Exciting Tech Updates from 2018 DiabetesMine Innovation Summit was discussed by Jimmy McDermott and Brian Levine on diaTribe.org, 19 November 2018 … lots of interesting highlights!
Dance Biopharm’s Inhaled Insulin and Connected Inhaler was presented, “as “pure,” “preservative free,” “no cough,” dose-adjustable inhaled liquid insulin formulation 
delivered in a connected, electronic inhaler. The insulin has a slightly faster onset than injected mealtime insulin (though slower than Afrezza). The insulin is reported to stay in your body longer, providing some “basal” coverage too. Though the Dance inhaler currently requires the possibly inconvenient use of an eyedropper to load each dose (the company says it is working to incorporate the insulin dispenser into the device), we are glad to see the focus on connectivity and no-needle insulin delivery.
Klue, an Apple Watch app for automatically detecting meal start and eating speed without user intervention, announced a new diabetes-focused feature: an automatic bolus reminder. Klue uses the motion sensors on the Apple Watch to detect movement and determine when someone starts eating and how fast. The new upcoming feature will recognize when a meal is starting, pulling up the Apple Watch notification pictured below: “Eating?” “Yes, bolused”; “Snooze”; “Hypo.” Stanford 
Professor of Pediatrics Dr. Bruce Buckingham came on stage after the pitch with tremendous enthusiasm – he had used the Klue app on his Apple Watch over the past week and reported that it had “really captured almost all” of his meals. He exclaimed that Klue “is the real key for full closed loop,” as the Watch app could detect a meal and begin to increase insulin accordingly – all without the user telling the system they are eating.
The current version of Klue on the Apple App Store provides meal and water tracking and gives real-time feedback to slow down eating – clear potential for weight loss and slowing down eating to give insulin boluses time to catch up.
Read more: Tech Updates from 2018 DiabetesMine Innovation Summit
Dexcom G6 Accuracy vs. iCGM Special Controls was shared by Mila of TuDiabetes.org, 14 November 2018. It’s technical and interesting.
For the first time since G6 launched, we got to see the sensor’s accuracy stacked up against the iCGM special controls – 95% lower confidence bound finally included for all glucose bins. The G6 label does not actually share the confidence intervals around the point estimates, so this was a long-needed slide.
The takeaway remains the same: FDA has set a very high bar for accuracy. However, it’s now even clearer just how high that bar is, since G6 barely crosses the thresholds in some areas. All in all, it’s clear that Abbott and Medtronic are not likely to obtain iCGM accuracy standards unless they can make leaps forward in sensor accuracy. Senseonics may meet the bar with Eversense, though it is prioritizing 180-day wear first.
Read more: Dexcom G6 Accuracy vs. iCGM Special Controls
The new Insulin Pill breakthrough was discussed by Martin Hensel on InsulinNation.com, 11 December 2018.
Oramed and Rani Therapeutics are early leaders in the oral delivery of insulin. They take very different approaches with each having their own challenges compared to the food additive path envisioned by Dr. Samir Mitragotri of Harvard University.
Geranic acid is a fatty acid that presents as an oily liquid. It naturally occurs in tea, tomato, and wine and synthetic geranic acid is commonly used to add orange, tea, mint, ripe fruit, and melon notes to foods.
Read more: The new Insulin pill breakthrough
Verily, Alcon halt work on glucose-sensing smart contact lens was reported by Conor Hale of FierceBiotech.com, 19 November 2018. I remember being so excited about this … well, no more.
After more than four years in development, Verily and Novartis’ Alcon unit have decided to mothball their work on a smart contact lens to measure glucose levels in users with diabetes. In a posting by Verily’s chief technical officer, Brian Otis, Ph.D., the company said its clinical work was unable to consistently measure levels of glucose across the tear film of the eye, as well as its correlation with blood glucose concentrations.
Read more: Verily, Alcon halt work on glucose-sensing smart contact lens
Medtronic’s insulin pumps highlighted in medtech injury report was reported by Sarah Faulkner on DurgDeliveryBusiness.com, 26 November 2018.
