The diabetes market has seen a huge influx of software-based devices and applications meant to ease the treatment burden of these diseases. Despite this, however, there is still a long list of challenges people living with diabetes face every day. As SaMD technology advances, the opportunities for erasing these burdens become more plentiful.
In this article, we’ll look at some of the most common challenges faced by those living with type 1 and type 2 diabetes. From these, we propose potential solutions SaMD could provide.
Challenges in Diabetes Treatment and Care
Type 2 diabetes is a complex metabolic disorder. Progressive insulin resistance in people living with this condition leads to serious health complications that affect multiple systems including the heart, eyes, kidneys, and nerves. Avoiding debilitating complications requires a constant focus on eating right and staying active and, often, taking multiple medications.
Type 1 diabetes is an autoimmune disorder that has no cure and requires a lifetime of strict insulin dosing, careful carb counting, and constant attention. Failure to maintain normal blood sugar levels results in many of the same debilitating complications as type 2 diabetes.
In either case, people living with diabetes face frequent challenges that current technology does not provide adequate relief for.
There are many medications approved to help treat diabetes in all forms. Strict adherence to type 2 medications is associated with positive outcomes and reduced risk of complications. Proper insulin dosing for people living with type 1 and advanced type 2 is paramount for achieving normal blood sugar levels. Balancing multiple medications and multiple daily doses of insulin with real life often leads to doses being missed.
Problems with Insulin Absorption
Those on insulin must carefully dose the correct amount to see the intended results. If absorption of this insulin is hindered or delayed, it can cause short and long-term problems for the patient. Poor insulin absorption is possible with insulin pens and syringes, but it is especially common for type 1 diabetics using insulin pumps.
Changing Dose Needs
Insulin dosing is unique in the medical world in that there are literally dozens of factors that influence the dose needed at any given time. Patients must consider exercise, food consumption, time of day, previous doses, and more to determine how much insulin they need to take. And influences like the patient’s menstrual cycle, current body weight, stress, and daily routine can further change these doses from day to day.
Miscalculated Meal Stats
People living with type 1 must bolus insulin based on the amount of carbohydrates they will eat. The amount of fat and protein on the plate can also influence insulin needs. If the wrong dose is calculated based on faulty meal statistics, it can have dire consequences. Too much insulin can result in deadly low blood sugar while too little can lead to harmful hyperglycemia.
While insulin provides almost instant feedback in terms of blood sugar, many oral medications do not have such a noticeable effect. Because of this, many people living with diabetes do not take their medication as prescribed. This is especially likely if the patient is experiencing side effects from the medication.
Lack of Patient-Provider Communication
Diabetes care requires constant attention. A person living with type 1 may make upwards of 20 decisions per day that will directly affect their condition. Aside from the occasional doctor’s visit, most are left to make these decisions on their own.
High Complication Risk
Diabetes comes with a long list of complications. Nearly every system in the body is affected by these diseases over time. Hypoglycemic events cause acute problems with cognition, emotional stability, and motor skills. Hyperglycemia maintained over time can hurt the kidneys, cardiac system, nervous system, and brain function, and increase the risk of infection. Yet the health of most of these systems is not monitored in conjunction with blood sugar levels.
Lack of Communication Between Devices
As technology advances, more devices and apps become available to help people manage their diabetes. But without adequate communication between devices, the advantages of these devices are limited.
Multiple Data Streams
When devices do not communicate or interact, the patient is left with multiple separate data streams on which to base treatment decisions. For the average person, interpreting this disparate data is simply not possible. Even doctors, who have limited time with each patient, struggle to compile data from multiple devices in order to provide the best treatment advice.
Untapped Data Sources
Blood sugar is influenced by hundreds of different factors, yet most treatment decisions are based on only one or two. Because of this, many patients see their treatment results as unpredictable. This can lead to treatment burnout which further increases the odds of unpredictable and unmanageable blood sugars.
Opportunities for SaMD Solutions
For people living with diabetes, these challenges are a reality they must accept. But for medical technology companies looking to create the next life-changing product, they represent untapped opportunities. The need for these products exists, what’s missing is the SaMD required to fulfill the need.
Dose and Medication Tracking
Advancements like the Tempo Smart Button have turned analog devices like insulin pens into trackable digital devices. But automated medication dose tracking is still a largely untapped market. Smart caps for pill bottles exist but do not readily integrate with diabetes care apps.
