People with diabetes today spend hours each week carefully tracking blood glucose levels, food intake and physical exercise to calculate when and how much insulin should be injected into their bodies. Living with diabetes requires constant vigilance and a strong sense of self-determination and efficacy. While diabetes research has made enormous strides in the past decade, those living with the condition are still faced with the daily reality of the fact that a cure remains elusive. As such, much of the current research has centered on the improvement of “maintenance” technologies. While the implementation of these treatments – an artificial pancreas, insulin inhaler, and a myriad of mobile apps, among others – has been less efficient than most would say is ideal, the proliferation of “smart” devices has positioned such new technologies to play a pivotal role in the way diabetes is controlled and monitored.
With a health condition like diabetes, where the individual is responsible for round-the-clock self-monitoring, there are many benefits to come from care that is both increasingly automated and personalised for the individual. While many of us already use phone apps to help manage glucose levels, there are a multitude of other devices in development striving to offer new ways for both people with Type 1 and Type 2 diabetes to gain better control over this condition.
Many of these new tools are influenced by healthcare’s recent progression towards greater patient-physician connectivity. The increased usage of mobile apps and patient portals to engage with people with diabetes allows researchers access to a plethora of useful data for analysis. Utilising technology to facilitate a more aggressive monitoring of this condition will hopefully lead to insight into new devices and treatments, while fueling the continual improvement of those already in use.
Let’s take a look at some of the newest technological devices available, as well as several poised to hit markets within the next few years:
The Artificial, or “Bionic” Pancreas:
Despite steady improvements in treatments for Type 1 diabetes, most patients still spend most of their lives outside the ideal glycaemic zone. This information has led researchers to concentrate efforts towards the creation of a device capable of sensing a patient’s glucose level and automatically secreting the necessary quantity of insulin. This “artificial” or “bionic” pancreas is certainly not a cure for diabetes, but there is optimism that it will positively affect the overall landscape of diabetes control as it currently stands.
The artificial pancreas will effectively function as a marriage between the two technological advancements – continuous glucose monitors and portable insulin pumps – at the forefront of diabetic treatment. After making a very promising debut this spring, the inventors behind the “bionic pancreas” in Boston have projected hopes that this device will revolutionise the way people with diabetes interact with their blood glucose levels.
Ideally, the new product will take over the body’s task of monitoring and regulating glucose levels in the blood. With this device, a signal will be transmitted wirelessly every 5 minutes from a glucose monitor under the patient’s skin to a smartphone app, displaying their blood-glucose status. The accompanying app will then calculate the amount of insulin or glucagon needed to balance blood glucose, automatically sending a signal to the pumps carried by the user in order to administer the required dose via a catheter. Ideally the system will require little, if any, input from the user.
“The bionic pancreas system reduced the average blood glucose to levels that have been shown to dramatically reduce the risk of diabetic complications,” says the co-author of the new paper on this device, Steven Russell, of Massachusetts General Hospital. Findings in his study proved that the bionic pancreas, using the newest smartphone app technology, helped its users maintain blood glucose levels more consistently within a normal range than users who manually monitored their glucose levels with finger stick tests. While the FDA in the US has not yet approved a fully-automated artificial pancreas device system yet, there have been tremendous strides made in its development.
The GMate Smart Blood Glucose Monitoring System:
Produced by Philosys, a South Korean company, the Gmate Smart allows people with diabetes to use their smartphones to analyse and measure their blood glucose levels. The small, quarter-sized device plugs into an iPhone, iPad, or iPhone Touch via the headphone jack. Users operate it by opening the free app, inserting a test strip, and applying their blood sample. The app not only analyzes the results, but acts as a log of personal test results. It offers the additional features of goal-setting and graphing, as well as the ability to send glucose test data directly to a physician. The device received 510K U.S. Food and Drug Administration approval for use in the United States this August, and hopes to arrive in U.S. markets very soon.
This new device is the first half-unit dosing pen that also incorporates a memory function. By remembering both the dose and the amount of time passed since the last injection, it gives users the luxury of having a constant reminder to determine if they took their insulin or not. Additionally, half-unit dose increments allow for finer adjustments, which are important for children but just as convenient for adults who would prefer to be more accurate with their dosages. 12 removable “skins” and different color choices give kids the option to customize their pen to their own personal tastes and style.
