medicaldesign

A multi-institution proof-of-concept funding program is seeking applications for digital health projects for the first time, in addition to its life science tracks, according to a statement from the University City Science Center.

The QED Proof of Concept program, run by the University City Science Center, was the first program of its kind for life sciences and includes 21 institutions across Pennsylvania, New Jersey and Delaware. Its fifth round, launched today, will give support for up to 16 projects, six more than in previous rounds, and provide funding for up to four of them. The deadline for application submissions is the end of July.

The electronic medical record mandate was the primary reason for adding the digital health track, particularly with the deadline for implementation coming up.

“There is an increasing demand for commercialization resources among projects in the digital health domain, and supporting these projects works to our region’s core strengths,” said Adam Greenspan, the Science Center QED program manager.

It also added two organizations to the program this month: Penn State College of Medicine in Hershey, Pennsylvania and the New Jersey Institute of Technology in Newark, New Jersey. Penn State in particular adds a significant resource as a research organization.

The QED program is funded with a $1 million grant from the U.S. Economic Development Administration, with additional financial support from the Commonwealth of Pennsylvania’s Ben Franklin Technology Development Authority, the William Penn Foundation and Wexford Science and Technology. Last year the Science Center announced the a fundraising initiative to raise $15 million for its program.

 

Take growing adoption of smartphones and tablets among the general population, add it to anxiety about regulation in healthcare and an empowered patient population, and you get an explosion of consumer-focused  digital health ventures.

That’s where we’re at now, thanks to investors who have reached into their pocketbooks to fund a pool of emerging digital health companies.

Granted, there’s a lot of noise in this market, especially among mobile health apps, and there are a few challenging barriers to adoption. But there are also some companies doing really interesting work with some high-powered partners and investors.

Below is a list of some of the digital health and wellness companies we’ll be watching closely over the next several months. Feel free to share others you think we should all be watching in the comments.

PUSH Wellness. Unlike many corporate wellness programs that incentivize participation, PUSH has companies designate dollars to be dealt out to employees as monthly cash rewards for achieving measurable improvements to their health. It also sends employees targeted messages to help them improve their PUSH score – a proprietary health score based on biometrics – and earn more dollars.

This Healthbox graduate generated major reader interest when MedCity News reported on the company last month.

Zeo. Founded by a group of sleep-deprived Brown University students, Zeo makes a system (available in bedside or mobile-compatible version) that helps people manage and improve their sleep quality and quantity. Users wear a headband that measures brainwaves to determine what sleep stage they are in, which triggers an alarm to wake them up at the optimum time. The system also collects and organizes sleep data, enabling the user to see relationships between lifestyle and sleep quality.

Reviews of the product reveal that it could use some tweaking, but it seems to be an accessible, consumer-friendly way to address a problem that many people wouldn’t likely to address otherwise. The company has gotten the attention of some high-profile investors including Trident Capital, Best Buy Capital, iD Ventures America, Johnson & Johnson Development Corp. and numerous angel investors.

Global Fitness Media. Launched in 2009 by Jake Steinfeld (aka the “Body by Jake” guy), this company’s first product, FitOrbit, is a web and mobile platform that matches customers with a personal trainer who will develop personalized meal and fitness plans for them and provide virtual support. The platform includes tracking and progress monitoring capabilities along with access to a few other features.

Although it removes the face-to-face element of personal training that many people struggling to lose weight need, it costs significantly less ($40/month) and allows “24/7 access” to trainers. Perhaps the most interesting thing about FitOrbit is the list of heavy hitters supporting it. Early investors include angel investor Ron Conway, AOL President and CEO Tim Armstrong, Spark Capital, Polar Capital and WellPoint Inc.

Meddik. Aiming to streamline the way the general public gets health information online, this platform asks users to input information about themselves, their symptoms and their medical conditions (if known), which it uses to build a network of people with similar conditions and symptoms. It customizes the user’s page to deliver news, crowdsourced content and discussions that similar users found helpful.

Meddik recently closed a $750,000 seed round with investments from Collaborative Fund, Founder Collective, Great Oaks Venture Capital, Silicon Badia and five angel investors.

