The anxiety of young people is contributing to the "big business" of blood glucose meters | MedTech

Written by Hu Xiangyun

Edited by Qiao Qian

First of all, this is not for treating diseases, and An Yu wants to emphasize this point.

Her sugar control experiment started from a small health salon. The presenter said, "Don't take health for granted", and then explained in detail the impact of blood sugar imbalance on the body, such as fatigue, sugar addiction, weight gain, and hormone disorders. An Yu has a paranoid pursuit of "efficiency" and "optimization". If the drowsiness caused by the rise of blood sugar after a meal affects her work state, or if she has an urge to overeat due to too much pressure, "she really can't stand it".

Therefore, buying a blood glucose meter to monitor the impact of the food she eats on her blood sugar has become the simplest way to maintain her mental state. After being "dominated" by the numbers on the APP for a few weeks, An Yu successfully quit coffee and ice cream, fell in love with drinking plain boiled water, and felt that "it is easier for her to concentrate during the day".

On Xiaohongshu, posts sharing experiences of controlling sugar and losing weight with a dynamic blood glucose meter are the real "traffic code". Among the hundreds of comments at every turn, netizens enthusiastically share which one is the "blood sugar assassin" between carrots and oat milk, how to eat fruits to consume less sugar, and how many units the blood sugar has risen after eating a certain food.

Dynamic blood glucose meter sharing on social media

Just like middle-aged people who swallow a handful of pills every day to resist aging, or weight losers who take "Semaglutide" to maintain their figure, the blood glucose meter is becoming a new favorite for young people who are passionate about health management, driving the audience of dynamic blood glucose meters from the traditional medical field to a broader consumer market.

This kind of blood glucose meter, the full name of which is Continuous Glucose Monitoring (also known as "dynamic blood glucose meter"), was originally designed for diabetic patients with long-term blood sugar monitoring needs.

But now, in the dynamic blood glucose meter market where diabetic patients are still the main purchasers, the enthusiasm shown by "An Yus" as ordinary consumers cannot be ignored by equipment manufacturers: Just recently, Abbott and Dexcom, the world's top two blood glucose meter brands, have successively launched over-the-counter blood glucose monitoring products for ordinary consumers, aiming to help them understand their own blood sugar, sleep, mood and other conditions, and achieve the best health state by adjusting their own metabolism.

In China, blood glucose meters are also gradually becoming the top products in various consumer festivals. In the just-ended "the longest Double 11 in history", the growth trend of the family diagnosis and treatment instrument category is still gratifying, and blood glucose meters are popular products on the "shopping subsidy" list of various platforms. JD.com data shows that the order volume of the health purchasing and marketing live broadcast room has increased by 5 times month-on-month, and the "transaction amount of the dynamic blood glucose meter category has achieved a double growth year-on-year".

The "health anxiety" of young people is catalyzing this new business of blood glucose meters.

Blood Glucose Meter Users Are Getting Younger

When did a small device start to be noticed by young people?

Compared with the traditional finger blood test, the hardware part of the dynamic blood glucose meter consists of three parts: sensor, transmitter and receiver. It mainly monitors the glucose concentration in the human body in real time through the sensor implanted under the skin, and converts it into an electrical signal and transmits it to the supporting receiver or APP. It has the advantages of 24-hour dynamic monitoring, storage function, low infection risk, and painless wearing.

If the traditional finger blood test is just "taking a photo" of the blood sugar value at a specific moment, then the dynamic blood glucose meter is "recording" continuously. Just "nailing" a coin-sized circular device shallowly into the fat layer of the arm or abdomen, it can continuously monitor blood sugar for 2 weeks. The usage is simple, and more importantly, it doesn't hurt much.

To some extent, the easier-to-use blood glucose meter product is a result, and the reason is the prevalence and younger trend of diabetes.

Xie Yun is now working at Zhu Xianyi Memorial Hospital of Tianjin Medical University and has been an endocrinologist for decades. In the past, most of the time, she faced middle-aged and elderly diabetic patients. But in the past two years, more and more young people have begun to appear in her consulting room, telling her about the abnormal blood sugar indicators in their physical examination reports. "The youngest Type 2 diabetic patient I have managed is only 9 years old."

China has always been a big country with diabetes. As of 2021, the number of diabetes and prediabetes ("sugar-pre" group, referring to the transitional stage before the onset of diabetes) in China has reached 150 million and 350 million respectively. And the new trend in recent years is that the prevalence rate of young people is continuously rising, and the proportion of Type 2 diabetic patients is continuously increasing.

