How a Diabetes Platform Can Help Lower A1c

There's a company I have been wanting to talk about for some time as I really have enjoyed their social media presence, and their approach to managing diabetes using digital health. One Drop is based in New York City and has been around for a bit. Their platform is FDA approved, and available for purchase through Amazon, and their website. But, the company itself is more interesting.

CEO Jeff Dachis has diabetes, and his difficulty managing the disease led him to found One Drop. Like many stories I hear in healthcare and tech, it's the personal experiences in their health or loved ones that leads many founders to explore and search for solutions, especially based on their frustrations with the current space. Often, I think this is why we get so many companies that have innovators with no medical backgrounds innovating in health—we who have been educated, and practiced in healthcare so long may be inclined to accept the current space for what it is without questioning it at times.

Jeff's solution though isn't too different from current interventions for diabetes care. The One Drop platform relies on users using an SMBG kit, and an app that takes all data collected, and compiles it in an excellent visual mechanism to spotlight great and bad readings. I do like the SMBG kit, called One Drop Chrome, as it comes in a sleek little carrying case. Members can subscribe for test strips and lancets through One Drop, with 50 test strips (testing 1-2/day) running at $16.95 a month, and 100 test strips (testing 3-4/day) running at $33.90 a month. But, one unique thing, is that users who test over +4/day can subscribe for $50.85 a month. I'm not sure how they keep track of this and make sure no users abuse it, and then sell them on the gray market, but I would hazard there must be a limit to some extent.

Their testing meter,I feel, hits the nail on the head, as compared to other blood glucose meters on the market, One Drop's is Bluetooth enabled. This foresight is beneficial, as while other companies created SMBG meters that tethered directly to a smartphone (to cut down on battery life, and ease data transfer) they were then suspect to updating the hardware if the phone changed. Take for instance the iPhone, which in the past 5 years got rid of the 30-pin adaptor, and phone jack many companies had been using.

But if One Drop was just a hardware company focused on SMBG alone, I do not think they could get to where they are today, and survive. Instead, One Drop has another cool feature, whereby members can subscribe to the use of Certified Diabetes Educators who review patients' collected data. This includes glucose levels, medications used, food (via their database), and activity monitoring. What is nice is that users don't just have to upload the data themselves to the app, as they also allow integration with other apps and platforms for data collection. For patients who want to buy this service, it runs at $129.95 a year.

Now, for some readers, the question becomes, 'How effective is all of this?' and you would be right to question that. Currently, other companies, and platforms are tackling similar issues, and like them, One Drop has recently released the results of some of their clinical trials using the platform that really made me want to write about them. Now, some of their publications are posters, though they also have some peer-revied papers as well, but the numbers are interesting. Using their platform for around 3 months seems to generate a decrease of A1c of about 1% to 1.3%. Other outcomes include helping the patient to remember to take their medications, track food better, and getting more activity.

Now, taking that as a whole, One Drop essentially delivers a system that costs about $200 a year out of pocket that can reduce A1c more than 1%. I would say that is worth noting, as only several drug classes can lower A1c to that extent, and they all have adverse effects. Take, for instance, the use of a sulfonylurea, such as Glyburide, which you can buy a month supply for cash at $4 ($48/year). While it costs $150 more than the medication, a platform such as One Drop could offer patients an alternative path that doesn't rely on pharmacotherapy, and its possible adverse effects, and costs associated with followup and clinical monitoring.

This is all just theoretical from my view. I am not sure how often patients were able to discontinue their treatments or what their medication loads in these trials were, but the case I want to make here is that these platforms taking a holistic view of a patient are very attractive to patients, as we will inevitably see more of them come around in the future.

Drug treatment won't go away anytime soon. But, for some patients, I feel recommending a platform to use adjunctively to help with therapy is a viable option that previously was more labor intensive. Thanks in part to the rise of technology, better data integration, and teleservices, patients can use many clinical services without leaving their homes, and still get a personalized touch. For those patients that lament the number of medications they are on, these interventions may be much more attractive in the long term.

Reference

One Drop website. https://onedrop.today/. Accessed April 2, 2018.