Over the last decade, Medtronic’s insulin pumps and its parts were linked to 20 recalls and 100 lawsuits, according to the report. The ICIJ analysis found that the company’s insulin pumps have accounted for 150,000 injuries and 2,600 deaths. Malfunctioning pumps represent a big problem for users who rely on the technology to effectively deliver insulin. In one case, the report said, a pump problem may have resulted in the delivery of too much insulin, sending the person into a diabetic coma.
Read more:
- Medtronic’s insulin pumps highlighted in medtech injury report
- Insulin pumps have most reported problems in FDA database
Eversense CGM Wins a 2018 “Best of What’s New” Award was published by Senseonics on their website, 27 November 2018.
Eversense® Continuous Glucose Monitoring (CGM) System has been awarded one of Popular Science’s 2018 “Best of What’s New” Awards in the Health category. Each year, Popular Science magazine reviews thousands of new products and innovations in order to choose the top 100 winners across 10 categories. In order to win in a category, a product or technology must represent a significant step forward in its category.
“We are pleased and honored to be chosen by Popular Science as a ‘Best of What’s New’ winner for 2018,” said Tim Goodnow, President and CEO of Senseonics. “Our goal is to create innovative technology to help people with diabetes have an easier time managing their disease. This recognition just reinforces how consumer-driven medical devices can transform patients’ management of a chronic disease. At Senseonics, we’re proud that we’re changing the paradigm for diabetes care.”
The Eversense CGM System consists of a fluorescence-based sensor, a smart transmitter worn over the sensor to facilitate data communication, and a mobile app for displaying glucose values, trends and alerts. In addition to featuring the first long-term and first implantable CGM sensor, the system is also first to feature a smart transmitter that provides wearers with discreet on-body vibratory alerts for high and low glucose and that can be removed, recharged and re-adhered without discarding the sensor. The sensor can now be inserted subcutaneously in the upper arm by a health care provider via a brief in-office procedure.
Read more: Eversense CGM Wins a 2018 “Best of What’s New” Award
Seraxis Islet Technology Aims for Practical T1D Cure was presented by Martin Hensel of InsulinNation.com, 13 December 2018. Seraxis has developed scalable islet production and a way to protect islets from rejection that avoids the need for immune suppression therapy.
After nearly six years in stealth mode, Seraxis has emerged as a front-runner in the race to clinical islet deployment. Privately funded, and without any NIH or University affiliations, Seraxis has been remarkably efficient and comprehensive in their progress.
Islet manufactured in Seraxis lab which was stained.
Red dots are pancreatic cells expressing insulin,
green dots are pancreatic cells expressing glucagon
and blue dots are other pancreatic cells 
Seraxis has created a human islet factory that produces islets that closely mimic donor human pancreas islets. The Seraxis scientists started with donor human pancreas cells and converted these to induced pluripotent stem cells (iPSC). Unlike embryonic stem cells or other iPSC, these cells were specifically engineered to preferentially mature into their former identity: a mature pancreatic islet. Only a mature pancreatic islet can manage the complex, real-time regulation of blood glucose. The Seraxis maturation process takes about 30 days using a clinically compliant and scalable process. So far, the company has five granted patents for their islets and production process. These islets have a long shelf life and can be shipped worldwide in standard chilled containers already used for organ transplant shipments.
Read more: Seraxis Islet Technology Aims for Practical T1D Cure
The SGLT2 Inhibitor-Amputation Link was published by Dr. Adva Eisenberg on MedPageToday.com, 5 December 2018. Scary but don’t panic as there is conflicting data… just talk with your doctor
Sodium glucose co-transporter 2 (SGLT2) inhibitors have shown cardiovascular and renal benefits for patients with type 2 diabetes. But some SGLT2 inhibitors — canagliflozin (Invokana), in 
particular — have reported an increased risk of lower limb amputation. Why this happened is unclear and whether it occurs with all SGLT2 inhibitors is controversial.
Read more: The SGLT2 Inhibitor-Amputation Link
