Where does diabetes technology stand in 2022?
Over the course of the last few years, diabetes management has seen a radical transformation, thanks to technology. Through online mediums, the diabetes patient community has found a strong voice. Technology has allowed for continuous glucose monitoring taking the place of finger pricks; insulin pumps making the insulin dosage more predictable, digital patches. There is the promise of connected devices allowing for artificial pancreas’ in the near future. So, what could we expect to see from diabetes technology in the next 5-10 years?
Digital health tech companies and the diabetes community push for change
Millions of people around the globe continue to suffer from diabetes. Around 425 million people live with diabetes, according to the International Diabetes Federation, and this number is slowly increasing. This means that one in eleven people has to handle the condition every day. Diabetes can lead to blindness, heart attack, stroke, amputation, or kidney failure. The prediction is that by 2045, the number of sufferers is expected to rise to 629 million.
Fortunately, more tech companies specializing in diabetes are working on generating remedies to ease the daily struggles the condition presents. Large tech companies like Apple, Amazon, and Google, plus small start-ups, are all developing solutions. The diabetes community is one of the most prominent online, and they are too pushing for advancements to make disease management easier, simpler, and more efficient. The community most recently undertook the #wearenotwaiting movement on Twitter. Dana Lewis, the instigator of the movement along with her husband, built an artificial pancreas at home and began to share the blueprints on Twitter with other people with diabetes. No FDA-approval was held for the technology. So why did this happen? Because patients needed it, and it worked. The US Food and Drug Administration approved it in 2016 after Lewis had been using the device for two years already.
Times are changing, and in the last four years, large healthcare companies have recognized the potential in health devices that keep the patient connected. A huge amount of effect has gone into the build of a new artificial pancreas. New products have been introduced by digital health start-ups so that diabetes patients can use digital patches and their smartphones for monitoring their blood glucose instead of having to prick their fingers. The users of this technology are slowly increasing. Through this article, we will look at where we expect to see from diabetes tech in the next 5-10 years?
Glucose monitoring taking the place of finger pricking
Whether a diabetes patient is suffering from Type 1 (where the body doesn’t produce insulin) or Type 2 (the organism can’t use the insulin effectively), blood glucose levels need to be regularly monitored. This means a needle prick to the finger up to 10 times a day, in traditional methods, so a drop of blood can be tested. For most sufferers, this is troublesome and limiting, so the diabetes community is pushing for change.
Creating continuous glucose sensing technologies since 1999 is DexCom, a diabetes management company based in San Diego. DexCom has most recently created the Dexcom G6, the system, approved by the FDA in March 2018, doesn’t require any finger pricks or blood to be drawn. It is comparable to other continuous glucose monitoring systems. It lets diabetes patients see their blood sugar levels during the day and night with a sensor inserted underneath the skin. The company has been collaborating with Apple to be able to connect the Apple Watch with the Dexcom G6 system. We could expect to see an official launch of the product very soon, according to industry insiders. DexCom will also be updating the G6 device to the G7 as a result of cooperation with Alphabet’s Verily. At one point, Google was attempting to create a non-invasive glucose monitoring technology in the form of a smart contact lens. However, this was tried but failed. Now, it appears that tech companies have learned their lesson and admit to needing health industry companies with valuable expertise to help build safe devices that meet regulatory approval.
As well as DexCom, other companies are working on CGM devices too. Released by Abbot, the FreeStyle Libre is a wireless monitor that uses flash technology to monitor glucose levels. The device is worn on the upper arm, and it measures glucose in the body water, known as “interstitial fluid.” Abbot achieved clearance from CE Mark in October 2018 to release the Freestyle Libre 2 device, which comes with customizable alarms and Bluetooth.
