FEATURE: The diabetes connection

6/1/2004
Come November, plenty of supermarkets will recognize American Diabetes Month by handing out brochures, posting signage, and setting up special displays. But for a few, more proactive retailers, diabetes education will have been at the forefront all year long.

Once a pharmacy-only issue, diabetes -- which is defined as a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production -- is now beginning to stake its place on the corporate agenda of more and more grocery retailers as they realize the seriousness of this increasingly common disease, the importance of diet in its management, and the value of those repeat customers who are dealing with it on a daily basis. The nation's focus on obesity and low-carb diets has also helped push diabetes awareness to center stage, along with a flood of sugar-free and potentially diabetes-friendly products that continues to be introduced.

"Medical science is invading traditional supermarket operations," notes retail analyst Richard Hastings, a v.p. at New York-based Bernard Sands. "The line is very straight from carbohydrate content to glucose conversion to obesity, and from glucose and obesity to diabetes." All the new healthier-for-you products may bring about a new round of vendor allowances, he adds, which would be a welcome change for supermarket operators.

Suppliers of diabetes care products have also taken notice of supermarkets' newfound interest in their wares. "Retailers are becoming opportunists, knowing that the diabetes market is lucrative and very profitable. They want to own a big part of this market," observes Gary April, president of Health Care Products in Amityville, N.Y., a division of Hi-Tech Pharmacal. Chains that have recently agreed to roll out diabetic planograms in significant portions of their chains include Kroger, Food Lion, Kash n' Karry, and Raley's, he notes.

As of 2002 the number of people suffering from diabetes had more than doubled since 1980, according to the most recent estimates from the U.S. Centers for Disease Prevention. At least 13 million Americans were diagnosed with diabetes, and another 5.2 million were undiagnosed. More troubling news from the government estimates that 41 million Americans have pre-diabetes -- blood sugar high enough to dramatically increase their risk of getting the full-blown disease.

Type 2 diabetes, which accounts for up to 95 percent of diagnosed cases, was typically referred to as "adult-onset diabetes," but it's increasingly being diagnosed in children and adolescents. While family history is a big factor in who will get type 2 diabetes, experts caution that diet and exercise also play important roles.

"In managing or preventing type 2 diabetes, the nutrition side is critical," says Deborah Faucette, director of pharmacy operations for the NACDS Foundation. "The supermarket is a wonderful venue for this, because while the pharmacist is giving the patient nutrition tips, they can direct them right to the aisle to purchase them."

Faucette points to Richmond, Va.-based Ukrop's as a retailer that's been at the forefront of diabetes outreach. The regional supermarket chain offers a "Living Healthy with Diabetes" program that includes one-on-one appointments with its pharmacists, some of whom are certified diabetes educators, who explain what the disease is, the self-care steps involved, sick management, and how to use glucose meters, among other tips. A corporate dietitian helps put together those education modules and also helps coordinate meal plans and recipe ideas.

Ukrop's also offers classes that are targeted toward people who already have the disease. Customers can take store tours to learn more about which aisles to shop and how to read labels -- a very important part of diabetes education, according to Faucette.

"At Ukrop's the senior management has really bought into this, so you'll see them working with the rest of the store, putting up fliers or identifiers and really enforcing the message," she notes.

Chainwide programs

Among the larger nationwide chains, that coordination doesn't seem to be quite as prevalent, but things may be changing, starting with Pleasanton, Calif.-based Safeway. "Safeway is the first major retailer to take a uniform approach in their stores," points out Steven Safran, corporate development director with the American Diabetes Association (ADA).

Safeway is teaming with the ADA in a yearlong "Walk the Store for Diabetes" campaign, which it kicked off in March. All 1,700 Safeway stores bannerwide will use product merchandising and diabetes education materials developed by ADA and Safeway. Healthy Living shelf tags featuring the ADA logo and contact information will highlight products from 13 participating brands, including Del Monte, Diet Coke and Minute Maid, Ocean Spray, and Equal.

Health Care Products' April notes that a growing number of food retailers are attempting to create a one-stop destination shop for their diabetic customers. Planograms used by the company's most successful customers range from three feet to eight feet of shelving and represent devices, testing kits, meters, OTCs, sundries, and nutritional products. "There's also a move toward offering a greater selection of nutritional and low-glycemic or low-carb products," he adds. In many cases these efforts are combined with store tours, signage, and handouts featuring general information about diabetes.

Giant Food of Landover, Md. not only offers store tours and diabetes workshops, but also publishes a "Healthy Ideas" newsletter that digs a little deeper on food and health issues. The March/April issue highlighted the link between low-carb foods and diabetes, noting that "controlling carbohydrates is not the same thing as a low-carb diet." It stressed that the ADA recommends moderate carb intake in healthy diets -- which can be very different from the amounts recommended in most of the popular low-carb diets.

Some supermarkets are letting kiosks do the talking when it comes to diabetes information. More than 6,500 retailers in the United States, Canada, and the United Kingdom employ programs from Portland, Ore.-based Healthnotes, Inc. in their stores and on their Web sites, according to marketing manager Amy Garland. While about 20 percent of the company's business already comes from supermarkets, it's focusing on the grocery channel for growth, since, as Garland puts it: "Supermarkets are in a unique position to help consumers make healthy food and lifestyle choices. They have all the products in one place -- including pharmacies -- so it's a logical place for consumers to go for the resources, products, and information they need."

Diabetes is one of the top 10 health concerns being looked at by consumers who use Healthnotes' products, according to Garland. "Because of this we're revamping our Health Centers databases, specifically the Diabetes Center, to make the information even more useful for customers while they're in the store," she says. In addition, related articles include a Healthnotes Checklist, which outlines supplements, herbs, and medications that may be helpful for different conditions.

Recognizing a prevalence in diabetes among Hispanics, Healthnotes also recently launched Healthnotes Spanish, which features a bilingual health resource in-store and online. One of the retailers using the Spanish edition on its Web site is Navarro Discount Pharmacies, a Miami-based company that caters heavily to the U.S. Cuban population.

At the end of the day, though, pharmacists are still often the ones that make more personal connections with their customers. "When a person is newly diagnosed as a diabetic, they end up having a sit-down with a certified diabetic educator. They get so much information all at once, and it's difficult to remember it all. The pharmacist becomes a critical person to reinsure that the person is following everything they learn and read," Faucette says.

As one-stop shopping becomes more sought after by harried consumers, a supermarket that includes a pharmacy; fresh, healthy food in its perimeter departments; and a diverse product selection on its shelves is the ideal place for them to make that connection.
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