Insulin Technology & Pump Therapy Innovation: Omnipod, Standard vs. Patch Pumps
Several readers queried me recently on a Korean pump manufacturer by the name of Diamesco. This company apparently exhibited at last summer's ADA conference, and has discussed plans to introduce its BEST LIFE insulin pump in the US market some time later this year.
"My understanding is that it delivers only meal-time boluses, basal dosing requires a separate injection. On the other hand it is supposed to be easy and comfortable to insert because of a 'soft wing' and it delivers precise insulin dosing," one reader writes to me. "What do you know about the company? Are they considered reliable in Korea? Any regulatory or PR problems you may have heard about?"
Great questions, My Friend. I'm afraid the company's web site is a bit cryptic and half-baked. Which may be a function of language issues and pre-market status. But it makes evaluation difficult at this point.
From what I can tell, the BEST LIFE pump comes in several varieties, including one that is programmed for bolus dosing only. The most information is available at this link, which details their special features: the BEST LIFE pump communicates to your computer via a cradle (pictured), allowing you to actually program the pump via your PC screen. It features extra-simple battery change, and a big, bold readout that uses icon designs "so old people can easily use it without taking pains." Diamesco also boasts Swiss-designed micro-controlled motor parts for ultimate precision and reliability.
"But it's just another standard pump with tubing. These are all just bells and whistles -- all cosmetic improvements, not functional improvements. The technology itself is nothing revolutionary," D-industry analyst David Kliff tells me. I turned to him yet again for some industry-insider feedback.
"One of most misunderstood aspects of the pump market is that everybody foolishly believes that making the pump itself is the difficult part. It really isn't; it's not brain surgery," Kliff says. "The big challenges are more pulling together a strong sales team that can sell the product. Then you need insurance reimbursement. Then tech support. And all the incremental advancements your competitors are making..."
A real revolution in pump therapy comes with something entirely new and different, like what Insulet did with the OmniPod, Kliff says. They were the first to separate the controller and insulin reservoir and make it a wireless system.
What he'd like to see -- and I couldn't agree more -- are smaller pods or "patch pumps" that could be worn longer than 3 days running. Although the 3-day limitation is about protecting the skin at the infusion site -- rather than an insulin delivery issue per se -- wouldn't it be wonderful to change your set less often and waste less insulin all around?
In terms of reducing the profile of those pods (ie making them flatter) this will likely become possible by employing higher-concentration insulin, Kliff says. The current standard we all use is called U100 insulin, or a concentration of 100 units of insulin in 1 mL of solution. But there is also such thing as U200 and even U500 insulin, which has 500 units of insulin in 1 mL. This type of insulin is rarely used, mainly for people with severe insulin resistance.
[A spokesman for Eli Lilly tells me that Humulin® U-500 Regular sales amount to only 5 percent of the company's overall Humulin sales, but use is rising along with the epidemic of obesity and Type 2 diabetes.]
According to Kliff, Insulet is experimenting with using this higher concentration insulin in its pods with some of its OmniPod patients now.
"Imagine if you could wear a pod longer, or have a much smaller profile pod. With U500 it could be smaller profile AND maybe you could wear it for 5 or 7 days. That's the kind of pumping improvement that matters to someone like me," Kliff says.