DXCM DexCom Inc

By Peter Loftus 

Diabetes patients are increasingly using electronic skin patches and their phones, instead of pricking their fingers, to do the complex job of managing a disease that affects more than 30 million Americans.

The transformation in blood-sugar testing suggests how harnessing technology and data may drive improvements for disease management -- and profits for manufacturers.

Many patients now wear coin-sized skin patches on their arms or abdomens that test for blood-sugar levels automatically, then send the data to a patient's smartphone or even to a wearable insulin pump that delivers the medicine.

Patients in the U.S. using the devices, known as continuous-glucose monitors, numbered almost 840,000 as of March 31, more than double the 389,000 using them at the end of 2017, according to Seagrove Partners LLC, a health-care research and consulting firm.

Sales of the products are fueling growth at companies including DexCom Inc., Abbott Laboratories and Medtronic PLC. Their sales of the devices are expected to hit $3.2 billion this year, triple the 2016 total, according to JPMorgan Chase.

The market for the devices "is extremely large and growing really fast," said Mike Hill, who heads the Medtronic unit selling the sensors.

Tracking blood-sugar levels is vital for many diabetics, who must regularly check if they are within healthy levels or need to take insulin, sugar or some other medicine to avoid fainting or worse. For years, many patients have had to prick their fingers several times a day to draw blood and then insert the blood into a meter for a reading.

Use of digital blood-sugar monitors, which first hit the market in the mid-2000s, has soared in recent years partly because the devices have become more accurate and more health plans are paying for them.

"There's very few other diseases like this that put the bulk of the data in the hands of the patient," said Aaron Kowalski, chief executive of JDRF, a group that funds Type 1 diabetes research.

In Type 1 diabetes, the body doesn't produce insulin and patients rely heavily on insulin therapy. In Type 2, the more common type, the body doesn't use insulin properly.

With the connectivity linking monitors to smartphones and insulin pumps come cybersecurity risks. The U.S. Food and Drug Administration warned last month that certain models of Medtronic insulin pumps could allow hackers to gain access, change settings and cause patient harm.

Medtronic, which is recalling the pumps, said they were older models and has recommended patients consider switching to newer Medtronic models that have better cybersecurity protections.

The disposable sensors can be worn around the clock. They stick to a patient's abdomen or arm and insert a tiny needle into the skin to sense changes in blood sugar and transmit readings wirelessly. Some patients have the glucose data sent to a wearable insulin pump; some pumps can adjust the dose based on the glucose reading.

Some monitors sound alarms and keep track of long-term data, which patients can share with their physicians.

A DexCom-funded study published in JAMA in 2017 found that patients using its monitor had greater decreases in average blood-sugar levels than those using finger sticks and test strips.

The data deluge, however, can overwhelm some patients, especially new users. Some patients say they feel punished when the monitor shows sugar levels are out of range and have asked for more positive feedback when they stay in range, like a smiley face, DexCom CEO Kevin Sayer said in an interview.

Raynham McArthur, a 14-year-old in Hamilton, Ontario, used to wake up at midnight and 3 a.m. every night for her parents to take blood samples. The multiple finger sticks left her fingers bruised and sore.

Now, her sensor sends blood-sugar data to her parents' phones. "I probably sleep through easily four nights a week," said her mother, Joanna Wilson, a university science professor. She and her husband, Andrew McArthur, monitor Raynham's sugar levels while she is at school and text her to make sure she takes steps if the numbers go out of range.

Raynham calls it "blood-sugar stalking." But the device made it easier for her to go on a two-night school trip to Ottawa in June without her parents. "It's a lot easier for me to go out and do things with friends, " she said.

The cost, however, would be unaffordable for many patients who lack insurance or whose insurer doesn't cover the devices, said Mayer Davidson, a diabetes specialist at Charles R. Drew University of Medicine and Science in Los Angeles.

Abbott's device, called FreeStyle Libre, costs around $1,308 a year for the average patient; DexCom's system is about $3,000. With insurance, the typical patient copay for Abbott's product is about $31 a month, and $50 a month for DexCom's, said Erik Verhoef, president of Seagrove Partners.

Competition for sales among device makers has been fierce. Abbott priced its system at a significant discount to DexCom's to grab an edge. Jared Watkin, senior vice president of Abbott's diabetes-care unit, touts Libre's sensor, which lasts longer than competitors'.

DexCom, which is working on a new version of its device with Alphabet Inc.'s Verily unit, has been hiring data-analytics workers to search for insights by pairing sugar data with exercise data collected from other wearable devices, Mr. Sayer said.

Medtronic has used data collected from devices to develop algorithms that predict when patients' blood-sugar levels will fall too low, Mr. Hill said.

Write to Peter Loftus at peter.loftus@wsj.com

(END) Dow Jones Newswires

July 29, 2019 05:44 ET (09:44 GMT)

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