DiaMonTech and the development of non-invasive blood glucose monitoring
Professor Werner Mäntele has considerable experience as a physicist and a physical chemist, and is now Head of Research and Development for DiaMonTech, which has developed technology to revolutionise monitoring glucose levels for diabetics, using molecular spectroscopy – the study of the absorption of light by molecules.
Mäntele has a broad history in analytics and medical issues, in particular molecular analytics. For the past 40 years there has been work on molecular spectroscopy, which he is now using to benefit diabetes patients by offering a non-invasive way to keep track of glucose levels. Diabetes is not only becoming a wider issue among the world’s population, but billions every year are being spent on controlling the disease.
Diabetes: A growing industry
According to a study by BCC Research, the global market for diabetes therapeutics and diagnostics was valued at $110bn in 2011 and was set to reach $118.7bn the following year. 2017’s market value was expected to reach nearly $157bn after increasing at a five-year CAGR of 5.7%. Grand View Research has also predicted that the global market for devices alone – that is, diagnostic, monitoring and insulin delivery products – will reach $35.5bn by 2024.
Grand View cited major drivers of the market as “the growing number of diabetic patients owing to sedentary lifestyles and unhealthy food habits”. The report also stated that the “growing demand for advances and minimally invasive diagnostic, as well as monitoring, devices is expected to propel the market growth”.
There’s certainly a demand for a new type of diagnostic product, since Grand View has found that “in 2015, the test-strips sub-segment captured the largest market share in the blood glucose monitoring and diagnostic devices segment” which accounted for around 71% of the total market as it is an area of high repeat purchases.
The diagnostic and monitoring segment, according to Grand View, was set to maintain dominance over the next few years “owing to the introduction of technically advanced products coupled with the high adaptation of these products in the near future”.
Non-invasive glucose measuring has become more of a holy grail within the market for diabetic products in recent years. Currently, most techniques to evaluate glucose levels are invasive, carrying the risk of infection. They are also considered a detached and impractical method to continually measure glucose levels.
The problems for non-invasive glucose measuring are that it remains difficult to accurately test for blood sugar without breaking the skin, as levels of sugar in the blood vary. In addition, according to the Diabetes Control and Complications Trial and Follow-up Study, intensive control and management of blood glucose reduced the risk of complications for eye diseased by 76%, kidney diseases by 50%, and nerve diseases by 60%.
Replacing needles with light beams
That’s where DiaMonTech comes in: the company has now patented technology whereby an invisible infrared light beam is placed into the skin, enabling the beam to calculate glucose molecules non-invasively. An optic lens guides the infrared laser beam to a sensor crystal, burying the laser further into the skin. At the heart of the measurement system is a state-of-the-art quantum cascade laser, which emits the infrared light in a spectral range, which is then absorbed by the glucose.
The Berlin-based startup was founded in 2015 by Mäntele and current CEO Thorsten Lubinski, who has vast experience in startups. However, Mäntele, inspired to make game changing progress in molecular spectroscopy, had started out with a fundamental scientific view of this problem 20 years ago.
Since then, there has been a gradual evolution in achieving glucose monitoring without pricking a finger for blood. Mäntele reflects: “We could apply the technologies we had in medicine and we started to investigate blood samples and measured them, and then believed we could use more elaborate methods around 2005, measuring molecules through skin.
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“I saw the necessity to do this, but it required improvement and cooperation between doctors and scientists. Our biggest challenge is the human skin which varies from person to person and with time. To develop a quantitative molecular measurement system and to discern between molecules is a huge mountain to climb.”
Around 2010, molecules in the skin could be measured in laboratories, and it was then decided to move the process from research to the development of a prototype. The funding received from the business angels was imperative, as industry partner support was necessary to build a prototype – even the big players in diabetes were hesitant to take any part in clinical testing.
The research and development programme from DiaMonTech will be completed in three stages, with the base model taking the form of a shoebox sized contraption providing all optical and electronic components as well as data processing. This element is due to be completed in 2018.
