Technology Updates in Diabetes Management

March 2020

According to the Centers for Disease Control and Prevention (CDC), there are currently over 30 million Americans living with diabetes.  Ninety to ninety five percent of people with diabetes have type 2 diabetes, with the remaining having type 1 diabetes.1,2  Despite advancements, diabetes is on the rise in the United States. The CDC discovered that there were 26 million people living with diabetes in 2010. By 2014, there were 29 million people living with diabetes and that number has continued to increase.1,2

Individuals with type 2 diabetes have insulin resistance and often have an insulin deficiency as well.1,3,4  This causes an excessive amount of glucose to stay in the bloodstream instead of reaching the cells in throughout the body. For individuals with type 1 diabetes, the pancreas produces no insulin.1,3,4 Insulin blocks new glucose production in the body and helps to increase the breakdown of glucose in cells.  When the body has no insulin to let glucose into the cells, glucose builds up in the bloodstream. Often, individuals with diabetes also have other comorbid concerns such as abnormal lipids, hypertension and vascular inflammation.1,3,4

Over the last several years, we have seen rapid advances in the technologies that aim to treat people with diabetes.

The presence of too much glucose in the blood, as well as other aforementioned comorbid concerns, can cause a variety of health issues such as heart disease, kidney disease, eye disease and neuropathy.1,3,4  As a result, it is important for those with diabetes to monitor their glucose levels throughout the day to ensure their levels remain stable. This can be quite burdensome and painful, as the individual must prick their finger multiple times per day.4

Luckily, technology used to monitor and treat individuals with diabetes has improved rapidly in the past few years. One recent innovation in glucose monitoring is continuous glucose monitoring (CGM) systems. A CGM works by inserting a small sensor under the skin. Throughout the day and night, the sensor measures the individuals' glucose level. The system then sends the glucose readings to a monitor. Some CGM systems can even send information directly to a smartphone. CGM systems often have an alarm built-in to alert the individual if their glucose level is too high or too low.5

As of October 10, 2019, the Food and Drug Administration (FDA) approved a CGM system by the manufacturer Dexcom that can be used in patients as young as two-years-old.6  Another CGM manufacturer, Eversense, was recently approved by the FDA as the first CGM system to include a fully implantable sensor that can be worn continuously for up to 90 days. Prior to Eversense, the sensor on most continuous glucose monitoring systems had to be replaced every three to seven days.7

Another recent technology for diabetes management is One Drop, a wireless blood glucose monitor that includes an app to track glucose readings. One Drop's platform is integrated with Apple's Health Records, which allows users to easily share health data with their doctors and receive real-time glucose readings on their smartphone. One Drop also leverages artificial intelligence to “provide users with forecasted blood glucose predictions and behavioral recommendations based on those predictions.” Using the 1.3 billion data points received from users, One Drop is able to make accurate predictions of an individual’s glucose trends.8

Additional innovation in the treatment of type 1 diabetes comes in the development of the artificial pancreas. Artificial pancreas systems not only provide continuous glucose monitoring; but also deliver insulin to the individual as needed without human intervention based on the current glucose readings.9

The first commercialized artificial pancreas entered the market in June 2017.9  A six-month clinical trial involving 168 participants was completed to evaluate the effectiveness of an artificial pancreas. Participants were split into two groups and given either the artificial pancreas technology or a traditional insulin pump for the trial. The study found that the participants using the artificial pancreas technology were better able to keep their glucose levels in a healthy range 2.6 hours more per day than the control group. The study also found that the participants using the artificial pancreas had fewer highs or lows in their glucose over a 24-hour period.10

As these technologies improve even further and new innovations are developed, the management and treatment of diabetes should be easier and more accurate for the millions of people living with this disease. As use of these technologies improve both morbidity and mortality for those living with diabetes, these individuals should be able to purchase life insurance and disability income products at a lower cost than they could previously. For life insurance companies, lower mortality rates mean less claims and a more favorable block of business. 

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Rachel Eberle
Rachel Eberle
Underwriting Consultant
Underwriting Services
References
National Diabetes Statistics Report, 2017. (2020, February 13). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/data/statistics/statistics-report.html 2 Paddock, C. (2014, June 12). Diabetes rise in the US is 'alarming,' say CDC. Medical News Today. https://www.medicalnewstoday.com/articles/278140#1 3 What is diabetes? (2020, February 13). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes 4 Type 1 diabetes. (2020, February 13). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011 5 Continuous glucose monitoring. (2020, February 13). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes/continuous-glucose-monitoring 6 Boxler, D. (2019, October 10). Dexcom G6 Continuous Glucose Monitor Approved by FDA. Drug Topics. https://www.drugtopics.com/new-products/dexcom-g6-continuous-glucose-monitor-approved-fda 7 What is Eversense CGM? (2020, February 13). Eversense Diabetes. https://www.eversensediabetes.com/ 8 One Drop becomes first diabetes blood glucose monitoring platform to integrate directly with Apple watch. (2018, September 11). One Drop.https://onedrop.today/blogs/press-releases/one-drop-apple-watch-direct-integration 9 Ebmeier, M. (2018, February 6). The Artificial Pancreas: What Is It and When’s It Coming? Taking Control of Your Diabetes. https://tcoyd.org/2018/02/the-artificial-pancreas-what-is-it-and-whens-it-coming/ 10 Hale, C. (2019, October 16). Closed-loop artificial pancreas from Tandem, Dexcom aces Type 1 diabetes study. Fierce Biotech. https://www.fiercebiotech.com/medtech/closed-loop-artificial-pancreas-from-tandem-dexcom-aces-type-1-diabetes-study

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