November 14 is World Diabetes Day, which aims to raise awareness of the chronic disease. The date marks the birthday of Frederick Banting who won the Nobel Prize for Medicine in 1923 as a key figure in the discovery of insulin — a protein produced by the body to regulate glucose levels in blood. If the pancreas fails to produce enough insulin or should the body be unable to use it effectively, diabetes mellitus develops — either as Type 1 or Type 2 respectively.
Diabetes in both forms has been identified by many as one of the main unmet needs in the medical industry. Today, about 387 million people globally are affected by the condition, with 4.9 million deaths attributed to it in 2014, according to the International Diabetes Federation (IDF). The overwhelming majority (90%) of sufferers have Type 2, and with aging populations, changes in diet and increasingly sedentary lifestyles in much of the western world, the number affected is likely to rise — the IDF estimating that 592 million people will have diabetes by 2035.
With such a large demand around the corner, who might be able to meet that need for insulin — so crucial in treatment today — and what advances are being discussed in monitoring and prevention to combat a so far incurable disease?
I identified these companies and others by conducting a search on AlphaSense for “diabetes,” and organizing the results by sector and relevance.
Production & Delivery
Novo Norodisk ($NVO) is the largest manufacturer of insulin with a 47% market share globally and will undoubtedly be a key global player. Tresiba, their new-generation basal insulin, recently received FDA approval for the U.S. market, having been approved and marketed elsewhere since 2012. “We know from countries, whether it’s Europe, Latin America, Japan, that Tresiba is getting an extremely good reception.” Other major producers of insulin include Sanofi-Aventis ($SNY) and Eli Lilly ($LLY).
In monitoring and delivery, Tandem Diabetes Care ($TNDM) announced shipping of their touch-screen t:slim G4 Insulin Pump with continuous glucose monitoring (CGM) began on September 23, following FDA approval on September 9, 2015. The addition of screens and simpler feedback mechanisms to monitoring systems will likely continue and make treatment easier for users.
Patches & Lenses
One new idea has been the development of patches for insulin delivery, an area where Sanofi partnered with Medtronic ($MDT) to accelerate such progress: “… if you could put your patch on Monday morning and not to worry about until the next Monday, I would assume that it would please at least a certain number of patients.”
Perhaps the most interesting research is around contact lenses. Sanofi and Alcon, a division of Novartis ($NVS), both have projects underway in partnership with Google ($GOOG) “to develop a smart contact lens to help diabetic patients monitor their glucose levels via tear fluid in the eye.”
Vaccines & The Future
One segment for exciting progress is within Autoimmune Diabetes. “There is currently no approved treatment in the market that can interrupt or prevent the autoimmune process,” according to Diamyd Medical ($DMYD B.SE). “By using the diabetes vaccine Diamyd®, we want to stop the immune system’s attack on the insulin-producing beta cells to preserve the body’s vital capacity to produce insulin.” Furthermore, the company stated that “the diabetes vaccine Diamyd® is tested to prevent or delay the onset of type 1 diabetes in children,” which if successful could be revolutionary.
Future delivery mechanisms could include nasal, transdermal, needle-free (high pressure) injection and pulmonary — research for which are all underway. In addition, there is opportunity for companies to improve monitoring, as well as combat some of the causes of Type 2 diabetes, such as helping with weight loss through apps or drugs. Ultimately, advances in diabetes treatment are sure to be just around the corner as more companies focus on a growing problem — which can only be a good thing for everyone.
1. “IDF Diabetes Update 2014.” idf.org
2. Novo Norodisk Investor and Analyst Event, June 7, 2015
3. Sanofi Thematic Conference Call on Diabetes, June 16, 2014
4. Novartis Inc 2014 Annual Report, January 27, 2015
5. Diamyd Medical Quarterly Report, Press Release, April 1, 2015
6. Diamyd Medical Quarterly Report, Press Release, April 1, 2015
7. Diamyd Medical Quarterly Report, Press Release, April 1, 2015