In the classification of diabetic patients, the main cause of Type 1 is genetics, while Type 2 diabetes is closely related to lifestyle and environmental factors. Zhao Weigang, the chief physician of the Endocrinology Department of Peking Union Medical College Hospital, explains: "Generally speaking, the more elite a person is, the more likely they are to get diabetes. That's because of high pressure, bad living habits, overeating, and lack of exercise." In recent years, the drugs and monitoring methods for clinical treatment of diabetes have become more and more mature, and the level of doctors has also been continuously improved, but there are more and more patients, which is something we don't want to see."

Many young people who come to see a doctor or want to try a dynamic blood glucose meter may not really be diabetic patients, or even belong to the "sugar-pre" group. Xie Yun mentioned that normal people may also have short-term blood sugar fluctuations due to factors such as exercise, diet or emotion. Although "in principle, a dynamic blood glucose meter can be used, but it is not recommended from the perspective of clinical treatment guidelines" - one is that the cost performance is not high, and the other is that the sensor technology used by different dynamic blood glucose meters is different, and there will be errors in the monitoring results, which may cause unnecessary anxiety for users.

But in the face of the fear that "if you really get sick, it may accompany you for a lifetime", young people will still try every means to figure out whether the fluctuating blood sugar value will deteriorate their health.

Chen Chen is 35 years old and has had diabetes for 23 years. When the dynamic blood glucose meter product had not yet officially entered the mainland market on a large scale, he had already started to purchase it from Hong Kong through a purchasing agent. He has seen many young people in the "sugar-pre" stage, confused about why this situation suddenly occurred to them. At the same time, "you can't imagine how fast they scroll through their phones. Weibo, Douyin, Xiaohongshu, the information is very complex, and they may not really be able to distinguish it, but at this time, they just want to know how to quickly control their blood sugar".

Another interesting phenomenon is that in recent years, those who use GLP-1 products to lose weight are becoming loyal fans of dynamic blood glucose meters.

"From the perspective of being willing to accept new things, the audiences of these two types of products may overlap," An Yu guessed: "It's always good to know your own health status."

Price Reduction, Blood Glucose Meters Become Big Consumer Products

Just after November 11, Sinocare, a leading domestic manufacturer, released a "battle report" saying that during this year's "Double 11", the sales of dynamic blood glucose meters on the entire network exceeded 400,000 boxes, with a growth rate of 400%; Silicon Biosystems said that the sales of its own dynamic blood glucose meters exceeded the 100 million level, and the transaction volume of its self-operated e-commerce channels increased by 176%.

Behind the excitement, if we look back at the development process of the dynamic blood glucose meter market in China, around 2017, overseas brands such as Abbott and Medtronic entered China, which may be regarded as a starting point. But it has really flourished in the past two years.

Yang Tian is an upstream chip supplier of dynamic blood glucose meters. The data he provided to 36Kr shows that until 2020, the domestic dynamic blood glucose meter market size was only about 150 million yuan, but in 2023, this number directly soared to 4 billion yuan.

The increasingly stable product performance is a major prerequisite for the improvement of market penetration. In the evaluation system of dynamic blood glucose meter products, the MARD value, which represents the monitoring accuracy, is the most commonly used reference indicator.

It refers to the average error range between each measured value and the matching reference value. The smaller the MARD value, the higher the accuracy. Nowadays, the industry almost assumes that although an MARD value of less than 15% can be declared for listing, it is generally recognized by the mainstream market only when it is lower than 10%.

At present, the MARD values of the dynamic blood glucose meter products sold by mainstream domestic and foreign brands are basically the same, mostly maintained between 7.5% - 9.5%.

At the same time, as a type of product that requires continuous repurchase, the comfort of wearing the product and whether the data reading is intuitive also affect the purchase intention of patients. Yang Tian mentioned that in the early years, some products had a too strong spring in the needle assist device, which could make people bleed; or the software receiver matched with the product was inconvenient to operate, which might cause users to give up using it. And these "problems related to the product experience can only be gradually polished through continuous market feedback".

In addition, behind the nearly 25-fold market growth in the past three years, another variable that cannot be ignored may be that a number of domestic products have been approved during this period, and directly led the dynamic blood glucose meter to enter the "price war" era.

