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Test Strips and Meters from South Korea

Greetings from the bottom of my heart and the top of Seoul. I am writing you from South Korea where I am for two weeks at the invitation of one of the largest blood glucose meter and test strip manufacturers in the world.

People from i-SENS Inc., a company headquartered in Seoul that designs and manufacturers blood glucose monitoring systems, asked me to visit them this fall. In fact, they originally invited me to come last October. But I had to postpone my visit because I had an emergency operation for twisted small intestines at the beginning of that month, and my surgeon said I couldn’t travel.
For the first few days of my trip I am staying on the top floor of a hotel in the Seongbuk district of Seoul, near the company’s headquarters. With 24.5 million inhabitants Seoul is the world’s second largest metropolitan areas in population (after Tokyo and ahead of Mexico City, New York City, and Mumbai, in that order). Seoul has been Korea’s capital for more than 600 years.
On Friday I left Seoul for the day to visit the new factory that i-SENS built in Wonju city four years ago to make test strips for its blood glucose meters. I went with my friend and hostess, Margaret Leesong. The i-SENS director of international business relations, Margaret visited me in Boulder a couple of years ago, when we had a great hike together in the foothills of the Rockies.

Margaret lived in the States from 1973 to 1978 and then again from 1988 to 1996, when she moved to Australia, remaining there until 2005. After her college years at Seoul National University, she earned a Ph.D. in biophysics from Purdue University in Indiana and then an LLB (law degree) from the University of Sydney. She speaks flawless English.
When Margaret met me at the hotel on Friday morning, we took a taxi to the bus station, where we took a two-hour ride to Wonju, a much smaller city of about 300,000 people in northeastern Korea. From there a staff member who helped us as driver and tour guide from the company picked us up and took us to the factory.

This factory makes all of the test strips for the two dozen or so blood glucose meters that i-SENS sells around the world under both its brand name and that of many other companies as an OEM. In the U.S. its best selling meter is the CareSens N (the “N” stands for no-coding). The factory has a capacity of producing one billion test strips per year, making it one of the largest such factories in the world.

We started our visit by meeting the two founders of the company for lunch in the company cafeteria. We had the standard lunch of the day except the cafeteria staff added a salad for me and for the chief technology officer, who explained to me that salad isn’t typical lunch fare in Korea. Of course, lunch also included kimchi, a staple of the Korean diet, which so far I have had at every meal in Korea.

Lunch at the i-SENS Factory (Margaret, Dr. Nam, Four Visiting Professors, Dr. Cha, Me)

About 200 people work in production and QA at the Wonju factory. Another 80 or so people work in administration, sales, marketing, R&D, and other departments of the company in the Seongbuk district of Seoul.

The CEO, Geun Sig Cha, was one of the two men who founded i-SENS in 2000. Dr. Cha earmed a Ph.D. in chemistry from the University of Michigan and has a second full-time job as a professor of chemistry at a university in Seoul.

The CTO, or chief technology officer, Hakhyun Nam, earned a Ph.D. in chemistry from Michigan State University and also has a second full-time job as a professor of chemistry at the same school with Dr. Cha. Drs. Cha and Nam have worked together for more than 18 years in the same field.

I had not even expected to meet the company’s two leaders, much less to have such a pleasant and relaxed conversation with them over the course of many hours. When I did meet the CEO and CTO, I expected them to be stiff and standoffish. Quite the contrary, they were most welcoming and pleasant and cheerful, telling me that they have followed my work for many years.

After lunch, Dr. Cha, Margaret, and I toured the clean rooms of the factory. Completely decked out in hair coverings, robes, and slippers, we went in through an air shower that removed our dust. The factory struck me as being quite different from the other strip-making factory that I had toured a couple of years ago, Roche’s factory for making Aviva meter test strips in Indianapolis.

Dr. Cha, Margaret, and I Tour the i-SENS strip factory

Drs. Cha and Nam were interested in my comparisons of the two factories. The amazing thing was that they had never seen a factory for making test strips before they build their first factory between 2000 and 2003, when it went into production. Dr. Nam told me that his team designed the factory on their own, scaling up from the logic of laboratory design.

The other thing that surprised me most about the factory was that the employees seemed to have a good job. Far from working in the robotic environment that I assumed all factories in Asia had, their working conditions are pleasant and almost relaxed. And, of course, far from being the grimy, dirty environment I associate in my mind with factory work, their working conditions are as clean as we can have.

i-SENS is privately held, owned by its employees including not only Drs. Cha, Nam, and Leesong (i.e. Margaret), but also including staff like factory workers. I think that this ownership accounts for a lot of the good vibes I felt there. Several venture capitalist firms also own a part of i-SENS.

