When Adam Berger, 29, who has Type 1 diabetes, decided to get a sandwich from a deli, he first ran it by his mobile application ezbds, which he launched in Stamford two years ago.
The app told him that in the past when he’d eaten that particular sandwich from the same deli, he hadn’t experienced glucose spikes. “So I decided to stick with it,” Berger said. “An hour later when ezbds reminded me to check, my glucose was 123.” That’s a good number according to the American Diabetes Association (ADA), which suggests a target of less than 180 mg/dL an hour or two after beginning a meal for adults with diabetes.
“By tracking what they eat, people can identify how certain foods affect their blood sugar,” said Nancy Salem, coordinator of the Diabetes Education Program at Danbury Hospital. “Apps have made it a lot easier for patients to make better choices.”
Berger’s ezbds LLC is among a handful of Connecticut startups with diabetes apps competing in a market cluttered with more than 165,000 health apps, according to the Danbury-based IMS Institute for Healthcare Informatics.
But adaptation remains a challenge. The September 2015 IMS study found that 40 percent of apps had less than 5,000 downloads.
“It’s very difficult,” Berger said. “There’s resistance to new technology.” Even though ezbds is downloadable for free, it has just 1,200 users to date.
The new players have limited product differentiation and are vying for marketshare with established apps such as dLife’s Diabetes Companion, Glucose Buddy from SkyHealth, iDiabetes from iHealth Ventures, Track3 from Coheso, GoMeals from Sanofi-Aventis, and One Drop from Informed Data Systems. Some apps are downloadable at no cost, but others are priced from $2.99 for iDiabetes to $5.99 for Track3.
The use of smartphone apps to manage diabetes is part of the conversation that many doctors are having with their patients. Doctors say that self-management drives better health outcomes and apps enable accountability.
“A good diabetes app helps patients track their numbers—blood glucose readings, carbs, calories and weight. Some even let you map your emotions, stress, and sleep,” said Dr. Yi-Hao Yu, director of endocrinology at Greenwich Hospital’s Center for Behavioral and Nutritional Health.
Bunny Kasper, 73, of Hamden credits the Dexcom’s Share app with saving her life. She was asleep when the app notified her son in Massachusetts in the middle of the night that she was experiencing a hypoglycemic episode.
“I was almost semiconscious when my son got the alert,” Kasper said.
At Saint Francis Hospital and Medical Center in Hartford, health care providers help patients chose the best app. “The average patient doesn’t have the know-how to find the right app,” said Dr. Latha Dulipsingh, director of the Center for Diabetes and Metabolic Care at Saint Francis. “Most of my patients’ app data is reviewed by the diabetes educator. We [doctors] make a lot of medication changes based on patterns we see.”
Educators at Dulipsingh’s center, one of 11 facilities statewide to offer the Centers for Disease Control and Prevention-recognized National Diabetes Prevention Program, suggest apps as an additional tool.
About 250,000 adults (8.9 percent) in Connecticut have been diagnosed with diabetes, according to the state Department of Public Health’s 2016 report. More than 83,000 adults have prediabetes.
And diabetes is an expensive disease to treat. According to latest data from the ADA, diabetes cost Connecticut an estimated $2.92 billion in 2012. A single injectable drug, Lantus Solostar, priced at $395 for a five-pack, is among the 10 most prescribed drugs in the HUSKY Health program.
Companies claim apps enable better self-management and thereby help lower health care costs through reduced hospitalization and emergency care.
According to a February 2014 study published in US Endocrinology, just one smartphone app alone, from Massachusetts-based Telcare Inc., helped drive a reduction of $3,300 in annual health care costs among employees with diabetes.
Despite opportunities, app makers are struggling. New Haven-based Applivate LLC has exited the business after turning over to Tolland-based Loon Medical Inc. the ShugaTrak app, which transfers blood glucose measurements from the glucose meter to a secure database for review by medical professionals. Plans are underway to expand the rebranded SensaCare’s connectivity with a wider range of glucometers, and link it to other parameters that impact diabetes, such as weight.
“We’re starting our first clinical study to track blood glucose levels,” said Joel Douglas, chief technology officer for Loon Medical. “Hospitals want data to prevent readmissions as they get penalized by Medicare for too many readmissions within 30 days. We’ll provide them with graphs and hundreds of readings.”
This fall BetweenMD LLC in Farmington is set to launch its diabetes app that can be connected to any Bluetooth-enabled device. The market? Self-insured employers seeking to cut medical costs for their diabetic employees. “Costs [of employee medical expenses to a company] can run on average about $10,000 a year,” said Andy Quinn, co-founder. “I’m also to looking to partner with companies that have connections with doctors.”
Biorasis Inc. of Storrs is developing an app to run its grain-sized implantable glucose sensor wirelessly and to collect and store data. “Biorasis is testing the system on the International Space Station, where the absence of gravity allows us to study sensor accuracy,” said Ilze Krisst, chief operating officer.
C-HIT is hosting a free community forum on diabetes from 5 to 7:30 p.m., Thursday, at the Lyceum, 227 Lawrence St., Hartford. The event includes a cooking demonstration and sampling of health food choices by Becky Stevens-McGuigan, executive chef at The Kitchen at Billings Forge, followed by a panel discussion with top doctors and dietitians. Live Spanish translation will be available. For information and to register click here.