.”

How aware of the media are Latino patients? Sixty-four percent of patients have seen or heard a blood glucose monitoring (BGM) advertisement. As shown below, findings reveal that the media of choice for Latinos is television. Spanish versus English language information access does follow along acculturation status, with the numbers leaning heavily in the direction of Spanish.



An important finding is that Latino diabetes patients are far less likely to be insured than the general U.S. diabetes population and this extends to Medicare as well. The unacculturated patient segment is significantly less likely to have health insurance when compared to the acculturated segment.

To resonate with the Latino market, diabetes communications must take acculturation differences into account, especially in consideration of the differences between predominantly Spanish-speaking versus English-speaking patients. Spanish language communications should be sensitive to cultural differences and should not simply be a translation of the English-language version. For example, they should reflect the needs of the large number of less-acculturated patients who may need information that helps them understand why blood testing can help in controlling their condition.

Profile of the African-American Patient Market Segment

The segment possibly most in need of greater information on their disease is the African-American patient. In keeping with government estimates, the research predicts there are approximately 2.8 million diagnosed African-American diabetes patients in the United States. This corresponds to the 17 percent of all diabetes patients in the United States.

Overwhelmingly, African-American diabetes patients are Type 2 and are being diagnosed at a faster rate in the past 12 months: 14 percent versus 8 percent for non-African-American patients.

The social-economic profile of the African-American diabetes patient, in terms of education and income, is lower than other diabetes patients. This corresponds to the fact that African-American patients are less likely to have attended college. It’s important to note that African-American patients are diagnosed at a younger age than other patients – at 47 years old compared to 51 years for other patients. As seen below, they are also more likely than other patients to suffer from concomitant conditions, including cardiovascular problems and hypertension, which can put them at a greater risk for a heart attack or stroke. In addition, they are more likely to experience microvascular complications, specifically numbness or tingling, a possible sign of latent neuropathy. This patient segment is also more likely to suffer from obesity and report their health as being only fair or poor as compared with other diabetes patients.



Although they are less likely to have Internet access, African-American Type 2 diabetes patients are more likely to use the Internet as a source for diabetes information. Age significantly affects choice of media sources, with younger patients more likely to use multiple resources, including the Internet. Although generally coming from a lower socioeconomic background, African-American patients who are younger than other diabetes patients are more likely to use TV, radio or other diabetes patients as sources of information.

Overall, the African-American diabetes patient segment is more likely to be younger, newly diagnosed, from a lower socioeconomic background, obese or morbidly obese, suffering concomitant conditions, medicated for diabetes care and finally, they are more likely to be seekers of diabetes information.

Summary

Looking across these market segments, one continuous thread weaves these diverse patient populations together – the need for information for both patients and health care providers.



Potentially larger than imagined, the pre-diabetes market presents opportunities for lifestyle changes, pharmaceutical intervention and blood glucose monitoring. With a warning or diagnosis of pre-diabetes, and subsequent physician recommendations and lifestyle changes, a pre-diabetes sufferer can alter the course of his or her health before being diagnosed with diabetes.

For the Latino market, the forces of culture are critical. The degree of acculturation and assimilation drives how patients get their information and how they treat their condition. Given the widespread use of Spanish as well as English language sources for information, marketers must be sensitive to the specific needs and culture of this rising segment.

For the African-American patient segment, the need to educate is critical, especially with regard to the relatively widespread prevalence of conditions, such as obesity and high blood pressure and the importance of regular blood glucose monitoring. Like Latinos, this is a fast-growing segment and less affluent than other U.S. patients, yet its very youth may engender a greater reliance on the Internet as well as on TV, family, friends and other patients for diabetes information. This implies that African-American diabetes patients may require special marketing and communications approaches to reach them effectively.

Whereas Type 2 diabetes has often been seen as a disease that skewed older, these segments seem to be even younger than the mainstream diabetes population, which itself is now dominated by baby boomers. Marketers who can fill the need for the necessary information and treatment so critical for these patient segments can bring the needed change to this complex landscape.

The information shared here provides only highlights about these newly emerging patient segments. For more comprehensive information and data, we encourage you to access an educational teleconference held by GfK Market Measures’ Roper Global Diabetes Group on the same topic last month. (Click here to view the archived webinar presentation. Please note: You must enter your e-mail address to access the presentation).




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