Diabetes tech was in the thick of headlines in 2024—not so much for new devices but rather for continuing to improve existing technologies’ wear time, convenience, accuracy, and algorithms, says Mark W. Ginestro, partner and principal of life sciences, Ernst & Young-Parthenon, EY-US.

MD+DI asked Ginestro to share his insight on the diabetes tech news in 2024, which got the most traction.

What are your thoughts on the 2024 diabetes technology industry?

Ginestro: The biggest thing that happened, in my opinion, was the rollout of continuous glucose monitoring (CGM) to over-the-counter products, basically targeting consumers. Abbott came out with its Lingo and Dexcom come out with Stelo for over-the-counter use.

It really opens a whole new market for CGM as a business opportunity and for users to access continuous glucose monitors. I think there is a lot of pent-up demand and curiosity around, ‘How does my blood glucose behave, even if I don’t have diabetes?’ It opens up a nice avenue for the consumer and patients to get access to these technologies in a less controlled environment.

There was a partnership announced between Abbott and Medtronic. To outsiders, this may not seem like a big deal, but you’ve basically got two long-term competitors in the CGM market partnering … pairing Medtronic’s insulin delivery devices and insulin delivery algorithms with Abbott’s CGM. So, you see two market leaders in insulin delivery and CGM coming together saying we want to deliver better technology for patients.

Related:Glucotrack Begins Enrollment for Long-term Implantable CGM Study

Omnipod 5 also came out, from [market leader] Insulet. That’s a small wearable insulin delivery device.

In thinking of notable developments in diabetes technology, [Eversense (Ascensia Diabetes Care) has the 365 model approved for a year.] Despite this approval, I think most of the diabetes world is not expecting the uptake of the device to be that substantial. [The company has] less than 1% share of the market today. Additionally, market participants I speak with generally indicate that patients and physicians remain hesitant about the implant procedure and also on the explant procedure required at the end of the use period.

There was a big shift not in technology but I would call it the business model. There has been a little bit of a disruption in Dexcom’s performance in the past six months or so. They were previously a very fast-growing CGM provider, and their growth has slowed significantly because of some channel conflicts. They did a sales restructuring and from what we can gather from investor calls … is that sales restructuring hasn’t gone well. They’ve lost quite a bit of share as a result. Abbott has been probably the biggest beneficiary of that. Medtronic has actually been a beneficiary of that as well in picking up some of that share.

Related:Embecta Pumps the Brakes on Insulin Patch Pump Program

I can see where the transition of CGMs from the diabetes market to the consumer would increase sales but aren’t there challenges, too?

Ginestro: Yes, from a go-to-market perspective … it’s more a health and wellness market as opposed to a chronic or life-threatening condition. It’s for people who want to know about their health and how their eating choices impact their blood glucose, liver function, and overall health.

The technology is largely the same, it’s just bringing it to a sophistication and price point that’s lower, more accessible, and at a safety level where FDA is comfortable with [users] who may not have active physician monitoring.

Any other areas where there’s promise or not?

Ginestro: I think on the ‘not’ side, the smart pen market hasn’t really developed as quickly as everybody thought. Perhaps this is a good thing. The … the delivery devices have gotten better–to where people are more comfortable migrating to a wearable long-term patch, as opposed to carrying around a smart pen.

Related:Dexcom Finds New Partner in Oura Smart

And I feel like you can’t have a conversation about diabetes without talking about GLP-1s. When GLP-1s started becoming really popular, maybe 15 months ago, everyone was concerned about what they would mean to the diabetes technology market.

As people have gotten more familiar with how GLP-1s are being used, how efficacious the GLP-1s are, and really the overall population that is on GLP-1s, I think there’s a lot more moderated view on [how these drugs will impact the] diabetes market. Now, it’s largely viewed as a complementary product–that CGMs and insulin delivery devices can be used in patients who are on GLP-1s.

There is a portion of the population that has prediabetes that may never end up in the type 2 bucket [due to GLP-1s]. But the market opportunity for patients trying to monitor their blood glucose is still very untapped.

Any evolutions in the technology that will be noteworthy in 2025?

Ginestro: I’m looking forward to seeing the results of the Medtronic partnership with Abbott. [It may result in a more closed loop system,] where you’ve got a pump and CGM working in concert.

I think longer wears on some of these devices will be something to watch. (Again, Decom filed for a 15-day wear).

In addition, there is the continued evolution of the channel dynamics where you have the pharmacy channel and the DME (durable medical equipment) channel. The pharmacy channel has been emerging and growing much more rapidly than the DME … and with OTC products, you’re going to see that continue. So, I think you’re going to see your local CVS and Walgreens having more and more of those products.   

Article source：Medical Device and Diagnostic Industry