Where is Tyler?
It seems try as we might we just can’t get Tyler from concept to a real insulin dosing system. Now just in case anyone has forgotten and not sure how anyone could as we have continually described that Tyler is an insulin dosing system that includes a connected insulin pen – which can either be a durable pen or a cap cover for a disposable pen – a CGM and app which collects the data analyzes it and then using an insulin dosing algorithm sends recommendations to the patient on how much insulin they should be dosing. While Tyler can be used with almost any insulin using patient its initial target market, if he ever gets here, is a patient following multiple daily injection (MDI) therapy.
The closet thing we have to Tyler is the InPen system from Companion Medical. It’s not quite a Tyler but it’s pretty damn close. Companion has integrated with the Dexcom G6 CGM and has a way cool whiz bang app.
Last week it was widely reported that Bigfoot was getting ready to submit their Unity cap cover system to the FDA. This was after they closed their latest financing round which raised $55 million. According to a company issued press release;
“Bigfoot Unity utilizes proprietary, smart pen caps for basal and meal-time insulin dosing recommendations integrating Abbott’s FreeStyle Libre platform. FDA submission of Bigfoot Unity is anticipated in 2020 with a target launch soon after clearance.”
Sounds like a Tyler right? Not exactly as we have learned that the Unity DOES NOT measure how much insulin is taken merely that insulin was taken. Now we aren’t sure how the system can make dosing recommendation without this critical piece of information. Nor are we sure there is any real value to the PATIENT in knowing they just injected, something they would know without the Unity. Seriously when we heard this we thought someone was pulling our leg, yet it wasn’t until we confirmed this with THREE yes THREE sources that we began to believe Bigfoot could be this STUPID.
Frankly we aren’t shocked or surprised by this stupidity as Bigfoot is a company best known for over promising and under delivering. Now one just might think that after all the money they have raised something like $155 MILLION they could come up with something of real value. Nope our friends at BigMouth seem to believe that patients are stupid, which they aren’t, and will spend their hard-earned money on a system that tells them they just injected their insulin. Seriously you just can’t make this stuff up, we wish we were but again this is the wacky world of diabetes where anything no matter how stupid is possible.
The real value of a REAL Tyler is that it helps more effectively dose their insulin. Which in turn should produce better outcomes and help patients avoid severe hypoglycemic events. Glucose data combined with how much insulin was taken is CRITICAL to make this happen. There is no real value is just knowing that insulin has been taken. The Unity does not help in anyway whatsoever and quite frankly could be lethal. Just how the Unity calculates insulin dosing recommendations without knowing how much insulin was taken is something we want to see as we are sure it’s whiz bang way cool bullshit.
A REAL Tyler can produce insulin pump like outcomes at a fraction of the cost of an insulin pump. This is why we have always characterized Tyler as real threat to insulin pump adoption. A REAL Tyler may not produce outcomes like the Control IQ from Tandem but for patients who are either uncomfortable with insulin pumps or who cannot afford the startup and ongoing costs of an insulin pump Tyler is a great option. Even better it doesn’t require much in the way of patient training or patient support which makes it better for any company who brings a REAL Tyler to market.
It’s not surprising that all the major insulin companies are working on their version of a Tyler or that nearly every diabetes device company is interested in developing a Tyler of their own.
Folks we’ve said it before and will say it again a REAL Tyler has the potential to be game changing technology. Sadly what BigMouth has isn’t even close to being a REAL Tyler, but it is consistent with the company’s panache for over promising and under delivering.