EMERGING TRENDS IN CONTINUOUS GLUCOSE MONITORING (CGM) DEVICES MARKET

Diabetes has emerged as a chronic condition affecting a vast majority of the population, according to International Diabetes Federation (IDF), globally there were about 462.9 million people affected with diabetes in 2019, as diabetes leads to serious problems such as cardiovascular diseases, (coronary artery disease, heart attack, stroke, and atherosclerosis), neuropathy (nerve damage), nephropathy (kidney damage), retinopathy (eye damage), and other condition, monitoring the blood sugar level regularly and analyzing the results is crucial in managing diabetes. Self-monitoring of blood glucose level is an integral part of diabetes management because it puts the patient in charge. The monitoring of glucose level is achieved by using either continuous glucose monitoring (CGM) or self monitoring of blood glucose (SMBG) devices. According to IQ4I Research, the glucose monitoring global market is expected to grow at low digit CAGR from 2020 to 2027 to reach $15.3 billion by 2027.
Continuous Glucose Monitoring systems are advantageous over SMBG device as they provide glucose level information throughout the day and night and there is no requirement of blood sample to measure the glucose level. A coin sized sensor is applied on the skin which contains a tiny electrode, the glucose sensor produces an electric signal by measuring the glucose level in interstitial fluid (the fluid in and around the cells) which is connected to a transmitter that sends the information to the data monitoring device using radiofrequency and then records the glucose level at predetermined time interval for further analysis of glucose trend. The advantage of CGM is that it monitors and notify whether the glucose level is reaching a high or low limit (hyper and hypoglycemic events) and also notifies while sleeping. As these patients need to maintain tight glycemic control to prevent long-term complications continuous blood glucose monitors are extensively adopted by people who are dependent on intensive insulin therapy, where the CGM is often paired with an insulin pump.
 
Based on technology, CGM devices are also classified into real-time CGMs (rt-CGM) and intermittently scanned (is-CGM) systems. The rt-CGMs transmit the glucose data of the user automatically, provides alerts and alarms in situations such as hyper and hypoglycemia devices manufactured by most of the companies fall in this category. In the case of is-CGM, the device continuously measures the glucose level data but this is transmitted only when the custom-built scanner is moved over the sensor, the device from Abbott Laboratories (FreeStyle Libre) falls under this category. 
 
As CGM technology matures, it is finding non-diabetic use such as personal-use product for lifestyle management and as a tool to improve athlete’s performance, for instance, Abbott in September 2020, received CE approval for its world’s first sports-centric CGM, the Libre Sense Glucose Sport biosensor which is designed to continuously measure glucose levels and their performance.  The Libre Sense Glucose Sport Biosensor is a consumer over-the-counter product designed for performing sports such as cycling, running, and swimming, to understand the efficacy of their nutrition choices on training and competition. To promote this product, Abbott has tied up with Supersapiens, an Atlanta-based sports technology company that is focusing on providing athletes with actionable and personalized insights on real-time biometric data, starting with glucose. The product is currently available in eight European countries namely Austria, France, Germany, Ireland, Italy, Luxembourg, Switzerland, and the United Kingdom.
 
New companies are starting to exploit CGM technology as a lifestyle tool, for instance, the U.S.-based Levels Health is promoting the use of CGMs to make it easy for people to understand how their diet and lifestyle affect their health through their Levels app. They help the subscribed members to find their optimal diet and improve the metabolic health. To augment their efforts, In November 2020, Levels Health received $12.0 million in investments from A16Z for the development of biowearable to provide real-time feedback on how diet impacts health. 
 
Tech giants such as Apple, Samsung and new entrants such as Onedrop (Sano) have announced that, they are working on smart watches and wearable devices with non-invasive continuous glucose monitoring capabilities which could change the market dynamics. Various companies and Universities are working on implementation of Artificial Intelligence (AI) technology and machine learning technique as a Decision Support Systems (DSS), which could recommend therapeutic decisions directly to patients based on information from glucose level, diet, insulin administration and physical activity level.  These emerging trends would benefit the diabetic population by improving affordability, reliability as well as reduce the cost of care while advancing the technology.
 
Companies offering CGM devices are Abbott Laboratories (U.S.), Dexcom, Inc. (U.S.), Medtronic, PLC (Ireland), Senseonics (U.S.) and many emerging players are entering this market which includes Medtrum Technologies, Inc., (China), Zhejiang POCTech Co., Ltd., (China), MicroTech Medical, Inc. (Aidex) (China), Infinovo., (China), Nemaura (Waveform Technologies)/Menarini Diagnostics s.r.l (Italy), Integrated Medical Sensors (IMS) Inc. (U.S.), Percusense (U.S.).

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