Researchers and scientists continue to work on new treatments and technologies for various conditions, including diabetes. We know that you like hearing about (possible) new options to help you manage your diabetes better and with less effort, so here Carolien Koreneff, a credentialled diabetes educator, attempts to give you a bit of an overview of some new tools and novel diabetes technology.

New medications

New GLP-1 agonist: Wegovy

GLP-1 medications target areas of the brain involved in regulating appetite and food intake. This can help you eat less, which helps lower blood glucose levels and can lead to weight loss.

GLP-1 medications have been in the media a lot lately, leading to a surge in the number of people using the medication Ozempic (Semaglutide). Unfortunately, this has caused a nationwide shortage of Ozempic and Trulicity (Dulaglutide, another GLP-1 medication).

Wegovy (Semaglutide) is the latest addition to the family of glucose-like peptide-1 (GLP-1) medications. While Ozempic and Wegovy contain the same active ingredient, semaglutide, they have different uses, as well as different dosages and devices. As such, Ozempic and Wegovy are not interchangeable.

Unfortunately, Novo Nordisk is not yet supplying Wegovy in Australia because of the increased global demand for semaglutide products. This also impacts the availability and certainty of supply of Ozempic in Australia until at least early 2023.

https://www.novonordisk-us.com/products/product-supply-update.html

New class of medication: GIP/GLP-1 agonist: Mounjaro

Mounjaro (Tirzepatide) is a new weekly injection for the treatment of type 2 diabetes.

Mounjaro is a combination medication mimicking glucose-dependent insulinotropic polypeptide (GIP) and glucose-like peptide-1 (GLP-1) actions. Trulicity and Ozempic mimic the single GLP-1 hormone. GIP and GLP-1 are hormones that are released by the cells in your gut whenever you eat; they cause the pancreas to release insulin.

Mounjaro is the first GIP medication available on the market and is currently awaiting approval by the Therapeutic Goods Administration (TGA) to assess our medications’ safety in Australia. Mounjaro lowers blood glucose levels, assists in weight loss and reduces the build-up of fat in your liver that can lead to inflammation.

Current Medicines | Our Medicines | Lilly Australia

New medication: PATAS

A team of French, English, American and Australian researchers found that insulin resistance is caused by an inability of fat cells to regulate glucose metabolism. A new medication that ‘reboots’ how your fat cells use insulin could revolutionise the treatment of type 2 diabetes.

PATAS is being developed and, if successful, could be delivered by injection or possibly a patch. PATAS may also have the potential to prevent type 2 diabetes, Non-Alcoholic Fatty Liver Disease (NAFLD) and could reduce the risk of the serious complications of diabetes including heart, kidney, liver and eye disease. Researchers are hoping to start human trials in 2023.

https://www.monash.edu/medicine/news/latest/2022-articles/innovative-drug-could-improve-type-2-diabetes-treatment2

BAQSIMI

Anyone using insulin injections to manage diabetes is at risk of hypoglycaemia (low blood glucose levels). Therefore, in the past, you would have relied on intra-muscular glucagon injections by a trained support person, usually a family member or friend, in the case of severe or unconscious hypoglycaemia.

The glucagon in BAQSIMI is the same active ingredient that has been around for decades. t BAQSIMI is different from other low blood glucose emergency treatments as it’s given as a nasal spray instead of an injection.

BAQSIMI raises low blood glucose when you can’t safely eat or drink oral carbs. It is not for everyday ups and downs in blood glucose but rather for a low blood glucose emergency. BAQSIMI does not need to be refrigerated, so you can keep it with you wherever you go. BAQSIMI has been approved by the TGA but is not yet available in Australia.

https://www.baqsimi.com/

New Apps

Have you ever considered including an app in your diabetes management toolkit? Apps can help count carbohydrates, monitor blood glucose levels or track physical activity. Whether you’re looking for an app to count carbohydrates, monitor your blood glucose levels or help manage stress, there is an app out there that can help. Your diabetes health professional can suggest apps to support your diabetes management. Apps are never meant to replace healthcare professional advice.

Try to pick apps that are created for use in Australia. They should use relevant units like mmol/L rather than mg/dL for glucose levels and kg or g for weight rather than lb or oz. For a food-related app, the data should be based on the Australian food supply, as overseas apps will have different labelling laws and may have different names of foods or ingredients which can lead to confusion.

OMNIA

Bolus insulin calculator apps (and other diabetes management technologies) have been around for some time and can be useful tools in improving diabetes management. According to our sources, a number of companies worldwide are working on Apps that can help improve Time in Range, make life easier and help you collect (and share) data. One example of such an App is OMNIA.

According to the developers, OMNIA is an artificial pancreas system which helps you stay in a safe glucose range and avoid complications associated with diabetes. It’s an app built with a neural network powered algorithm, it has an easy setup process and configuration. The makers state that “with OMNIA it’s very easy to achieve more than 70% Time in Range and make life with diabetes much easier”. OMNIA is currently available in Europe, parts of Asia, the Middle East, and the United States.

https://www.omnia.care/

MySugr

MySugr is another useful app. It offers glucose tracking, carbohydrate counting and a bolus dose calculator. You can get weekly, monthly and even annual reports. This app can sync with many of the meters that are currently available in Australia, it can send you reminders such as to check your blood glucose level after exercise and you can easily forward reports to your diabetes health professional. Best of all, it is available now, free of charge (in-app purchases are available).

