According to the 9th edition of the International Diabetes Federation’s “Global Diabetes Atlas (IDF Diabetes Atlas)”, about 500 million people worldwide are currently suffering from diabetes. Although there is no cure for diabetes, interventions based on factors such as medication adherence, lifestyle, nutrition, physical exercise, and stress reduction can significantly improve the condition. More importantly, patients should strengthen self-management.

Diabetes is a time-intensive disease to manage, and patients must make daily decisions about blood glucose monitoring, nutrition, insulin and medication intake. Patient-centric digital management is an excellent solution for diabetes, and we are constantly experimenting and iterating on the technology.

Diabetes Digital Care Center – Medical Solutions

The project is a typical diabetes digital health program, with the help of digital tools, people can evaluate the lifestyle changes of interventions based on individual data, as well as the impact on blood sugar control, other medical parameters and medication.

Digital medical care should have “3D” elements, namely: Device, data Data of the device, and Decision of medical decision generated by the data. Among the three elements, Device ranks first, which shows its importance. The same applies to the digital management of diabetes, and enough smart devices can solve the problem.

Models for Diabetes Care Centers

Throughout the current mainstream digital diabetes management models, there are two main categories according to the applicable patients and usage methods: one is the artificial pancreas system based on continuous glucose monitoring (CGM), automatic insulin infusion (AID) and control algorithms; The second is a self-management system based on smart fingertip blood glucose meters, insulin pen injection dose counters and intelligent decision-making.

Smart Devices and Artificial Pancreas Diabetes Care Center

Strive to return to normal life is not only the strong desire of diabetic patients, but also the ultimate goal of scientific and technological workers to tackle key problems. The “artificial pancreas” that imitates the working mechanism of the human pancreas is the landing product of this goal.

As smart devices for continuous physiological index data acquisition and continuous drug delivery, CGM and AID can dynamically adjust blood glucose levels, maximizing close to the physiological function of the pancreas. Therefore, the development of the two also represents the progress of the artificial pancreas.

The workflow of artificial pancreas

The value of CGM and AID for artificial pancreas
According to the consensus of the American Diabetes Association (ADA), the American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE), CGM and insulin pumps are mainly suitable for patients with type 1 diabetes and those with type 2 diabetes who require intensive insulin therapy.

CGM can help the above-mentioned patients understand the changes and trends of blood sugar caused by their own diet, exercise, drug treatment and other behaviors, so as to help patients accurately calculate and adjust the insulin injection dose, and comprehensively control diet and exercise. However, the early “CGM+insulin pump” required manual adjustment of insulin doses, so it was called an open-loop artificial pancreas system. With the development of intelligent insulin infusion technology, the closed-loop system of “CGM+control algorithm+intelligent insulin pump” has come out.

The continuous blood glucose monitor continuously collects the blood glucose data of patients, and adjusts the insulin and glucagon infusion doses of patients with type 1 diabetes through artificial intelligence algorithms, reduces the occurrence of hyperglycemia and hypoglycemia, and keeps blood glucose within the normal range.

Fundamentals of Diabetes Care Center CGM

CGM consists of three parts: sensor, transmitter and receiver. Among them, sensor is the core component, which directly determines the accuracy and stability of CGM measurement results. Currently, CGM technologies exist for sensor outer membrane design, calibration algorithms, and sensor enzyme immobilization techniques. For example, the difficulty of the calibration algorithm is that there is an inconstant difference between the glucose concentration in the subcutaneous interstitial fluid and the blood glucose concentration measured by CGM. The calibration algorithm needs to solve different physiological states, passivation of the sensor surface and foreign body wrapping, test environment, etc. The resulting measurement difference.

The ideal technology of CGM is non-invasive continuous monitoring. Non-invasive detection technology is the basic principle of strong correlation between in vitro test indicators and blood glucose concentration.

In the market, due to reasons such as economic ability, wearing comfort, and product accessibility, the current blood glucose monitoring of diabetic patients outside the hospital is still dominated by the use of finger blood glucose meters; the overall penetration rate of CGM is insufficient, far lower than that of finger blood glucose meters. penetration.

Smart Devices and Self-Management System in Diabetes Care Center

If the artificial pancreas emphasizes the professionalism of technology and therapeutic effect, then the management model for patients with type 2 diabetes requires the establishment and maintenance of good living habits and compliance with medical plans.

Personalized reminders, intelligent suggestions, incentives, and human-computer interaction based on individual data are the fundamental solutions for this group, that is, a “smart device + intelligent decision-making” digital diabetes management system.

Due to the large population of patients with type 2 diabetes, a management system suitable for these patients should have broad coverage, low cost, and high retention and high activity characteristics.

In this digital management system that emphasizes patient self-management, blood glucose monitoring is still the most basic work. At present, our non-invasive blood glucose meter adopts the Bluetooth connection method, which is convenient for registration, easy to apply to other management systems, and easy to connect with the artificial pancreas system.

The portable non-invasive CGM blood glucose meter can better solve the problem of patient self-management compliance in the digital diabetes management scheme. Such a design must also pass more stringent approval standards, that is, the blood glucose meter is registered and approved together with the digital health APP.

From the perspective of the two management modes, the artificial pancreas and its important components, CGM, AID, etc., are equipment-type models that focus on technical expertise; portable non-invasive CGM blood glucose meters, insulin injection dose counters and other equipment are patient-type models that focus on coverage. . No matter which mode, it collects data through equipment, and then uses artificial intelligence to match healthy life solutions. It has the characteristics of high efficiency and personalization, which is the basic premise for follow-up management.

For the 500 million diabetic patients in the world and the 1.5 diabetic patients in China, the supply of health intervention provided by medical care is far from enough, and manual intervention has shortcomings of high cost and low efficiency. In digital management, whether it is a device-based model or a patient-based model, it can exert great value for the corresponding patient groups. At the same time, we also saw the driving factors such as technical barriers and key innovation points of equipment in the two models, which have become the direction of continuous iteration of digital diabetes management.

In addition to equipment, data and intelligent decision-making also play a crucial role in the “3D” element.

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