How Edinburgh based Dexcom is disrupting healthcare management

Published: 17 October 2016

This article was published on the City A.M. website on 17 October 2016 as part of Invest Edinburgh Talk.

Digital healthcare has emerged as one of the central tenets of what’s been described by the World Economic Forum as the fourth industrial revolution.

Technology has the ability to transform not only clinical diagnosis and treatments, but also empower individuals to take greater control over their own health.

Take the subject of diabetes management. In the UK alone, more than 3.5m people live with diabetes and, according to Diabetes UK, there are an estimated 549,000 people who have the condition yet don’t know it.

Transformational impact

Underlining the transformational impact of digital healthcare, many living with diabetes are increasingly turning to technology to help manage their condition on a daily basis.

Leading this revolution are companies such as Dexcom. The San Diego-headquartered medical devices company develops and manufactures continuous blood glucose monitors (CGM), small wearable devices that track a user’s glucose levels 24 hours a-day, providing real time alerts if levels exceed or drop below defined user-defined levels.

Well established in the USA, where up to 15 per cent of people with type 1 diabetes already use CGM technology, the business has recently expanded into Europe with the opening of a new international product support, sales and R&D office in Edinburgh.

John Lister, general manager EMEA at Dexcom, says: "Dexcom has been advancing CGM technology more or less on our own over the past seven years. We’ve seen penetration grow from less than 1% of those with type 1 diabetes in the USA, to today’s figure of close to 15 per cent, so the market has seen phenomenal growth,” explains John.

“In Europe alone, there are about 1.25m - 1.5m living with type 1 diabetes, yet penetration of CGM technology in that segment is probably less than 5 per cent.”

According to Diabetes UK, there are now 3.5m adults in the UK who have been diagnosed with diabetes. There are also thought to be 549,000 people with undiagnosed Type 2 diabetes."

Currently, diabetes costs the NHS and England and Wales more than £1.5m an hour, or nearly 10 per cent of its total budget. If current trends continue, and one in ten of us will be living with type 2 diabetes by 2034.

In terms of clinical benefit, the benefits of CGM for those requiring tight glycaemia control, are undeniable. The technology has the potential to transform patient’s lives.

Managing health with wearable tech

“There’s also the convenience of being able to wear a sensor and check your blood glucose with your phone. It means if you’re a parent, or have a friend or loved one with diabetes, you can monitor their blood glucose levels remotely,” adds John.

“Wearing CGM is like having GPS as a driver. You always know where you are and where you’re going. Unlike a finger stick measurement, which measures a static point of time, but gives no indication if glucose levels are rising or falling, CGM allows you to see trends over time and therefore help users make better-informed decisions as part of any insulin regime.”

While CGM is of greatest relevance to those with type 1 diabetes – an auto-immune condition leading to the failure of the body’s own insulin-producing cells in the pancreas – it is also used by some with type 2 diabetes – a metabolic condition – in particular those with complications or advanced conditions.

“We’ve also seen it used as behavioural tool, helping people with diabetes better understand their condition. When you wear CGM for a week, it can give you a much better understanding of how exercise affects your blood glucose levels; how stress can impact your body.

International collaborations

Having recently signed an agreement with the German Health Ministry to improve the reimbursement of real-time CGM technology for those with type 1 diabetes, as well as those with type 2 diabetes who require intensive insulin therapy, Dexcom has already begun to improve access to existing CGM technology. However, the goal is to further miniaturise the technology and further improve accuracy.

Dexcom is leading the drive towards smaller, more accurate and less intrusive CGM sensors through a number of number of international collaborations, including a groundbreaking link-up with Google’s life sciences division, Google Verily. The partnership combines Dexcom’s industry-leading CGM sensor accuracy with Google’s expertise in miniaturising electronics and data analytics.

It’s a collaborative model the business is seeking to replicate in the UK. “We want to become part of the community in Edinburgh,” says John, “and will actively be seeking ways to collaborate – whether that’s through clinical trials or research studies that make use of Scotland’s national diabetes database, which would be a powerful platform.  It’s one of the reasons why we located here. We feel there’s a good cultural match between Dexcom and Scotland’s reputation for innovation, especially here in Edinburgh, with its skilled and experienced workforce."

"Edinburgh's highly skilled and experienced workforce, and its reputation for innovation will be key to Dexcom's expansion into Europe."

"As a company occupying the middle ground between technology and healthcare, having access to the right talent and passionate people is going to be crucial to raising awareness of the benefits of CGM and improving access to market for patients.”

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