The Center for Data Innovation spoke with Eduardo Jorgensen, co-founder and chief executive officer of MedicSen, a Madrid-based startup that has developed an app for predicting the needs of diabetics, accompanied by an AI-driven device for administering insulin. Jorgensen talked about how AI could automate insulin delivery for diabetics and what other conditions could benefit from similar technology.
Nick Wallace: How does MedicSen make predictions about how diabetics will feel and what their needs will be in the immediate future, and how is that information useful for patients?
Eduardo Jorgensen: Diabetic patients have to calculate food and insulin doses all the time. They have a lot of uncertainty about what will happen in the future, because it’s not the same to drink a coke today as to drink it at the same time tomorrow, your body might behave differently even if you keep the same routine. That generates a certain amount of pain in the planning of the life of an individual.
We thought we could solve that by giving them the chance to know what will happen in the near future. What we do is collect information from third-party wearable devices that patients are currently using, like continuous glucose watches, smartwatches, or fitness trackers.
With that information, we predict future glucose levels for the patient and interact with them through the chatbot feature. They can ask questions like, “what happens if I drink a coke in 30 minutes?” and they will know exactly how their body will behave. This is because our algorithm integrates different variables to create a biological model of the user. It understands how glucose behaves in the user after as little training as one week.
Then it’s able to even understand when the patient has had lunch, even if the patient doesn’t tell us. Those kinds of things happen because we end up knowing our user, and they have the benefit of knowing in advance how to be within safe ranges of glucose levels, without having to be worried all the time.
At the moment, we give patients advice about sports, meals, and how to manage glucose with tips about general lifestyle, like stress. In the near future we’ll be implementing insulin dose calculation, in order to be able to suggest dosage modifications, so patients can be safer with drug use. But that requires medical device regulation, which requires safety trials in a clinical environment with patients, where we can prove that our algorithm works correctly, and we’re just in the middle of that process. We expect to have it ready by the end of the year.
Wallace: MedicSen also produces a device that you call a “smartpatch.” What is that? How does it work, and how does it interact with MedicSen’s app?
Jorgensen: The smartpatch is one of our biggest innovations. It’s basically a needle-free syringe, but in the shape of a patch. The user will put it either on the arm or on the belly, and it will deliver the insulin through the skin, without any kinds of needles, and no pain for the patient. We’ve adapted it to insulin, but it can work with most of the big drugs that need to be injected nowadays.
The difference from nicotine patches, which most people are aware of, is that nicotine is a very small molecule, so it can pass through the skin of its own accord. But insulin is very, very big. If nicotine is a grape, then insulin is a watermelon. It cannot go through the skin on its own, so we help that with our patch. We create a micropore on the upper layer of the skin and then we allow the drug to go through it. Then when we stop the device, the micropore closes and goes back to its original state, so it doesn’t harm the skin in the long term. We have already gone through laboratory tests with pork skin, we have verified that it doesn’t produce any kind of harm, and now we’re moving towards human trials, for which we’re looking for funds right now.
We’ll initially bring it to market as a needle-free syringe that the user needs to activate whenever he wants. But in the future, we envision the device being a non-invasive artificial pancreas on a closed-loop system. You will be able to interact with it through the app, and the algorithm will manage the insulin dosages. The only input required by the user will be the meals he’s having, and at some point we will be able to establish a routine for him and reduce interaction to a minimum.
That AI is the engine of our app currently, so when we want to predict future glucose levels, or we want to know what amount of carbs would be safe for the patient to eat right now, that sort of stuff happens in the algorithm, and that’s the same algorithm that’s growing up to calculate insulin doses and to be able to manage the patient in a closed-loop system.
Wallace: How far away are products like this from routine use in healthcare services? What are the obstacles?
Jorgensen: I think it’s close. Probably in 2-5 years we’ll start seeing private insurance companies offering these kinds of wearable devices, because they improve management and decrease costs in the long term. It’s definitely going to come soon.
However there are a couple of barriers that we still have to overcome, such as building safe algorithms that respect the privacy of the data, and still manage the user remotely and take care of everything. For that kind of system, MedicSen and the rest of the community still has to go through a lot of regulatory issues. Current laws have not adapted to this technology. So it’s going to take a little bit of time, but it’s definitely going to come, and I would say that it’s not going to take more than five years.
The European Union is trying to update the guidelines, but the truth is that if you want to develop a device like MedicSen is developing, there’s not that much information out there on how to do it, and what specific tests you’re going to need to get the approval. You end up having to hire consultants for these aspects. For most small companies, that’s not an option, so you struggle to be able to find the balance between what you can do, and what you need to ask of external consulting firms.
Wallace: What’s your professional background, and how did you end up co-founding MedicSen?
Jorgensen: I’m a medical doctor. I studied here in Spain, and I come from a family related to medicine. I always loved surgery, I wanted to be surgeon. But when I was on my clinical path, I ran into a little girl with diabetes at a consultation in the hospital. She rejected her treatment. She just placed her insulin pump on top of the table and said she didn’t want to use it. That was kind of shocking to me, because I wasn’t expecting the reasons she gave. Not being able to have a normal life, being sick of using needles all the time, and of her friends laughing at her.
It was kind of a tough moment, and so I came up with the idea of an artificial pancreas. I decided I wanted to follow-on with it, and luckily enough I had wonderful friends that formed a team with me, and we became the co-founders of MedicSen back in 2015. Since then, I’ve still had to follow the clinical path a little bit, but eventually I decided I wanted to be full-time with MedicSen, because it the only way it was going to happen.
Wallace: Could this kind of technology be re-engineered for other long-term health conditions?Jorgensen: We’re basically trying to create a system for managing chronic diseases. There are others, for example epilepsy, that could benefit from continuous monitoring of certain variables in order to predict risk events, and the ability to deliver drugs that can prevent those situations. We could even use it to monitor heart pathologies, where the patient can benefit from the same thing—we could even get to the stage of predicting heart attacks. We saw a change in the healthcare model coming, and we built our technology to be modular, so we can adapt it pretty easily to the management of different conditions.