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History of diabetes management innovation

Diabetes has been a prevalent condition for centuries, significantly affecting populations worldwide. Over the last decades, remarkable advancements have been made in this field, and these scientific discoveries and innovations have consistently been improving the quality of life for millions. This article explores the evolution of diabetes management through key breakthroughs that have shaped the journey from basic treatments to cutting-edge technologies.

đź’ˇ DISCOVERY OF INSULIN
With the discovery of insulin in 1921 and the first application in 1922, everything changed in the treatment of diabetes and the life expectancy of people with diabetes. Before this discovery, diabetes was essentially a fatal disease, with patients often succumbing to the illness within a short period due to complications arising from uncontrolled blood sugar levels. While insulin is not a cure to diabetes, it gave people with diabetes a chance to life a longer life.

đź’‰ SELF ADMINISTRATION
In the first years, insulin administration was done exclusively by physicians in hospitals, due to the complexity and precision required in dosing. These early insulin preparations also required strict refrigeration and had shorter durations of action, necessitating frequent visits to healthcare providers. The next evolution of diabetes therapy was the self-administration of insulin by people with diabetes. With the development of insulin syringes and more reliable, longer-acting insulin types, patients began to learn how to administer their own injections. This was the first step towards empowering people with diabetes to take care of their condition by themselves.

đź“š KNOWLEDGE ON DIABETES
Along with innovation in insulin administration, it was also necessary to empower patients by sharing knowledge about diabetes, that had previously been confined to the medical profession. This would equip individuals living with this condition with a better understanding of the factors affecting glycaemic changes and the means to solve these imbalances. From the beginning, a structured education was a pillar of diabetes therapy. Transferring knowledge from clinical entities to individuals enabled them to self-manage diabetes and to integrate therapy options in their daily lives. To this day, structured diabetes self-management education remains a key factor as the prognosis is largely dependent on the self-management of people with diabetes.

đź“Š CONTINUOUS GLUCOSE MONITORING
Diabetes is the only chronic condition in which the people affected have direct and continuous real-time access to the parameter that defines their condition – glucose levels. This allows for a precise adjustment of insulin dosing in the blood and helps prevent extreme sugar swings resulting in hyperglycaemia (high blood sugar) of hypoglycaemia (low sugar levels). At first, test strips for blood glucose measurement were the only option for glucose monitoring. They provided glycaemic information based on blood samples read by a specific measuring device. They are still widely used due to their simplicity, portability, and affordability. However, continuous glucose monitoring (CGM) systems offer nowadays a real-time assessment of glucose on a continuous basis. The manual glucose analysis is therefore bypassed and enables an immediate reaction from the individual. This represents another step of giving control to people with diabetes.

⚙️ AUTOMATED INSULIN DELIVERY
The next step in evolution was the automatic insulin delivery by combining CGM and insulin pumps with an algorithm that automatically calculates the insulin doses based on current and expected glucose levels. This marks a shift in diabetes self-management, as people with type 1 diabetes were used to manage glucose levels by themselves and how an algorithm takes some control of glucose management.

🚀 MUSIC4DIABETES AS NEXT STATE OF THE ART
MuSiC4Diabetes aims to achieve the next step in diabetes management, and represents the technological culmination of more than a century of innovation in the field. Through the integration of several state-of-the-art technologies and focusing on the daily challenges that patients face daily, the Consortium substantially invests in the efficiency, convenience and safety of the device.

The continuous glucose monitoring (CGM) technology will evolve to not only measure glucose but also track other substances, offering a more comprehensive view of glucose fluctuations and the factors that influence them, such as physical activity. Designed for an estimated eight-year lifespan, the device eliminates the need for patient maintenance or recharging. The insulin reservoir will be refilled every 3 months via a port system by a high concentrated insulin, which is stable for three months at body temperature. The system provides long-term monitoring with minimal user intervention. The integrated MEMS pump, implanted in the abdomen to deliver insulin near the liver, automates the process, freeing patients from the burden of managing dosage and timing. This shift means that effective diabetes management will no longer rely on the patient’s knowledge or skills, as the device ensures accurate and timely dosing. By incorporating advanced algorithms, the device not only ensures precise insulin delivery based on sensor data but also includes robust safety features, such as a "safety valve" mechanism to prevent significant insulin leakage. This combination of smart monitoring and automated delivery enhances both patient safety and quality of life. Additionally, the project’s emphasis on human factors highlights the psychological and mental challenges patients face, driving research that addresses real-world needs.

Check our animated recap video below:

Read our approach to the MuSiC4Diabetes project here.