Abbott [NYSE: ABT]

Janna Parks

Diabetes is a chronic condition affecting how the body processes food for energy. Specifically, as the foods we eat are broken down into sugar (or glucose), the body generates insulin. This insulin helps sugar move from the bloodstream into the cells to be used for energy. If there is not enough insulin, the sugar stays in the bloodstream, which can have adverse effects on our health.

Since the first historical mention of diabetes in around 1500 B.C., managing diabetes care has evolved. In the 1920s, the availability of insulin was lauded as one of the greatest medical advancements for any disease. Without insulin, a diabetes diagnosis meant death within a few short years. Although a diabetes diagnosis today is not as feared as it once was, it remains a profoundly severe disease. Conditions such as heart disease, kidney disease, and even vision loss can result from elevated blood sugar levels associated with diabetes.

Approximately 1 in 10 adults worldwide are living with diabetes, and those numbers are projected by some organizations to continue increasing at a rate of 20 percent by 2030. This means over six hundred million adults will be faced with managing diabetes care in their daily lives by the end of the decade. There are three types of diabetes:  Type 1, where the body stops making insulin; Type 2, where the body still produces insulin but struggles to maintain blood sugar levels; and gestational diabetes, which tends to go away after pregnancy.

Technological advances provide better opportunities for patients and their caregivers to manage their health. Since self-monitoring of blood glucose became a standard of care in the 1980s, fingersticks paved the way for continuous glucose monitoring (CGM) systems like Abbott’s FreeStyle Libre system. These CGMs provide patients the ability to check glucose levels in real-time.

Patient D. Smith—a chef whose career revolves around different foods—stated that since he now has the ability to monitor his glucose frequently and throughout each day, he is not only in a better position to manage his blood sugar, but he also can see in real-time how different foods affect his sugar levels. This had allowed him to make better decisions about meal planning after a full day in the kitchen to offset “tasting” certain types of food while cooking.

“Smart innovation must consider all economic variables and extend beyond the device technology. Watching the innovation evolution in the diabetes care market will be interesting, with everything from smart tattoos to cell therapy on the horizon."

Fingersticks measure blood glucose at a single point in time, whereas CGMs measure glucose levels in interstitial fluid rather than directly in the blood. While there is a slight delay before glucose level changes are realized via CGM (typically less than 10 min), CGMs and their associated wearable technology are making it easier for patients to track glucose (blood sugar) over time and in various situations (exercise vs. sedentary, etc.)The opportunity to trend glucose levels during different activities and after different types of foods over time can provide deeper insight into how each person responds. This providesimproved glucose maintenance and a more stable overall physical health.

It is important to remember that advancing medical technology requires more than just the device technology itself. Any new game-changing medical device must be manufactured in a way that makes it cost-effective and able to be delivered to the massesproducinganother set of challenges, particularly in today’s med-tech space. Companies around the globe are suffering from supply chain challenges, which make designing for manufacturing more complicated and better planning more critical. With the number of diabetes patients continuing to grow, medical device companies are constantly seeking the next quality of life improvement opportunity. Unfortunately, just designing the next-generation device is not enough.Successful design teams must also incorporate supply chain concerns into material selection and, in some cases, even design an entirely new manufacturing space to produce the millions of devices and components necessary to support the target population. This can include establishing vertical integration and specific maintenance plans into the design and manufacturing strategy from the beginning.

When producing millions (or billions) of components to support diabetes patients worldwide, a single hour of downtime in production can be significantly impactful. Building redundancy into operations, strategically developing preventive maintenance plans to reduce downtime, and well-defined statistical process controls can help. The best companies build this into the device design process so that once a new technology has been approved, production is staged to begin. Too often, great innovation is stalled because manufacturing was not well-planned, and the devices are too expensive or even impossible to mass produce. By the time cost-effective production is implemented, the competition has already caught up to the new technology.

Within diabetes care, companies around the globe are consistently striving to find new ways to improve the lives of hundreds of millions of people. Smart innovation must consider all economic variables and extend beyond just the device technology itself. It will be interesting to watch the innovation evolution continue in the diabetes care market with everything from smart tattoos to cell therapy on the horizon.