The Roche digital solution to the diabetes challenge

November 14, 2018

Diabetes is described as the epidemic of the 21st Century, in the view of Roche Diabetes Care, who are using digital technology and data management to help patients, healthcare professionals and payers address this costly challenge

There are more than 400 million people globally who live with diabetes¹. In the UK alone, this figure is 4.5 million people². The incidence of the disease, which is a characterised condition by high blood sugar levels, is growing – indeed, estimates suggest that some 629 million people worldwide will have diabetes by 2045¹.

Much of this increase is driven by type 2 diabetes, but type 1 diabetes is still a concern with the number of cases increasing by 4% a year³. Regardless of the type, however, diabetes is a chronic condition, which is posing a costly concern for healthcare systems around the world. Meanwhile, people with diabetes are forced to juggle complex and fragmented data and make difficult medical and lifestyle decisions for themselves 24/7.

In many ways, diabetes has reached a tipping point. Just 6.5% of people with type 2 diabetes in Europe achieve their combined therapy targets⁴; the rest are struggling. In addition, physicians lack time and infrastructure support to sufficiently manage their patients and the disease. Together, this is putting pressure on healthcare systems and the costs are mounting¹; in the UK, for instance, treating diabetes and associated complications represents 10% of the NHS budget, amounting to £10 billion each year⁵. The healthcare challenge presented by diabetes is immense – but it’s not insurmountable. The challenge is making the system sustainable in the long-term.

The solution to this complex problem cannot solely be delivered by the introduction of another pharmaceutical drug. As Dr Partha Kar, diabetes and endocrinology consultant and associate national clinical director of diabetes with NHS England, said recently during techUK Rise of the Machines event: “It’s not a new insulin alone that’s going to change diabetes treatment – it’s technology”.

Roche Diabetes Care believes that digital health solutions and integrated diabetes management solutions have the power that will move the needle, bringing true relief to people with diabetes and developing a transparent system for healthcare professionals and payers that drives optimal care for this chronic condition.

Roche Diabetes Care envisions a holistic approach to addressing the diabetes challenge. Driven by technology and integrated solutions, this one open ecosystem, involving input from partners and other stakeholders, will ensure people with diabetes benefit from improved outcomes, physicians have the means to manage the disease and treatment, while payers can track the costs.

By better managing diabetes and designing more efficient healthcare infrastructure and support systems, great strides can be made in avoiding the costly and life-altering complications associated with this disease. Roche Diabetes Care’s approach aims to directly address the multifaceted and clinical complexity of diabetes currently seen across the healthcare system⁶.

The key to achieving improved outcomes is focusing on the data, with the patient at the centre. Diabetes is a complex condition where people with diabetes must monitor various and often times confusing, data sources including insulin and blood sugar levels, activity and nutrition. This complexity can be mastered by moving beyond drugs alone and taking a holistic approach where tools can integrate and analyse the data to help make treatment decisions, delay disease progression and empower people with diabetes to better manage their disease. This data can also be shared between the person with diabetes, their healthcare professional and their payer.

The Eversense® XL continuous glucose monitoring (CGM) system by Senseonics Inc is one example where Roche Diabetes Care, as the distributor in the UK and some European countries, is combining digital technology with data management in an open ecosystem to improve outcomes for people with diabetes. The Eversense XL CGM system by Senseonics is an implantable CGM sensor, which can measure glucose values for up to 180 days, compared to seven or up to 14 days for non-implantable systems that are currently available in the market⁷.

The sensor is implanted underneath the skin on the upper arm and communicates with a rechargeable wearable smart transmitter, which alerts the person with diabetes when glucose levels become too high or too low. Meanwhile, real-time insights on glucose data and trends are relayed to The Eversense smartphone app. This CGM system provides people with diabetes more support in managing their blood glucose levels and therefore helps to better manage their condition. Furthermore, this data can easily be shared with the individual’s physician for a more personalised approach to care.

In clinical trials, people with diabetes who used The Eversense CGM system for 180 days saw a reduction of 0.35% in their HbA1c, which identifies the average plasma glucose concentration7. The higher HbA1c, the greater the risk of developing diabetes-related complications, CGM has also been shown to support people in managing the extreme fluctuations of glucose which can cause both immediate harm and long term damage such as cardiovascular disease.

Systems such as The Eversense XL CGM system are digitising the data in such a way to make it more meaningful and transparent for people with diabetes and healthcare professionals. By managing the flow of this data, systems such as The Eversense CGM system are directly addressing the vast majority of the problems and challenges associated with diabetes. In addition, digitising data allows healthcare to move in the direction of personalised treatment, providing the right treatment for the right patient at the right time, which will also help to overcome clinical inertia, improve outcomes and cut costs.

It’s particularly notable that solutions such as continuous glucose monitors and digitally connected and integrated diabetes management solutions are what people with diabetes want. Healthcare systems around the world have already witnessed patients who, frustrated by the slow uptake of technology, have turned to reverse engineering and algorithms to create their own diabetes management solutions themselves.

In response to this do-it-yourself movement, the US-based JDRF has called for greater action on the part of industry and regulators to accelerate getting this technology to market and find ways to put in place the regulatory and legal frameworks for safe and approved technology to support the evolving research and development of artificial pancreas technology. Roche Diabetes Care is currently exploring different ways this collaboration with JDRF and other stakeholders could work. This is also an example that tackling the diabetes challenge requires a collaborative and innovative approach that taps into the new technologies available.

Now is the time to elevate the debate, to involve all stakeholders, including people with diabetes, to work alongside the medical devices industry to address the challenges of this complex condition and to improve the outcomes for people with diabetes and healthcare systems alike.

References

1 International Diabetes Federation Diabetes Atlas – 8th Edition, 2017 http://www.diabetesatlas.org/ accessed April 2018.

2 DiabetesUK The Future of Diabetes report (page 2) https://www.diabetes.org.uk/resources-s3/2017-11/1111B%20The%20future%20of%20diabetes%20report_FINAL_.pdf accessed March 2018.

3 JDRF https://jdrf.org.uk/information-support/about-type-1-diabetes/facts-and-figures/ accessed March 2018.

4 Barnes et al., Diabetes Educ., 2004; Chen et al., Archives of Internal Medicine, 2009; IDF Diabetes Atlas 8th Edition, International Diabetes Federation, 2017.

5 DiabetesUK The cost of diabetes report 2014 (page 5 & 6) https://www.diabetes.org.uk/resources-s3/2017-11/diabetes%20uk%20cost%20of%20diabetes%20report.pdf accessed April 2018

6 Stone et al., Diabetes Care 2013; Ross et al., AM J med 2013; Strain et al., Diabetes Ther 2014.

7 Accuracy and Longevity of an Implantable Continuous Glucose Sensor in the PRECISE Study: A 180-Day, Prospective, Multicenter, Pivotal Trial Eversense XL is a trade mark of Senseonics inc

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