Diabetes devices may be having their iPhone moment.
For decades, the daily routine of diabetics involved painful needles, finger-pricking lancets and imprecise glucose meters. Now, manufacturers have begun incorporating the slick and consumer-friendly designs of Silicon Valley, linking to phones and other tech devices.
“This is a crossroads for diabetes technology,’’ said Raj Denhoy, an analyst at Jefferies in New York.
September marked a breakthrough in the US, as regulators approved the first glucose-monitoring system that doesn’t need a blood sample, Abbott Laboratories’ FreeStyle Libre. The new devices do away with fingerpricks, changing an unpleasant, several-times-a-day routine into quiet monitoring in the background through a sensor worn on the back of the upper arm.
Other companies have been left behind. Johnson & Johnson is closing its insulin-pump unit after failing to keep up with Medtronic Plc. DexCom, the current leader in glucose-monitoring systems, lost a third of its market value on Sept. 28 after Abbott’s Libre got approval.
On DexCom’s earnings conference call Wednesday executives, peppered with questions about the Libre, said the company hopes to introduce its own fingerprick-free device before the end of 2018. The comments about next-generation monitors helped assuage investors’ concerns about DexCom’s prospects, sending the stock up 9.5 per cent in the two trading days following the results.
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“Companies who succeed will be those who can figure out this convergence of health care and technology,” said Arda Ural, a partner at Ernst & Young in New York. “And they’re very different animals to bring together.”
For the winners, the potential market is huge. Diabetes device sales totaled US$14 billion in the US last year, according to Ernst & Young.
For now, the bulk of the sales are to the 1.25 million American diabetes with the most severe form of the disease, type 1. Because their pancreas can’t produce insulin, those patients have to constantly monitor their blood sugar and frequently inject themselves with insulin when it spikes.
There’s a larger, mostly untapped market: the about 20 million Americans with type 2, whose body’s ability to use insulin fades slowly over time and who don’t regularly use tools to manage their disease.
Yet some patients have been waiting for decades for better devices to control a condition that, unchecked, can lead to complications including kidney damage and heart disease.
Aaron Kowalski, chief mission officer of diabetes research foundation JDRF, was diagnosed as a 13-year-old in the 1980s. At the time, people measured their glucose by urinating on a stick or placing a drop of blood on a color strip that gave a rough number.
“It was barbaric,” he said.
Abbott’s Libre will arrive in the US soon. It’s already been sold to 400,000 consumers internationally, including Brenna Wilson, an 18-year-old high-school student in Ireland who was diagnosed with type 1 at age 3.
Before she bought the Libre in March, it had “kind of been hell” managing the condition, Ms Wilson said. Teachers have been irritated when she pricked her finger in the classroom.
“The Libre makes it a lot easier,” she said. “I can just check what it is, and it doesn’t have to be this whole big thing. It’s very discreet. People don’t even notice it.”
Dexcom, despite the recent blow, has been making strides as well. Its G4 and G5 sensors stick on the body and are only calibrated twice a day with a finger prick. In September, the San Diego company teamed with Fitbit to link its devices with the latest Fitbit Ionic smartwatch. The companies hope to get the product out next year.
Unlike many consumer products, diabetes devices face two major hurdles -- the Food and Drug Administration and health insurers.
Joel Goldsmith, senior director of product innovation at Abbott, said it can take years to get products through long trials required by the FDA before a device can reach the market.
“There’s a new phone model every six months,” he said. “The medical device world doesn’t operate at that same pace.”
Eventually, the long-term profitability of the technology revolution will depend on coverage. Insurers have increasingly balked at paying for novel devices they don’t deem medically necessary. The Libre will retail in the US at a similar price as in Europe, which comes to about $5 a day, including a reader and sensors that must be replaced every 10 days.
A year ago, the FDA approved Medtronic’s MiniMed 670G, an insulin-delivery system that works like an artificial pancreas, ahead of schedule. Medtronic is still waiting, however, for the agency to rule on its smartphone application, Sugar.IQ, which will track meals, blood-glucose levels and insulin dosing, said Huzefa Neemuchwala, head of innovation at the company. So far, only DexCom has an FDA-approved app.