BitGym. Lots of companies are working in the health gaming space; this one aims to use existing devices to make going to the gym more fun. Through a partnership with Virtual Active, BitGym created an app for the iPhone and iPad that, when the device is set on the magazine rack of an exercise bike or elliptical machine, places users in a virtual world. Existing technology on the devices picks up vibrations in the exercise machine to determine the users’ speed in the game, and steering is controlled by the device’s camera, which picks up small head movements.

This one is a relatively young company, having graduated from the Rock Health accelerator last year. It hasn’t disclosed any investors but is reportedly in talks with two major fitness industry players for collaborations.

The effort to repeal the 2.3 percent medical device tax is winning bipartisan support.

There are reportedly four separate bills in Congress that seek to ensure that the tax, designed to go into effect in 2013, never sees the light of day.

But who would benefit the most if it were repealed?

Analyst David Lewis of Morgan Stanley believes the companies that would enjoy the biggest reprieve are those that share these common characteristics – they have higher percentage of overall revenue derived from sales in the U.S. and lower operating margins.

In a note to investors, Lewis said that the company to benefit the most is Abiomed who would see a 13 percent bump to its 2013 expected earnings per share. Boston Scientific and Integra would also see a 10 percent positive effect on their calendar year 2013 EPS.

Across the board, medical device companies should see a 4 percent bump in both top and bottom lines, Lewis said.

But there are companies who, unlike Abiomed, Integra and Boston Scientific, don’t have much skin in the repeal-the-device-tax game. They are those whose revenue comes from overseas, have higher operating margins and those who sell pharmaceuticals or plasma/blood products that are outside the scope of the tax.

Those companies include Grifols, Abbott, Baxter, and Johnson & Johnson.

[Photo Credit: freedigitalphotos user renjith krishnan]

I think the problem is too many people still think Mayo Clinic is a hospital.

Mayo – which treats patients, conducts medical research, launches startup companies, builds mobile apps, and serves as a major healthcare publisher – was dinged this weekend for making money on its WebMD-like site, MayoClinic.com. One of the ad networks Mayo uses pushed an ad selling baby clothes on a page in its pregnancy section that shared a story about a condition that almost always results in the death of the unborn child.

“Here is a word I rarely use on my my blog: Stupid,” wrote marketing expert Mark Schafer on his blog. “But I think it is an unavoidable description when an organization sells the soul of their brand for a few advertising dollars with a mindless strategy of advertising children’s clothes to women who have just lost their child.”

He went further in an e-mail to me: “I think an experienced marketer would know that you can’t engage in any activity that jeopardizes your brand promise. There may be ways to use ads in a way to enable the clinic’s strategy, but I can’t view a decision to shill children’s clothes to its pregnant patients as anything but opportunistic, and, in this case, disastrous. The clinic has spent millions of dollars in advertising and marketing to nurture its stellar reputation. Why threaten this hard-earned and sacred trust by trying to pick up a few dollars on blog ads? It makes no sense whatsoever.”

Mayo this morning blocked the ad from that page, thus caving to the philosophy of a bygone era when hospitals didn’t think creatively about revenue (it also reminded me of that Mad Men episode about the American Airlines crash when everyone hurried to pull the airline print ads).

But these institutions formerly known as hospitals are now full-blown publishers. So don’t treat them like hospitals. Keep in mind:

• MayoClinic.com is the health system’s commercial site. MayoClinic.org, the main hospital site, doesn’t take ads (neither does the new Mayo Clinic social network).
• Mayo Clinic is not only competing with other hospitals launching similar sites, but with the likes of WebMD, which also takes advertising (and have unfairly criticized for doing so). Mayo claims, by the way, that the dot-com site gets more than 30 million monthly visitors and 90 million to 95 million monthly page views.
• Health systems don’t make enough money for just taking care of patients, so they need new revenue streams.
• MayoClinic.com is profitable thanks to both online advertising and content syndication. And Mayo takes the revenue above the cost of the site and uses it to fund patient care. (There are a lot of caveats with this point, however. Mayo staff members would not outline how much the site makes, how much the site costs to run and what percentage of that revenue comes from advertising versus syndication. Lindsay Dingle, director of health information and promotion business line in Mayo Clinic Global Business Solutions, also said the site generates revenue through attracting patients, but did not have figures on how many patients Mayo credits the site for attracting.)
• There’s actually a pretty legitimate advertising policy on MayoClinic.com coupled with criteria of what can and can’t be sold.
• Yes, it looks bad for that ad to appear. But I don’t think anyone really cares.

