Invest in the future of blood glucose monitoring

According to a publication of the International Diabetes Foundation (IDF), roughly 537 million people suffered from diabetes worldwide in 2021. By 2045, this figure will rise to roughly 783 million people. In emerging market and newly industrializing countries, an even greater rise in the number of diabetes cases is expected. In Southeast Asia, an increase of 68 % is expected and 134% in Africa. In industrialized countries like in America (US and Canada), roughly 51 million people, or 14 % of the total population, suffer from diabetes.

The market for conventional blood glucose measuring devices is growing at an annual rate of approximately 10.4 % and was, in 2020, about 19.3 billion US dollars. The market is dominated to more than 75 percent by the classic finger prick method where capillary blood is put on a test strip, which is then read using a measuring device. The market for conventional blood glucose measuring devices is dominated by manufacturers like Roche, Lifescan (Johnson & Johnson), Abbott and Ascensia, although most turnover is actually earned through the sales of the test strips.

In 2000, the first transcutaneous Continuous Glucose Monitoring System (CGMS) was put on the market (by Minimed, now part of Medtronic). This device could measure and save glucose values continually for 3 days. The values were only available at the end of the three-day period, though, after which therapy adjustments could then be checked, for example. Today, there are three transcutaneous and one subcutaneous implant system available that record continuously for up to 6 or 14 days (in case of the impant, 180 days with surgical procedures to insert and remove the implant) and provide patients with data in real time: Dexcom (G6®), Abbott (Freestyle Libre 2®), Medtronic (Enlite®) and Senseonics (Eversense® XL implant).

Diabetes Mellitus, or simply Diabetes, is a collective term for a variety of metabolic disorders which all lead to uncontrolled blood glucose levels. Diabetes is mostly chronic and is caused by the inability of the pancreas to produce sufficient insulin, or by the body’s inability to effectively use the insulin that it produces.

Type 1 Diabetes

Type 1 diabetes is an autoimmune disease affecting the pancreas, meaning the body is no longer able to produce insulin. As a result, patients are dependent on injected insulin throughout their entire lives. Type 1 diabetes often develops suddenly and during youth. With the correct insulin therapy and strict regulation of blood glucose levels, a normal life is possible. The number of Type 1 diabetes affected patients continues to rise every year. Although the reasons for this are not yet fully understood, it is suspected that environmental causes, events in utero or viral infections may play a role.

Typ 2 Diabetes

Type 2 Diabetes is the most common form of diabetes. Patients do not react sufficiently to insulin produced by the body. Often, Type 2 diabetics can keep the disease under control via dietary measures and medication, thereby avoiding the need to inject insulin. In advanced cases, however, an insulin therapy may become necessary, along with monitoring blood glucose levels. The number of Type 2 diabetes affected patients continues to rise every year. Possible explanations are an increasingly aged population as well as contemporary economic development and its effects on eating habits, lifestyle and lack of physical activity.

Gestational diabetes

arises, as the name suggests, during pregnancy and is caused by insufficient insulin production during this period. Normally, gestational diabetes disappears after birth.

Too high or too low blood glucose values (hyperglycaemia/hypoglycaemia) can, in its acute form, result in coma. Particularly insulin-dependent diabetics are at risk of hypoglycaemic attacks. Hyperglycaemia over a long period leads to a series of diabetic late-onset complications such as cardiovascular problems (heart attack), kidney disease (kidney failure), blindness (diabetic retinopathy), nerve damage (neuropathy, sensation of pain, numbness), blood vessel damage with poor circulation, as well as reduced capacity for healing wounds and even the loss of extremities (diabetic foot).

It follows that the goal of any type of therapy is to control blood glucose and to keep it at a normal level using suitable measures. Depending on the particular form of diabetes, this translates into a special diet, medication or insulin injections.

Although blood glucose values can vary greatly both day and night and even within the space of an hour, the unpleasantness of finger-pricking hinder many from checking their values more often: not only is the lancing procedure itself painful, but, for some, the fingers may constantly hurt, or the finger tips may become numb. On the other hand, skipping measurements brings with it the worrying risk of hypoglycaemia or even coma.

Overcoming these barriers would – in combination with suitable insulin doses and conscientious living – make it much easier to keep the blood glucose curve within a range comparable to that of a non-diabetic and would help avoid symptoms. For many years, experts have been striving to develop a blood glucose

measuring principle that fulfils customers’ desire for a blood- and pain-free process.

Continuous glucose monitoring (CGM) delivers automatic continual blood glucose values and informs the patient when values are critical (hyper- and hypoglycaemia) – even before they get that far – which helps to improve the patients’ quality of life and sense of security. The first prototypes are showing very good clinical results. The long-term aim is the (semi-) automatic regulation of an insulin pump for diabetes patients.