Data source: Huachuang Securities Research Report

Chen Chen still remembers that when he was diagnosed with diabetes around 2000, the first question the doctor asked his father was "How is the family's financial situation?". At that time, finger blood testing was still the mainstream, "A blood sugar test strip costs 5 yuan, and it is recommended to test 8 times a day", and the cost of test strips alone could reach 15,000 yuan a year. Then, in the first few years after the dynamic blood glucose meter was introduced, the price of the sensor was generally several hundred yuan.

But in the past two years, domestic players have entered the market in a concentrated manner, directly reducing the price of dynamic blood glucose meter products by more than 50%. Especially after this year's "Double 11", the price of a single sensor has been pulled down to the range of 100 - 200 yuan. The penetration rate of domestic brands has also increased, and the market share has reached about 20%.

It is quite cost-effective for young consumers to be able to continuously monitor their blood sugar health by saving a few cups of coffee money every month.

"From our perception, a certain domestic listed company is the one that is fighting the 'price war' the hardest." To some extent, Yang Tian and others do not reject seeing this kind of phenomenon. Because in this way, downstream manufacturers "will have the motivation to reduce costs and increase efficiency", and the chip, which originally accounts for a not low proportion in the entire manufacturing cost of the dynamic blood glucose meter, is naturally one of the most suitable "optimization" objects.

Around 2020, at the eve of the concentrated approval of domestic dynamic blood glucose meters, Yang Tian's company became one of the early manufacturers to transform to the research and development of medical chips. In his opinion, the dynamic blood glucose meter is a rare track in the current medical industry that has both To B and To C attributes and an incremental market. This year, after the company's products began to be sold in large quantities, the revenue expectation of the dynamic blood glucose meter sector has reached more than 10 million yuan.

However, the price war will not last forever. Under the influence of multiple factors such as cost, brand, and channel, the pricing of dynamic blood glucose meters in the domestic market has become stable. 36Kr noticed that during this year's "Double 11", the prices of dynamic blood glucose meters of brands such as Sinocare, Yuwell Medical, MicroTech Medical, and Silicon Biosystems on e-commerce channels are mostly maintained at around 150 yuan; the prices of dynamic blood glucose meter products of overseas brands such as Abbott are maintained in the range of 250 - 300 yuan, and there is no situation like "cutting it in half" directly as last year.

It seems that enterprises have gradually reached a tacit understanding: They want the market, but also profits.

When such a pattern is gradually formed, the next question is: After the price war, where should the dynamic blood glucose meter go next?

Non-invasive, the Trend?

Under the continuous market education, today's consumers almost assume that the blood glucose meter is a circular device that needs to be attached to the arm. Although it needs to be replaced every two weeks, it is not very troublesome to use.

But from the perspective of technological iteration, making the trauma smaller has always been the pursuit direction of domestic and foreign blood glucose meter manufacturers.

At the end of October this year, the National Medical Products Administration approved a non-invasive blood glucose meter of Lepu Medical. As the name suggests, it is a further step than the dynamic blood glucose meter. The non-invasive blood glucose meter even saves the process of sticking a needle into the arm, and is generally achieved directly by clamping the finger.

In principle, these products generally use light as the carrier to indirectly calculate the blood glucose concentration by extracting the information changes related to the blood glucose concentration on the human body; or by using the thermal method to measure the heat, glucose phase and other information in the human body, and then deriving the glucose concentration in the blood. Thanks to the convenient measurement, rich information contained, and the ability to achieve true non-invasive and other characteristics, these methods have gradually become a research hotspot in recent years.

In China, in addition to Lepu Medical, non-invasive blood glucose meters of enterprises such as Bobang Fangzhou and Jingce Medical have also been approved previously; overseas, technology companies represented by Apple, Google, and Samsung are keen to explore such methods, and the product forms cover various common life categories such as glasses, watches, and rings.

But overall, whether it is a traditional medical enterprise or a new technology upstart, whether the research and development ideas are optical or thermal, or whether it is trying to sample and determine the blood sugar value from body fluids such as tears and sweat, almost every technical path of the non-invasive blood glucose monitor cannot completely avoid the two major problems of result lag and low accuracy.

A doctor who has come into contact with a certain non-invasive blood glucose meter on the market mentioned that making the blood glucose meter non-invasive has always been the pursuit of the industry, but the overall "it is not as reliable as obtaining information by burying the needle in the tissue fluid". "When doing research, the MARD value must be controlled within 15%, but the test conditions are often controlled more strictly, and this result may not be obtained in the market. I rarely recommend this type of product to my patients because it is not