Hospital systems need to be held accountable as publishers – and perhaps even more so than many private publishers. Hospitals need to be called out when they publish shoddy medical information in order to grab the public’s attention. Also, the general public needs to think more about the concept that health system-publishers, which rely on patient volume and clinical trials for major revenue, are often writing favorably about certain treatments or clinical areas that can drive that money.

But let the hospitals advertise. It puts them on equal footing with their real competitors and does not hurt their brand with anyone other than marketers.

 [Photo courtesy of BusinessGrow.com]

A fecal incontinence test, the technology for which was licensed from the Mayo Clinic, has won regulatory approval, announced the company that originally licensed the technology from the Mayo Clinic in 2009.

Medspira, based in Minneapolis, said that the FDA has approved its mcompass anorectal manometry device that can evaluate how the pelvic floor of  a person with constipation or fecal incontinence functions.

The system comprises three components – a disposable catheter, mobile tablet PC and wireless portable manometer. The test can be conducted by even inexperienced users, noted the company in a news release and results are displayed on the tablet PC in real time.   The fully secure data can be emailed to specialists for review and interpretation.

Fecal incontinence plagues the elderly mainly and an estimated 18 million Americans experience it.

“Fecal incontinence and related chronic constipation are major medical problems and growing significantly with today’s aging population,” says Jim Quackenbush, CEO of Medspira, in a news release. “Yet, despite the health and lifestyle consequences, only one in 13 patients with fecal incontinence or chronic constipation is tested to determine the cause of their disorder. Often, sufferers are provided a range of treatments that fail to address the root of their problem.”

Medspira expects to market the product to colorectal surgeons and gastroenterologists, Medspira as well as to primary care physicians, gerontologists, URO/GYNs and OBGYNs.

Aside from mcompass, Medspira also makes the Breath Hold device, which enables patients maintain consistent breathing during imaging exams and other medical procedures where breathing plays a role. In November, Medspira announced that Philips Healthcare  would be offering its Breath Hold interactive tool along with its imaging system to help patients in maintaining a consistent breathing during CT and other imaging tests.

A third device is a small extremity coil made exclusively for GE MRI systems. It can be used to scan hands, fingers, wrists and other small parts of the body.

In September, the company announced that it had raised $2.25 million from a private investment firm.

[Photo Credit: freedigitalphotos user Surachai]

Specialty pharmaceutical company Auxilium Pharmaceuticals (NASDAQ: AUXL) has inked a deal with with GlaxoSmithKline (NYSE: GSK) to co-promote its testeosterone replacement therapy gel Testim in a bid to grab a bigger slice of the primary care physician market, which accounts for 70 percent of TRT gel prescriptions, according to a conference call detailing the deal.

The deal, scheduled to start in the third quarter this year, will last through September 2015. It prompted Auxilium to add $10 million to its projected revenues for 2012 to as much as $315 million and reduce net losses to $5 million to $10 million. Last year it had net revenues of $264.3 million with net losses of $32.9 million.

Although details of the deal are still being worked out, GSK will get a majority of revenues above baseline sales.

Testim is used to treat hypogonadism, a condition in which there is reduced or no secretion of testosterone that can lead to symptoms such as low energy, loss of libido, adverse changes in body composition, irritability and poor concentration. Although the Malvern, Pennsylvania-based company launched the TRT gel in 2003, it has had greater competition for marketshare with rival products from Endo Pharmaceuticals, Lilly and Abbott.

With TRT increasingly prescribed by primary care physicians as well as urologists and endocrinologists, Auxilium is hoping its Big Pharma deal will help it wrest back marketshare from the increased pool of rivals in the market. The co-promotion deal will target the 39,000 physicians responsible for 80 percent of gel prescriptions. U.S. prescriptions for Testim grew 22 percent from 2005 to 2011, with primary care physicians accounting for 59 percent.

The deal comes at an interesting time for Auxilium as it awaits approval from the U.S. Food and Drug Administration on a new indication for its drug Xiaflex to treat Peyronie’s disease later this year. The company is hoping that a more expansive relationship with urologists as part of the co-promotion deal could help lay the groundwork for the company’s success with the new application.

