Nov 04, 2019Tracking glucose levels and administering insulin can help people with diabetes live an otherwise healthy life. But following doctors' recommended schedules to keep blood sugar levels healthy can prove challenging. People with chronic conditions such as diabetes must often adjust their lifestyle around health-care testing and medication.
Swedish technology startup Brighter AB has developed a new Internet of Things (IoT)-based solution that is intended to automate the process of collecting glucose readings and insulin injections, as well as capture and collect data about these processes for patients, no matter where they may be located. The company's Actiste solution employs a pocket-sized device that tests blood sugar levels and administers injections. It also has built-in cellular connection functionality to transmit data to a server, where the information can then be shared with authorized doctors and family members.
The system employs hardware developed by Brighter throughout the past four years, in addition to Ericsson's embedded subscriber identity module (eSIM)-based cellular network as part of the mobile operator IoT service powered by Ericsson's IoT Accelerator. The solution is designed to ensure that measurements on the device can be reliably and securely transmitted to a server, no matter where an individual may be located, says Charlotte Skånstad-Shand, Ericsson's head of sales and IoT connectivity management for the Asia-Pacific region.
The Actiste system is being prepared for its first pilot, to be carried out in the United Arab Emirates (UAE), and is expected to be made commercially available in Sweden and other parts of Europe during the coming months. In the long term, the solution is anticipated to become available globally, according to Henrik Norström, Brighter's CEO, and meets the requirements of European regulatory bodies, with the U.S. Food and Drug Administration (FDA) requirements to follow.
The product was first conceived by Brighter's founder, Truls Sjöstedt, in 2007, when his diabetic wife was pregnant and required a strict regimen of blood sugar tests and medication to ensure her own health and that of the baby. Sjöstedt found it challenging to meet the required schedules and keep track of each test and insulin injection. He thus launched Brighter to offer a solution, Norström explains: a single device that could test glucose levels and administer insulin, and with the connectivity required to capture and store information about each test and drug, then share that information with those who need it.
The demand for such a solution is a global one, the company reports. There are about 428 million diabetics worldwide, and the numbers are rising in most countries. In fact, it is the fastest-growing chronic condition in the world. According to the International Diabetes Federation, one in ten people live with diabetes, though half of them may not realize it. Those with the condition are no longer able to make insulin naturally, resulting in a rise in glucose levels that, over time, can damage the body's organs and tissues.
The standard treatment is to manage glucose levels by testing blood regularly and injecting insulin when sugar levels rise above a healthy range. Patients often do not meet the expected schedule of self-testing and treatment, however, simply because they forget or do not find the time.
The Actiste solution centers around enabling all necessary tasks with a single device. The system, Norström says, needed to offer four key features to be of value to patients, their families and health-care providers: security, reliability, reach and autonomy. This meant ensuring that collected and shared data was secure and private, that the system always worked, and that it had the reach to ensure it continued capturing and sharing information wherever the device was in operation. Additionally, the solution required autonomy so that it could still work even when offline.
For connectivity, the company considered multiple available technologies. Bluetooth could connect the device to a user's smartphone, but not every user would always have a smartphone available, and pairing issues could make such a system less reliable. Wi-Fi connectivity was another option, Norström says, but the system requires a secure connection, and there might not always be a Wi-Fi network available, while a public network might not be properly secured. To provide reliable service, the device needed to be able to connect no matter where an individual was using it.
For cellular service, Norström says, the firm evaluated multiple technology partners before selecting Ericcson, which was providing eSim solutions as part of its IoT Accelerator offering. IoT Accelerator is aimed at connecting and managing billions of devices and millions of applications around the world. "We realized there really was an opportunity with eSim, which was still bleeding-edge" at that time, Norström states. "Our ambition was to offer an IoT product that can be rolled out on a global scale and would have a huge health benefit."
A user first receives the device and downloads the Actiste app on his or her iOS- or Android-based device. That individual could then set up an account and add authorized users who could receive data regarding glucose tests and insulin injections. The individual would then use the device at pre-determined intervals to check glucose levels and administer medication. Each time he or she did so, data would be automatically sent through the cellular network to a cloud-based server.
Physicians could access that data on a dashboard in the cloud-based software, as well as view data related to all patients using the system, monitor their habits over time, and identify when problems occur, such as a patient not testing glucose levels as often as he or she should. This data is useful not only historically, but in real time in the event of an emergency, Norström says. For instance, if someone were to come home from work to find his or her diabetic spouse unconscious or in distress, that person could view data in the Actiste system or access the app to see what activities had taken place. For instance, if the diabetic patient had not kept up with scheduled insulin injections, the response would be different than if too much insulin had been administered.
"Now, they can see the necessary data and make a life-saving decision," Norström says. By connecting to mobile operators that are using Ericsson's IoT Accelerator service, the Brighter software can view content such as where its devices are being used around the world. The company is also able to view the functionality of each device, along with whether it is having battery problems or other issues. In that way, the firm can send a replacement device or otherwise address the problem with the patient preemptively.
According to Norström, the company has been working with the UAE Ministry of Health to begin the pilot, which he says will begin in the coming weeks. "We chose the UAE because it has one of the highest rates of diabetes," he explains. A pilot is also in the planning stages in Southeast Asia. In the long run, the company hopes to see the technology in use all around the world.
Ericsson's IoT Accelerator makes the rollout of a global solution possible, Skånstad-Shand says. The telecommunications company already works with 35 local carriers to ensure secure cellular connections worldwide, and it has been working closely with Brighter as the startup developed its solution. "We are proud to be part of this project," she states. "It's been a long journey. We came onboard at the time that they needed to decide what technology suited their needs." The cellular connection, she says, will be future-proof, scalable and secure, and will provide global reach. "This is a true collaboration between a large cellular provider that has been around for more than 140 years and a startup trying to change lives."
Brighter AB will sell the solution as a fee-based service, and will provide the necessary needles and other consumables, as well as recycling services for consumables used. The data helps Brighter to keep each patient's medications replenished, Norström says. "Since we know the stock they are using," he notes, "we can refill the stock as they need it," making re-ordering unnecessary. Users would not buy the device itself, but rather pay a monthly fee of about $60. "Obviously, this needs to be a solution that is affordable. Therefore, we have adopted a universal pricing model that is subscription-based."
