Move over, test strips! Step aside, hand-held blood glucose monitors! Make way for a new generation of diabetes management tools that are changing the way patients manage their disease and their lives.
Today’s innovative smart technology ranges from insulin pumps and memory chip-equipped insulin pens to sensors applied directly to skin for continuous glucose monitoring (CGM) and other wearables. All this and more is currently in development and coming to market at an impressive rate.
CNBC reported earlier this year that a team of biomedical engineers at Apple is involved in an initiative to develop noninvasive sensor technology to continuously monitor blood sugar levels. Verily has at least two glucose sensing/monitoring projects in the works, including a glucose-sensing contact lens. Both companies are participating in the FDA’s precertification pilot program, part of its initiative to foster digital health innovation.
Independent pharmacist Jonathan Marquess, PharmD, CDE, a Past President of the Georgia Pharmacy Association, is enthusiastic about new technology that makes it easier to individualize treatment plans for his patients. He is particularly excited about alternatives to the traditional finger stick, which provides information at just one point in time, and not a more useful glucose profile.
Marquess also likes the versatility of the newer insulin pumps. “It is exciting to know that we have new pumps that we can set for various basal rates,” he says. “There are many small, discrete pumps now that let patients enter the amount of carbohydrates that they ingest and the pump will calculate how much insulin to secrete.”
Another smart tech option that will soon be available is Abbott Labs’ FreeStyle Libre Flash CGM system that was approved by the FDA in late September. It replaces finger sticks with wired enzyme technology embedded in a sensor about the size of a quarter that measures glucose in subcutaneous tissue. Users wave a small mobile reader over the sensor to get their blood-glucose reading and more.
“Instead of just one piece of glucose information that you get from a test strip, you get three key pieces of information: your current glucose level, the direction it’s going in, and where it’s been,” said Chris Thomas, PhD, Director of Biosensor Technology at Abbott Diabetes Care. “With a test strip, there’s no way to get information overnight without waking up.” he said. “A quick scan when you wake up in the morning tells you what your glucose levels have been doing overnight.”
Thomas reports that in FreeStyle Libre clinical trials, people with Type 1 and Type 2 diabetes spent 38% and 50% less time in hypoglycemia, respectively. Those numbers have been confirmed in use outside the trials.
Smart technology products offer a critical new wave of care, according to Richard Bergenstal, MD, Executive Director at the International Diabetes Center at Park Nicollet in St. Louis Park, MN, and Past President, Medicine and Science, of the American Diabetes Association. He thinks it can help realize the triple aims of improving quality, improving patient experience, and reducing costs when it comes to diabetes care.
“We’ve been stuck for 35 years using the hemoglobin A1c,” he said, adding that while the test is great for quantifying risk for long-term complications, it’s not very helpful for day-to-day management of the disease.
“Finally, patients are seeing their profile, their life, their day-to-day activities reflected in these glucose patterns, and they can relate much more to it,” he said.