New Innovations in Diabetes Technology By: Suhas. D. Research Scholar Tezpur University Tezpur, India New Innovations in Diabetes Technology

Introduction Over the next decade, management of diabetes will change significantly and embrace new wearable and IoT innovation. New ways in which individuals are able to monitor glucose levels and deliver insulin are gaining regulatory approval and coming to market.

Technologies for Diabetes Management Glucose Sensors Ketone Sensors Insulin Pens Insulin Pumps

Contents Introduction to diabetes Glucose Monitoring Traditional test trip testing Gaining value from glucose data Wearable Glucose Monitors Implantable glucose Monitors Non Invasive glucose Monitors Insulin Pumps Artificial Pancreas Insulin Pens Market Forecasts

Diabetes – A Global Epidemic Diabetes is a condition where the body cannot properly digest sugars. The number of people with diabetes has risen from 108 million from 1980 to 422 million in 2014. Around 50% of people living with diabetes are undiagnosed. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. In 2012, an estimated 1.5 million deaths were directly caused by diabetes and another 2.2 million deaths were attributed to high blood glucose.

Three Types of Diabetes

Market Segmentation in Diabetes Care

The Glucose Test Strips A glucose blood test requires a small amount of blood to be applied to a disposable test strip , connected to a meter. 2 x 10^10 glucose test strips will be produced in 2017. All manufacturers differ slightly, but general structure remains the same. Detection of glucose is based on redox reaction with glucose oxidase. Current produced proportional to glucose concentration. The four big Test Strip manufacturers are Abbot, LifeScan, Roche and Ascensia.

IoT based Glucose Monitoring Connected devices collect and store data and make treatment decisions. This is where glucose meters are connected to Smartphones and recording glucose measurements to track daily trends. Large growth in the number of apps used for glucose monitoring. As population ages, it is more important to monitor glucose and ensure insulin has been taken. Connected devices ensure this, and prevent severe hypo- and hyperglycaemia in elderly people with diabetes.

Connected Healthcare This method takes measurements from glucose, heart rate, BP, etc. and combines with hospital based testing to store all health based data for each individual in a central location to provide medical professionals with long term health information to better diagnose, prescribe and treat patients.

Wearable Glucose Monitors Place a minimally invasive sensor under the skin for 5 – 14 days. Glucose measurements are made every 5 – 15 minutes in interstitial fluid, some delay – and not 100% correlation with blood measurements. E.g.: Dexcom G5 Continuous Glucose Monitoring and Flash GM cheaper than CGM. Cost is a major hurdle to the uptake of devices.

Continuous vs. Flash Glucose Monitoring Flash Glucose Monitoring; developed by Abbott; lower cost alternative to CGM. Flash GM sensors are factory calibrated, CGM sensors must be calibrated with finger stick tests. FlashGM system transmits data via NFC technology. Key players in implantable glucose monitoring: Senseonics, Glysens, Glosense.

Non Invasive Glucose Monitoring End goal for many. Wearable and non invasive devices would be greatly compliant on patients and thus better glucose control. Use different biological fluids such as tears, sweat to measure glucose. Even optical measurement can be used to measure glucose in a non invasive manner.

Insulin Pumps First commercial Insulin Pumps were designed in 1963. First devices were made available in the UK in 2003. Insulin pumps use a range of sensors to monitor temperature, amount of medicine dispensed, remaining volume of medicine.

Artificial Pancreas Consists of Glucose monitor and Insulin pump working in tandem to maintain constant blood glucose level in the patient. The system measures blood glucose levels on a minute to minute basis using CGM, and transmits the information to an insulin pump that calculates and releases the amount of insulin needed for the body. The first AP was released in 2016 by Medtronic in USA.

OPENAPS A group in USA, frustrated with regulatory controls have released information on building AP using Insulin pump and CGM. As the information is freely available and the device is not being sold, medical regulation does not apply. Building instructions and all codes are freely available on the internet.

AP Roadmap

Insulin Pens People don’t want to be hooked to insulin pumps all the time. So Insulin Pens are being released throughout 2017/2018.

Market Forecast