Based on what is experienced with this device, miniaturisation will proceed towards a pocket device, which has attracted the sobriquet the ‘muffin’. This portable pocket glucometer is due to be ready in 2019, and as it can be carried around day and night by the end user, it will make it possible to monitor blood sugar levels frequently.
The final piece of the DiaMonTech jigsaw is to create a wrist watch device which will be able to constantly screen blood glucose. It is hoped that this will be ready by 2021. Alarm features will be part of the design, in order to track glucose levels and notify the user if they are too high or too low.
A German company with global potential
DiaMonTech prides itself that all of its technology and devices have so far been completed with German DNA: German engineers have been responsible for the transformation from a research project to a medical project.
“We have one engineering partner, Seleon, who supports us with their knowledge in making medical products ready for mass production, and with their expertise in all regulatory affairs,” explains Mäntele. “We outsourced the building of the devices, plus CE and medical device certification. It’s a regulatory challenge to get the CE approval and to optimise the medical device. At DiaMonTech we focus on research and development of a prototype.”
Apple, with its spectacular global reach, has been battling it out to delve into molecular spectroscopy technology, which begs the question of whether DiaMonTech would consider any kind of collaboration with the tech giant, or indeed any other organisation of similar size. Even a business the size of Apple would not hold any advantage in terms of the science behind the idea. In fact, this isn’t a privilege held by anyone since DiaMonTech’s technology is patented.
Mäntele asserts: “We would take care not to be swallowed up, and we are not selling the idea for a lump of money. If what we achieved was noticed by big players, then we would use investment to increase our employees and so on. The central principle is all ours. However, big corporations like Apple, Samsung and Nokia are very good at building small, often elegant devices for the mass market and selling several millions of devices. As a startup we don't have their know-how, so of course we would consider a partnership.”
Once all of DiaMonTech’s products have been completed and tested, how then will the devices make in onto the shop floors at the local drugstore, in the same way that blood pressure testing devices have done? Mäntele believes that there is no problem with the technology reaching those who need it most, and maintains that it will be promoted and distributed accordingly.
He enthuses: “We get pre-orders, and the diabetic patient community is very well organised with a developed information flow – they have their own journals. The community knows about new products, and due to their marketing of them, micro non-invasive blood measuring products would sell like hotcakes.”
With more work by scientists like Mäntele and further success for DiaMonTech, which won the 2017 “most innovative startup” award from German magazine Bilanz, we could soon see test-strips and finger pricking become a thing of the past for this $35.5bn market.
How UiPath robots are helping with the NHS backlog
The COVID-19 pandemic has caused many hospitals to have logistical nightmares, as backlogs of surgeries built up as a result of cancellations. The BMJ has estimated it will take the UK's National Health Service (NHS) a year and a half to recover.
However software robots can help, by automating computer-based processes such as replenishing inventory, managing patient bookings, and digitising patient files. Mark O’Connor, Public Sector Director for Ireland at UiPath, tells us how they deployed robots at Mater Hospital in Dublin, saving clinicians valuable time.
When Did Mater Hospital implement the software robots - was it specifically to address the challenges of the pandemic?
The need for automation at Mater Hospital pre-existed the pandemic but it was the onset of COVID-19 that got the team to turn to the technology and start introducing software robots into the workflow of doctors and nurses.
The pandemic placed an increased administrative strain on the Infection Prevention and Control (IPC) department at Mater Hospital in Dublin. To combat the problem and ensure that nurses could spend more time with their patients and less time on admin, the IPC deployed its first software robots in March 2020.
The IPC at Mater plans to continue using robots to manage data around drug resistant microbes such as MRSA once the COVID-19 crisis subsides.
What tasks do they perform?
In the IPC at Mater Hospital, software robots have taken the task of reporting COVID-19 test results. Pre-automation, the process created during the 2003 SARS outbreak required a clinician to log into the laboratory system, extract a disease code and then manually enter the results into a data platform. This was hugely time consuming, taking up to three hours of a nurse’s day.
