“DogFight” for Control of the Continuous Monitoring Market

News Flash: Abbott Diabetes is apparently “talking tough” about how its new FreeStyle Navigator will quickly become the “device of choice” among us D-types struggling to better manage our disease using constant glucose monitoring.  (The Navigator’s expected to win FDA approval by the end of this year).  Freestyle_navigator_slide_1According to the sweeping Reuters story, at least one Morgan Stanley analyst agrees, saying the Navigator trumps the competition on accuracy and ease of use.  Hmmph.  Hard to say, since hardly anybody’s tried it yet.

Meanwhile, Johnson & Johnson LifeScan is aggressively pursuing its own strategy to get into the continuous monitoring game with a new CGM product under development which “could be launched internationally in late 2008 and in the US in 2009.” Not surpsingly, they claim to build a better mousetrap, offering “significant advantages” over current and pending Dexcom, Medtronic, and Abbott products.

According to a recent company briefing, the Lifescan CGM will include:

  • a shorter warm-up period (15 minutes, versus 2 hours for MDT/DXCM and 10 hours for ABT)
  • no calibrations (versus DXCM/MDT/ABT, which all currently require some calibration regimen with traditional fingerstick measurements), and
  • improved accuracy at the hypoglycemic (low blood sugar from too much insulin or too little glucose in the blood) range.Lifescan_cgms

Ideally it will also perform well with highs (hyperglycemia), based on Lifescan’s lag mitigation technology, which the company has touted previously with positive results data.

Here’s the interesting bit: JNJ Medical Devices Review reports that the Lifescan CGM should interact with the same remote monitor that’s being developed to interact with a next-generation insulin pump:

“This integrated meter/insulin pump can control the insulin pump with the wireless monitor/meter, or the pump itself, and is slated to be launched next year. This remote monitor/meter may also offload some of the features required in an insulin pump, thereby allowing an insulin pump with a smaller screen and pump size. The Lifescan CGM measures interstitial fluid (ISF) transdermally with a shorter needle, versus subcutaneously. The device can be taken on and off more easily due to the shorter warm up period and lack of necessary calibrations. The ability to only wear the device when the patient wants CGM should be of particular interest to the patients that plan to use continuous glucose monitoring less frequently.”

And when will current insulin pumpers want to wear the CGM? 

The publication reports:
“In a 300-patient survey we published 11/29/05, we asked current insulin pumpers how often they were considering using a continuous glucose monitor (multiple answers were allowed). Overall, 47% answered 24 hours a day, 19% every day, 16% every night, 19% some days, 17% some nights, 18% at least one three-day period a week, and 20% at least one three-day period a month. The 15% other responses included: when changing insulin doses or if feeling ill; stress or travel times; one three-day period each quarter; one 24-hour period/month; during periods of exercise or when flying.” 

Oh yes, when flying.  I’m on board with that. Too bad LifeScan’s new improved CGM option’s not landing for another two years… May the best CGM win.  And soon.  And with adequate insurance coverage, please.

15 Responses

  1. Johnboy
    Johnboy September 30, 2006 at 6:02 am | | Reply

    All I can say regarding a dogfight is “bring it on.”

    As consumers and people who need improved technology, it benefits us!

  2. Anne
    Anne September 30, 2006 at 8:56 am | | Reply

    I was too impatient… I bought a Dexcom yesterday. I hope I like it but also hope I don’t go broke in the process.

  3. Prakash
    Prakash September 30, 2006 at 10:50 am | | Reply

    Keeping fit and maintaining timely and proper diet would solve half and problem for diabetics. The other half is just the knowlwedge about diabetes. Diebetics, therefore should imbibe as many information as possible. Great tips are avaiable at
    http://www.hot8sites.com/diabetics/

  4. AmyT
    AmyT September 30, 2006 at 10:56 am | | Reply

    Mr. Prakash,
    With all due respect, what you said here is uninformed and even insulting to people with Type 1 diabetes. Keeping fit is nice, but ain’t solvin’ nuthin’ if your pancreas is dead. Bring on the CGM!

