Insights Into the Key Advancements Transforming the Type 2 Diabetes Treatment and Management

Diabetes is a chronic metabolic disorder that is influenced by a wide variety of factors and is characterized by high or low blood glucose (or blood sugar) levels in the body. Diabetes is a major risk factor for blindness, kidney failure, heart attacks, stroke, and lower limb amputation. Also, it can significantly affect several body parts, such as the heart, blood vessels, eyes, kidneys, skin, and nerves. Diabetes can have various socioeconomic consequences on the affected person and their families. It is generally considered a rich people disease with high prevalence in developed countries. But the global prevalence scenario is evolving immensely. Now, it is a fast-growing problem in poorer communities and in low- and middle-income countries as well. Technological innovations and developments play a crucial role in the management of diabetes. Over the past few years, pharma and tech giants have launched several key products and therapies in the market, providing sufficient options for better managing diabetes and its complications. 

Diabetes Prevalence and Overview

As per estimates, globally, diabetes rose from 108 million in 1980 to 422 million in 2014, and between 2000 and 2019, a 3% increase in diabetes mortality rates by age has been observed. Diabetes is clinically classified into three types, namely type 1 diabetes (TD-1), type 2 diabetes (TD2), and gestational diabetes. TD1 is the consequence of an autoimmune reaction that causes the pancreas to suppress insulin-producing β-cells and leads to severe insulin deficiency. While type 2 diabetes is more common and linked to a genetic factor. Type 2 diabetes occurs when the blood glucose, also called blood sugar, is too high. Insulin resistance (inadequate reaction of peripheral cells to insulin) and pancreatic β-cell dysfunction (impaired insulin secretion) are marked by type 2 diabetes, leading to relative insulin deficiency.

In the United States, more than 34 million people have diabetes (about 1 in 10), and approximately 90-95% of them have type 2 diabetes. Similarly, In the UK, type 2 diabetes accounts for about 90% of all diabetes cases.  Some easy lifestyle modifications such as a healthy diet, regular physical activity, maintaining normal body weight, and avoiding tobacco can prevent or delay the onset of type 2 diabetes. People over age 45 and older are most likely to get affected by type 2 diabetes. However, in recent years, more and more teens and young adults have been affected by type 2 diabetes

Major Advancements in Type 2 Diabetes Treatment and Management

The rising cases of Type 2 diabetes is a major health concern in many countries worldwide. It has a substantial impact on the patients and a rapidly growing burden for health care systems. However, over the past few years, there has been a significant advancement in type 2 diabetes management and treatment. Advancements in technology are widening the scope for type 2 diabetes control. Various options are available, from monitoring glucose levels to diet regime and from medications to better disease management support. These noteworthy breakthroughs have a significant impact on diabetes management. Some of the key advancements in type 2 diabetes treatment and management include the following – 

Insulin Pumps Getting More and More Innovative

Insulin pumps play a key role in the life of people affected by type 2 diabetes as they need to take insulin to manage their blood sugar levels. People with type 2 diabetes have to inject insulin several times a day. To overcome these challenges, insulin pumps have emerged as a great alternative. The first Insulin pump was introduced in the market in 1974; thereafter, several developments have been registered in the Insulin pump segment. Insulin pumps are like computerized devices, which are about the size of a deck of cards and provide an alternative to self-injection. The insulin pump can deliver precise doses of rapid-acting insulin into the tissue just underneath the skin. Insulin pumps can be worn around your waist, put in a pocket, secured with an armband, or attached to a belt or bra. 

Today, a variety of insulin pumps are available to cater to the different needs and requirements of patients; in general, there are two types of pump devices, namely traditional Insulin pumps and Insulin patch pumps. Traditional Insulin pumps have an insulin reservoir (or container) and a pumping mechanism and can be attached to the body with tubing and an infusion set. While the Insulin patch pumps consist of three parts, which include an insulin reservoir, a pumping mechanism, and a cannula.  Insulin patch pumps can be worn directly on the body, and different components are set inside a small case. Patch pumps are in great demand today as they can be controlled wirelessly by a separate remote device and can be programmed to deliver insulin from the patch. The patch pumps mostly need to be replaced every three days. Over the past few years, there have been several advancements in the Insulin pumps Market. Now, many insulin pumps are coming up with several smart features that can be compatible with smartphones or CGMs. Owing to the ongoing innovation, the Insulin pumps market is set to evolve immensely in the coming years. 

As per DelveInsight, the global Insulin Infusion Pumps market was valued at USD 6.48 billion in 2021, and it is expected to grow at a CAGR of 8.69% during the forecast period (from 2022 to 2027) and is anticipated to reach USD 10.68 billion by 2027. The insulin infusion pumps market is slated to witness prosperity owing to factors such as the growing prevalence of diabetes, increasing sedentary lifestyle, growing aging population base which is susceptible to the development of diabetes, and the growing focus on improving the safety and usability of insulin infusion pumps.

