When diabetes patients are asked what has the greatest negative impact on their quality of life there is one answer that outnumbers all others: it is not the injections, or the daily blood glucose measurements, or the dietary restrictions that impact their life the most. It is the need to pay attention to their condition every day.

Drug delivery device developers in the diabetes industry understand this, and the many projects aiming to develop an artificial pancreas show the community’s commitment to allow diabetes patients to live a normal life without constant attention.

Professionally I have worked on insulin delivery device design for more than 15 years, but after I was diagnosed with asthma last year and given my first inhaler I have come to better appreciate what a diabetes patient – or any patient with a chronic condition and maintenance therapy – lives with.

I think about the weather, the pollen count, the pollution level and whether I inhale correctly when I remember to do so. I sometimes forget to inhale or forget to carry my inhaler with me on travels

In other words, I need to pay attention to my asthma.

My inhaler has a mechanical dose counter and a whistle that warns me if I inhale too strongly. A development engineer would say these are extra features on a drug delivery device. We should consider the inhaler, dose counter and whistle the first tentative steps towards a therapy manager for asthma.

Ideally, my Asthma Manager should:

  • remind me to inhale according to my schedule (with a sense of context, please. If it’s warm and dry and the pollen count is low I can go without).
  •  keep an eye on my travel itinerary and remind me to pack it.
  • check the weather, pollen count and pollution levels for me and warn me if necessary.
  • check the air quality in real time.
  • check if I inhale correctly and help me improve my technique.
  • measure my air flow and tell me what to do if it is critical.
  • keep an eye on remaining drug and order new drug canisters when I’m about to run out.

In short, my Asthma Manager should pay attention to all things asthma-related so I don’t have to.

It is not only the insulin pump and the inhaler which could evolve into therapy managers: Chronic illnesses such as Parkinson, Rheumatoid Arthritis or MS often require drug delivery but patients also have a need for monitoring health and sometimes need help overcoming obstacles in everyday life caused by the illness. All of these could be considered when moving to a therapy management device.

Devices integrating these features are challenging, both from a technological and a regulatory perspective, but at Cambridge Consultants we have a long track record of implementing breakthrough technology into medical technology products.

Lasse Mogensen
Senior Consultant