Westerlands Awakes

As the Kingdom awakes and gets set for another day a few quick news items;

1. From the late to the game category comes word from Medtronic that they have begun trials for their latest whiz bang way cool toy the Bluetooth enabled 780G. Now we hate to dump on our friends in Northridge but check out this quote that came from a Medtronic press release;

“We are very excited about this next-generation CGM sensor as it is designed to require calibrations only on the first day of wear, reducing fingersticks by 95% over our current CGM,” said Ali Dianaty, vice president of research & development for the Diabetes Group at Medtronic. “We strongly believe calibration on the first day of wear is necessary to improve day one performance, which we know from physician and patient feedback is a challenge for all sensors. Our research shows this day one performance is critical for keeping patients safe in hybrid closed loop, or Auto Mode, which we know from real-world experience delivers the optimal Time in Range for patients on insulin therapy.”

Ok if we’ve got this straight while everyone else already has Bluetooth and neither Dexcom or Abbott require calibrations Medtronic is telling everyone that patients want to calibrate their sensors. Seriously we wish we were making this up but we aren’t.

2. Since when is an HbA1C greater than 7 considered good control. We ask this because check this out;

“The study found that the use of Ascensia’s investigational IDMS was associated with a significant decrease in HbA1c levels in people with type 2 diabetes, independent of any changes to diabetes medication, suggesting that the solution could lead to improved self-care and better glycemic control. As the primary endpoint, mean HbA1c significantly decreased by 0.43%, from 8.44% at the start to 8.01% after 12 weeks. These data are the first indication of clinically meaningful results from the use of this IDMS and suggest that the solution has the potential for benefit in the management of type 2 diabetes.”

Listen we know the days of old fashioned BGM are coming to an end and that BGM companies are desperately trying to remain relevant but something tells us that this isn’t the way to do it.

3. That poor dead cat isn’t just hitting a Tyler at every turn or another Dexcom wannabe, we can add bolus dosing algorithms to the list. Yes there are millions of insulin using patients who do not follow basal bolus but use long-acting alone or in combination with orals. Patients who don’t monitor their glucose levels and typically follow the dosing recommendations made by their physician. Therefore it makes perfect sense that there are a host of companies who believe these patients will change their behavior, not happening, or believe their smartphone app over what their physician says, not happening either. But what the heck it is whiz bang and way cool.

4. Tonight Novo Nordisk will be conducting their Investor event and what we want more than anything is to see a demonstration of how the new oral semaglutide will be dosed. Keep in mind that the drug MUST be taken on an empty stomach, CANNOT be taken with too much water and then the patient MUST wait 30 minutes before eating anything. Violate any one of those THREE conditions and the drug DOES NOT WORK.

We have little doubt the FDA will approve the drug, nor do we doubt that when launched it will get off to a great start. The problem will come when patients and their physicians realize that this is not just a pill you pop and be on your way or a shot you take just once a week, this is good drug that only works when this complex dosing regimen is followed to the letter with no deviations. And we all know that patients never deviate from what their doctor tells them to do.

5. Let’s end this mornings post with some wild ass speculation. As we all know our Chardonnay guzzling friends in France will soon have new leader who just so happens is friends with the leader at AstraZeneca. These buddies also have something else in common neither one has a diabetes franchise that’s doing all that well and both companies have done an outstanding job of turning gold into sand.

Now we have long contended that for Astra to have any chance to compete with Lilly the one thing missing in their portfolio was insulin and that the quickest way to solve that problem would be to buy Sanofi’s diabetes franchise. The new guy at Sanofi looking to make a splash and mark his territory just might go to his friend who can help him dump this franchise and look like a hero. He could sweeten the deal by throwing in their interest in the Google partnership which Astra would eat up as it puts them in the land of way cool whiz bang.

Well that’s all for now have to hurry off to the conference before the wicked witch of the west gets on her broom.