Ironically, the men who founded the company that helps millions of people around the world to control their diabetes themselves became pre-diabetic and diabetic this year. The CEO, Dr. Cha learned that he was pre-diabetic within days of when the CTO, Dr. Nam, learned that he had diabetes.
Dr. Nam told me that he started feeling very thirsty and also got so tired when driving from Seoul to the factory in Wonju that he often had to pull over to take a nap at a rest stop. Of course, he knew about diabetes but was sure that it wasn’t the problem, because nobody else in his family has diabetes. It wasn’t until his wife, a former nurse (professor now), suggested that he check his blood glucose that he knew.

About eight months ago, he bought a meter set from his company as a present for one of his friends. Of course, he bought an i-SENS meter. He set the time and few other basic parameters of the meter before he gave it to his friend. He then checked his own glucose level as a test. To his surprise, his blood glucose level was above 400 mg/dl, which he and I both know is incredibly high (a non-diabetic level is about 80 to 100). He couldn’t believe it. So he kept on testing — with similar results. That was really bad news because he knew then that either his work producing blood glucose meters and test strips or his body was faulty.

His body had failed him. Or, perhaps more accurately he had failed his body. With two full-time jobs he had tried to survive on fast food and little exercise. But, as Margaret says, Dr. Nam is a logical and determined man. He immediately changed his life, realizing that control of diabetes comes largely from more activity and less and better food. He began to run regularly and changed his diet to one based on a low level of carbohydrates. For example, he drastically reduced the amount of rice to less than 50 grams (a normal Korean meal provides a bowl of rice that alone contains about 200 grams); rice is one of the two staples of the Korean diet (the other staple, kimchi, could hardly be more healthy). He has never taken any diabetes medication and has now reduced his A1C level to the normal range of 6 or less.
He still had to eat out often, but by testing his blood glucose every half hour after a meal he began to see that apparently similar meals at different restaurants produced quite different blood glucose levels. As a result, he used blood glucose testing to evaluate restaurants and foods, a neat trick that I hadn’t heard of before.
I asked Dr. Nam to write his story in greater detail, because I knew that it can inspire others to follow his course. And Dr. Nam agreed to write it and send it to me by the end of the year so I could post it on the Web.

All i-SENS employees wear badges with their photos around their neck. Margaret pointed out that Dr. Nam’s photo shows the face of a man who was much heavier. I took a photograph of Dr. Nam holding up that picture near his present face.

Dr. Nam and His Old (Heavier) Photo

After our tour of the factory, we all went back to a conference room where Margaret narrated a video presentation about the company. Then, rather late on Friday afternoon we left the factory. Our driver and tour guide, a Mr. Lee from the factory, took Margaret and me to Chiaksan National Park, a few miles beyond Wonju. There we hiked a half hour up a trail along a mountain stream with oriental white oak and hornbeam trees that were beginning to change their color to brilliant red. We hiked up to Guryongsa, an ancient Buddhist temple complex where I took a lot of photos.

Guryongsa, a Buddhist Temple in Chiaksan National Park

By the time we left the temple the large bell gong was sounding the end of the day and the light was fading. We decided to go to dinner there rather than wait until we returned to Seoul, when it would be close to our bedtime. I’m so glad that we ate there, because we chose a traditional Korean restaurant with traditional country food. As usual, I took photos, including one of a cook preparing our meal. I got her to smile by saying, “kimchi!” The only word of Korean that I know, it’s one that photographers use the same way that we say “cheese” when we want people to get ready for a photo.

We ordered a hot and spicy fish stew that was delicious. It also came with about a dozen side dishes, including four or five forms of kimchi, a couple of delicious root plants related to ginseng, and tasty seaweed. The three of us came nowhere close to finishing all that the restaurant offered us. We sat on mats on the floor at a low table. While we ate the fish stew with a spoon, I fumbled for the side dishes with chopsticks.

Mr. Lee took us to the bus terminal for the long ride back to Seoul, where Margaret eventually got a taxi to take me to my hotel while she went to her home in the other direction in another taxi. Finding taxis was easy, but finding a driver who knew how to get to my hotel wasn’t. The first three drivers she asked had no idea where the hotel is. Finally, she found one who also didn’t know where it is but had a GPS in his taxi. He got me to my home away from home about 10 p.m., concluding a wonderful day the seamlessly combined business and pleasure as well as the good food and activity we all need to maintain our health.

This article is based on an earlier version of my article published by HealthCentral.

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