California startup Bigfoot Biomedical is working on an app that will link to the Libre and on an automatic insulin pump. Co-founder Jeffrey Brewer, whose son was diagnosed with type 1 in 2002 at 7, knows first-hand the need for user-friendly tools. One day, he hopes, Bigfoot will package devices in a slick box that unwraps like an Apple product.
“This is a category where consumer-focused design is going to explode,” he said. “It’s going to be transformative for the people who live with this disease. And my son is going to be the first customer.”
The Freedom Artist
By Ben Okri (Head of Zeus)
Match info
Uefa Champions League Group B
Tottenham Hotspur 1 (Eriksen 80')
Inter Milan 0
BOSH!'s pantry essentials
Nutritional yeast
This is Firth's pick and an ingredient he says, "gives you an instant cheesy flavour". He advises making your own cream cheese with it or simply using it to whip up a mac and cheese or wholesome lasagne. It's available in organic and specialist grocery stores across the UAE.
Seeds
"We've got a big jar of mixed seeds in our kitchen," Theasby explains. "That's what you use to make a bolognese or pie or salad: just grab a handful of seeds and sprinkle them over the top. It's a really good way to make sure you're getting your omegas."
Umami flavours
"I could say soya sauce, but I'll say all umami-makers and have them in the same batch," says Firth. He suggests having items such as Marmite, balsamic vinegar and other general, dark, umami-tasting products in your cupboard "to make your bolognese a little bit more 'umptious'".
Onions and garlic
"If you've got them, you can cook basically anything from that base," says Theasby. "These ingredients are so prevalent in every world cuisine and if you've got them in your cupboard, then you know you've got the foundation of a really nice meal."
Your grain of choice
Whether rice, quinoa, pasta or buckwheat, Firth advises always having a stock of your favourite grains in the cupboard. "That you, you have an instant meal and all you have to do is just chuck a bit of veg in."
NEW ARRIVALS
Benjamin Mendy (Monaco) - £51.75m (Dh247.94m)
Kyle Walker (Tottenham Hotspur) - £45.9m
Bernardo Silva (Monaco) - £45m
Ederson Moraes (Benfica) - £36m
Danilo (Real Madrid) - £27m
Douglas Luiz (Vasco de Gama) - £10.8m
RESULT
Arsenal 1 Chelsea 2
Arsenal: Aubameyang (13')
Chelsea: Jorginho (83'), Abraham (87')
World Series
Game 1: Red Sox 8, Dodgers 4
Game 2: Red Sox 4, Dodgers 2
Game 3: Saturday (UAE)
* if needed
Game 4: Sunday
Game 5: Monday
Game 6: Wednesday
Game 7: Thursday
SPECS
Nissan 370z Nismo
Engine: 3.7-litre V6
Transmission: seven-speed automatic
Power: 363hp
Torque: 560Nm
Price: Dh184,500
Essentials
The flights: You can fly from the UAE to Iceland with one stop in Europe with a variety of airlines. Return flights with Emirates from Dubai to Stockholm, then Icelandair to Reykjavik, cost from Dh4,153 return. The whole trip takes 11 hours. British Airways flies from Abu Dhabi and Dubai to Reykjavik, via London, with return flights taking 12 hours and costing from Dh2,490 return, including taxes.
The activities: A half-day Silfra snorkelling trip costs 14,990 Icelandic kronur (Dh544) with Dive.is. Inside the Volcano also takes half a day and costs 42,000 kronur (Dh1,524). The Jokulsarlon small-boat cruise lasts about an hour and costs 9,800 kronur (Dh356). Into the Glacier costs 19,500 kronur (Dh708). It lasts three to four hours.
