According to the World Health Organisation, the number of people living with diabetes had risen from 108 million in 1980 to more than 422 million in 2014. Then, in 2015 an estimated 1.6 million deaths were directly caused by diabetes.
However, whilst both Type 1 & 2 diabetes are life-altering, they are treatable, and modern technological advances are helping patients suffering with diabetes to help treat themselves more and more effectively.
For a diabetic, the most important intervention that can be made comes from blood glucose control, to stop the patient becoming hypo or hyper glycemic. To regulate this effectively diabetics must closely monitor their blood glucose levels.
The monitoring process has, up until recently, revolved around a blood sample test – pricking the finger with a Lancet device (small, sharp needle) before putting a drop of blood onto a test strip and inserting that strip into a meter that displays your blood sugar levels.
This process would have to be repeated many times a day, including before and after meals, causing significant disruption and discomfort to patients. However, in the last few years the diabetes market has seen a few notable, disruptive companies emerge which can significantly improve the lives of diabetics. Firstly, the idea of CGM or continuous glucose monitoring has been around for some time, which enables the patient to keep an eye on their glucose levels without having to draw blood many times a day.
Dexcom are one of the big names in CGM. Their technology, the G5, works with a small sensor placed on the skin which monitors levels which are then transmitted to a mobile device like a smart phone. This technology still requires a finger prick calibration every 12 hours, but delivers continuous data to your phone without scanning, or having to finger prick in between. Dexcom have even partnered with the Apple Watch so uses can discreetly view their glucose reading, trend arrow, and trend graph at a glance of their wrist! The app is also compatible with Android Wear Watches too.
Dexcom's sleek G5 design with examples of connectivity
Next up, a competitor of Dexcom’s is Abbot’s Freestyle Libre system. Marketed as a potentially cheaper alternative to the Dexcom product, Freestyle Libre incorporates Flash monitoring, which eliminates the need to finger prick. Instead, the patient wears a disposable patch which can be checked by scanning the device over the patch at regular intervals.
Abbot's FDA/CE approved Freestyle Libre system
Finger prick testing is still required if the app tells you to, or your symptoms don’t match readings, but both of these competitors dramatically reduce the frequency of finger pricks.
Bigfoot Biomedical are another name I’ve come across recently, who have a great backstory on their site.
According to the ‘Legend’ found on their website, a few years ago the five year old son of a wall street banker, Bryan Mazlish, was diagnosed with Type 1 diabetes. Rather than just accept the treatment options available on the market, Bryan decided to hack into an off the-shelf insulin pump and an early iteration of the Dexcom system, before merging the two together with a mobile app which effectively creates an automated insulin delivery system.
What Bigfoot Biomedical's product could look like!
You can read the full story here, and the fully commercialised system is nearing the market, after Bigfoot recruited some big names including former JDRF CEO Jeffrey Brewer and former Medtronic Chief Engineer Lane Desborough. Watch this space for more developments on this!
Next up is an automated insulin pump from Cellnovo which is a mobile diabetes management system. This one handles the actual distribution of insulin, as opposed to just the monitoring of glucose levels.
Cellnovo's innovative insulin pump
The Cellnovo solution, includes an insulin pump, cellular-enabled wireless touchscreen handset and an integrated blood glucose meter. Their claim is to be the first mobile diabetes management system, as their subtle insulin pump which is attached to the skin is an alternative to the painful insulin injections Type 1 diabetes patients have to otherwise endure.
Getting ever more futuristic, Senseonics have come up with an implantable monitoring system, which stays under the skin.
Senseonics' small implantable sensor
Whereas the Dexcom and Freestyle Libre systems both have disposable elements the Eversense will continually measures glucose levels for the operating life of the sensor (approximately 90 days).
After the sensor has been inserted, the system includes a smart transmitter which fits over the top and gives on-body vibrating alerts when glucose levels are low or high.
All these solutions have the potential to help improve patients’ quality of lives dramatically, but as yet we haven’t seen one comprehensive solution for glucose monitoring and management, which is why we’re currently seeing a swathe of partnerships across the industry.
Two of the businesses we’ve already mentioned, Bigfoot and Freestyle Libre announced their formal partnership earlier this year, and Dexcom have also looked to create partnerships with various different pump manufacturers. One of the most notable of these is Tandem, a manufacturer of small pumps which Dexcom hope will enable them to create a comprehensive full diabetes management system.
Those are just a selection of companies I come across regularly from working within the diabetes space, but the future looks even brighter, with some frankly astounding technologies currently in development.
Pills with hidden insulin-injecting needles are one idea touted in this article from Diabetes Forecast, and ‘smart’ insulin is currently in Phase 1 trials with pharma giant, Merck, which automatically goes into action when glucose is too high, and then deactivates when glucose is back down to a stable level.
The diabetes market is a great place to be at the moment – every month we’re seeing new phases of testing and FDA/CE approvals which have the opportunity to shake up the market dramatically, and the innovation taking place has potentially fantastic implications for patients and businesses alike.
I’d be really interested to know who you think could shake up the market next year. Have I missed any major companies or technologies off this list? Let me know in the comments, or directly at firstname.lastname@example.org