A massive diabetes challenge and pharma-tech moonshots, Europe starts 2025 in launch mode – Euractiv

Diabetes, a chronic condition affecting millions globally, has seen significant advancements in its treatment and management over the past two years. Still, nothing has dented its catastrophic rise as an age-related disease.

Despite technological and biopharmaceutical breakthroughs, the consequences of not adhering to medical guidelines continue to impact Europe’s citizens.

New medications that promise to delay or even reverse the onset of diabetes are emerging, and the move towards personalised treatment plans is advancing, but public understanding of the disease has had limited impact on societal behaviour.

According to a report published this month by the European Federation of Pharmaceutical Industries and Associations (EFPIA) – 2024 Pipeline Review – the number of people over 65 is expected to double by 2050, driving increases in dementia, diabetes, COPD, depression and cancer.

The authors describe obesity as “one of the greatest public health crises facing society,” with an estimated one in eight people globally classified as living with obesity. An estimated annual cost of €460bn is related to the economic impact of obesity in Europe.

The cost of obesity expands as it plays a significant contributory role in the development of multiple NCDs, such as diabetes, CVD, MASH, Alzheimer’s disease and cancer.

When it comes to obesity management medication, the report shines a spotlight on GLP-1 Receptor Agonists (GLP-1 RA) – GLP-1 RA, which is the focus of clinical activity in the OMM space.

Developed to treat type-2 diabetes, GLP-1 RA mimics the action of the hormone GLP-1, which is released after eating to stimulate insulin release, slow gastric emptying, and increase feelings of fullness.

Diabetes technology wins

In the last two years, diabetes treatment has witnessed remarkable innovations.

One of the most significant breakthroughs is the development of a new treatment combining ReCET (Re-Cellularization via Electroporation Therapy) and semaglutide. This combination has shown the potential to eliminate the need for insulin in 86% of type 2 diabetes (T2D) patients.

The ReCET procedure enhances the body’s sensitivity to its own insulin, while semaglutide, a GLP-1 receptor agonist, helps regulate blood sugar levels. This novel approach addresses the root cause of T2D rather than just managing its symptoms.

Another notable advancement is the use of continuous glucose monitoring (CGM) systems. These devices provide real-time data on glucose levels, allowing for more precise management of diabetes.

The integration of CGM with insulin pumps has led to the development of hybrid closed-loop systems, often referred to as artificial pancreas systems. These systems automatically adjust insulin delivery based on glucose readings, significantly improving glycemic control and reducing the risk of hypoglycemia.

In the pipeline, researchers are exploring the potential of gene therapy for diabetes.

Early-stage studies have shown promise in using gene editing technologies like CRISPR to modify genes associated with insulin production and glucose metabolism. While still in the experimental phase, these therapies could offer a long-term solution for diabetes management.

Diabetes digital transformation

Mobile apps and digital health platforms are now increasingly integrated with diabetes devices. These apps provide comprehensive diabetes management tools, including glucose tracking, meal planning, and activity monitoring. They also facilitate data sharing with healthcare providers, enabling more personalised care.

Europe’s digital health transformation is set to revolutionise diabetes prevention and management, with the integration of artificial intelligence (AI) and big data in healthcare promising to be a game-changer. Enabling continuous remote monitoring of patients through wearable technology, sensors, and smartphones is just the beginning.

This data-driven approach allows for the collection and analysis of vast amounts of physiological and environmental data, which can be processed by sophisticated machine learning algorithms to enhance diabetes care.

This syncs with the rise of personalised medicine as another significant trend in the diabetes space.

While oncology currently leads in personalised molecular diagnosis and tailored treatments based on genetics, diabetes research is rapidly advancing.

Although the genetic contributions to diabetes phenotypes remain complex, the accumulation of big data through digital technologies is paving the way for better characterisation of disease subtypes. This progress is expected to lead to more tailored treatments and improved patient outcomes.

Diabetes drug market

Over the past decade, the pharmaceutical landscape for diabetes treatment has transformed significantly.

Diabetes drugs now represent over 75% of total sales in the metabolic disorders market, up from below 40% ten years ago, according to a report by Pharmaceutical Technology.

The report shows that eight of the top ten best-selling drugs in the metabolic disorders sector are for diabetes.

However, most of these, except Eli Lilly’s Trulicity, have peaked in sales and are being replaced by newer treatments.

Novo Nordisk’s Ozempic and Rybelsus, Eli Lilly’s Trulicity, and AstraZeneca’s Farxiga are now expected to be the main growth drivers in the diabetes drug market.

These drugs are projected to contribute over $15 billion to the diabetes sector by 2025. These newer treatments will play a crucial role in the future of diabetes management.

Diabetes, competitive opportunity

If the new European Commission is serious about implementing Mario Draghi’s report on EU competitiveness, starting with diabetes as a problem to solve and a global market opportunity in its infancy, it looks like a winnable strategy.

When it comes to technology, a report by Mordor Intelligence showcases Europe as home to several leading diabetes technology companies at the forefront of innovation in diabetes care.

Novo Nordisk, based in Bagsværd, Denmark, is known for its innovative insulin products and GLP-1 receptor agonists. Novo Nordisk is also investing in digital health solutions to enhance diabetes management.

Medtronic, with its European headquarters in Dublin, Ireland, is also a major player in the diabetes technology market. The company is renowned for its insulin pumps and continuous glucose monitoring (CGM) systems. These are just two examples from a globally ambitious European sector.

Speaking at the launch of the Pipeline Review, Nathalie Moll, Director General, EFPIA, emphasised Europe’s capacity to tackle diseases such as diabetes:  “The Pipeline review is an important reminder that many people continue to live with debilitating and life-limiting disease […] there is much more that we can achieve if EU policymakers work with us to incentivise more research and development in this vital area of unmet need.”

Moll added: “Political instability and an ever-evolving disease burden means that now, more than ever, we must support Europe’s health security and its ability to innovate for patients. This can only be achieved through policies delivered through a coherent European life science strategy and a collaborative approach among all stakeholders.”

As Mario Draghi once said: “Whatever it takes.” For diabetes, now is the time. Delay will be economically deadly.