These technological achievements are life-changing for people with diabetes. The most significant changes for diabetes patients suffering from Type 1 are continuous glucose monitoring, lower costs, and continual insight into living with the condition – something that isn’t achieved only through blood testing. Some people have chosen to have an artificial pancreas fitted for, instead of delivery of insulin from a pump or MDI, as a result of the insights they have noticed. Let’s look at the different options available in more detail, such as digital patches, artificial pancreases, and various blood glucose monitoring products.
Digital skin patches – invasive or non-invasive
There are now longer-term versions of CGM’s that can already be placed under the skin, like the Eversense sensor. This sensor monitors blood sugar every 5 minutes for 90 days once implanted. It works by a light signal being generated in response to the levels of glucose in your interstitial fluid.
But, many people prefer non-invasive solutions rather than having a sensor planted into their bodies. The POP! One System was recently FDA-approved. The system allows for on the go glucose testing. It is attached to the back of a smartphone and includes a sensor port, a lancet, and all other requirements so results can be returned in around 30 seconds. After the test is finished, the results are available on the smartphone app with accompanies the product.
Nemaura, a UK-based company, developed a non-invasive system called SugarBEAT CGM and is planning to achieve FDA approval very soon. SugarBEAT is a smart patch that draws a small amount of glucose from the interstitial fluid, a method that is pain-free. Early study results showed, however, that SugarBEAT didn’t have as accurate results as those from Dexcom or other companies. However, it is advancing technology and one that competes well on price. The University of Bath, England, has recently developed a transdermal patch that is capable of testing glucose from the interstitial fluid without actually needing to measure the blood itself.
Insulin pumps versus SmartPens
Programmed to deliver a predetermined insulin rate over a day, insulin pumps are advanced devices that can also store data about usage patterns. They can sometimes be hefty devices, so not exactly the most patient-friendly option as they have to be attached to the body. Pens, however, are lightweight, affordable, and non-invasive. Many diabetes patients opt for insulin pens because of these reasons. Their downside, however, is that they were not originally programmable, nor did they capture data.
Introducing the smartpen! These are the latest innovations in diabetes technology. InPen and Gocap are just two of the many options available, and they connect to your smartphone via Bluetooth so you can keep track of your insulin dose and timing. Companion Medical is the developer of InPen, and it was made available to a US audience in December 2017. Since then, the device has worked much like a traditional insulin pen, except now it has Bluetooth technology that can track your data on your smartphone.
Another innovation is the NovoPen Echo Plus, capable of storing up to 800 shots (3 months’) worth of days; it will be able to be connected to other diabetes monitoring systems to allow for better diabetes management. The NovoPen 6, by Novo Nordisk, was meant to be launched in 2019; however, this is yet to be rolled out. Regardless, the company expects the device to deliver connectivity for its disposable, pre-filled injection pens from now and into the future. The company is aiming to increase the solutions offered for personalized treatment guidance too.
Can we cure diabetes? What does the future hold?
As we are already on the path towards creating the “real” artificial pancreas, MIT researchers have developed a truly forward-looking device. This device can keep pancreatic islets alive after transplant into the body. Additionally, collaborators from Novo Nordisk, the University of Michigan Medical School, and Cornell University have developed their own implant version that has living pancreatic cells. There are various innovations here that could see failing organs being replaced with organic versions in the future, either with new organs developed from stem cells or with gene therapies.
Tim Street, founder of the Diabettech blog, wrote “the future in this space is not only mechanical/technological. It is also biological, with the idea that glucose-responsive insulin that could be taken once a week could react to variation in the blood glucose levels and not require the use of CGM or a pump, but I’d suggest that’s ten years off. In the meantime, potentially better insulins may help enable technological systems to operate more effectively.” And what if we dream big and look to the far future? He also believes in the power of gene therapies: “in an ideal world, there would be no diabetes management, as there would no longer be type 1 diabetes. This will be driven by suppressing the immune-response and gene-therapies that allow those with the disease to be cured.”
As a community, we can all hope that we one day have a world where the everyday struggles of diabetes no longer exist.