The tours: It’s often better to book a tailor-made trip through a specialist operator. UK-based Discover the World offers seven nights, self-driving, across the island from £892 (Dh4,505) per person. This includes three nights’ accommodation at Hotel Husafell near Into the Glacier, two nights at Hotel Ranga and two nights at the Icelandair Hotel Klaustur. It includes car rental, plus an iPad with itinerary and tourist information pre-loaded onto it, while activities can be booked as optional extras. More information inspiredbyiceland.com
England's lowest Test innings
- 45 v Australia in Sydney, January 28, 1887
- 46 v West Indies in Port of Spain, March 25, 1994
- 51 v West Indies in Kingston, February 4, 2009
- 52 v Australia at The Oval, August 14, 1948
- 53 v Australia at Lord's, July 16, 1888
- 58 v New Zealand in Auckland, March 22, 2018
SHOW COURTS ORDER OF PLAY
Centre Court (4pm UAE/12pm GMT)
Victoria Azarenka (BLR) v Heather Watson (GBR)
Rafael Nadal (ESP x4) v Karen Khachanov (RUS x30)
Andy Murray (GBR x1) v Fabio Fognini (ITA x28)
Court 1 (4pm UAE)
Steve Johnson (USA x26) v Marin Cilic (CRO x7)
Johanna Konta (GBR x6) v Maria Sakkari (GRE)
Naomi Osaka (JPN) v Venus Williams (USA x10)
Court 2 (2.30pm UAE)
Aljaz Bedene (GBR) v Gilles Muller (LUX x16)
Peng Shuai (CHN) v Simona Halep (ROM x2)
Jelena Ostapenko (LAT x13) v Camila Giorgi (ITA)
Jo-Wilfried Tsonga (FRA x12) v Sam Querrey (USA x24)
Court 3 (2.30pm UAE)
Kei Nishikori (JPN x9) v Roberto Bautista Agut (ESP x18)
Carina Witthoeft (GER) v Elina Svitolina (UKR x4)
Court 12 (2.30pm UAE)
Dominika Cibulkova (SVK x8) v Ana Konjuh (CRO x27)
Kevin Anderson (RSA) v Ruben Bemelmans (BEL)
Court 18 (2.30pm UAE)
Caroline Garcia (FRA x21) v Madison Brengle (USA)
Benoit Paire (FRA) v Jerzy Janowicz (POL)
Specs
Engine: 2-litre
Transmission: Eight-speed automatic
Power: 255hp
Torque: 273Nm
Price: Dh240,000
Brief scoreline:
Manchester United 0
Manchester City 2
Bernardo Silva 54', Sane 66'
Six tips to secure your smart home
Most smart home devices are controlled via the owner's smartphone. Therefore, if you are using public wi-fi on your phone, always use a VPN (virtual private network) that offers strong security features and anonymises your internet connection.
Keep your smart home devices’ software up-to-date. Device makers often send regular updates - follow them without fail as they could provide protection from a new security risk.
Use two-factor authentication so that in addition to a password, your identity is authenticated by a second sign-in step like a code sent to your mobile number.
Set up a separate guest network for acquaintances and visitors to ensure the privacy of your IoT devices’ network.
Change the default privacy and security settings of your IoT devices to take extra steps to secure yourself and your home.
Always give your router a unique name, replacing the one generated by the manufacturer, to ensure a hacker cannot ascertain its make or model number.
Scoreline
Germany 2
Werner 9', Sane 19'
Netherlands 2
Promes 85', Van Dijk 90'
Abu Dhabi GP schedule
Friday: First practice - 1pm; Second practice - 5pm
Saturday: Final practice - 2pm; Qualifying - 5pm
Sunday: Etihad Airways Abu Dhabi Grand Prix (55 laps) - 5.10pm
MORE ON INTERNATIONAL JUSTICE
If you go
The flights
There are various ways of getting to the southern Serengeti in Tanzania from the UAE. The exact route and airstrip depends on your overall trip itinerary and which camp you’re staying at.
Flydubai flies direct from Dubai to Kilimanjaro International Airport from Dh1,350 return, including taxes; this can be followed by a short flight from Kilimanjaro to the Serengeti with Coastal Aviation from about US$700 (Dh2,500) return, including taxes. Kenya Airways, Emirates and Etihad offer flights via Nairobi or Dar es Salaam.
Match info
Premier League
Manchester United 2 (Martial 30', Lingard 69')
Arsenal 2 (Mustafi 26', Rojo 68' OG)
