By Scott Jung, iQ Contributor & Senior Editor at MedGadget
New technologies are making diabetes easier to manage and less expensive to treat – for both patients and medical professionals.
In the United States today, 29.1 million people live with diabetes – that's about one-tenth of the population. At a cost of $245 billion in medical expenses and lost wages, diabetes is crippling for our healthcare system. "Diabetes is arguably the chronic condition most ripe for technological disruption," says Dr. David Ahn, an endocrinology fellow at the University of California at San Diego. He says technological breakthroughs could have a bigger effect on diabetes than hypertension, coronary heart disease and even cancer.
"What's fascinating, is that people with diabetes are the original 'quantified selfers' – dating back to the mainstream availability of glucose meters in the 1990's," Ahn said. Adding that, while the notion of collecting data to track your health isn't new, it hasn't evolved much – until recently. "[Diabetes patients] are just now starting to benefit from the recent attention to digital health and the quantified-self movement."
Ahn said technology is being utilized in three stages of the disease: prevention, management and the quest for a cure.
Big data and analytics can look at a person's health and lifestyle choices and assist healthcare providers in identifying patients who are at risk of developing diabetes. Web-based and mobile programs can then help these at-risk patients make lifestyle changes to slow or eliminate the progression of the disease.
For those who have type 1 diabetics, meaning the body cannot produce enough insulin to regulate sugar levels in the blood, Ahn says insulin pumps and wearable sensors called continuous glucose monitors (CGM) can now wirelessly transmit blood glucose levels every five minutes. Diabetics will no longer have to remember to check their blood sugars and give themselves insulin injections.
Ahn believes that the next big trend in glucose monitoring will be the ability to control CGM's on smartphones (and smartwatches). CGM manufacturer Dexcom recently received FDA approval for Share, a cradle that wirelessly transmits glucose readings to the cloud for loved ones to be able to follow a user's blood sugar in real time.
Technology is also helping researchers find a cure for diabetes.
At the Bionic Pancreas Project, a collaboration between Boston University and Massachusetts General Hospital, doctors and engineers have created an "artificial pancreas" by combining CGM, insulin pumps and a smartphone "brain" to mimic the function of the human pancreas. It has allowed people with diabetes to go five days without worrying about what they eat or insulin dosages, which has profound implications for diabetics who often feel tethered to pumps or monitors.
At the other end of the spectrum, ViaCyte is doing compelling work in regenerative medicine. Their VC-01 Combination Product is a device implanted underneath the skin. It contains stem cells that will mature and produce the insulin that diabetics lack. While the technology is still early in development, mice studies have yielded promising results.
From a research standpoint, Ahn hopes for a day when treatment of diabetes actually reverses the disease process.
"Stem cell treatments offer the potential for a true "cure" to type 1 diabetes by recreating pancreatic tissue." he says. "For both types of diabetes, there is ongoing research to better understand what causes diabetes at the molecular level to better identify targets for therapy."
San Francisco-based Omada Health raised $23M and recently received a $950,000 grant to help low-income populations reduce the risk of type 2 diabetes. Sean Duffy, Omada's co-founder and CEO, says type 2 diabetes, which is when the body is less able to respond to insulin, is entirely preventable. Omada's recent research scientifically demonstrates that if doctors could help people with pre-diabetes (those who have abnormal blood sugar, but not abnormal enough to yet be diagnosed with type 2 diabetes) make substantive lifestyle change, their chances of getting diabetes is dramatically reduced.
"This is why I became interested in diabetes." says Duffy. "It's a huge crisis, but one that is entirely subject to intervention and change. We can re-route the epidemiology around diabetes if we think big." Omada Health works with the Center for Disease Control's National Diabetes Prevention Program (NDPP) through a 16-week intensive lifestyle program for people with a high risk for type 2 diabetes. These users are put into small groups and guided through interactive curriculum and support tools so they can successfully reduce their risk of getting diabetes.
"Two things are needed to stem type 2 diabetes, screening and programs to intervene for when people are identified to be at risk for type 2 diabetes," said Duffy. "The health care system is making progress on both fronts, and we have the chance to make an extraordinarily impact."
