This story explains in plain language that there might indeed be a better way on the horizon for diabetics tied to the daily routine of regular insulin injections. It could have benefited from more outside expertise, some cost information and a more thorough explanation of the risks and benefits. All told, though, readers are left with a better understanding of the challenges surrounding diabetes management than is offered in most stories about emerging drugs.
As the story notes, there are potentially 70 million people in the United States who stand to benefit from an improved insulin delivery system. Writing about how a medicine is consumed is never as sexy as writing about a brand new cure or an oddball alternative therapy. This reporter shows others how you don’t have to write about the announcement being made at a medical association’s conference. Instead, you can take what’s being reported elsewhere in breathless terms as a breakthrough and build on that with solid reporting that takes readers — both those who might benefit and those who will not — inside the complicated world of medicine.
This is the one big hole in the story. The one nod to costs in the story comes toward the end, where it says, "Further, he notes, the new devices are somewhat wasteful in that they need to use more insulin to deliver the same dose as an injection, which will push their cost up." Given that there already was a similar device on the market that failed, it would have been good to at least discuss how much that drug cost.
It would have been nice to see some absolute numbers or a number needed to treat. But, given that this is a broader story and not just focused on one drug or device, the potential benefits are quantified well enough.
There is a lot in here about the potential harm of not taking insulin or taking the wrong dose. There should have been some discussion of side effects seen in the new approaches. We know from the first inhaled insulin that was removed from the market that there is also potential harm from delivering insulin through the lungs. If there are other factors that affect the absorption of insulin either via the airways or the buccal mucosa it should have been mentioned.
The story is not a day-after clinical trial results story but more a step-back story. In this context, the evaluation of the evidence is fair.
The story identifies conflicts and quotes one outside expert. It is clear, though, that the reporter did a lot of reading well beyond what any of the named sources say. The quotes aren’t what gives this story balance. It’s the synthesis of the facts about diabetes and insulin that does that. We’re going to grade this satisfactory, but the absence of any quotes from people who successfully use insulin with no problems, and the lack of discussion of the advent of the shorter acting insulins or the use of insulin pumps are big omissions that might not have happened if more independent sources had been used.
This story does a good job comparing many of the current and potential devices, but it does fall short by not discussing the insulin pump and shorter acting insulin injectables.
The story makes it clear that the key drugs discussed are in late stage clinical trials and approaching FDA consideration.
The story explores the two drugs getting close to FDA approval and sets them in the larger context of the many attempts to change the way people receive insulin. As noted elsewhere in this review, we think the story should have mentioned insulin pumps and the newer short-acting insulins. But we won’t ding them for that in this criterion.
The story goes so far beyond any news release. While it does not hit all the criteria, it is a great example of how to take the "news" of a clinical trial and build it into an interesting and informative story.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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