 

New Jersey-based healthcare system Meridian Health’s joint venture, iMPak Health announced its next low-cost mobile health device, a Near Field Communication (NFC) enabled credit card sized ECG device that pairs with NFC-enabled smartphones and tablets. iMPak, which Meridian co-founded with Swedish technology vendor Cypak, said the device, called RhythmTrak, works with Android devices today and [...]

A biopharmaceutical startup developing a new treatment for asthma that targets the nitric oxide signaling system has raised $50,000 of a planned $500,000 fundraise, according to recently filed SEC documents.

SAJE Pharma LLC’s lead compound appears to have been discovered at Johns Hopkins University and in preclinical stages. Aside from respiratory diseases like asthma and COPD, the company is also devoting research efforts to using its technology in the treatment of inflammation and cardiovascular diseases like hypertension, according to its website.

Nitric oxide is a highly reactive signaling molecule that regulates numerous physiological and cellular processes and has been implicated in a variety of diseases. SAJE says that its technology pharmacologically regulates levels of nitrosylated proteins, so it is more targeted than agents that simply increase the levels of nitric oxide in tissues. It will develop its lead molecule through Phase 2 clinical trials, the company says on its website. CSO Dr. Helen Pentikis didn’t respond to a request for more information.

Like the current market, dominated by GSK’s Advair, AstraZeneca’s Symbicort and Merck’s Singulair, the pipeline for asthma and COPD drugs is already quite strong with candidates from numerous Big Pharmas. Recent FDA approvals have included Merck’s combination drug Dulera, Novartis/Genentech’s Xolair and Novartis/Schering-Plough’s Fordail, plus a new non-drug treatment called bronchial thermoplasty. GSK/Theravance’s Relovair is expected to be submitted for approved this year.

Market research from BCC Research and GlobalData estimate that the $26 billion asthma/COPD drug market will grow slowly through 2014, with product differentiation and targeting to specific patient pools becoming increasingly important.

Formed in 2009 by life science entrepreneur/consultant Matthews Bradley and Pentikis, SAJE operates out of Baltimore. The company was awarded $75,000 from the Maryland Technology Development Corp.’s Maryland Technology Transfer and Commercialization Fund last year.

Minneapolis software company Preventice announced Monday that it is partnering with Avery Dennison Medical Solutions, which is will manufacture and sell its wearable body sensor once it is cleared by the Food and Drug Administration.

The company, formerly called Boost Information Systems and based near Mayo Clinic in Rochester, has filed a 510(k) application for its miniature, remote body monitor called  BodyGuardian. Avery Dennison will build a version of this patch-based wearable sensor and sell it under the name of Metria, explained Colleen Kulhanek, director of corporate marketing, in a phone interview. (Although the 510(k) is for the device called BodyGuardian, since the product is not cleared yet, the name is not final, Kulhanek said.) The technology is partly based on Mayo’s intellectual property.

So how does this remote monitoring system work?

The device is worn underneath clothes next to the skin and is able to monitor heart rate, ECG, respiratory rate and physical activity, said Judy Eastman, Preventice’s director of product development and management, in an earlier interview. Designed to monitor nonlethal irregular heart rhythm, the BodyGuardian collects the physiological information and transmits it using wireless and smartphone technology to a physician who can monitor a patient remotely.

Earlier this year, another Preventice executive told a audience at a conference in New York that the final product will be as unobtrusive as a band-aid.

To make that device requires expertise that Preventice – a software and mobile app company – does not have. And that is what Avery Dennision brings to the partnership, especially with its experience in making adhesive materials for medical applications.

The device also uses the Preventice Care Platform “which creates a real-time, continuous connection between patients and health care providers through mobile, cloud-based and sensor technology,: a company news release said.

However, before it can be sold, Metria will need to be cleared through an extension of the original 510(k) application of BodyGuardian that was filed in April, said Preventice’s Kulhanek. Aside from manufacturing Metria, Avery Dennison is also licensing proprietary algorithms from Preventice in order to develop its own  clinical applications of the technology.

Preventice’s sensor and remote monitoring technology incorporate know how from Mayo Clinic and Proteus Biomedical. In fact Preventice licensed certain algorithms and clinical practices from Mayo in November 2010 to develop BodyGuardian and Mayo has an equity stake in the company.

