The Future of Diabetes Management
Diabetes is an adamant condition requiring constant attention. Let me show you how technology can take the burden off the shoulders of suffering patients and their loved ones.
One in eleven persons has to cope with diabetes worldwide on a daily basis
According to the latest estimates of the WHO, 422 million people suffer from diabetes worldwide – and the number is growing steadily. It means that one person in eleven has to manage the chronic condition on a daily basis, which might lead to stroke, blindness, heart attack, kidney failure or amputation. There are two types of diabetes: when the body does not produce enough insulin (type 1 diabetes) and when the organism cannot utilize the generated insulin (type 2 diabetes). While the latter can be prevented with conscious lifestyle choices, the former is a mystery to the medical community. But if someone has diabetes, that means having a constant companion.
In both cases, the treatment of the symptoms requires constant blood glucose control, which usually requires a kind of insulin intake at regular intervals, as well as blood pressure control and/or foot care. It is a truly technologically dependent condition: you need to monitor your blood glucose level, your blood pressure, your weight, follow a meal plan, test your blood every now and then. Luckily, there are so many digital health innovations for diabetes patients out there that diabetes management has been improving for years steadily – and it will significantly change in the coming years.
But technology in itself is insufficient: you need people to utilize it – and diabetes patients do. It is one of the largest and most motivated communities both online and offline, sharing their experiences on social media and other platforms. I believe one of the most amazing development is due to the diabetes community: the #wearenotwaiting movement advocated the absolutely efficient DIY artificial pancreas for so long and so successfully that the FDA approved it! Democratized healthcare at its finest!
1) Digital Contact Lenses
Although Google stopped developing its augmented reality glass, Google Glass, they did not give up on combining vision and technology. The search engine giant and Novartis signed an agreement in order to cooperate on the development of the digital contact lens patented in 2014. According to the plans, through the lens, you can get more information from the digital world plus it can measure blood glucose levels from tears as an added benefit.
Google and Novartis said the lens would contain a tiny and ultra slim microchip that would be embedded in one of its thin concave sides. Through its equally tiny antenna, it would send data about the glucose measurements from the user’s tears to his or her paired smartphone via installed software. Originally, the companies promised to put the digital contact lens around 2020 on the market, but Novartis Chief Executive Joe Jimenez in 2015 said that the contact lens would be on track to begin testing that year – and backtracked later.
Since then, there has been no news about the state of progress. However, in March 2017 Novartis Chairman Joerg Reinhardt talked down the chances of the project bringing visible results in the next couple of years, which is not very promising. [It’s] a long-term project, not something where we were expecting a breakthrough in the first couple of years. We certainly haven’t seen such a breakthrough. We don’t expect anything incredible in the next three to four years, Reinhardt said.
Isn’t it more fun to make the diabetes monster happy than to boringly measure blood glucose level? There are already companies leveraging on your inner child. There are amazing applications for smartphones that can help you manage diabetes efficiently. MySugr, an Austrian company, released several applications that can add a little bit of gamification to the traditional diabetes management apps.
The company also developed the mySugr Junior App designed for kids to learn how to manage diabetes properly. It also enables parents to keep control over the therapy when they are not around the kid. The app looks like a game in which the children get points for every entry and the goal is to score a particular amount of points every single day.
3) Patient empowerment with big data
I have been quantifying my health for decades, I have even done so before the start of the wearable revolution: in an excel spreadsheet. But it’s not just l’art pour l’art data collection, I want to know everything about my organism in order to live longer and healthier in full mental, physiological and psychological capacity. So I am always happy to see inventions aiming to do the same.
Doug Kanter collected data about himself for a full year – blood sugar readings, insulin doses, meals, sporting activity etc. His company, Databetes was born out of his own experiences with diabetes. It helps patients better manage their condition by providing a good way for logging and measuring data, as well as a revolutionary concept to analyze the big data behind one person’s disease. Patients can support each other through social media channels and become coaches for each other. Look at sixuntilme.com for best practice examples.