A word of caution

Apps range in functionality from being simply a reminder system, providing modest information, social networking, or clinical statistics, through to a more complex analysis of glucose patterns or to calculate insulin dose recommendations. Due to the wide variety of functionality between apps, caution is needed when using Apps.

It is recommended, when using Apps for the management of your diabetes, to use Apps that have been approved by the TGA, as some diabetes app manufacturers make claims that are not confirmed by appropriate scientific evidence. You should always talk to your diabetes health professional for advice when setting up diabetes management Apps.

Insulin pump technology

A lot is happening in the space of insulin pump technology. Following are a few new developments we found interesting and promising.

Sigi^TM patch pump

Sigi™ works with prefilled insulin cartridges (so filling reservoirs will become a thing of the past) and is controlled directly from your smartphone. Simply insert a new insulin cartridge into your patch pump and click it back on. Sigi^TM will connect with CGM and Sigi^TM patch pumps are kinder to the planet as each user receives 2 rechargeable Sigi™ pumps, which last for years. Sigi^TM is not yet FDA approved or CE marked, so is not available on the market yet, but it looks pretty sleek and sounds promising.

https://sigipump.com/

Tandem Mobi

The makers of the t:slim X2 insulin pump are developing a pump that is roughly half the size of the original pump and without any display screen. Initially they called it the t:sport, but the Tandem Mobi minipump as it is now called, has both a short 4-inch tubing and adhesive on the back, so it can also be stuck to the body (like a patch pump) or it can be used with the existing Tandem infusion sets. The Mobi will be operated through an iOS or Android phone, will be compatible with CGM (Dexcom) and allows for wireless charging.

Tandem are also developing the Mobi Tubeless. Mobi Tubeless will have a “disposable on-body kit.” Conceptual designs appear to show the Tandem Mobi Tubeless sticking directly onto the body, with a black rectangle shape and removable insulin cartridge. As it uses the same Mobi pump design, it will likely also hold 200 units.

https://www.tandemdiabetes.com/about-us/product-innovations

Omnipod 5 tubeless system

The new Omnipod 5 tubeless insulin pump system, formerly known as Omnipod Horizon, is a closed loop system. It connects the Omnipod tubeless patch pump to a CGM via a smart algorithm, allowing for automatic insulin dosing adjustments.

The Omnipod 5 tubeless system based on the Omnipod DASH (which is currently available in Australia) and uses the same insulin pods and mobile app. It will first be available to connect with the Dexcom CGM and later with Abbott’s FreeStyle Libre. It is not known when this system becomes available in Australia.

https://www.omnipod.com/what-is-omnipod/omnipod-5

Medtronic extended-wear sets

Medtronic is developing an extended-wear infusion set, designed to last more than twice as long as existing infusion sets. That means it can be worn on the body for up to 7 days — compared to existing sets that must be changed out every 2 or 3 days.

This new extended infusion set will have changes to the tubing material and a different connector that will reduce the loss of preservatives, prevent tube occlusions (insulin blockages in the pump tubing) and keep the insulin chemically and physically stable over time. Less frequent set changes allow skin site locations to rest and heal, and would reduce insulin waste.

https://www.medtronic.com/us-en/healthcare-professionals/therapies-procedures/diabetes/education/diabetes-digest/extended-infusion-set-and-reservoir.html

Continuous Glucose Monitoring

Of course, there are also advances in CGM technology on the horizon.

Dexcom G7

The latest model of Dexcom CGM is expected to bring a combined sensor and transmitter design. The integrated G7 will be smaller, fully disposable, can be worn for up to 10 days (with a 12-hour grace period) and is expected to eventually support up to 15 days of sensor wear. The G7 will only need 30 minutes to warm up and will roll out with a completely new App, which is expected to have the Clarity software integrated into it. Dexcom also plans to update the Follow app at a later time. Dexcom G7 is available in the UK, Ireland, Germany, Austria and Hong Kong; it is not known when it will be available in Australia.

https://www.dexcom.com/g7-ce-mark

FreeStyle Libre 3

Freestyle Libre 3 no longer requires any sensor scanning to provide real-time glucose readings, meaning it has full CGM functionality. Freestyle Libre 3 displays a real-time glucose reading every minute on the compatible mobile app on iPhone or Android. It is 70 percent smaller, uses 41 percent less plastic and has customisable alarms. FSL-3 is currently available in the USA, it is not known when it will be available in Australia.

https://www.freestyle.abbott/us-en/products/freestyle-libre-3.html

Eversense 180-day implantable

The Eversense implantable CGM is a first of its kind that has been available in the United States since 2018. The next-generation version currently under development would allow for the same tiny sensor to be implanted for 180 days (or 6 months rather than 3). This version will also reduce the number of fingerstick calibrations needed down from two to just one per day, according to the company. Eversense is not yet available in Australia.

https://www.ascensiadiabetes.com/eversense/

Conclusion

There is a lot happening in the world of Research and Development, so this list is by no means a complete list. It is more a snapshot if some interesting new developments. We hope you enjoyed reading it.

Article for Circle

Written by Carolien Koreneff, CDE-RN

Updated 5 May 2023