Currently,  heart rate, ECG, respiratory rate and physical activity are the four metrics are what the sensor can track today, it will have the technological capability to track other physiological functions in the future, Kulhanek said. That is why the plan is to have several designs of the products for a variety of customer.

“Our final, go-to-market plan is still being decided but the bottom line is we want to a come out with a full-feature remote monitoring technology with different cost and design options,” Kulhanek said. “With this announcement, we are broadening that ecosystem with a new partner.”

 

Anyone familiar with the web version of GP Notebook and finds it useful should be encouraged to purchase this app. The overall feel and use of the app is impressive and the ability to access the wealth of content online/offline is a major plus point. Whilst this app mainly appeals to general practitioners, the information contained within is widely applicable to anyone involved in community healthcare.

The breakthrough cancer pain treatment developed by BioDelivery Sciences (NASDAQ:BDSI) International is making progress toward entering the European market, triggering a $2.5 milestone payment from BDSI’s drug partner Meda Pharmaceuticals.

The milestone was triggered by registration and pricing approval of the drug Breakyl in Europe. Raleigh, North Carolina-based BDSI is due another $2.5 million upon commercial launch, expected to occur in late 2012. Meda will be responsible for selling Breakyl in the European Union.

Breakyl is already commercialized in the United States under the name Onsolis. The product employs BDSI’s dissolvable film technology, which quickly delivers medication via a small disc placed on the inside of the cheek. Onsolis, designed for breakthrough cancer pain that does not respond to other pain treatment, quickly administers the painkiller fentanyl.

The U.S. Food and Drug Administration approved Onsolis in 2009, though the product has experienced slow U.S. sales since. The FDA put the product under a Risk Evaluation and Mitigation Strategy, or REMS, which imposes stricter requirements of products that pose higher health risks or have the potential for drug abuse. BDSI has said that it was at a competitive disadvantage because fentanyl products commercialized before the FDA’s REMS requirement continued on the market without the same requirements.

A standard REMS applying to all fentanyl products is now in place, though BDSI has not been able to take advantage of it yet. BDSI postponed its Onsolis relaunch in March after the FDA expressed concerns about a color change in the product’s appearance over its two-year shelf life. The FDA said that the color change could confuse patients. BDSI said in its quarterly report that the company has been adjusting Onsolis’ formulation and that work is expected to be completed before the end of the second quarter. The company will then meet with the agency to discuss the changes and a review of the product. Until then, BDSI cannot offer any timeline for relaunching Onsolis in the United States.

The color change raised by the FDA is not expected to become an issue for the European launch of Breakyl. Breakyl will be made by a different manufacturer.

[Image from BioDelivery Sciences International]

 

Surgical sponge detection company ClearCount Medical Solutions has raised $1.5 million, according to a regulatory filing.

Pittsburgh-based ClearCount has been quiet on the fundraising front since August 2010, when it announced a $5 million series B round of investment led by Draper Triangle Ventures.

ClearCount Medical has developed the SmartSponge and SmartWand systems, which use radio-frequency identification (RFID) technology and chips embedded in sponges to allow surgeons and nurses to detect and count sponges during operations.

ClearCount’s latest funding comes in the form of options and debt and was sourced from one investor, according to the regulatory filing.

Surgical sponges are the most frequent and dangerous “retained surgical items” (RSIs) that are mistakenly left inside patients.

ClearCount says its products can reduce or eliminate preventable hospital costs and delays associated with RSIs, including additional surgery and infection costs, litigation and unnecessary X-rays.

Earlier this year, ClearCount released a new product, the SmartSponge Flex, which features improved design for OR use, according to the company.

ClearCount has at least two major competitors that take different approaches to surgical sponge detection: SurgiCount Medical uses bar-coding technology and RF Surgical Systems uses electronic surveillance technology.

ClearCount CEO David Palmer didn’t immediately return a call.

So often I hear of Telcos’ failed efforts to engage patients with mHealth offerings while Apple seemingly continues with it’s golden touch so I think it’s helpful to share how a US telco (Sprint) is working to drive adoption of Google Wallet – a contactless payment service that’s been struggling with adoption.

Quite a simple value proposition really: activate the feature within 7 days and receive a $50 credit.

