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Diabetes Patients And Tech Companies See Value In Continuous Glucose Monitoring
Yehuda Friedman is a hockey fanatic. When the 11-year-old isn’t on the ice, he’s zooming around his house in Phoenix on rollerblades, taking shots on the net in the living room.
But two years ago Yehuda started feeling lethargic and lost a bunch of weight. Turns out he had Type 1, or juvenile, diabetes. Or, as Yehuda explained, "My pancreas doesn’t function anymore.”
His mother, Abby, said young kids already have a lot to worry about.
“It’s a lot for him to think about, but I guess for him, it rolls off," she said.
Friedman said since the diagnosis, they’ve had a few scares. Yehuda's sister had to slap him back into consciousness one time when his sugar levels crashed. But for the most part, they’ve been able to manage the disease.
Yehuda wears a continuous glucose meter on his arm. It’s a little plastic device about the size of a pack of gum that his mom applies with a sticky adhesive.
"We have a real problem with these things staying on," Friedmans laughed as she applied the meter. "He’s a very active boy.”
Friedman uses an applicator with a tiny needle that puts a transmitter under Yahuda’s skin. The meter sends his glucose levels to an a smartphone app that the whole family can can keep an eye on.
“So wherever he is — my husband is in Albuquerque right now and he’s getting his blood sugar readings,” she said.
Based on those readings, Yehuda uses a pump that he wears on his side to dose himself with insulin. A typically tech savvy kid, he sets his monitor and skates off to play outside.
The new technology is a big leap forward from the finger-stick method for checking glucose levels, but not all patients have embraced the change.
Kevin Sayer is the CEO of Dexcom, the San Diego-based company that makes Yehuda’s glucose meter.
"The thing that holds a lot of people back is that they don’t necessarily want something on their body,” he said.
Dexcom recently built a new factory in Mesa where it’ll produce its smallest meter yet. Sayer wants to get the meter down to the size of a penny.
To do so, Dexcom is partnering with Verily, a division of Google’s parent company Alphabet. Chief Technology Officer Brian Otis sees continuous monitoring as an untapped opportunity resource.
“There’s a lot of information about the body, a lot of data that is simply vanishing," Otis said.Most Type 1 patients — there are about 1.5 million in America — are still using the finger-stick method. This method involves testing their blood manually four to eight times a day and recording the numbers in a log book. Otis imagines a time when continuous meters, which take more than 300 readings a day, are utilized by the more than 20 million Americans with Type 1 and 2 diabetes.
"Our goal is to enable people who are not on insulin — at some point even people that have pre-diabetes — to be able to afford and integrate continuous glucose monitors into their everyday life,” Otis said.
Scaling up even further to diabetics world wide would mean potentially hundreds of millions of people. Otis said the mountain of data generated would be incredibly valuable to a company like Verily and its their parent Alphabet, as well as for patients. But you’ve got to get people to wear the device.
"That’s why size is so important," Otis said. "Seamless use is extremely important as well.”
But that’s an area where Dexcom has struggled. The company issued a recall in 2016 when its devices failed to alert people when they hit dangerous glucose levels.
Anne Dennis with the American Diabetes Association said while continuous monitoring is useful for some patients, it’s not for everyone. Glucose meters costs thousands of dollars without insurance. And Dennis said they're not foolproof.
“So everyone needs to have a backup plan. So people should have meters with them and strips with them. Just like with an insulin pump if it should malfunction then people should have syringes insulin vials with them,” she said.
Abby Friedman said Yehuda’s meter has failed to alert them several times, and they still use the finger-stick method as a backup system.
"It gives you a true reading, right away," she said as she took a reading or her son's glucose levels. "He’s a 141 — yay! That’s a really good number. We live by numbers over here.”
But now those numbers look more like trends, and Friedman said that’s making her son’s disease easier to treat.