How can a non-invasive glucose monitor help providers improve outcomes?

We’ve covered a lot of topics here on the DiaMonTech blog- from the environmental impacts of diabetes monitoring to the science behind our non-invasive technology- but one area we’ve yet to capture is the perspective of healthcare providers. Specifically, for those who work with patients with diabetes or other metabolic conditions, how would a non-invasive blood glucose monitor improve their treatment abilities? I was fortunate to connect with Dr. Ravi Kamepalli, MD and Medical Director of Infectious Diseases, Obesity and Wound Care, at the Regional Infectious Diseases and Infusion Center in Lagrange, Georgia, USA.

Dr. Kamepalli has devoted much of his career to understanding and treating patients with infectious disease, complicated wounds and diabetes, and other metabolic dysfunctions. He cites his personal family tragedy in 2015 as a turning point in his career, shifting his focus from managing symptoms of a disease to a focus on the root cause of the symptoms. And this source, he has found, is glucose. Glucose causes metabolic mayhem, and the cascading effects of this run deep within the body. “There’s currently a ‘mass medicine mindset’ within the industry that focuses on the treatment of common symptoms rather than specific solutions catered for the individual; truly personalized care. My goal is to work with a patient to build metabolic fitness and heal metabolic injury.” Once this is done, human beings have the innate ability to heal.

As DiaMonTech progresses towards market launch of our non-invasive blood glucose monitor, I was fortunate to connect with Dr. Kamepalli for his thoughts on the benefits that this technology would give providers and their patients.

What are the limitations with modern glucose monitoring technologies that you see your patients experience?

• The technology itself, whether needle or sensor, is invasive and presents many potential issues to the user. A lot of patients with glucose challenges also have skin conditions — vitamin D deficiency, for example — that cause a sensor to fall off. This leads to frustrations and a distrust of the technology, and can require extra steps such as supplemental glues to improve these issues. Of course, this is in addition to the painful experience of finger sticks and breaking the skin for measurement. As a whole, the patient experience isn’t consistently good, determining compliance.

What differences do you see in the outcomes of patients who can actively and repeatedly measure their glucose from those who can’t?

• It comes down to expectation management from the provider. The purpose of the monitoring has to be pre-determined: Why is the provider initiating glucose monitoring? For me, I want to know the glucose performance and trends of the patient. This is where the power of data sharing from devices like DiaMonTech’s D-Pocket hold power. I have to understand the problem: is it insulin resistance? Or is it sugar intake? Let’s identify the root cause. Once I have that clarity, how can I utilize the technology to improve the process? Patient outcomes are better correlated with adherence to the plan developed with a provider than simply with a set number of measurements.

Speaking of data sharing, how would a device that integrated with your patient softwares improve your ability to manage patient conditions and improve outcomes?

• Integration is critical to understanding the patient. Metabolically, A1c is not as important when compared to glycemic variability. Most of the injury I see is due to glycemic variability: the extreme swings in glucose levels over the course of a day. These levels could still average to a clinically respectable A1c measurement, however the highs and lows could still be contributing to negative impacts internally.

Among the three primary groups — pre diabetes, T2D, and T1D — which do you envision the most value for a noninvasive glucose monitor? Where is the impact the highest?

• I would push back against looking at this in the context of groups. Ideally, all Physicians would prescribe CGM to the members of any of those groups who have the potential to find high value in a non-invasive glucose meter; it’s really up to them and their doctor. Besides, how exactly do we quantify value as long as the tool improves a user’s management? Certain positive outcomes shouldn’t outweigh other positive outcomes simply due to perception. And to take this thought a step further: diabetes groups aren’t the only ones who will find value in a tool like this. There are many metabolic conditions outside of diabetes that would benefit from the tracking of glucose, and I intend to introduce this tool to those patients of mine. The device will hold tremendous value to many people as long as it is reliable, replicable, scalable. Then it will have the potential to overhaul how human beings’ lifestyle choices can be impacted by the knowledge of glucotoxicity.

Finally, considering a non-invasive monitor as a tool to support metabolic management, what goals would you aim for your patients to achieve?

• Getting the patient to become metabolically flexible, where the body is able to handle carbohydrates that do not spike the glucose to a higher level and if they do, the ability of the body to hormonally quickly bring it back. Glycemic variability and how metabolic flexibility interactions impact it is how outcomes happen to the patient. Noninvasive glucose monitoring that is reliable, reproducible and exponentially implementable will influence how healthcare is going to be delivered, and the patients themselves will understand how their body is handling the glycemic challenges they themselves are putting it through. Once this level of understanding is achieved, I believe patients will have the power to manage themselves at depths never previously available.

I found ‘metabolic mayhem’ to be a unique and fitting term- a thief that steals from us in many different ways. But as technologies continue to develop, providers like Dr. Kamepalli will be able to identify and address the unique pain points of each patient. He refers to this model as the Endgame of Medicine, wherein providers and patients will have the means to work together in identifying root causes on a case by case basis, and fight together in overcoming their conditions. And, of course, at DiaMonTech we are looking forward to providing the monitoring technology to support patients and doctors in this fight.