Continuous Glucose Monitors (CGMs) Playing a Much Critical Role In Diabetes Management

Continuous glucose monitoring (CGM) measures blood sugar (glucose) levels and automatically manages type 1 or type 2 diabetes with fewer fingerstick tests. Continuous glucose monitors (CGMs) have significantly transformed the glucose monitor pattern. Earlier, glucose meters were used to monitor the blood sugar level, which requires a drop of blood to check the blood glucose levels and was considered a prolonged process. A CGM works via a tiny sensor that is inserted under the skin, usually on the belly or arm of the patient. The sensor tests glucose levels every few minutes and can work continuously for 24 hours.

CGM come with a transmitter that sends results to a wearable device or cell phone. The sensor measures the interstitial glucose level, which is the glucose found in the fluid between the cells. A transmitter wirelessly sends the information to a monitor. Continuous glucose monitors have the benefit that they can alert the user when the glucose level is too low or too high. With ongoing innovation and advancements, the CGMs are expected to be more accurate and much more widely available for home use. Thereby reducing the patient’s visits to hospitals and clinics. 

According to the assessment by DelveInsight, the global blood glucose monitoring systems market was valued at USD 13.06 billion in 2021, and the market is expected to grow at a CAGR of 7.72% during the forecast period (2022-2027). By 2027, the blood glucose monitoring systems market is anticipated to touch USD 20.40 billion. The increasing prevalence of diabetes among the population across the globe, the growing burden of the geriatric population who are susceptible to developing hyperglycemia, the technologically advanced blood glucose monitoring devices product launch, and government initiatives to raise awareness regarding proper diabetes management, among others, are the factors likely to spur the global blood glucose monitoring systems market.

Connected CGM-Insulin Pumps Providing New Dimension to Diabetes Management

Continuous glucose monitors (CGMs and insulin pumps perform different functions to manage diabetes. CGM devices measure the glucose level in the body every few minutes and throughout 24 hours a day, while Insulin pumps deliver a steady flow of insulin to match your body’s needs based on instructions given by the diabetes patient. Companies are working on delivering a combination of CGM-insulin pumps and allowing them to work together. Connected CGM-insulin pumps work in a synchronized way in which the pump uses the data from the CGM to suggest changes in medication dosing or make necessary adjustments on its own. Connected CGM-insulin pumps are of great use and have a huge market potential in diabetes management as they require less direct involvement for patients in managing their diabetes. Connected CGM-insulin pumps can help improve and manage type 2 diabetes by quickly reducing blood sugar. Moreover, it can reduce the time required to address hazardous and harmful blood sugar levels in the body.

In June 2020, U.S. Food and Drug Administration (FDA) cleared Abbott’s next-generation FreeStyle® Libre 2 integrated continuous glucose monitoring (iCGM) system for adults and children ages 4 and older with diabetes. FreeStyle Libre 2 iCGM System has several unique and improved features, including minute-by-minute glucose readings and a sensor that can be worn for 14 days before being replaced. Connected CGM-insulin pumps are one of the most competitive segments in the diabetes market. Several key players, such as Tandem, Insulet, Medtronic, and others, actively work in the segment to deliver the product. Moreover, several FDA-approved connected CGM-insulin pumps products to launch are anticipated to hit the market, thereby stimulating the competition.

Advances in Diabetes Medications Leading to Better Outcomes

There is no permanent cure for diabetes. Nutrition management, physical activity,  regular screening, and treatment for complications are considered key practices for managing and delaying diabetes. Similarly, medicines are available in the market to control blood sugar levels. Insulin has been available in the market. However, medications are getting much more targeted for specific diabetes issues. The most pressing unmet need in the diabetes space is the development of breakthrough treatments that address the underlying cause of the disease; many companies are developing products to target specific diabetes issues. Similarly, various drugs belonging to different classes have been approved by the US FDA over the years, like AstraZeneca’s Forxiga, Eli Lilly/Boehringer Ingelheim’s Jardiance, and Astella’s Suglat, Mounjaro (tirzepatide) by Eli Lilly, and others.

Type 2 diabetes is linked with a genetic factor, which is far more common. Type 2 diabetes is substantially correlated with obesity and unhealthy lifestyles. Insulin resistance (inadequate reaction of peripheral cells to insulin) and pancreatic β-cell dysfunction (impaired insulin secretion) are marked by type 2 diabetes, leading to relative insulin deficiency. In recent years, several therapeutic advances have been registered in the diabetes medication market. For type 2 diabetes, Metformin, which belongs to a class of medications called biguanides, is often the first prescribed medication. Similarly, Meglitinides and sulfonylureas, DPP-4 inhibitors, thiazolidinediones, alpha-glucosidase inhibitors, SGLT2 inhibitors, bile acid sequestrants, etc., are also suggested for T2D. In September 2019, the US Food and Drug Administration approved Rybelsus (semaglutide) oral tablets to improve the control of blood sugar in adult patients with type 2 diabetes, along with diet and exercise. 

