Diabetes mellitus is a group of diseases characterised by high levels of blood glucose resulting from defects in insulin secretion, insulin action or both. Diabetes is highly prevalent, afflicting approximately 50 million people in Europe and is expected to increase to almost 60 million by 2030. Worldwide, this figure is around 170 million, and this number is expected to double to more than 350 million in the year 2030. Much of this increase will occur in developing countries and will result from population ageing, unhealthy diet, obesity and a sedentary lifestyle. For example, in India there were approximately 32 million people with diabetes in 2000, but by 2030 this number is expected to increase to almost 80 million. According to a new publication by the World Health Organization (WHO) and the International Diabetes Federation (IDF), there are around 3.2 million deaths attributed to diabetes each year. Updated estimates suggest that six deaths are attributable to diabetes or related conditions somewhere in the world every minute.
The goals of diabetes treatment are to keep blood glucose levels as near normal as possible while avoiding acute and chronic complications. Because the normal homeostatic control mechanisms are disrupted in patients with diabetes, food intake, emotional stress and changes in physical activity can cause blood glucose to become too low or too high leading to the acute complications of hypoglycaemia or hyperglycaemia. In addition, inappropriate nutrition and insufficient physical activity increase the risk of developing the long-term complications of diabetes, especially heart disease. Keeping blood glucose within a target range requires feedback in the form of self-monitoring of blood glucose. Home blood glucose meters have revolutionised diabetes care. With a meter, patients can measure blood glucose levels at any time, and within seconds, they can decide whether to eat some food, how much to eat, or how much insulin to take. Self-monitoring also allows patients to find patterns in their blood glucose levels and evaluate how well their food choices, exercise, and medicines are controlling their diabetes.
The second and third-generation diabetes monitors continue to refine self-monitoring use, by becoming smaller, faster, more convenient devices with improved memories, better accuracy and a host of add-on innovations developed in response to the varying needs of diabetes patients. The diabetes test kit market is dominated by various devices, meters and a range of novel testing strips, which in 2004 accounted for over 80 percent of category sales across Europe. Although, glucose strips obviously continue to drive sheer volume numbers, manufacturers are continually looking at ways to make self-monitoring and insulin administration easier and less painful. The market for Europe reached $2.1 billion in 2004 and exhibited an estimated growth rate of 14.8% in 2004. Governments of European countries, such as Germany and the United Kingdom, have taken initiatives to promote education and awareness to create a demand of regular self-monitoring which is expected to have a positive effect on the growth rate. In this regard, the diabetes self-monitoring market is expected to be valued at around $5.4 billion by 2011.
Hurdles & Improvements
It is important to remember that there are several challenges that must be addressed in order to achieve growth. One of the main challenges that this industry has faced is that it has often been described as a 'free meter market' because of the heavy discounts or leasing contracts that characterise the meters component of the self-monitoring kits. Compared to strips, meters are generally more costly, and often, they are deeply discounted, given away for free, or leased on a timed-contract with the purchase of multiple packs of strips. Test strips are high-margin and provide repeat sales opportunities in contrast to loss observed in meter components by manufacturers. The challenge presented to manufacturers is to find the correct and ideal diabetic patient that will frequently use meters to monitor blood glucose and thus generate repeat test strip sales. Furthermore, as the pool of undiagnosed populations shrinks and the competition of products increases by manufacturers grabbing a slice of the share, the market becomes more mature and reaches a peak in growth. Eventually, the growth of the industry depends upon the current population increasing its consumption of products, which proposes a significant challenge for manufacturers to encourage the diagnosed populations to increase regular monitoring. However, a series of other new advancements in diabetes testing have greatly improved life for those living with diabetes. Alternative site blood glucose meters are able to test blood taken not only from the fingertips, but also from the forearm or elsewhere. These sites have fewer nerve endings and some people find using them is a worthwhile way to reduce pain. Sampling blood from alternative sites can allow companies to maximise net returns by tailoring to specific niche populations such as those with a fear of needles.
Blood glucose meters used in conjunction with testing strips form an essential element in the armoury of a person with diabetes, allowing them to closely monitor their condition and to adjust their insulin regime and other therapies accordingly. Tomorrow’s next generation meters will contain a host of complex features completing faster tests with less blood, incorporating added features such as advanced data management facilities and enable diabetics to maintain accurate monitoring without significant interruption to busy and active lifestyles. But challenges still lay ahead, with better education and training through a common source, the future will be sweeter for diabetic patients and their physicians to monitor patterns more effectively and achieve improved compliance.
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