Two of the biggest annual conferences showcasing healthcare technology just wrapped up at the start of 2020, and of course, diabetes was center stage.
At the Consumer Electronics Show (CES) in Las Vegas and the J.P. Morgan Healthcare Conference in San Francisco, investors just can’t seem to get enough of hot new gadgets and science that look promising for the multi-million-dollar diabetes market.
Here’s a list of some highlights to know about, and how they impact us patients IRL:
A so-called “digital diabetes alert dog” system made headlines out of CES in early January. It’s not a dog robot as you might imagine, but rather a wearable noninvasive wristband continuous glucose monitor (CGM) that uses nanotechnology to detect blood sugar highs and lows.
The idea was sparked by an actual diabetes alert dog named Wiley, adopted by AerBetic CEO Anar Thors. He apparently wondered why wearable technology couldn’t perform the same function that alert canines do.
The system uses a nano gas sensor, created by San Diego-based AerNos, to detect certain gases that human bodies emit via exhaled breath. Scientists have identified these gases as early indicators of hypoglycemia or hyperglycemia.
The device connects to a smartphone app and can be linked to other smart home devices via Bluetooth and/or Wi-Fi. It also uses artificial intelligence to continuously improve the performance of the sensors and fine-tune each unit to the individual patient. Users can manually enter glucose readings into the app, which over time help the system to “learn” the person’s unique breath signatures.
At the CES 2020 show, AerBetic’s Thors said he expected this wearable D-tech to come to market within 2 years and cost about $500, significantly less than the thousands of dollars necessary to obtain an actual diabetes alert dog.
Why it matters:
We may never see this one come to market, but we love that it’s making a splash at the big Consumer Electronics Show — alerting all to the prevalence of diabetes and the need for better tools.
Rumor has it there are up 44 different companies developing their own CGM systems now, at least half of those aiming for noninvasive monitoring (that doesn’t penetrate the skin).
Another announcement creating buzz was a new AccuWeather partnership aimed at weather-related health. The global weather company partnered with Paris-based Plume Labs in a first-of-its-kind collaboration incorporating localized air quality info into weather forecasts around the world.
Through the AccuWeather app as well as via the web, people will be able to see how temperatures and air pollution levels may impact their health and well-being.
Why it matters:
Those of us with diabetes have often shared that our blood sugar trends seem to be impacted by the weather. This tool may help us explore that. CGM users might want to place their CGM mobile app icon on the homescreen right next to the AccuWeather forecast app, for easy comparisons!
Timed with the J.P. Morgan Healthcare Conference, San Diego-based Dexcom, which leads the continuous glucose monitoring market, announced yet another partnership — this time with diabetes digital health platform company Livongo.
Livongo’s service, which helps patients track glucose levels and connects them directly to diabetes educator coaches, was based on its own proprietary fingerstick (and test strips) to date. But now, Livongo users who also wear a Dexcom G6 device will be able to synch the data from that CGM with the Livongo platform.
Why it matters:
Investors are excited about this from the Livongo viewpoint, as the JPM conference marked its debut as a public company, following its much-hyped recent IPO.
But for patients, it’s exciting in another sense: As Livongo caters mainly to type 2 diabetes patients, this is further evidence that CGM is really going mainstream. The end goal of course is for CGM to become “standard of care” for all people with diabetes — meaning that one day, it would be mandated by both doctors and insurance companies that every newly diagnosed person is directed to use CGM rather than a traditional fingerstick meter.
Dexcom has also been working with Verily (formerly Google Life Sciences) to develop its highly anticipated next-generation G7 sensor — which is supposed to be miniaturized and less expensive, and therefore appealing to a broader consumer market.
Apparently in his first JPM presentation last week, Verily CEO Andy Conrad leaked some details of the design that Dexcom hadn’t yet signed off on — specifically the inclusion of an accelerometer for real-time tracking of effects of exercise on blood glucose.​
The terms of the Dexcom-Verily agreement changed in November, but Dexcom CEO Kevin Sayer insists they are still on track for a 2020 launch of the jointly developed G7. The new terms apparently “increase synergy” with Verily’s Onduo type 2 diabetes management program, and officially name Dexcom as the “preferred” CGM device supplier.
Why it matters:
News of the accelerometer made wearable technology enthusiasts gasp with anticipation. And it’s exciting for PWDs (people with diabetes) too: If the integrated activity tracker will really allow us to see our BG data overlaid on workout tracking, this could be the first viable tool to reliably understand and manage different forms of exercise with diabetes.
There was a lot of buzz around the JPM conference about the fact that approval from the Food and Drug Administration (FDA) is dragging for Abbott’s next-generation flash glucose monitoring (FGM) system, the Libre 2 product. Libre is the little round disk-sized sensor worn on the arm that provides readings when a user waves a scanning device over it. The first-gen product does not include any alarms to alert users to highs and lows.
