Analytics, connectivity help diabetes management get smart

Convenience has always been king, but another concept — connectedness — is bringing new solutions to the diabetes management space.

With the Centers for Disease Control and Prevention estimating in 2017 that 30.3 million people — roughly 9.4% of the total U.S. population — have diabetes, the space is ripe for solutions that are aimed at making managing the illness easier.

With the rise of connected health documented by such firms as Deloitte — whose recent survey on healthcare trends found that the use of digital devices to chart health and fitness goals has tripled between 2013 and 2018 — many companies are eyeing high-tech solutions to ease the burden of diabetes management. At the same time, these tools open the door for better clinical oversight and, ultimately, better patient health.

“In years gone by, the patient would get their blood glucose reading off their device and they would act accordingly,” said Brahim Zabeli, vice president of sales at Smart Meter, which makes the iGlucose diabetes care solution. “That patient was on their own doing this without any real assistance from day to day. Some of the new blood glucose systems that are out there have more data features than ever, and for those patients with diabetes, it gives them more tools to look at the readings over an extended period.”

With the iGlucose system, the use of its cell-enabled glucose monitor can be augmented by the iGlucose personal web portal for patients, where automatically transmitted readings are stored, and the virtual health coach, which offers automatic feedback on the readings. Zabeli said that the readings also can be shared with health professionals who can keep a better eye on patients. He also said that in a recent pilot with FlexCare Pharmacy in Washington, D.C., found that patients who knew their physicians might look at their results, they test more frequently.

“By having access to the data much more frequently, that healthcare professional that’s working with the patient can now monitor his or her patients on a weekly basis and take action on a weekly basis if needed,” Zabeli said.

The role that access to data plays in helping patients manage their condition also is a key component of Dexcom’s approach to the space. The company’s recently launched G6 continuous glucose monitor conducts a reading every five minutes — all without a finger stick.

“If you don’t have that real time data feed, you may miss a lot of highs and lows,” said Rick Doubleday, executive vice president – chief commercial officer at Dexcom, who added that users can share their readings with physicians and even family members. “Our system is not going to miss those, and it’s going to alert you — and if you’re using the follow function, it’s going to alert a loved one, and that loved one has the ability to then engage to help the individual.”

Retailers also can benefit from the health information that’s coming from diabetic patients, Doubleday said.

“As we collect this data, we’re creating APIs with those data streams, and retailers are going to be able to access those data streams and have software in-store where they can look at an individual patient and potentially better coach and counsel them to manage their diabetes,” he said.

Though monitors have been a primary focus of innovators in the space — many with the eventual goal of creating an artificial pancreas — one company has given a Bluetooth-enabled brain to a diabetes management mainstay — the pen injector. Companion Medical’s InPen, conceived in 2013 and being commercialized this year after several rounds of funding and Food and Drug Administration approval, was the winner of DSN/ECRM’s Buyer’s Choice Award at the recent Diabetes/Clinical Programs, Chronic Care Management & Adherence Solutions EPPS.

Accompanied by an app that displays the user’s last glucose reading — the app is interoperable with blood glucose meter, including CGMs — their last insulin dose and when the dose was administered, the pen transmits the insulin dose when the patient administers it.

Sean Saint, CEO of Companion Medical — who has Type 1 diabetes himself — said it was designed to bring the ease of monitoring of an insulin pump to the most commonly used method of administering insulin.

“We tried to take into account patients, providers and the payer when we developed this, and recently we added the pharmacist,” Saint said. “In doing that, we’ve added a lot of features and capability to the product.” He said that in the same way Dexcom offers a near-constant look at blood glucose, InPen offers a similar look at insulin doses and recommends subsequent doses based on past doses and glucose readings.

It’s worth noting that not every innovation in the diabetes management space is cell-

enabled or outfitted with hidden Bluetooth transmitters. One product that caught the eye of retailers at a recent ECRM meeting was a straightforward, if low-tech, management system for new and used pen needles. Excelsior, Minn.-based UltiMed’s UltiGuard Safe Pack offers a dual system for dispensing new pen needles and safely disposing of used ones via a built-in sharps container.

“Diabetes is a disease you not only manage daily, but hourly and sometimes by the minute,” said Sarah Hanssen, UltiMed’s vice president of sales and marketing. “It’s something people with diabetes have to constantly attend to, so anything that will make it a little bit easier is a lot.”

Hanssen said that the company works with retailers around merchandising the product, including making it a preferred choice in-store and co-branding with such retailers as H-E-B.

With all of these solutions, besides making patients’ burden of disease management lighter, there also is an opportunity to be more involved in care. Dexcom’s Doubleday said that its APIs could in the future be used to help push refill alerts to patients.

Though the main hurdle for any technology is adoption — and Smart Meter’s Zabeli said that there is potential for confusion among older-skewing patients — this underscores the aim that Saint said informed Companion Medical’s development of InPen.

“Our vision was something that was extremely familiar,” Saint said. “Our product is extremely similar to a traditional insulin pen — it’s no different. There are no buttons, no switches, no screen, no recharging — nothing.”

If companies can achieve adoption, it will mean more opportunities to drive patient outcomes. “The opportunity exists for pharmacists to be involved in this practice and not only gain revenue, but greater loyalty on the part of their patients,” Zabeli said. “Having pharmacists, particularly clinical pharmacists, involved in this practice could be a boon to the retail

pharmacy community.”

Doubleday said, “All of this is coming together to provide individuals better insight to their health than they’ve ever had before. All of that data together will help provide the individual so much greater insight than they’ve ever had before, and that’s what’s going to help drive outcomes.”
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