This report covers mature, growing and emerging fields in diabetes technology, researched through primary interviews with companies, physicians and diabetic individuals to establish how the technological roadmap for diabetes management will develop over the next decade.
The report examines diabetes technologies across seven key areas:
Sensors for glucose monitoring - The established blood glucose market manufactures over 20 billion test strips annually, however, as is discussed here, several factors are restraining the profitability of the industry and driving technological changes.
Beyond blood glucose measurements
- Glucose exists in biological fluids other than blood, continuous glucose monitors and wearable devices are gaining traction and seeing large uptake by consumers.
Sensors for Ketone monitoring - When blood glucose levels are too high, acidic ketone bodies, the by-product of improper metabolism build up in the blood stream, leading to potentially life threatening complications. The range of available biosensors to measure and quantify ketone levels are reviewed.
Smart insulin pens
- Start-ups backed by large pharmaceutical companies are adding sensors and connectivity to insulin pens to unlock a range of analytical tools. Several leading start-ups an companies are profiled and their products discussed.
Insulin pumps: towards an artificial pancreas - Compared to insulin pens, insulin pumps offer a more controlled rate of hormone delivery. Discussed is the progress whereby combining pump technologies with continuous glucose monitoring platforms is leading to the development of an artificial pancreas device, offering real-time sensor automated insulin delivery in response to changing glucose levels.
Sensors for side effects
- Covering the diverse utilisation of innovative sensor technologies across novel aspects diabetes care, including; sensors in wearable devices, the ability to monitor other end points such as diabetic neuropathy as well as assessing ulcer development in diabetic patients.
Sensors for early diagnosis - Discussing the use of emerging technologies to aid the early detection of diabetes, thereby preventing long hospital stays and other complications.
The report contains 10 year forecasts across all relevant market segments, detailing revenue predictions, and volumes across multiple sensing technologies.
The analyst has identified and profiled key players to build a comprehensive picture of the diabetes technology industry. Significant stakeholders have been identified and profiled through primary research and interviews to understand the technology roadmap of diabetes care and to give an insightful, contextual and timely analysis of the industry now and in the future, identifying factors crucial for the triumph of a company in this ever-growing field.
Key Topics Covered:
1. EXECUTIVE SUMMARY 1.1. Diabetes in numbers 1.2. Market segmentation in diabetes care 1.3. Key players and acquisitions- glucose monitoring 1.4. Academic research into glucose monitoring grows every year 1.5. More than 400 billion test strips have been produced 1.6. Ketone monitoring using test strips 1.7. Profitability in the test strip industry is falling 1.8. Blood, sweat & tears: new ways to monitor glucose 1.9. Comparison of sample sites 1.10. Continuous glucose monitors gaining adoption 1.11. Abbott launch rival to CGM systems 1.12. Implanting a sensor under the skin for long term measurement 1.13. New methods in on demand glucose monitoring 1.14. Market forecast: glucose monitoring 1.15. Closed loop artificial pancreas systems represent the next step 1.16. Security is a major issue for closed loop systems 1.17. Smarter insulin delivery informing decisions 1.18. A new $80million investment fund for diabetes 1.19. Report outcomes
2. INTRODUCTION TO DIABETES 2.1. Type 1 diabetes 2.2. Type 2 diabetes 2.3. Gestational diabetes presents dangers for mother and baby 2.4. Differences between type 1 and type 2 diabetes 2.5. Global diabetes figures 2.6. Diabetes treatment costs by region 2.7. Diabetes treatment costs are high 2.8. Diabetes side effects make up 90% of diabetes care costs 2.9. Rising numbers of people with diabetes 2.10. Technologies and functions of diabetes technologies
3. MARKET FORECASTS 3.1. Forecast assumptions 3.2. Market forecast: primary method of glucose monitoring for people with type 1 diabetes 3.3. Market Forecast: Disposable test strips by revenue 3.4. Market Forecast: Disposable test strips by volume 3.5. Market forecast: glucometers by volume 3.6. Market Forecast: Glucometers by revenue 3.7. Market forecast: Wearable glucose sensors by revenue 3.8. Market Forecast: Wearable glucose sensors by volume 3.9. Market forecast: reusable insulin pen devices by volume 3.10. Large market growth in smart pen devices expected 3.11. Market forecast: insulin pump by volume 3.12. Market forecast: insulin pump by revenue 3.13. Sensors within an insulin pump 3.14. Sensors within an insulin pump