Libre 2 will solve that problem, integrating Bluetooth Low Energy (BLE) communication to offer optional alarms.
Sounds simple enough to sail through FDA, but the delay is apparently tied to Abbott’s insistence on seeking the FDA’s new “iCGM” designation, that would certify it as interoperable with other diabetes devices.
This is important of course, as we move towards automated insulin delivery systems combining insulin pumps and CGMs, but some say the delay is also a competitive disadvantage for Abbott, because it buys more time for Dexcom’s G7 to hit market first and overshadow it.
On the integration front, note that Abbott also just headed up a $45 million investment in Bigfoot Biomedical, the Northern California startup that’s developing and automated insulin delivery via a connected insulin pen. Abbott’s Libre 2 is slated to be at the heart of that system.
Why it matters:
Patient choice, for one thing! Not everyone wants to wear an insulin pump or a traditional CGM. Different designs can provide options for people with various needs: small children, athletes who sweat or get wet a lot, older people who may prefer fewer alarms and less data overload.
Also, connected insulin pens (aka “smart pens”) are a huge up-and-coming product area. Why shouldn’t a PWD taking injections be able to track their data and get insulin dosing recommendations based on real-world data? On that note, Companion Medical’s InPen also made a big splash with its JPM debut presentation.
Virta Health, with its mission to reverse type 2 diabetes through nutrition, captured the “Most Committed to Clinical Impact” award in Rock Health’s Top 50 in Digital Health at #JPM2020.
The San Francisco-based company has published six peer-reviewed articles evaluating the impact of their program on BG levels, cardiovascular health, fatty liver disease, inflammation, sleep, and more. “At two years, the data show that those on the Virta Treatment had: 67% elimination of diabetes-specific medications, 81% elimination of insulin, 55% of patients fully reversing diabetes, 12% weight loss on average, and 22% reduction in triglycerides.”
Why it matters:
Those results are pretty amazing! And you know a company is kicking it among patients when they start tattooing the logo on their bodies.
Virta pairs T2 PWDs with virtual coaches, who work with them to make important lifestyle changes, with an emphasis on “drastically reducing carbohydrate intake to just a small portion per day.”
Their success is a testament to food as medicine, the huge benefits of low carb eating for people with diabetes, and the importance of one-on-one coaching for patients who’ve struggled on their own for years, getting nowhere. Thanks Virta!
ViaCyte presented at the BioTech Showcase, which is held in conjunction with JPM but not a part of the conference itself. ViaCyte is the San Diego-based biotech company developing a method to “reprogram” human stem cells to grow into new insulin-producing cells that would be implanted in the body housed in a tiny device — effectively, a functional cure for diabetes.
While they’ve been working on this for years (science is a slow burn), their CEO Paul Laikind says they’ve made “significant clinical progress” in the last year: “We expect that this year we can accelerate our mission to deliver transformative therapies for insulin-requiring diabetes.”
Why it matters:
Because cure research. While the incremental progress of science infuriates most of us, ViaCyte’s path to reach a cure is a front runner to actually get us there.
The fact that ViaCyte was showcased at this big investors’ conference should be a cause to celebrate for all those in the diabetes community who worry that there’s too much focus on new tech and not enough emphasis on finding a cure.
In case you missed it, in the midst of all this showcased innovation, on January 14, pharma giant Lilly announced plans to introduce two additional lower priced versions of their Humalog Kwikpen mealtime insulins. Available by mid-April, they’ll have 50 percent lower list prices than the branded versions.
This adds to Lilly’s first 50 percent cheaper insulin, Lispro, available as of May 2019 from all major U.S. wholesalers and can be ordered at any pharmacy. The company reports that in November 2019, more than 67,000 people filled prescriptions for that lower priced insulin, and approximately 10 percent of people taking the branded version have transitioned to the lower priced option.
Why it matters:
Three words: Insulin. Pricing. Crisis.
Clearly these discount versions are workarounds that won’t solve the systemic problem. But these cost-saving options are helpful to people paying high out-of-pocket costs for insulin — including those in the coverage gap of Medicare Part D. As we noted last spring, it’s a good start. Let’s keep pushing for more truly affordable insulin.
Amy Tenderich is the founder and editor of DiabetesMine, a news and advocacy resource she started after her own diagnosis with type 1 diabetes in 2003. She has become a nationally known patient advocate, public speaker, researcher, and consultant, who runs a series of influential DiabetesMine Innovation forums. When not working, she enjoys spending time with her three daughters, and hiking the great outdoors in the San Francisco Bay Area.