Think of diabetes; you probably picture one or two people in your life living with this condition. It is a common struggle, yes, but what if I told you that for every person diagnosed, there is another, or even more, unaware that they are caught in this silent pandemic. The thought of so many living with undiagnosed diabetes is unsettling.
In 2021, an estimated 537 million adults were living with diabetes worldwide and that number is projected to hit a staggering 783 million by 2045 [1,2]. What’s more disturbing is that half of these folks do not know that they have it, especially in lower income countries. This delay in detection often leads to severe complications such as blindness, kidney failure, heart attacks, stroke and even amputation [1,3]. This is a dire situation screaming for better ways to diagnose early and manage the condition.
Fortunately, the way we monitor glucose is changing dynamically. We are moving from old urine tests, whose accuracy was not reliable, heading into the future where managing diabetes is not just about blood sugar levels rising and dropping, but actually predicting and preventing it.
Science is ready to make diabetes care proactive, personalized and less burdensome. But if we cannot afford the solutions we have now, how will we manage to access the future technologies under development? What can bend the cost curve? Including continuous glucose monitors, insulin, and other diabetes management essential supplies in national insurance benefits is one way to ease the burden of cost. Another might be tax exemptions for diabetes diagnostic & treatment equipment.
Local development and manufacturing of technologies required for diabetes management could greatly benefit the region and the continent at large by have low-cost products, made in Africa for Africans, leveraging the deep pool of talent in the region to develop cost-effective solutions for the increasing population with diabetes. MEDevice Africa has made a commitment to research, explore and develop innovations that will improve diabetes management and care. We are forming strategic partnerships for innovation in technology development, as well as innovative financing, business models and policy. We can turn the silent tsunami into a controllable tide by providing quality and affordable diabetes management solutions for the continent.
A Look Back and Where We Are Now
Glucose monitoring has come a long way. Back before the ‘60s, it involved urine glucose testing, a complicated and inaccurate method that provided a semi-quantitative assessment of glucose levels. The real game changer happened in the 1960s, with self-monitoring blood glucose (SMBG) meters. These gave people the power to monitor their blood sugar levels at home with a simple finger prick [4]. While SMBG is still useful, it only gives a snapshot of the glucose levels and misses all the fluctuations throughout the day and night [5,6].
That’s where Continuous Glucose Monitoring (CGM) stepped in, revolutionizing diabetes management in the late 1990s. A little sensor stuck on your upper arm that tracks your glucose level 24/7, giving real-time, continuous glucose data [4,7]. This constant feedback means people could actually see what was happening with their blood sugar after having cake at a party or a jog around the track, and adjust before things went sideways, greatly reducing the risk of dangerous highs and lows.
But even with these leaps forward, our current methods aren’t perfect. SMBG still involves painful finger pricks which could be inaccurate if not done right [5,6]. CGM, though amazing, can sometimes cause skin irritation, might still need occasional calibration for some devices, and let’s be honest, the cost can be a huge hurdle [5]. Most Kenyans cannot afford to pay for it out of pocket and national insurance does not cover continuous glucose monitoring which costs roughly $120 per month.
The horizon of diabetes management: Proactive, Personalized, and Painless Care
The future of glucose monitoring is incredibly exciting, fueled by research to make managing diabetes more accurate, convenient and integrated into everyday life.
1. Non-invasive glucose monitoring
This is the “holy grail” of glucose monitoring, targeting to eliminate the need for any skin penetration. Various non-invasive techniques are being explored by researchers and innovators to achieve this goal. One of the most promising methods is the use of optical sensors, these utilize light to measure glucose levels in body fluids or tissues, mostly applied in wearables. Think of it as a smart watch that keeps track of your glucose fluctuations and alerts you without having to prick the skin [4,8]. Isn’t that awesome?
Other novel approaches include analysis of breath, sweat and tears.There are even contact lenses embedded with glucose sensors! While several non-invasive prototypes have emerged, achieving comparable accuracy, selectivity and sensitivity to invasive methods remains a significant challenge for widespread clinical adoption [6].
2. Artificial Intelligence (AI) and predictive analysis
AI is playing a crucial role in analyzing vast amounts of CGM data to identify patterns, predict future blood glucose excursions, especially for hypoglycemia, and offer personalized insights and recommendations for diet, exercise and medication adjustments [5,8].
AI-enabled glucose monitoring devices can shift diabetes management from reactive to proactive, allowing individuals to take action before an incident occurs, thus improving the quality of life [5].
3. Integrated closed-loop systems
Imagine not having to worry about monitoring your glucose or insulin injections. Smart devices that offer a closed-loop system, monitoring your glucose and promptly dispensing the precise, required amounts of insulin exist. Sadly, they are out of reach for a vast number of people in our part of the world. Development of sophisticated, and affordable, closed-loop insulin delivery systems is critical. The future is use of an artificial pancreas, that seamlessly integrates CGM data with insulin pumps to achieve near-automatic glucose control [4]. This includes systems that can learn individual glucose patterns and recommend optimal insulin pump settings.
Conclusion
The landscape of glucose monitoring has transformed dramatically, empowering individuals with diabetes to take greater control of their health. While current methods have their limitations, ongoing research, particularly in non-invasive technologies, AI-powered analytics and integrated closed-loop systems, promise a future where diabetes management is even more personalized, proactive, and less burdensome. These advancements hold the potential to significantly improve glycemic control, reduce complications, and enhance the quality of life for millions living with diabetes worldwide. To achieve health equity, it is important to actively and aggressively manage the costs of these life altering innovations.
References
[1] Diabetes Australia. (n.d.). Diabetes globally. https://www.diabetesaustralia.com.au/about-diabetes/diabetes-globally/
[2] International Diabetes Federation. (n.d.). IDF Diabetes Atlas Tenth edition 2021.
[3] World Health Organization. (n.d.). Diabetes – Fact sheets.
https://www.who.int/news-room/fact-sheets/detail/diabetes
[4] NCBI. (n.d.). Introduction: History of Glucose Monitoring. In: Feingold KR, et al. South Dartmouth (MA): MDText.com, Inc.; 2000. https://www.ncbi.nlm.nih.gov/books/NBK538968/
[5] Diabetes Educators Calgary. (n.d.). CGM Benefits and Challenges. https://diabeteseducatorscalgary.ca/devices/continuous-glucose-monitors/continuous-glucose-monitoring-cgm-benefits-and-challenges.html
[6] Perrault, A., et al. (2019). Challenges and perspectives in continuous glucose monitoring. VU Research Portal. https://research.vu.nl/files/119076355/Challenges_and_perspectives_in_continuous_glucose_monitoring.pdf
[7] NCBI. (n.d.). Monitoring Technologies- Continuous Glucose Monitoring, Mobile Technology, Biomarkers of Glycemic Control. In: Feingold KR, et al. South Dartmouth (MA): MDText.com, Inc.; 2000.
https://www.ncbi.nlm.nih.gov/books/NBK279046
[8] Number Analytics. (2025). The Future of Blood Glucose Monitoring. https://www.numberanalytics.com/blog/future-of-blood-glucose-monitoring