Smartphone applications that could connect these types of devices and provide reminders about missed doses would be highly beneficial. Even more useful would be an application that uses AI to learn schedules and provide reminders about missed insulin doses. Software that is integrated with a CGM could also use changes in blood sugar to determine missed dosing and provide reminders.
Comprehensive Pump Sensors
Insulin absorption can be a problem no matter what device is delivering the insulin. But people on insulin pumps experience this problem the most. Not only do pump sites experience blockages and problems with scar tissue, but improper insertion can lead to insulin never entering the body at all.
Smart sensors on insertion sites that detect insulin overflow could warn users of bad sites before they become a problem. Similarly, more sensitive sensors to insulin flow and pressure in the tubing and reservoir could detect occlusions sooner and potentially even adjust dosing to account for them.
Real-Time Dose Adjustments
As people living with type 2 diabetes lose weight, get active, and start eating better, their medication requirements naturally decrease. Often, a quarterly or biannual doctor’s visit isn’t frequent enough to catch these changes when they’re needed. Software that tracks these factors along with blood sugar averages could notify patients and their doctors of when a dose adjustment might be needed.
Dose adjustments with type 1 patients are even more frequent. Changes in routine, time of the month, environment, and more can cause insulin needs to fluctuate. Software that tracks more of these parameters and integrates data from pumps, smartpens, and CGMs could sense when dose changes might be needed based on these factors. This kind of software would also be valuable in picking up patterns to create customized insulin dosing for every situation.
Automatic Meal Calculations
AI meal calculators are slowly hitting the market. Some of these apps use photos to determine how many carbohydrates and other nutrients a meal contains. What is still missing is a direct link between meal estimators and insulin dosing. Advanced software could provide the macronutrient breakdown of a given plate of food as well as customized dosing recommendations.
Comprehensive Trend Tracking
One reason many people with diabetes don’t adhere to their medication guidelines is that they can’t see the positive effects the medication may be having. Tracking medication doses along with changes in weight, appetite, energy level, and blood sugars would provide the feedback patients need to follow through. This information would also be valuable to caregivers and help determine when dose or medication changes are needed.
Better Communication Platforms
There are plenty of computer and mobile applications that connect patients and doctors. But what we’re still missing are communication applications that integrate device data for seamless treatment conversations. Doctors do not have time to reference data on different platforms to answer simple treatment questions. To take this time, they often require the patient to schedule a remote appointment. Patients are resistant to this because it costs them money and time.
Communication options within device applications could bridge this communication gap. Whether the question is answered by a third party or the patient’s direct care team is less important than what data the person has access to in order to answer the question.
Comprehensive Condition Tracking
Medical technology used by those living with diabetes centers around blood glucose tracking, insulin dosing, and weight and diet management. What is missing is the technology needed to track common complications of these diseases.
Waiting to diagnose kidney issues, nerve damage, and heart problems after annual blood work isn’t necessary when we have the ability to track these conditions in real-time. Integrating pulse and blood pressure trackers, pulse ox monitors, and other advanced systems into diabetes software platforms would provide advanced warnings of these common problems.
Integrated Mobile Applications
More diabetes technology companies are joining forces to create integrated products. But these types of partnerships are inherently restrictive. While they bring some devices together, they will never allow for full integration of their competitors. It is up to third-party applications to provide this service.
Current attempts at comprehensive integration fail to deliver easy-to-digest data interpretation. In order for these apps to be useful to people living with diabetes, they need to provide easy-to-understand treatment suggestions based on data provided by all integrated sources.
Multi-Source Data Interpretation
Integration of data should not be limited to devices exclusively used by the diabetic community. Because so many factors influence blood sugar levels, there are limitless possibilities for the type of data that could be interpreted to provide diabetes treatment suggestions. The more devices and trackers integrated into these new applications, the more useful they will be.
SaMD is the Future of Diabetes Care
New hardware devices have been, and will continue to be, important in helping minimize diabetes treatment burden. But it is the software that connects, integrates, and analyzes the data created by these devices that will do the most to reduce common care problems that people living with diabetes experience.
If you need a knowledgeable partner with experience in the diabetes SaMD market to help you develop and launch your life-changing idea, Sequenex is here to help. Contact us today.