4. SENSORS FOR GLUCOSE MONITORING 4.1. Glucose monitoring 4.2. A history of glucose monitoring 4.3. Glucose monitoring strip mechanisms 4.4. Development of the glucose monitoring assay 4.5. Strip monitoring through a glucometer 4.6. Strip manufacture 4.7. Evolution of blood glucose monitors 4.8. Business model for glucose monitoring 4.9. Manufacturers of blood glucose meters 4.10. Electrode deposition: screen printing vs sputtering 4.11. Academic research into glucose sensing 4.12. New materials for biosensors: carbon nanotubes 4.13. New materials for biosensors: quantum dots 4.14. Challenges for printing glucose test strips 4.15. ISO standards are leading to changes in glucose test strip production 4.16. Medicare cuts limiting the glucose strip market 4.17. Key diabetes businesses changing hands 4.18. Drivers and constraints to the disposable test strip industry 4.19. New directions in internet enabled glucometers 4.20. The worlds first smartphone case glucometer 4.21. Finger stick tests as a subscription service 4.22. Large growth in third party diabetes management apps 4.23. Porters five force analysis of disposable test strip industry
5. BEYOND BLOOD GLUCOSE MEASUREMENTS 5.1. Measurements beyond blood 5.2. Measuring glucose through sweat 5.3. Measuring glucose through tears 5.4. Measuring glucose through interstitial fluid 5.5. Measuring glucose through saliva 5.6. Measuring glucose through breath 5.7. Measuring glucose through urine 5.8. Analysis of various glucose sampling sites 5.9. Qualitative glucose monitoring 5.10. Continuous glucose monitoring 5.11. How continuous glucose monitors work 5.12. Continuous vs flash glucose monitoring 5.13. Growing interest in ambulatory glucose monitoring 5.14. Anatomy of a CGM sensor 5.15. CGM sensor manufacture 5.16. Foreign body responses to CGM devices 5.17. Calibration of glucose monitoring devices 5.18. Is continuous glucose monitoring worth the high price? 5.19. Not all glucose measurements are equal 5.20. Factors determining the success of CGM devices 5.21. Key partnerships in emerging glucose monitoring technology 5.22. Abbott Libre 5.23. Abbott Libre glucose detection mechanism 5.24. Components in an Abbott Libre sensor 5.25. Cost of flash glucose monitoring compared to finger stick tests 5.26. New options for short term real time glucose monitoring 5.27. Dexcom 5.28. Dexcom glucose monitoring mechanism 5.29. Medicare provide coverage for Dexcom products 5.30. Cost of glucose monitoring compared to finger stick tests 5.31. Medtronic 5.32. Fitbit & Medtronic announce CGM partnership 5.33. Future miniaturisation of CGM sensors 5.34. Users experience of wearable devices 5.35. FDA gives approval for Dexcom to replace finger stick tests 5.36. Comparison of wearable technologies for glucose monitoring 5.37. Non-invasive glucose monitoring 5.38. Non-invasive glucose sensing by reverse iontophoresis 5.39. Non-invasive glucose monitoring- A first device to market 5.40. Google contact lens- an eye on glucose monitoring 5.41. Problems with a glucose contact lens 5.42. Monitoring glucose through breath analysis 5.43. A sweat sensor that delivers medicine 5.44. iQuick saliva analyser measures glucose from the mouth 5.45. Test strip requirements with newer devices 5.46. Implantable sensors 5.47. Glucose oxidase based implantable sensors 5.48. Fluoresence based implantable sensors 5.49. Failures of the GlucoWatch 5.50. A new generation of glucose monitoring watches 5.51. A non-invasive glucose monitoring wristband? 5.52. A non-invasive monitor has been developed 5.53. Hand held non-invasive monitoring 5.54. Optical testing as the next step for glucose monitoring 5.55. MIT patent Raman based glucose monitoring 5.56. Belgian start-up aims at optical implantable device 5.57. Non invasive optical device being developed 5.58. Single use vs ambulatory monitoring: future directions 5.59. The future for finger stick testing 5.60. Will CGM systems replace test strips? 5.61. The potential for non-invasive testing 5.62. New funding opportunities for diabetes devices
6. SENSORS FOR KETONE MONITORING 6.1. A severe lack of insulin can lead to Diabetic Ketoacidosis 6.2. Ketostix are a historically useful measurement of DKA 6.3. Electrochemical sensors are a more accurate method of ketone monitoring 6.4. Comparison between glucose and ketone test strips 6.5. Will we see continuous ketone monitoring?