I can imagine an offer like “Activate your TELUS HealthVault account within 7 days and get a free 3G Doctor consultation to use whenever you want” would work well for mHealth service providers and really help drive a whole plethora of downstream market opportunities, loyalty and new channel partners for a Telco:

Simplee, a Palo Alto-based medical billing management and payment portal that could be equated to the Mint.com for health care, has raised $6 million in Series A funding led by The Social+Capital Partnership and includes prior investors Greylock Partners Israel. Simplee has managed nearly half a billion dollars in medical expenses for members across thousands of medical providers. The company currently covers 80-percent of insurers in the US market, with the average user paying about $1,000/year via the platform. The [...]

By Andy Levitt

This past Friday, Facebook went public in the third-largest initial public offering in our history.  Investors piled more than $100 billion into the social networking company, betting on the fact that the company can continue to effectively monetize all of the site traffic and activity it generates each month.   This has been the biggest word-of-mouth success story in our history. 

Just think about it: Mark Zuckerberg creates something out of nothing for use within Harvard just 8 years ago. That’s right - only eight years ago!  At that moment, no one had ever heard of TheFacebook (as it was once called).  He launches the site, people start to use it, and word spreads on campus about this cool new website.  Before long, students begin to tell others at nearby campuses.  The news travels regionally, then nationally, and then tips from being a college-centric tool to the place where people of all ages spend more time every month than any other website that exists, including Google.   The icing on the cake is that Zuckerberg is a billionaire, and plenty of others who signed on to his vision years ago are wealthy beyond their biggest aspirations. Now with a global presence and closing in on one billion registered users, the power of Facebook - and its potential - is immense.    And the secret sauce to their massive growth over time: (hint: it wasn’t advertising).  It was the power of word of mouth.

We must be on to something…..

Finalists in the Sanofi-Aventis sponsored DataDesignDiabetes Challenge present their products during the competition's demo day at Blueprint Health.

A BBC report claims that the UK’s largest mental health charity is not answering 16,000 calls made to it’s 9-5 Mon-Fri advice line “because of demand” that has increased “since the start of the recession” and by 28% in the last year. It astounds me that there’s no mention of the failure to offer effective digital means of engagement as a complement to their telephone services.

Perhaps a prerecorded message could be played to those callers who are currently getting an unanswered call could say something like: “we’re currently very busy, why not try engaging with us on our website? MIND.ORG.UK”

The charity claims “calls about personal finance and employment issues have doubled since 2008″ so can you imagine the rich content they could support citizens with – this is after all a charity that excels at making it’s own quality online video content:

It depresses me to think that 12 years since Ryanair (Europes largest airline) launched it’s website and we’re still at a stage where connecting with a leading mental health charity that raises £27 million per year means you either send an email (to info@mind.org.uk) or call a number between 9 and 5, Monday to Friday…

Obviously I’d recommend they introduce a mobile web accessible advanced medical history taking questionnaires that have been clinically validated but there should be no excuses as even the NHS have basic survey tools for this type of thing that they’re looking to syndicate across the websites of charities:

The Health Care Cost Institute analyzed about 3 billion health insurance claims  and found that prices rose five times faster than overall inflation for ER visits, outpatient surgery and facility-based mental health care. The report found the biggest spending increases in the Northeast, up 4.3 percent and among children under 18, up 4.5 percent nationally. That compares with a 3.1 percent jump in spending on 55 to 64 year olds.

Veterans for Common Sense and Veterans United for Truth are appealing a ruling that says the court system has no jurisdiction to require an overhaul of the Veterans Administration’s mental healthcare system. The lawsuit began in 2007 and the plaintiffs said they expect the case to go to the Supreme Court.

A new report from the Department of Homeland Security recommends requiring vendor support for firmware, software patches and antivirus updates and using authentication and encryption to protect healthcare data on mobile devices. The report identifies the theft of medical information and malicious intrusion of healthcare technology systems as a major concern. Read the report here.

Recent articles in Forbes and the New York Times questioning the potential of drugs that raise HDL levels is bad news for Merck and Eli Lilly. Both companies are spending millions to develop the CETP drug class. FierceBiotech highlights the bad news from both sources.

Proteus Biomedical is raising money again to support its Raisin system which includes sensor-enabled pills, a peel-and-stick sensor patch worn on the body, and a mobile health app. The company raised about $17.5 million in a round of funding set to hit $50 million.

