In Depth: China’s Blood Sugar Tracking Device-Makers Come Down Off a High

The introduction of a small, adhesive sensor, designed to be worn on the upper arm, is revolutionizing how individuals manage their blood sugar levels. This device utilizes a micro-needle to monitor glucose levels continuously for up to 14 days without interfering with daily activities such as bathing or exercising. Data collected by the sensor is displayed in real-time on a smartphone app, providing users with insights into how different foods affect their blood glucose levels [para. 1][para. 2]. One user, Ou Lin, adopted the technology after seeing an ad, due to a family history of diabetes and personal health concerns. She found that beginning meals with vegetables, instead of proteins or carbohydrates, led to better blood sugar stability [para. 3][para. 4].

Originally developed for Type 1 diabetes patients to offer continuous data over traditional blood glucose meters (BGMs), continuous glucose monitoring (CGM) devices have begun to appeal to the general public for personalized health management [para. 5][para. 6]. In China, the CGM market now represents a vast opportunity due to the large diabetic population, though it faces pricing competition challenges, hampering growth. This trend highlights the commercial competition within China’s burgeoning market for such devices[para. 7].

After entering the Chinese market, initially led by multinational corporations Abbott Laboratories and Medtronic, domestic companies quickly followed suit [para. 11][para. 12]. By 2021, Chinese companies had launched competitive CGM products, which triggered intense price battles, subsequently reducing prices considerably. An example is Abbott’s FreeStyle Libre, which saw a significant price drop from 450 yuan to 200-400 yuan [para. 12][para. 13][para. 14]. Local firms, some pricing as low as 90 yuan, struggle to maintain margins, and many face losses while attempting to gain market share [para. 15][para. 16].

The shift from a promising market with considerable growth predictions towards decisive competition raises concerns about sustainability. Despite China having the world's largest diabetic population, and potential for high CGM adoption rates, the market remains underdeveloped compared to the U.S. [para. 19][para. 20]. Current penetration rates are low, though projections for 2030 suggest substantial growth[para. 22]. However, despite high potential demand, domestic companies have veered away from establishing strong hospital ties, focusing instead on the faster-growing personal consumer market [para. 25][para. 26].

To access the hospital market more effectively, companies would need to navigate significant barriers, including pricey entry costs and lengthy approval processes, compounded by challenges like patients finding cheaper alternatives online [para. 32][para. 35]. Some regions in China now offer partial reimbursement for CGM devices, aiding market adoption. However, widespread national insurance coverage for CGM devices remains unlikely in the short term [para. 41][para. 42].

The clinical application of CGMs faces challenges primarily due to accuracy concerns. Products must meet rigorous standards not only for regulatory approval but also for practical, clinical use. This demand for precision highlights an area yet to be fully addressed by domestic manufacturers [para. 48][para. 50]. Despite these challenges, the CGM market shows promise beyond hospitals, with potential health management uses for high-risk patients and general populations. The future success of these devices is dependent on adherence to medical device standards, prioritizing both academic research and clinical evidence, requiring patience and ongoing industry investment [para. 51][para. 53].