Currents of Disruption: Diabetics Reap Benefits From Smart Devices
Janus Henderson Client Portfolio Manager and type 1 diabetic Jen Nichols describes how new smart medical technology has helped her to train for and compete in ultra-marathons, while Global Life Sciences Portfolio Manager Ethan Lovell discusses the opportunities that breakthrough medical devices present to investors.
- Continuous Glucose Monitors (CGM) and insulin pumps that communicate with smartphones and wearable devices have the ability to transform the lives of people with diabetes.
- By constantly monitoring blood sugar, diabetics can better manage their short- and long-term clinical needs.
- Makers of medical devices that offer clear and substantial advantages to patients may provide investment opportunities for active stock pickers.
Jen Nichols: I’ve been running about 15 years. But, really, over the last five or six years I’ve really started to be much more competitive with my timing.
I’ve been doing ultra-races, so anything longer than a marathon. I’m going to complete my second ultra-marathon here in a couple weeks.
I was diagnosed as a type 1 diabetic in January 2003, so just before I turned 23 years old. Back then I was doing daily finger sticks in order to test my blood sugar. I was having to take six to eight finger sticks a day, poking myself in order to find out where my blood sugars were. I don’t know whether this 100 is going up or going down so I can’t make a necessary adjustment.
About two years ago I started using a CGM and it’s changed my life dramatically. I wear it 24 hours a day, and all of this information goes straight to my phone, and in this app I can see where my blood sugars are. So right now it says my blood sugar is 85 and it’s trending down, and I also wear it on my watch and so that’s super helpful in a race because now instead of having to look at my phone all the time, now I can just look at my watch and say, OK, here’s where my blood sugars are, is it trending up or down. Also, I can set alarms. My kids know what those alarms are. They know “Mom do you need to eat. Mom do you need something,” so it’s much more obvious to them in their daily lives because they are so used to what my CGM does and how it alerts me to different blood sugars.
I’ve been at Janus Henderson for four years. I’m a Client Portfolio Manager, and I actually work very closely with Ethan Lovell, one of our health care analysts. So I ping a lot of ideas off of him and ask him a lot of questions about whether it’s pumps, whether it’s CGMs, just the new technology that’s coming to market. I think having this diabetes connection has given us a connection that’s pretty unique in our field. He’s like my diabetes buddy.
Ethan Lovell: I’m not type 1 diabetic but I wanted to see what is the experience like for somebody who has one of these on their body? How useful is it? How often are they accessing the information? It was a very positive experience, even for somebody like me. I put this on, and for anybody out there who cares about CGM, this or any of the other devices that’s available today, you don’t even feel it going on.
Nichols: Ethan and I could compare, “Oh, where are you wearing yours?” It’s just kind of cool to compare notes for how the different systems work.
Lovell: You take the CGM situation, and that is a number of different technologies coming together to give you something truly disruptive, coupled to a regulatory environment that is much more conducive to speeding those products to market, because they recognize the value that is available. So once you get an approval for a new algorithm that manages this insulin dosing relationship with CGM, you just tell people to download the update, like you would for anything else that you use computerized technology for, digital technology for. We didn’t have that before. You would have to introduce a brand new product, hardware and software, all in one, and launch that. That changes the way diabetics manage their disease
Nichols: If you’re racing for time, trying to qualify for the Boston Marathon, you’re really focused on getting a specific time. Well, in 26.2 miles if you’re having to stop every couple of miles to stop and test your blood sugar by pulling out all of your equipment and testing your blood, that can waste you five minutes over the course of 26.2 miles, and when you’re trying to qualify for Boston, every minute counts.
Lovell: When we are looking at products and technologies that could transform the way that care is delivered and that therapies are administered, what we are doing is we are traveling to medical conferences and we are speaking with physicians and we are speaking with companies that are working on these technologies, and we are doing our very best to read all the literature and to evaluate the science. That is why we have a very deep and experienced team with a scientific background. And we are marrying all of that information with models that will help us predict whether the clinical outcomes are going to be favorable.
Nichols: One of the great things about the analysts that we have at Janus Henderson is that we want our analysts to be industry experts, and we think that goes above and beyond just talking to company management or just talking to other companies out there. It’s really about being an industry expert and being an industry participant. For example, Ethan going out there and trying out a product or talking to me as someone who is very well in tune with what the diabetes market means.