‘Digital therapeutics have proven to help in reversal of diabetes’, Health News, ET HealthWorld
In an interaction with ETHealthworld’s Rashmi Mabiyan, Dr Arbinder Singal, Co-Founder, and CEO, Fitterfly, elucidates the growth of digital therapeutics in the management of diabetes and the new initiatives being launched by the company.
Do you see the management of diabetes through digital therapeutics picking up in India?
As per statistics, the digital therapeutics market is growing at a CAGR of 31.4 per cent and will be worth $35.78 billion by 2030. Among other factors, widespread awareness about the benefits of the impact of digital healthcare in the wake of the pandemic, are behind this growth. The fact that diabetes is seen as a problem that can worsen COVID and other infections, makes people understand that managing or reversing it through digital therapeutics is a better option. Digital therapeutics is a comprehensive and structured system integrating dietary changes, personalization, workout routine, and continuous monitoring which has been proven to lead to reversal of diabetes in newly diagnosed patients. Even in long-term diabetes, doctors are recommending digital therapeutics as it can help in superior medication adherence and sugar control.
The prevalent belief is that living a life with diabetes means a lifetime of continuous medication, food restrictions and lifestyle changes. There is also mental stress about the condition being potentially harmful in many other ways. Therefore, once someone is diagnosed, the first preference is to find out alternatives to medication. Ironically, crash diets, emphasis on weight loss and other such things donтАЩt prove to be sustainable in the longer run. This underscores the need for a scientifically researched, validated, convenient and digitally driven therapeutic alternative that can appeal to audiences across India.
According to you, what are the major challenges that exist in managing diabetes, and how is Fitterfly working to solve them?
There are four main challenges around managing diabetes: poor outcomes due to a one-size-fits-all approach of treatment; zero motivation or interest in workouts; managing stress and sleep cycles; ensuring adherence and regular monitoring. We address these challenges through a four-pronged approach. We have built a sugar response engine (Personalised Glycemic Response) for 37,000 Indian foods by calculating their effect on blood sugar through continuous glucose monitors. This helps identify and recommend specific food items which will help an individual manage and lower their sugar levels.
This kind of smart technology-based diet plan is completely personalized and treats people at an individual level. We ensure that they not only eat the food items specified to them, but also the right quality and quantity for better outcomes. In terms of maintaining physical fitness, our coaches help people get started with exercise, manage pain, and become habitual of a structured workout plan.
Any successful diabetes care plan must integrate stress management into its ambit and underscore the importance of sleep quality and quantity. Our panel of psychologists and consultants help patients reduce stress and overcome challenges such as fatigue, poor sleep quality etc.
Lastly, we recommend people to regularly monitor their sugar levels and share the data with their doctors to ensure accurate medication support wherever needed. The entire system has been working very well, and we see blood sugar levels go down in 3-4 weeks, after which we consult doctors to reduce/alter or substitute the medication.
How will the real-time CGMS insights engine which will be launched in October for diabetes be an enabler?
Management of diabetes requires regular blood sugar monitoring. The traditional method of doing this is by using a glucometer. The issue is though people may have a glucometer at home, they donтАЩt use it very frequently since it is painful to prick and test the blood. On average, most people with diabetes check their sugar once or twice a month. Even among patients who have uncontrolled diabetes, the frequency of checking is no more than once or twice a week. Thus, given the present ecosystem wherein adherence to a proper regime is very low, painless sugar monitoring with CGM or continuous glucose monitoring becomes an enabler. As per reports, the India CGM market is expected to register a CAGR greater than 17 per cent during 2022-27.
CGMS devices have been available in India for last 5 years and have been used for understanding only blood sugar variations and changing medications. We were the first company in 2019 to start using the CGM data to plan better foods. Though CGM provides data every 15 min but we collect it every seven days and then retrospectively correlate using our proprietary meal mapping technology to generate personalized glycemic response insights. This enables us to know how different foods and activities affect sugar levels, and what can be done to reduce blood glucose or medication.
With the launch of real-time CGMS insights engine, people will be able to see their sugar data many times a day and monitor their sugar levels smartly. Suppose if the blood sugar has gone up, then our technology can suggest them ways to bring it normal earlier. The real-time insights will enable them to make quick changes in their meal and exercise plans on a daily basis. This will result in faster turnaround and lowering of blood sugars. Also, this will enhance engagement and significantly improve outcomes.
Could you tell us about the heart health DTx Program planned to be launched in April 2023.
Among all the chronic conditions in India, heart diseases and hypertension are the top two problems, and both are correlated with diabetes. Poor management of diabetes, unhealthy eating habits, smoking, and a sedentary lifestyle are some of the main causes of these problems. Even in our current diabetes cohort, 40 per cent of people have either hypertension or early heart disease, their BP medications come down and lipid profile becomes better. Thus, a lot of our learnings are getting translated into a heart health program and we believe that if we can make people understand their heart health and condition through advanced technology, and make them aware of the ways to increase their heart age and health, it can lead to a mass transformation. This includes reducing heart disease prevalence, better management of health conditions, and even reduction of medication for problems like hypertension and high cholesterol etc.
We are launching our Heart Health clinical study in November 2022, and the programme will be completed in March. After that, we plan to enroll 1000 to 2000 patients every month in our heart health DTx from April 2023 onwards. We are expecting a highly positive response from the patients and doctors alike because this programme will be able to fulfill a major healthcare gap in this arena. This program will also help corporates and insurers in a big way.
As a digital therapeutics company, what is the market share that you are looking to capture in the next 5 years?
While the overall estimated number of people affected by diabetes and prediabetes is expected to be around 170 million, the percentage of net and digital technology savvy people is expected to be around 20 per cent of that. We hope to capture 10 per cent of this market which is about three million people. Heart health has an overlap with this, and we plan to have another two million people with heart disease benefitting from our programs in next five years.