[Image from Kaiser Health News]

Walking out of your patients room, you pull out your smartphone to dictate a quick progress note. You note that your patient, hospitalized for a hip fracture, is complaining of bilateral leg swelling and orthopnea. Once you complete your dictation, you are immediately presented with the transcribed text. In addition, you see two flags. The first notes that the patient is not on DVT prophylaxis and suggests that given the patients age, weight, and co-morbidities, you use mechanical prophylaxis while [...]

Drugs that mimic beneficial bacteria found in the human gut,  implantable and incisionless weight loss devices and stem cells that restore pancreatic function.

If the world is going to make a dent in the diabetes epidemic, it’ll require innovative approaches like those mentioned above – and more.

Solutions to the “whole body” problem of diabetes are coming from a wide variety of sources: the chairman of Whole Foods, innovative but largely unknown startups, entrenched industry giants and stem cell researchers, for example.

The following innovations in the treatment of diabetes provide some hope of lowering blood sugar levels and the economic toll of this costly and chronic condition.

Gut bacteria: The gut is home to trillions of bacteria, some of which can improve or worsen insulin resistance in mice – and perhaps humans. Plus, certain types of bacteria are more often found in the guts of lean or obese mice. If researchers can figure out which bacterial species in the gut are beneficial and which are pathogenic, they might be able to reduce diabetes or even cure it, Nature reported. It may be possible to develop drugs that mimic the chemicals produced by the bacteria found in lean people’s guts, or inhibit molecules that lead to insulin resistance and diabetes.

Nu Me Health, co-founded by the chairman of Whole Foods Market, is developing a proprietary blend of prebiotics and other natural, plant-derived ingredients that are designed to alter the composition of the bacteria living in the gastrointestinal tract in order to help people with prediabetes maintain healthy blood glucose levels and body weight.

Incisionless, implantable devices: Medical device startup EndoSphere has developed an incisionless, anti-obesity device that could be used to treat diabetics. The device recently received the CE mark, and works by slowing the passage of food through the duodenum, the upper part of the smaller intestine that breaks down food. Because food is in contact with the duodenum for a longer time, the device essentially fools the body into thinking that it’s consumed more food than it actually has. It’s implanted with an endoscope in a quick procedure and can be removed just as easily. MetaModix also appears to be developing a device based on a similar approach.

Stem cells: Research published earlier this year in the journal BMC Medicine details a treatment that uses stem cells from cord blood to re-educate a diabetic’s own immune system cells and restore pancreatic function, allowing the pancreas to start producing insulin and reducing the need for the drug. “The concept is very intriguing, and the treatment seems to be so simple and so safe,” a University of Miami diabetes researcher told USA Today. The study was led by a University of Illinois at Chicago professor, who cautioned that it involved only 15 Chinese people and future studies would need to involve a much wider, more diverse patient population.

Smart blood glucose meter: There are plenty of glucose meters in development that wirelessly transmit blood glucose data to health providers, but a company called Hygieia is going a step further. The company is developing a device that uses proprietary software to generate recommendations on how diabetes patients should adjust their insulin dosages. A physician sets up the device and then patients take it home, and use it to measure their blood glucose levels. The software in the device analyzes patterns in those measurements and generates insulin dosage recommendations. The device would represent a cheaper alternative to diabetics than in-office tests and physician visits. It’s scheduled to be rolled out in the United Kingdom later this year.

Artificial pancreas: The artificial pancreas is often regarded as the Holy Grail of diabetes treatment. Ideally, the artificial pancreas would be a small, portable closed-loop system comprising a continuous glucose monitor, an insulin pump capable of delivering precise amounts of insulin and a computer algorithm to tell that pump just how much insulin to deliver based on blood sugar levels. The closest thing we have now to the artificial pancreas is Medtronic’s MiniMed Paradigm Veo, which is available in Europe but not the U.S.

That device comes with an insulin pump, a built-in continuous glucose monitor and personal therapy management software. A key feature is its Low Glucose Suspend (LGS) automation, which stops the pump from delivering insulin for two hours when a patient’s blood sugar level gets too low. The next key step in the quest for the artificial pancreas involves integrating an insulin-delivery algorithm and associated automation with the rest of the technology.

 

 

[Photo from flickr user by Jill A. Brown]