Tools for diabetes – 1/18/13

As I wrote about last month, I bought my dad an iPhone-connected glucometer from iBGStar for Christmas. I did a bunch of research on it at the time, and I already knew about all the companies with connected devices for diabetes from blogging, so I thought it might be helpful to share the breakdown of options out there and give my opinions on what I like and don’t like about them.

I should preface this by saying that this post is more about glucometers and logging glucose readings so it’s not totally relevant for all diabetics, just insulin-dependent diabetics. I think other connected devices like scales, activity trackers, and nutrition trackers are equally valuable for diabetics but I’m not covering them in this post.

The value, to me at least, behind any tool used to log glucose readings is that it 1) holds the person accountable to some other person or group that has access to that person’s readings (basically motivate them), 2) provides insight to the person about activities or meals or activities and associated glucose readings, 3) closes the feedback loop so users learn immediately how to correct a high or low glucose, 4) notify a loved or provider (call center, care manager, etc) if a reading is above or below a certain threshold, and 5) potentially give a provider useful information about a patient from between visits (this is a big “if” and depends on how the data is displayed to the provider, because a long list or even a list and trends without context is probably not very helpful). If you look at that list, all of the value I perceive in this is tied to using the data for something, not simply logging it and displaying it back to the user.

Tools to help diabetics keep track of glucose readings fall into 4 categories, with one to many offerings in each category. I’ll try to lay them out in order of  techniness, low to high.

app

Glucose Logger Apps. There are lots of options out there for this and, to be honest, none seems very good. I also haven’t seen any that have the features I’d want (the list above). I also don’t think you’re going to ever get consistent logging, or logging at scale, if it requires users to do that separate step from the actually glucose reading. The nice thing is that most of these apps are less than $5 and many times they are free. They also don’t require new, more expensive test strips. WellDoc is sort of in this category but it adds a whole bunch of clinical decision support for the patient and provider so is definitely a better option that just finding an app in an app store or marketplace.

Glucometer-to-device-cables (Glooko). To be honest I love this idea. It’s so simple. Use our $35 cable and turn almost any glucometer on the market into a smartphone-enabled glucometer. It’s cheap and users don’t have to worry about learning a new device or buying a new kind of test strip. I think I would’ve gotten the Glooko cable for my dad but it didn’t have FDA approval until this week (poor timing by the FDA to miss the holidays like that). I’m not very impressed with the features of the Glooko service and think they desperately need improvement. The logbook that it emails, at least based on the video above, looks horribly unfriendly to go through and I can’t see anything about enabling 3rd parties, especially family, to view readings. The price is great and with some added features, this could be the winner of the group.

ibgstar

Smartphone(iPhone)-connected glucometers (iBGStar). I have some buyer’s remorse about this one. It’s a cool looking device and I really wanted something that would make my dad’s new iPhone that much better for him since he’s a fan of it and always has it with him. The higher price of test strips (~$1.05/each vs my dad’s current cost of $0.50/each, might all change as he starts Medicare this month) and the need to apply for special programs to get them approved or discounted really sucks. Also, the app itself is horrible in my opinion and it does almost nothing that I listed above on my list of features. iBGStar got out into the market fast, with FDA approval, and it’s for sale at Apple Stores, but I think it’s going to have a hard time staying ahead of Glooko or Telcare unless it makes some major enhancements.

telcare

Wireless-enabled glucometers (Telcare). I’m still a little torn on Telcare. I really like the product and I love the service it provides. It’s done the best job integrating caregivers and layering in social. The main problem I have is the price ($150) and then the fact that you have to buy Telcare strips (also about $1.05/each). I know glucometers make recurring revenue on the strips but with almost no competition Telcare has very little pressure to reduce the price of these things. But then I go back to all the features Telcare has that would personally help me with my dad.

In the end, I probably would’ve been happier if I’d gotten the Telcare device or the Glooko cable. Glooko is cheaper and requires less change but doesn’t have all the features. Telcare locks you into strips but is currently such a superior service. Does anybody have similar experiences with these that they’d like to share? I’d love to get another opinion.

Finally, a really interesting company I’ve been following since it entered Rock Health’s first class a few years ago, Omada Health, launched its service for pre-diabetics recently. The service is called Prevent and it’s a 16-week program. The service is all about lifestyle change and comes with a connected scale and pedometer. Since it’s prediabetes, the goal of the program is to teach participants to eat healthier and be more active, ultimately aiming to lose weight and prevent progression from prediabetes to diabetes. Individuals are enrolled in groups so they can share experiences and get support along the way. There are also health coaches and other guidance. At the end of the program people roll over to the alumni network so they can continue to get support, be engaged, and sustain the positive changes they made during the program.

I think I’ve said this before but prediabetes to me seems like a very hard, yet massive (79 million prediabetics in the US), problem to tackle but I really like the Prevent approach. It combines technology with social, closes the feedback loop, and is about helping people instead of blaming them. I’m excited to see the kind of success that Omada has with Prevent and if there are other programs in the works for the company.

TGphoto

Travis Good is an MD/MBA involved with health IT startups. More about me.

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