Microsystem technology (MST) is set to revolutionize monitoring and diagnostics. Over the next 10 years, a large number of new sensor technologies are likely to be developed which, because of the manufacturing economies of scale that are possible with MST, can be low-cost, and thus, single-use. Simple measurements of blood pressure were the first medical application of MST, but in the future the characterization of individual cell behavior will be possible, and within the cell, analysis of DNA will enable more accurate diagnosis of many medical conditions.

Diabetes is one of the largest potential point-of-care (POC) applications for MST. In the U.S. alone, there are approximately 16 million diabetics, with many of them needing to monitor blood glucose levels frequently to avoid hypoglycemia, which can cause fainting, coma or death, and persistent high blood glucose concentrations (hyperglycemia) which can damage the retina, kidneys, nerves and circulatory system. Glucose concentrations are usually monitored in vitro by electrochemical or optical techniques. This requires a small sample of blood obtained by means of a fingerstick, which is painful and often discourages patients from regular monitoring.

Many MST methods are under way to find ways of monitoring glucose concentration noninvasively or by an implanted glucose sensor. The GlucoWatch from Cygnus (Redwood City, California) is a watch-sized monitoring system that uses a small electric current to extract fluid from under the skin. Glucose in this fluid is measured using special sensor pads that are replaced daily. The MiniMed (Sylmar, California) system uses a subcutaneously implanted sensor that can provide readings for up to three days. The sensor is located inside a small needle, and once it is inserted into the skin, the sensor remains in the subcutaneous tissue while the needle is removed and discarded. A thin wire connects the sensor to a glucose monitor and memory unit. The FreeStyle blood glucose monitor from TheraSense (Alameda, California) is not fully noninvasive, since it still requires 0.3 microliters of blood as compared to 1 microliter for standard systems. Nevertheless, this smaller blood sample means that blood can be drawn almost painlessly from the arm. Disetronic (Burgdorf, Switzerland) has exclusive distribution and marketing rights for the FreeStyle system in most of Europe and nonexclusive rights in the U.S.

The Precision Xtra test from MediSense (Waltham, Massachusetts) is a monitor that can measure ketones as well as glucose levels in blood. Diabetic ketoacidosis can occur where blood glucose levels are over 300 mg/dl over a period of time. Up to now, ketone levels were checked by a urine color change test, interpretation of which was subjective, with the test providing historical information several hours old.

Provalis (Deeside, England), formerly called Cortecs, last spring launched in Europe the Glycosal glucose monitor, which is currently sold in 15 countries, with sales to date of around 1,000 units. The company recently reported marketing approvals in the U.S. and Japan.

Tracking down 'diabetes genes'

Non-insulin-dependent diabetes mellitus (NIDDM) affects some 90 million people worldwide. This number is projected to double in the next 10 years, by which time treatment of the disease and its complications is likely to account for 10% to 15% of all medical costs globally. Factors implicated in this spectacular progression of NIDDM include industrialization and lack of exercise. However, predisposing genetic factors also exist.

To help identify these factors and to provide new tools for prevention and therapy, six European research teams have joined forces in a European Union-funded Biomed project: "Identification of the genes involved in the pathogenesis of NIDDM: a paradigm for multifactorial diseases." Their work already has cast light on a network of nuclear transcription factors produced by the pancreas and important in its formation. These factors control energy expenditure and blood glucose levels in response to metabolic signals. Transcription-factor mutations appear to be linked to some forms of NIDDM. In other forms, the transcription factors become down-regulated as the disease progresses, a mechanism which may explain why diabetes evolves unfavorably even when treatment is initially successful.

These findings offer new prospects for treatment of NIDDM, if drugs can be developed which enhance the action of these factors or prevent their down-regulation.

Degussa to sell dental interests

Degussa-Huls (Frankfurt, Germany), the specialty chemicals company formed in 1999 by the merger of Degussa and Huls, is preparing to sell its dental subsidiary in Frankfurt, Germany, and South Plainfield, New Jersey, in a transaction that could be valued at up to $500 million.

UBS Warburg, on behalf of the company, has approached possible buyers, thought to include five strategic and five financial investors. The auction, which was to start before the end of February, is expected to be concluded by the end of June. Degussa's dental subsidiary makes materials for dentures, fillings and orthodontics. Although Degussa does not break out the results of the dental operations, these are part of its Health and Nutrition arm, which last year saw sales rise 16% to $1.7 billion.

After the Degussa/Huls merger, the company said it expected to divest non-core divisions over the next few years. In addition to the dental unit, these include Asta Medical, the DMC precious metals activities, a phenol chemicals unit and Degussa Bank. The company said it expects to raise more than $4.5 billion through its disposals.

Secure transmissal system for France

Nets@nt , which is part of Groupe europMedica (Labege, France), has brought together a majority of the French companies providing laboratory information systems to hospitals in France. Europmedica covers more than 70% of the hospital market, both private and public, in France.

Nets@nt has been set up to address widespread concerns regarding security and confidentiality of medical information transmitted over the Internet, and has established a secure server,, which enables French diagnostic laboratories to transmit to physicians or clinics results of analyses made at their request.

Laboratory information system suppliers working with Nets@nt include Setec Sant (Nanterre), Hexaflux-SMS (Rungis), SAERI (Nogent-sur-Marne), TGS in Situ (Nice) and TSI (Meylan). The server also is available to the national Health and Social Security network and the Atmedica medical portal. This means that it can be accessed by all physicians who have PCs with RSS connections or any Internet access.

IBM signs $1.7B deal with AstraZeneca

In a $1.7 billion deal signed with AstraZeneca (London), IBM (Armonk, New York) has contracted to provide global information technology infrastructure for the company. The seven-year outsourcing deal is the largest of its kind in the pharmaceutical industry and confirms the increasing dominance of large companies in the sector.

Paul Burfitt, AstraZeneca's chief information officer, said the deal will allow the company to focus IT resources on higher-value activities.

Up to 1,200 AstraZeneca IT staff, mostly in the U.S., UK and Sweden, are to transfer to IBM. The companies said that no redundancies were expected. The deal adds to IBM's lead in the growing European outsourcing market.