7. SENSORS FOR INSULIN PENS 7.1. Insulin pens remain the primary delivery method for patients 7.2. Anatomy Of An Insulin Pen 7.3. At extreme temperatures, insulin dies 7.4. Forgetting a dose can be fatal 7.5. Smart insulin delivery device manufacturers 7.6. First smart pen to market 7.7. Smart pen platform preventing missed doses 7.8. The traditional inulin pen industry diversifying their portfolio 7.9. A Bluetooth connected pen set for US launch 7.10. Applying principles to disposable insulin pens 7.11. Is there room for new insulin pen manufacturers?
8. INSULIN PUMPS: TOWARDS AN ARTIFICIAL PANCREAS 8.1. Insulin pumps offer an automated delivery system 8.2. Insulin pumps currently available 8.3. Towards fully automated insulin delivery 8.4. Insulin pump breakdown 8.5. Sensor functions within a pump 8.6. Insulin pump technology roadmap 8.7. Hacking insulin pumps for autonomous diabetes control 8.8. Closed loop systems are coming 8.9. Modular System Enabling an Artificial Pancreas 8.10. Disposable insulin pumps for type 2 diabetics 8.11. Toward a 'smart' patch that automatically delivers insulin when needed 8.12. Security around insulin pumps is a key issue 8.13. Security risks for medical devices 8.14. Important considerations for device security 8.15. Future markets for insulin pumps
9. SENSORS FOR SIDE EFFECTS 9.1. Treatment of side effects account for 80% of diabetes costs 9.2. Diabetic foot ulcers 9.3. Pressure and Impact Sensors can Detect Foot Problems 9.4. Basic requirements of a diabetic footwear 9.5. Diabetic Insoles 9.6. Sensoria- Diabetic socks 9.7. Diabetic neuropathy is 9.8. Optical measurement of neuropathy 9.9. Sudomotor function as biomarker for neuropathy 9.10. Gait measurement to assess neuropathy
10. SENSORS FOR EARLY DIAGNOSIS 10.1. Diagnosis of diabetes is not a fast process 10.2. Remote Glucose Tolerance Testing is Possible 10.3. E. coli bacteria to change colour in the presence of sugar 10.4. Optical Sensors For Infant Diagnosis
11. REGULATION AND AVAILABILITY OF DIABETES MEDICAL DEVICES 11.1. Austria 11.2. Canada 11.3. France 11.4. Germany 11.5. Ireland 11.6. Netherlands 11.7. Switzerland 11.8. United Kingdom 11.9. USA
12. COMPANY PROFILES 12.1. Companion Medical 12.2. Dexcom 12.3. Dropsens 12.4. Emperra 12.5. Glysens 12.6. Google-Verily 12.7. GSI 12.8. GSK Medical 12.9. Medtronic 12.10. Nanoflex 12.11. PKVitality 12.12. Sensoria