Diabetes devices move from painful fingerpricks to slick tech

Bloomberg

Diabetes devices may be having their iPhone moment.
For decades, the daily routine of diabetics involved painful needles, finger-pricking lancets and imprecise glucose metres. Now, manufacturers have begun incorporating the slick and consumer-friendly designs of Silicon Valley, linking to phones and other tech devices.
“This is a crossroads for diabetes technology,’’ said Raj Denhoy, an analyst at Jefferies in New York.
September marked a breakthrough in the US, as regulators approved the first glucose-monitoring system that doesn’t need a blood sample, the FreeStyle Libre by Abbott Laboratories. The new devices do away with fingerpricks, changing an unpleasant, several-times-a-day routine into quiet monitoring in the background through a sensor worn on the back of the upper arm.
Other companies have been left behind. Johnson & Johnson is closing its insulin-pump unit after failing to keep up with Medtronic Plc. DexCom Inc., the current leader in glucose-monitoring systems, lost a third of its market value after Abbott’s Libre got approval.
On DexCom’s earnings conference call executives said the company hopes to introduce its own fingerprick-free device before the end of 2018.
The comments about next-generation monitors helped assuage investors’ concerns about DexCom’s prospects, sending the stock up 9.5 percent in the two trading days following the results.
“Companies who succeed will be those who can figure out this convergence of health care and technology,” said Arda Ural, a partner at Ernst & Young LLP in New York. “And they’re very different animals to bring together.”
For the winners, the potential market is huge. Diabetes device sales totalled $14 billion in the US last year, according to Ernst & Young.
For now, the bulk of the sales are to the 1.25 million American diabetes with the most severe form of the disease, type 1. Because their pancreas can’t produce insulin, those patients have to constantly monitor their blood sugar and frequently inject themselves with insulin when
it spikes.
There’s a larger, mostly untapped market: the about 20 million Americans with type 2, whose body’s ability to use insulin fades slowly over time and who don’t regularly use tools to manage their disease.
Yet some patients have been waiting for decades for better devices to control a condition that, unchecked, can lead to complications including kidney damage and heart disease.
Aaron Kowalski, chief mission officer of diabetes research foundation JDRF, was diagnosed as a 13-year-old in the 1980s. At the time, people measured their glucose by urinating on a stick or placing a drop of blood on a colour strip that gave a rough number. “It was barbaric,” he said.
Abbott’s Libre will arrive in the US soon. It’s already been sold to 400,000 consumers internationally, including Brenna Wilson, an 18-year-old high-school student in Ireland who was diagnosed with type 1 at age 3.
Before she bought the Libre in March, it had “kind of been hell” managing the condition, Wilson said.
“The Libre makes it a lot easier,” she said. “I can just check what it is, and it doesn’t have to be this whole big thing. It’s very discreet. People don’t even notice it.”
Dexcom, despite the recent blow, has been making strides as well. Its G4 and G5 sensors stick on the body and are only
calibrated twice a day with a finger prick. In September, the San Diego company teamed with Fitbit Inc. to link its devices with the latest Fitbit Ionic smartwatch. The companies hope to get the product out next year.

Major Hurdles
Unlike many consumer products, diabetes devices face two major hurdles— the Food and Drug Administration and health insurers.
Joel Goldsmith, senior director of product innovation at Abbott, said it can take years to get products through long trials required by the FDA before a device can reach the market. “There’s a new phone model every six months,” he said. “The medical device world doesn’t operate at that same pace.”