On World Health Day how medtech is addressing the diabetes epidemic

On 7 April, World Health Day, the World Health Organization marks its 70th anniversary. Over the past seven decades, WHO has spearheaded efforts to rid the world of killer diseases like smallpox and to fight against deadly habits like tobacco use.

This year, World Health Day is dedicated to one of WHO’s founding principles: “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”

“Good health is the most precious thing anyone can have,” says Dr Tedros Adhanom Ghebreyesus, WHO director-general.

“When people are healthy, they can learn, work, and support themselves and their families. When they are sick, nothing else matters. Families and communities fall behind. That’s why WHO is so committed to ensuring good health for all.”

One of the major health concerns in 2018 is diabetes. Now considered to be a global epidemic, figures from the International Diabetes Federation, estimate that 552 million people could be affected by the disease by the 2030. According to the WHO, in 2012 diabetes was the direct cause of 1.5 million deaths – more than 80% of these occur in low and middle-income countries.

The medical device space is at the forefront of providing technology for diabetes patients. Companies including Bayer, Samsung, Ascensia Diabetes Care and Medtronic are just some of the names making inroads in this market.

In the UK a device has been developed to help obese type 2 diabetic patients lose weight should be rolled out across the NHS, according to researchers.

The Endobarrier device is being presented as an alternative to gastric bypass surgery as patients do not have to undergo invasive surgery to have it fitted. The device is made of a 60cm long sleeve that coats the inside of the small intestine. This allows food to pass through but not be digested, making people feel fuller, quicker.

The device was used in a study with the NHS at the City Hospital, Birmingham, UK, in which the outcomes of the first 31 participants were presented at the European Association for the Study of Diabetes (EASD) Annual Meeting in Lisbon.

The study, led by Dr Robert Ryder, was set up to see if the Endobarrier could help the hardest to treat cases for patients with type 2 diabetes and obesity. 50 people have had the device implanted and from the outcomes of the first 31 participants, the Endobarrier showed it could help patients lose a significant amount of weight.

The participants also reported improvements in wellbeing, energy and the ability to exercise. Around 94% said that they would recommend the service to their friends and family.

The patients taking part in the study had lived with type 2 diabetes for around 13 years and over half were taking insulin. The patients were encouraged to change their lifestyle behaviour for the time when the device was implanted.

The authors of the study, said: "This inaugural NHS service demonstrates Endobarrier therapy to be highly effective in patients with obesity and diabetes that has been very hard to treat, with high patient satisfaction levels, and an acceptable safety profile. The Endobarrier service could be a safe and cost-effective treatment for the NHS--it does not involve surgery and patients do not have to stay in hospital (so reducing the risk of infection). As endoscopy units are located all over the UK, our service could be readily disseminated, with the registry being useful for on-going monitoring worldwide."

Wearable patch

Meanwhile a team of researchers has developed a wearable patch for diabetics that can measure blood sugar with a small amount of sweat without drawing blood and administer drugs in stages according to the wearer’s levels.

The team led by Kim Dae-hyung, professor of chemistry and biotechnology of the Nanoparticle Research Group under the management of director Hyun Taek-hwan, professor of chemistry of Seoul National University (SNU) at SNU’s Institute of Basic Science and Research (IBS) says the integrated system can measure blood sugar more accurately with less sweat than current diabetic patches.

The researchers created a smaller and more sensitive sugar sensor with gold with tiny pores to allow for accurate measurement of blood sugar with less sweat. It only requires a small amount of sweat.

Researcher Kim Dae-hyung said: "We have improved current diabetes patches so that patients can use diabetes patches more easily and make them commercially viable. These diverse technologies applied to the sugar sensor and treatment can be widely used for the diagnosis and treatment of various disease models besides diabetes treatment.”

Wound dressing

We also have the wound dressing  that saved a diabetic patient from amputation. Angela Montes de Oca from Indianapolis believed her foot would have to be amputated after she told that there were no other options to treat her diabetic ulcer. She teamed up with Dr Miller, a wound clinician, who was piloting KerraCel Ag, a wound dressing developed by UK-based medical company, Crawford Healthcare. KerraCel Ag is an absorbent gelling dressing which uses a proprietary technology developed by Crawford Healthcare and Exciton Technologies. After using the dressing Ms de Oca avoided amputation and recovered after eight weeks.

Dr Miller said: “This success story marks a hugely significant milestone in wound care treatment which promises to transform and even save the lives of many people around the globe.”

KerraCel Ag was developed and tested with the University of Manchester and received FDA clearance. The product is currently only available in the US but the success of the treatment began calls for it to be fast-tracked into the NHS.

Crawford Healthcare CEO, Richard Anderson, said: “To provide some context on the significance of Ms. Montes de Oca’s successful treatment, every single day in England there are twenty devastating amputations, with total expenditure related to foot amputation in people with diabetes in England estimated to be £1billion per year.”