To improve the treatment scenario, more than 100+ companies are working on 100+ pipeline drugs for type 2 diabetes mellitus based on different routes of administration, mechanisms of action, and molecule types. Some of the key companies in type 2 diabetes treatment market include AgeX Therapeutics (AGEX BAT1), Boston Therapeutics (BTI 320), Carmot Therapeutics (CT-388), Eli Lilly and Company (Tirzepatide), Lexicon Pharmaceuticals (Sotagliflozin), Oramed Pharmaceuticals (ORMD0801), Hanmi Pharmaceuticals (HM12460A  & HM14220), and others.

Innovation in Insulin Delivery Expanding the Treatment Landscape

The discovery of insulin has changed the treatment dynamics of diabetes and the lives of the affected people over the years. Several innovations have been registered in Insulin management and its outcome action in the body.  Similarly, now it is available in many forms, such as rapid-acting, long-lasting, and premixed formulas. Moreover, the delivery of the method has also evolved immensely. Now it can be delivered via insulin pens and pumps or continuous glucose monitors (CGMs). The accuracy of doses, glycaemic targets, and dose timing have resulted in effective insulin therapeutics intervention. 

With each passing day, new innovations and advancements are being made in Insulin formulas and the mode of delivery, which are expected to transform the face of diabetes management in the coming years. The innovation is paving the way for a new method of insulin therapy that has much higher safety and more efficiency. Similarly, it helps to overcome the inconvenience and stigma associated with the existing practices.

As per DelveInsight, the global Insulin Delivery Devices Market was valued at USD 15.51 billion in 2021 and growing at a CAGR of 9.28% during the forecast period (2022 to 2027); it is expected to reach USD 26.35 billion by 2027. Some of the key factors, such as the rising prevalence of diabetes among the geriatric population, favorable reimbursement scenarios, rising awareness about proper diabetes management and insulin delivery devices, and technological advancement in the product line, will drive the Insulin Delivery Devices Market in the coming years.

Easier-to-use Glucagon to Counter the Effects of Insulin

Glucagon is a peptide hormone that the alpha cells of the pancreas make to regulate the blood glucose (sugar) levels in the body. Glucagon elevates the concentration of sugar level and fatty acids in the bloodstream and prevents it from dropping too low. While insulin decreases blood sugar levels. Hyperglucagonemia is a key feature in patients with type 2 diabetes, which signifies excess glucagon in the blood. Type 2 diabetics have elevated glucagon levels, which induces gluconeogenesis and glycogenolysis in hepatocytes. Glucagon instructs the liver to release stored glucose into the blood and counteracts the effects of insulin.

Glucagon is used as an emergency medical treatment to effectively treat very low blood sugar or hypoglycemia, which, if not properly addressed, can lead to severe complications such as loss of consciousness, seizures, and in some cases, it may even lead to coma or death. Recently, several key innovations have been registered in the new glucagon molecule development, its usage, and administration. Devices such as injectable pens and glucagon are available in the market, which has made it much easier for diabetes patients to administer glucagon in the event of an emergency. Similarly, a wide range of glucagon products has been approved with different options, including unique routes of administration and dosing or generic options. 

Growth in Smartphone Apps for Better Diabetes Management

The adoption of smartphones and the growth in the usage of apps have also transformed diabetes treatment and management dynamics. Now, with the help of smartphone apps, the user can track blood sugar levels and analyze trends and changes. Similarly, smartphones are a great tool for monitoring the diet and suggesting recipes. Moreover, it can track exercise and physical activity, which is key in diabetes management. These apps come with a clean, intuitive, customizable dashboard interface and can sync with the glucose monitor. The application comes with an inbuilt feature to interpret and organize the collected data into valuable information and charts that can be easily shared with the doctor, which can help to customize the treatment plan better and more accurately. 

Bezzy T2D, Fooducate, MySugr, Glucose Buddy, Diabetes: M, Beat Diabetes, OneTouch Reveal, Diabetic Recipes, Glucose tracker – Diabetic diary are some of the best Diabetes smartphone apps available in the market. These apps provide a wide range of solutions, such as community conversations, comprehensive diabetes management, healthful eating, carb counting, bolus dose calculation estimation, blood glucose tracking, and easy shopping list creation for diabetic products, among others. Diabetes Apps are available on both iPhone and Android phones. With the growing demand, with each passing day, new apps are being developed and launched by tech companies in the market. 

Innovations in Type 2 Diabetes Treatment and Management – A Future Perspective

In 2019, diabetes and kidney disease due to diabetes led to nearly 2 million deaths worldwide. As per the  International Diabetes Federation, in 2021, about 537 million adults (20-79 years) were estimated to be living with diabetes. The number of people living with diabetes is anticipated to rise to 643 million by 2030 and 783 million by 2045. Presently, type 2 diabetes is the most prevalent form of diabetes, accounting for 95% of cases of diabetes. As per the estimate, type 2 diabetes is expected to record a surge in the number of cases in the coming years as well. The rising number of cases of type 2 diabetes is anticipated to drive the demand for better treatment and management options in the market.

To fulfill the unmet need, several companies are involved in clinical development activities for developing better and more effective treatment options in the type 2 diabetes market. Similarly, technological innovation in product and device development will also immensely stimulate market growth and is expected to provide superior options in the market for diabetes management.