Nowadays, when someone says the word ‘pandemic’ everyone automatically thinks of Covid-19. While the effects of Covid-19 have been devastating, there is another disease that has silently evolved into an even bigger global pandemic than Covid-19.

The condition in question is diabetes, that has become one of the largest global healthcare challenges during the last decades.The number of diabetics quadrupled during the last 40 years, and as a result more than 500 million people live with diabetes globally. To put this number into context, if all diabetics would form a country, it would be the third most populous country in the world after China and India. According to projections, the number of diabetics will reach almost 800 million by the middle of this century, meaning that every tenth person will live with diabetes. This rapid increase will be fueled by China, India and other low- and middle-income countries, with aging population, urbanization and sedentary lifestyle being the main factors behind this phenomenon. Arctic Aurora LifeScience and Arctic Aurora Biotech Select are invested in companies involved in developing better treatments and hopefully in the future cure to this devastating, costly disease. 

Diabetes is a serious long-term condition, that has two types. In Type 1 diabetes, the body cannot produce insulin, a hormone responsible for blood sugar regulation and is often diagnosed at an early age. This disease is currently incurable, patients can only be treated with different kinds of insulin. Type 2 diabetes accounts for 90-95% of patients, whose body became insensitive to insulin because of aging, obesity, and lack of physical activity. The long-term consequences of diabetes include increased risk of heart attack and stroke, leg ulcers and blindness. Diabetes kills more than 4 million people every year, while approximately 1 million people are blind due to this disease.

Diabetes also puts a significant burden on healthcare systems. Global health expenditure on diabetes care was more than 760 billion dollars last year, and this amount is expected to increase to 845 billion dollars by 2045.

From our investment portfolio in Arctic Aurora LifeScience Sanofi, Eli Lilly and Novo Nordisk are the leading companies in traditional Type 2 diabetes care with a considerable stake in insulin production and the latter two companies with involvement in newer blood glucose lowering drugs. Looking at emerging therapies a basket of biotech companies in Aurora LifeScience and Aurora Biotech Select funds are at the forefront of innovative therapies, looking for curative solutions for Type 1 diabetes.

Vertex Pharmaceuticals recently announced promising early-stage clinical results for the first Type 1 diabetes patient in their cell therapy development program. Here, insulin producing cells are transfused into patients and initial results were positive in several aspects. Biochemical measurements of patient-own insulin production were vastly improved, long-term blood sugar levels were lowered and the patient’s need for insulin injections was dramatically reduced.

On a similar approach the gene editing company CRISPR Therapeutics are working on next-generation insulin producing cells. The aim is not only to reboot the body’s own insulin factory, but to make the procedure easier by programming the cells to evade the donor immune response which could otherwise potentially destroy the introduced cells. That project in undergoing the last validation steps before entering clinical trials.

The research service organization and innovation hub Evotec are working on a similar program using stem cells that are transformed into insulin producing cells with promising preclinical data thus far. An among the pharma giants, Novo Nordisk have a research program within cell therapy that the company believe will be in clinical development in the not-too-distant future.

While these new technologies are exciting, being able to monitor blood sugar use and apply appropriate insulin injection doses is essential for short and long-term help for diabetes patients. In that respect, Dexcom has revolutionized the monitoring side of disease burden. Dexcom’s sensors that are attached to the skin sends continuous blood sugar level information to external devices such as mobile phones or other wearable connected hardware. Reliability and ease of use has transformed the Dexcom from a single-digit billion-dollar market value company in 2018 to more than 62 billion dollars today. For Aurora LifeScience Dexcom’s market value has grown more than 210% since our first investment in the company.

From an investor point of view, the strong performance of these companies during recent years signals the society’s increasing interest in diabetes care. Investor’s continued trust in these companies shows commitment to make a positive impact by tackling diabetes, the biggest global pandemic of the 21st century.