My Biggest Hopes for 2015
Coming off of a stellar 2014 for The diaTribe Foundation, I want to take a moment to turn my sights to the road ahead. We have plenty of challenges. The latest data suggests 64% of patients are meeting their target glucose goal, and an even more dismal 21% of diagnosed patients meet the ABC goals for A1c, blood pressure, and cholesterol. We need fewer people suffering from severe complications. We need more reimbursement and access to the most innovative, life-saving treatments available. And we need the world to realize that diabetes and obesity are the health crises of our time, and can’t be ignored any longer.
New Devices to Look for in 2015
I am looking super forward to the potential FDA approval of two Tandem devices: the t:flex, a 480-unit version of the t:slim pump for those with large insulin requirements, and the t:slim pump with Dexcom G4 Platinum integration. This year will also see the launches of the J&J Animas Vibe insulin pump with Dexcom G4 Platinum CGM integration, and the likely launch of the Insulet OmniPod with LifeScan Verio meter integration. Beyond that, CGM-integrated pumps are a major win for patients, since they reduce the burden of carrying multiple devices and allow for better real-time decision making. And of course, the transformative Freestyle Libre will continue its European launch, and we absolutely cannot wait for research progress in the US.
In automated insulin delivery, Medtronic plans to launch the MiniMed 640G in Europe by April of this year. The second-step toward an artificial pancreas, this device will suspend insulin delivery when hypoglycemia is predicted. A pivotal US trial of the device is already underway, and there is potential for an FDA submission before year-end. Aside from Medtronic, 2015 will see bigger and longer studies testing the safety and effectiveness of artificial pancreas systems. Adam and I are both currently in a multi-month, at-home artificial pancreas trial (previously these trials had been in controlled environments), and it’s been nothing short of fantastic. UVA’s DiAs system and the Bionic Pancreas are both set for major pivotal trials this year, and the key question now is less about whether they work, and more about how they will get to market.
New Drugs to Improve the Patient Experience
The year 2014 saw the approval of Afrezza, an ultra-rapid inhaled insulin that enables patients to take insulin without needles – we can’t remember a launch we are more excited about. Insulin is such a challenging drug to take and we know it’s also such a hard drug for doctors to teach patients to take, especially considering the limited time we get with them. I hope that its upcoming launch in the next couple of months will allow many to benefit from a more discreet delivery of insulin and a lower barrier to its use due to its simplicity (although this isn’t on the label we also believe from the stories we’ve heard from some of you in the trials that it results in less hypoglycemia and less weight gain).
On a very exciting note, this year also saw the launch of Trulicity, the first-ever once-weekly, ready to use GLP-1 agonist, as well as the approval of the transformative Xultophy in Europe, which combines Victoza (a GLP-1 agonist) and Tresiba (a long acting insulin) into a single drug – none other than the highly respected Dr. John Buse of UNC calls this a miracle drug. While Afrezza, Trulicity, and Xultophy – as well as the Abbott Freestyle Libre - are all quite different, they do have one thing in common: a much improved patient experience. I hope this year sees widespread availability of these drugs (and this device), as well as new entrants that continue to simplify treatment.
A Growing Role for Patients in the Public
Last year was a landmark for patient advocacy in diabetes, when our unprecedented November 3 discussion at the FDA on the unmet needs in diabetes included thousands of patients who attended over the Internet. Major news organizations, including the New York Times and the Washington Post, also captured the challenges and breakthroughs in diabetes through important stories. With even louder voices in 2015, emphasizing advocacy and education, here’s to our collective impact growing even stronger.