4) Artificial pancreas
The bionic or artificial pancreas basically replicates what a healthy version of the organ does on its own, and it enables diabetes patients to live an easier life in a sustainable way. The device can measure blood glucose levels constantly and decide upon the insulin delivery itself. Engineers from Boston University have developed a bionic pancreas system that uses continuous glucose monitoring along with subcutaneous delivery of both rapid-acting insulin and glucagon as directed by a computer algorithm. However, it was not in commercial use.
As there was no single device on the medical market, which was able to monitor blood sugar and supply insulin automatically, creative persons invented a DIY version from existing technologies. As I mentioned above, a grass-root (social media) movement called #wearenotwaiting grew out of the initiative, who campaigned for the introduction of such artificial pancreas on the market for years persistently. One of the leading figures of the movement, Dana Lewis told me how an artificial pancreas eases everyday life. She has been using the device for almost two years by the time the US Food and Drug Administration finally approved it.
5) Food scanners
Currently, we have absolutely no idea, what we are eating – not to speak about what we should. Food scanners promised they will be able to tell how many grams of sugar a piece of fruit contains, or what the alcohol percentage of a drink is. Canadian TellSpec announced its aim is to develop a hand–held food scanner that can inform users about specific ingredients and macronutrients, but the market launch is unfortunately in delay. The Israeli company SCiO uses a technology similar to TellSpec’s but is designed to identify the molecular content of foods, medicines, and even plants. The company says that in milliseconds the ingredients and molecular make–up of the foodstuff will appear on the user’s smartphone. However, their promises have yet to be fulfilled, as the scanner, they introduced on the market does not exactly deliver what the demo did.
The Nima gluten-sensor (already on the market!) was named one of Time Magazine’s 25 best inventions of 2015. It is a portable, nicely designed gadget, which is able to tell you from a small food sample within two minutes, whether the food on your plate contains gluten. The firm also hopes to apply its technology to detect other food allergens, including peanuts and dairy.
6) Pocket-sized gadgets
When you live with diabetes, you get used to carting around with plenty of things such as meters, test strips, lancing devices. Therefore a pocket-sized gadget combining many meters and strips can mean change in life quality. The personalized, pocket-sized, all-in-one glucose meter called Dario can offer you that comfort. Moreover, it comes with a robust real-time mobile app to manage diabetes quickly, efficiently and accurately.
For over 25 years, Medtronic has been helping people with diabetes with its complex insulin pumps. With its latest, personalized, hybrid closed-loop system it seems to get a step closer to build its own artificial pancreas. In 2016, Medtronic announced its partnership with IBM Watson. The company introduced a demo for a new app at CES 2016 that will eventually give patients detail information about the rate of insulin delivered, the constantly fluctuating glucose level and carbohydrate intake information, alongside with information from wearable trackers or calendar details.
7) Wireless blood glucose monitor
Glucose monitors usually work like this: you prick your finger, you apply the drop of blood to the glucose strip, and soon you will get the results. For someone, who requires glucose monitoring more than 3-4 times per day, it is a troublesome process.
The medical company Abbott released a FreeStyle Libre wireless monitor especially for them. It is the first of a new class of glucose monitoring devices that use “flash” technology. The user has to wear a sensor on the upper arm, which measures glucose in the body water known as “interstitial fluid”. The FreeStyle Libre is very accurate, as it can do the measurement every minute!
8) Digital tattoos
Doctors have been searching for ways how to spare patients from the pain and trouble of blood glucose monitoring for years. Beyond wireless monitors, researchers have created an electronic skin patch that senses excess glucose in sweat and automatically administers drugs by heating up microneedles that penetrate the skin. The prototype was developed by Dae-Hyeong Kim, assistant professor at Seoul National University and researchers at MC10, the company experimenting with all kinds of microchips and biostamps that can measure numerous vital signs simultaneously.
I hope that the technology will spread around soon and it will bring the era of wireless diabetes management to every patient.
So there are more and more technologies that can help people manage diabetes properly besides potentially future therapies such as new drugs or islet cell transplantation but it’s really time to manage diabetes in a gamified and comfortable way and I believe that the best gadgets and the best technological solutions are just yet to come.
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