Afrezza, or Inhaled Insulin:
On April 1st of this year the FDA approved MannKind Corp’s inhalable and ultra-fast insulin called “Alfrezza.” Taken before each meal, or immediately after starting to eat, Alfrezza does not require needles of any kind. The insulin is packaged in powder form and designed for adults with Type 1 or Type 2 diabetes. Alfrezza is not a stand-alone insulin treatment, however, and is meant to primarily control post-meal blood glucose spikes. The powder insulin is used with a device that resembles a small whistle. The second formulation of inhalable insulin to make it through the U.S. regulatory MannKind, recently announced that Alfrezza will be marketed by French pharmaceutical company Sanofi. The collaboration marks a milestone, or a resolution, for Mannkind, which spent nearly $2 billion and the better part of a decade developing the diabetes drug.
The SENSUS Pain Management System:
The SENSUS device is a non-invasive electrical nerve stimulator that is uniquely designed to provide relief from the pervasive feelings of numbness and pain that afflict many people with neuropathy. Diabetic neuropathy, or nerve damage as a result of chronically high blood glucose levels, can be one of the most debilitating complications of this condition. It affects roughly half of people with Type 1 and Type 2 diabetes throughout their lives.
Wearable devices, in the form of fitness bands or watches, are becoming popular at a remarkable rate – but they rarely do more than measure vital signs and detect when the user is in motion. With the SENSUS, however, the focus is not on measuring pain but managing it. Providing non-drug pain relief, it is worn on the leg below the knee to comfortably stimulate the sensory nerves in the wearer’s extremities. It works by transmitting low frequency electric impulses throughout the body, a process known as transcutaneous electrical nerve stimulation or TENS. The SENSUS device is non-narcotic with no side effects, and can be worn comfortably at night as well as discreetly under clothing.
“Smarter” Smartphone Apps:
ShugaTrak: ShugaTrak reads glucose levels inputted under the skin to give the most accurate readings. Using this app, people with diabetes can easily communicate their blood glucose levels to their loved ones. Especially useful for parents who worry about their children while they are separated from them during the school day, ShugaTrak records the results whenever the child measures his or her blood glucose and sends them immediately via text or e-mail back to the parent. Developed by John Fitzpatrick, a former neuroscience researcher and lecturer at Yale, ShugaTrak was labor of love to ensure families in the diabetes community have peace of mind when they are apart throughout the day.
Glucose Buddy: A free diabetes monitoring tool, Glucose Buddy provides users with a clearer visual understanding of trends in their glucose levels throughout the day. It also incorporates a diary for diet, medication, and exercise habit logging. The app also aims to close the gap between patient and healthcare provider, by including the option to have glucose readings sent via e-mail to the patient’s diabetes team.
Smart “Sox”: Foot problems – surpassing even heart attacks, strokes, and high blood glucose – are one of the most common reasons that a person with diabetes will be admitted to the hospital. “Smart Sox” are designed to identify locations in the foot as well as ranges of motion that could lead to problems. Developed by American doctors, the socks use fiber optics and sensors to monitor changing pressures in the patient’s feet. Whether a patient is at a clinic or at home, they’ll get word from the Smart Sox (via diagnostic component) that there is a need for treatment. In this way, doctors will also be able to provide more effective treatment in the form of exercise or medicine. Ultimately hoping to help wearers avoid additional complications, these socks can alert patients ahead of any developing foot ulcers and other painful trauma. Researchers expect Smart Socks to be available to the public by 2019.
For more information on apps that can help you manage your diabetes, check out this article we recently published on smartphone apps and diabetes management.
As tech industry website HealthITJobs.com notes, “medical technology is no stranger to the newest advances. The pace of innovation in diabetes treatment around the world is matched only by growing need.” As medical and consumer technology continues to merge, we can expect to see many new innovations inspired by the needs of people with diabetes. It’s likely that Google will be introducing a contact lens-based glucose monitor in the near future, and other tech industry giants have also dipped their toes into the realm of medical technology. Aggressive treatment options, technological or otherwise, are what counts until a cure has been found.
Ultimately technology that is focusing on improving lives, rather than corporate bottom lines, is what will allow people with diabetes to put their concerns associated with the condition behind them. And as Dr. Edwin Fisher, global director of Peers for Progress at the American Academy of Family Physicians Foundation, explained in a recent interview, “We really need comprehensive approaches that bring together clinical care, community care, social support, friends, and neighbors, to help people with diabetes live their lives well and take care of their diabetes well.”
In the ongoing fight against this condition and it’s many complications, new devices aren’t the only answer. An ongoing commitment to population health overall, and a greater discussion between manufacturers, researchers, and the diabetes community at large is needed to truly make strides against this dangerous and costly condition.
This article was written by Jared Hill.