UiPath software robots are now responsible for this task. They process the data in a fraction of the time, distributing patient results in minutes and consequently freeing up to 18 hours of each IPC nurse’s time each week, and up to 936 hours over the course of a year. As a result, the healthcare professionals can spend more time caring for their patients and less time on repetitive tasks and admin work.
Is there any possibility of error with software robots, compared to humans?
By nature, humans are prone to make mistakes, especially when working under pressure, under strict deadlines and while handling a large volume of data while performing repetitive tasks.
Once taught the process, software robots, on the other hand, will follow the same steps every time without the risk of the inevitable human error. Simply speaking, robots can perform data-intensive tasks more quickly and accurately than humans can.
Which members of staff benefit the most, and what can they do with the time saved?
In the case of Mater Hospital, the IPC unit has adopted a robot for every nurse approach. This means that every nurse in the department has access to a robot to help reduce the burden of their admin work. Rather than spending time entering test results, they can focus on the work that requires their human ingenuity, empathy and skill – taking care of their patients.
In other sectors, the story is no different. Every job will have some repetitive nature to it. Whether that be a finance department processing thousands of invoices a day or simply having to send one daily email. If a task is repetitive and data-intensive, the chances are that a software robot can help. Just like with the nurses in the IPC, these employees can then focus on handling exceptions and on work that requires decision making or creativity - the work that people enjoy doing.
How can software robots most benefit healthcare providers both during a pandemic and beyond?
When the COVID-19 outbreak hit, software robots were deployed to lessen the administrative strain healthcare professionals were facing and give them more time to care for an increased number of patients. With hospitals around the world at capacity, every moment with a patient counted.
Now, the NHS and other healthcare providers face a huge backlog of routine surgeries and procedures following cancellations during the pandemic. In the UK alone, 5 million people are waiting for treatment and it’s estimated that this could cause 6,400 excess deaths by the end of next year if the problem isn’t rectified.
Many healthcare organisations have now acquired the skills needed to deploy automation, therefore it will be easier for them to build more robots to respond to the backlog going forwards. Software robots that had been processing registrations at COVID test sites, for example, could now be taught how to schedule procedures, process patient details or even manage procurement and recruitment to help streamline the processes associated with the backlog. The possibilities are vast.
The technology, however, should not be considered a short-term, tactical and reactive solution that can be deployed in times of crisis. Automation has the power to solve systematic problems that healthcare providers face year-round. Hospital managers should consider the wider challenge of dealing with endless repetitive work that saps the energy of professionals and turns attention away from patient care and discuss how investing in a long-term automation project could help alleviate these issues.
How widely adopted is this technology in healthcare at the moment?
Automation was being used in healthcare around the world before the pandemic, but the COVID-19 outbreak has certainly accelerated the trend.
Automation’s reach is wide. From the NHS Shared Business Service in the UK to the Cleveland Clinic in the US and healthcare organisations in the likes of Norway, India and Canada, we see a huge range of healthcare providers deploying automation technology.
Many healthcare providers, however, are still in the early stages of their journeys or are just discovering automation’s potential because of the pandemic. I expect to see the deployment of software robots in healthcare grow over the coming years as its benefits continue to be realised globally.
How do you see this technology evolving in the future?
If one thing is certain, it’s that the technology will continue to evolve and grow over time – and I believe there will come a point in time when all processes that can be automated, will be automated. This is known as the fully automated enterprise.
By joining all automation projects into one enterprise-wide effort, the healthcare industry can tap into the full benefits of the technology. This will involve software robots becoming increasingly intelligent in order to reach and improve more processes. Integrating the capabilities of Artificial Intelligence and Machine Learning into automation, for example, will allow providers to reach non-rule-based processes too.
We are already seeing steps towards this being taken by NHS Shared Business Service, for example. The organisation, which provides non-clinical services to around two-thirds of all NHS provider trusts and every clinical commissioning organisation in the UK, is working to create an entire eco-system of robots. It believes that no automation should be looked at in isolation, but rather the technology should stretch across departments and functions. As such, inefficiencies in the care pathway can be significantly reduced, saving healthcare providers a substantial amount of time and money.