Glucose monitoring – the technologies of the future will be behavioural too!

One of our highlights from the 77th Scientific Sessions of the ADA. 

by Prof Jane Speight

Technological developments are always prominent at the American Diabetes Association conference, and this year was no exception. On Saturday 10 June, the symposium ‘Where is glucose monitoring taking us?’ was exciting and highly informative. Several presentations offered the latest clinical trial evidence, e.g. effectiveness of structured monitoring in non-insulin-treated type 2 diabetes (SMBG) , and of continuous glucose monitoring (CMG) in type 1 and type 2 diabetes using multiple daily injections (DIaMonD). Other presentations offered the latest innovations from industry. For example, Prof Hans de Vries (University of Amsterdam) presented the acceptability and accuracy of an implantable, 90-day CGM sensor, Eversense® (the PRECISE I and II trials).

One of the highlights was the presentation of Sugar.IQ , a partnership between Medtronic and IBM Watson, providing an ‘intelligent diabetes assistant’ to the person with diabetes. Sugar.IQ combines real-time continuous glucose data and contextualised data to enable Watson to develop personalised learnings and share insights and predictions with the person with diabetes. The premise of this system is to provide the ‘right insight at the right time’, with Sugar.IQ reducing the cognitive burden on the person with diabetes. For example, Sugar.IQ can offer insights such as ‘I notice that you tend to go low after meals with <20g of protein. Check here to find out more about…’ or ‘Planning your day? I notice you tend to go low on Saturdays between 12 and 3pm. Have you thought about…’. In each case, Sugar.IQ provides the person with a suggestion of what they could do to disrupt the observed pattern, e.g. review some educational materials, discuss this tendency with their health professional, change their eating habits. While concern was raised by some audience members about who has legal responsibilities if something goes wrong, it is clear that many people with diabetes are using guesswork (rather than analytics) or not reflecting or acting on such trends at all. Thus, the development is clearly highly innovative and an indicator of great possibilities for reducing the cognitive burden and optimising the behavioural self-management of diabetes in the future.