  5. JasonJayhawk
    JasonJayhawk September 30, 2006 at 11:57 pm | | Reply

    It looks like Prakash’s site is full of Google Ads spam and herbal medicine “remedies.” He’s using this blog to spout off snake oil remedies.

  6. Gary Krauch
    Gary Krauch October 1, 2006 at 5:18 am | | Reply

    More players jumping into this market is no surprise, and it’s great news for diabetics, although it’s going to be really confusing for awhile:

    Which CGMS should I go with, how much should I pay for this technology (all out of pocket costs for awhile), what features do I need, and on and on …

    Through all of the confusion and hype though, I agree with everyone here: BRING IT ON!!!

    -GaryK
    http://mycgms.com

  7. AmyT
    AmyT October 1, 2006 at 10:38 am | | Reply

    Hey Gary,
    I’m glad you liked my coverage and my headline enough to report it on your site, but how about a little shout-out next time?

    Thanks.
    - Amy

  8. Kevin
    Kevin October 1, 2006 at 11:24 am | | Reply

    Lifescan is also going to have a CGMS around 2008. So they will be entering the market soon.

    Also, Abbott should be coming out with the Freestyle Aviator Insulin pump, so there will be more competion there. Personally, I don’t see Dexcom surviving since they have nothing backing them up and but I do applaud them for their efforts.

    It will be nice to see what happens in 5 years and I’m willing to wait for technology to improve and insurance to cover it.

    ~Kevin

  9. GaryK
    GaryK October 1, 2006 at 5:58 pm | | Reply

    Hi Amy,

    I received a google news alert on the Reuters story with the word ‘dogfight’ coming directly from the Reuters article. I drafted my blog and the headline I used in it *before* I even read your *EXCELLENT* piece.

    Thanks for the info on what J&J is up to, it is very interesting and I’m looking forward to hearing more about it.

  10. Scott K. Johnson
    Scott K. Johnson October 2, 2006 at 8:35 am | | Reply

    I have mixed feelings on whether the CGMS would really benefit me.

    If I’m always running high because I can’t keep the food out of my mouth, the system would just be an annoying reminder of my lack of self discipline.

    However, if I could get my sh*t together with my eating, it would certainly help me nail down non-eating related problem areas.

    So, I guess what I’m saying is I can afford to wait. It wouldn’t do much for me right now anyway.

  11. David Harmon
    David Harmon October 10, 2006 at 4:01 pm | | Reply

    Scott: If the monitor beeps at you every time you spike, you can take that as “feedback”, a reminder that what you just ate was “too much”. You don’t have to take it as a personal attack….

  12. d
    d October 10, 2006 at 5:15 pm | | Reply

    I can’t even begin to say how great I think this is going to be. I have a friend whose adult son is a brittle diabetic, but whose short-term memory is very poor because of cancer and radiation treatments to his brain. He often forgets to push the button on his pump and his sugars skyrocket, or he forgets that he already did and does it repeatedly and they plummet. He gets so out of whack, and he has no idea that anything is wrong :( If this product can connect with the pump, so that the pump pumps when needed and maybe alarms when it’s too low (to remind him to eat something), that might be enough to allow him to live independently.

  13. Kristin
    Kristin October 16, 2006 at 3:40 am | | Reply

    I have heard that Dexcom will be able to connect to the Cozmo pump (as will the Navigator)– so Dexcom may not be completely on its own. The question is- will any Cozmo pumpers choose Dexcom over the Navigator? From what I have heard it sounds unlikely.

  14. lenlutz
    lenlutz January 31, 2007 at 12:13 pm | | Reply

    if you are interested, my Dexcom experence is found at
    http://www.lenlutz.com/mydiabetes.html

    I sure wish i could tell all of you that it was a happy, and successful experence.

  15. Norman Latour
    Norman Latour May 25, 2007 at 12:34 pm | | Reply

    a shorter warm-up period (15 minutes, versus 2 hours for MDT/DXCM and 10 hours for ABT)
    no calibrations (versus DXCM/MDT/ABT, which all currently require some calibration regimen with traditional fingerstick measurements), and
    improved accuracy at the hypoglycemic (low blood sugar from too much insulin or too little glucose in the blood) range.
    I have a one touch moitoring wireless communication

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