Many of the startups that participated on the recent L’Atelier Learning Expedition to Silicon Valley, focusing on ‘The Future of Health’, are working on the thorny subject of chronic illness, diabetes in particular.

Silicon Valley startups working on diabetes management tools

According to the American Diabetes Association, close to 30 million US citizens suffer from diabetes and the number is growing, with 1.4 million new cases identified each year. A high percentage of senior citizens fall prey to this chronic condition: some 26% of the US diabetic population is at least 65 years old. Diabetes is the seventh leading cause of death in the United States, being directly or indirectly responsible for close to 300,000 deaths every year.

The illness is moreover very expensive for US society, costing close to $322 billion annually. So it is perhaps unsurprising that quite a number of entrepreneurs in Silicon Valley are working to improve diabetes management. The market has seen the emergence of startups, such as Mountain View, California-based Livongo Health, producing connected glucose meters. This company, which raised $44.5 million in Series C financing in April and now has total equity funding of around $90 million, has developed a solution combining hardware and software. It comprises a connected glucose meter, which aggregates data linked to physical activity and provides real-time summaries to users. The glucose meter is also linked to a mobile app through which users can access a coaching module provided by healthcare professionals.

While some startups are developing new hardware, others specialise in finding ways and means to analyse glycemic and insulin data, with the aim of providing real-time recommendations to patients. Glooko, a company on which L’Atelier reported some time ago, raised $36 million to develop a mobile app for monitoring diabetes, which is compatible with more than 40 glucose meters currently on the market. The data collected on glucose and insulin levels can be directly downloaded from the smartphone app, which also takes into account available information on the patient’s physical activity and nutrition in order to be able to come up with more precisely tailored recommendations.  Users will be alerted whenever their results look worrying and the extra data collected can also feed into a general practitioner’s diagnosis.

A number of the startups visited by participants on the recent Connected Healthcare Learning Expedition  organised by L’Atelier to Silicon Valley are taking innovative approaches to improve the way diabetes patients manage their condition. Expedition members had the opportunity to meet a variety of players in this field, ranging from institutions positioned halfway between the academic and private sectors – such as the Center for Information Technology Research in the Interest of Society (CITRIS), a collaboration among the University of California campuses based at Berkeley; and SRI International, a US non-profit research institute headquartered in Menlo Park, California –  to a number of commercial startups specialising in the health field.

Smartphone doubling as a glucose meter

Smartphones – which now boast high-quality cameras plus greatly increased calculating power – are now demonstrating their usefulness in the field of medical analysis. Peek Vision transforms phones into low-cost retina analysis tools, which are proving of real benefit in regions of the world where access to healthcare is still insufficient. The University of Washington is currently also developing a smartphone-based solution for diagnosing anaemia. Meanwhile, Californian startup Nexpaq, founded by Max Wasmer and Jason Ko, has come up with a modular smartphone case with open slots on both sides for add-on modules – equipped, for example, with sensors – to fit into. This is intended to help boost the smartphone’s functionality, which could then include a solution for measuring the user’s glucose levels. Nexpaq, which is currently going through an incubator programme with Wearable IoT World in San Francisco, is looking for partners to help exploit the many potential applications of its product.

Connected textiles offer potential for monitoring diabetes

When diabetes is badly managed over too long a period, the resulting narrowing of the arteries can lead to inadequate oxygen flow and diminished sensitivity of the nerves in the lower limbs. In the most serious cases, limbs may have to be amputated. The website of the American Diabetes Association states that “in 2010, about 73,000 non-traumatic lower-limb amputations were performed in adults aged 20 years or older with diagnosed diabetes”, and points out that “about 60% of non-traumatic lower-limb amputations among people aged 20 years or older occur in people with diagnosed diabetes”.

Founded a year ago, Siren Care is the first company to develop ‘connected’ textiles to improve diabetes monitoring. This fledgling firm has developed a sock with embedded sensors that measure the wearer’s foot temperature on an ongoing basis. Via a user-friendly mobile app, Siren Care warns a user if the data fed back give cause for concern. Pre-ordering for the socks started last week. For the modest sum of $30 a month, Siren Care provides seven pairs of socks that you can machine-wash. The Siren Care solution also has potential uses in the textile and military industries.

Precision medicine and telemedicine join forces to manage diabetes

“$140 billion is spent every year on dealing with complications and hospitalisations resulting from poor diabetes management,” underlined Marlon Castillo, founder of insulin adjustment mobile app developer DoseDR at the Y Combinator Winter 2016 Demo Day. However, the number of endocrinologists working in the United States has slumped over the last ten years. By combining telemedicine and precision medicine DoseDR plans to drastically reduce the number of diabetes patients admitted to intensive care units with complications. The DoseDR app draws on data from the glucose meter, enabling advice to be given on the amount of insulin that a patient should inject, based on the view of a team of specialists. The company, which launched in January and currently has 300 patients, has signed a partnership agreement with Stanford Health Care, the most ‘connected’ hospital in the United States, to test its solution.

Return of the ‘smart’ pill container

‘Medical adherence’ – i.e. the extent to which a patient correctly follows medical advice and prescribed treatment – is still a major challenge for the health sector, especially as regards compliance with medication programmes. “In the United States, there are over 125,000 deaths a year linked to non-adherence. In addition, patients’ failure to take medication correctly costs the health system $290 million a year. These are avoidable costs,” argues Jeff LeBrun, cofounder of Pillsy, a startup which has developed a connected ‘smart’ pill container and mobile app. Poor medical adherence is also very costly for the pharmaceutical industry. US pharmaceutical companies’ budgets for patient adherence activities to address this problem have risen by 281% over the last three years.

Seattle-based Pillsy has developed a ‘smart’ pill container designed to serve as a sort of medical personal assistant. The container collects data on a patient’s pill-taking record. The hardware-plus-mobile-app solution enables reminders to be sent, helps patients to plan their pill-taking, and monitors side-effects and symptoms. Instructions for use of medicaments can also be digitised and feedback from a number of patients can be aggregated through the app. Pillsy is currently taking part in a brand new ‘Digital Health’ programme  run by venture capital seed fund and accelerator ‘500 Startups’ in San Francisco.

All in all, whether we are talking about hardware or software products, or both, the solutions being developed by Silicon Valley startups seem well on the way to improving the daily lives of diabetics.

By Pauline Canteneur