The outlook for diabetes drug treatment over the next few years is promising for type 2 and type 1 patients. Well known pharmaceutical companies, such as Johnson & Johnson, Novo Nordisk, Abbott Laboratories, Sanofi-Aventis, Merck, Bayer, and Roche are leaders in the diabetes drug and device arena but new companies are involved as well. Market competition will increase with companies setting up operations in emerging markets. China and India, two of the biggest markets are expected to account for much of the growth of the treatment market. This trend will stimulate innovation and price reduction which will provide access to treatments for poorer patients.
A little further down the pipeline is a device/system called The Bionic Pancreas which uses both insulin and glucagon along with a continuous glucose monitor that are controlled by a smartphone. This is truly a game changer and when it comes to market the diabetes world will take notice.
As a person with Type 1 diabetes I often struggle to keep my blood sugars in balance. It is no easy task to monitor my blood sugar while injecting insulin through an infusion pump to cover the carbohydrates I eat or to correct a high blood sugar. Balancing food, insulin, stress, and exercise at times can be a monumental task. I often joke about waving a device over food that can calculate the carbohydrates and automatically dispense the correct amount of insulin to cover the food I eat.
No joke, the team at the Diabetes Unit and Department of Medicine, Massachusetts General Hospital and Harvard Medical School along with the Department of Biomedical Engineering, Boston University may have just invented this device. It is fondly called the Bionic Pancreas.
In order to understand the game changing technology, it is important to point out the current technology being used to treat hundreds of thousands of patients with diabetes using insulin. Insulin is administered in mainly two methods, through a needle injection/pen or an insulin pump. Calculating the amount of insulin to administer prior to eating a meal or snack requires estimating the carbohydrates as well as being knowledgeable about the effect of protein and fat on blood sugar levels over time. Many times it is done through trial and error, especially when a new food is introduced.
Monitoring blood sugar is typically done through finger sticks with a traditional blood glucose device. More and more patients are using a fast growing device called a continuous glucose monitor which gives a number, typically every five minutes, but more importantly arrows that point up, down, or sideways to indicate trends and the rate at which the blood sugar level is moving up or down.
Glucagon, a hormone secreted in the pancreas, works by telling the liver to release sugar (glucose) into the bloodstream to quickly bring the blood sugar level back up before or when it drops too low. For patients with type 1 diabetes, a synthetic version of glucagon is used in emergency situations such as loss of consciousness due to a severe low blood sugar.
The team working on the Bionic Pancreas used these devices and drugs (insulin pump, continuous glucose sensor, insulin, and glucagon) as well as a smart phone with an app using the algorithm developed by the engineers on the team.
Overall, my experience on the Bionic Pancreas for five days was excellent. It was refreshing to not have to think about my diabetes as much as I do on my traditional therapy (an insulin pump and continuous glucose sensor). The key take-home message is that the Bionic Pancreas improved average blood glucose levels with less frequent hypoglycemia events in adults and adolescents with type 1 diabetes. The primary focus of the team of inventors at this juncture is to invent a dual chambered pump as soon as possible.
That alone would make me move to this device once it is cleared by the FDA and comes to market.
Outpatient Glycemic Control with a Bionic Pancreas in Type 1 Diabetes: Russell, Steven J., MD., Ph.D., El-Khatib, Firas H., Ph.D., Sinha, Manasi, M.D., M.P.H., Magyar, Kendra L., M.S.N., N.P., McKeon, Katherine, M.Eng., Goergen, Laura G., B.S.N., R.N., Balliro, Courtney, B.S.N, R.N., Hillard, Mallory A., B.S.N., R.N., Nathan, David M., M.D., Damiano, Edward R., Ph.D. New England Journal of Medicine: June 2014.