Is this just an exercise in futility?

Is this just an exercise in futility?

It seems that a day does not go by when yet another company comes along with what they think is a new twist on what’s really an old idea. That they have built a better mouse trap. This is exactly what’s happening in the world of interconnected diabetes management (IDM). Earlier this week we reported on how Glooko raised more money and how companies like TelCare, iHealth and Livongo have a chance to change the dynamics of the glucose monitoring market. We also noted that it won’t be long before the big four of the major BGM companies becomes the big one and little three.

Well it turns out we have yet another entrant to the IDM/BGM world, say hello to OneDrop the brainchild of Jeff Dachis, the former CEO of Razorfish and now person with diabetes. Rather than go into a detailed explanation of OneDrop Diabetic Investor recommends checking out an excellent piece written by Amy Tenderich at

What Diabetic Investor found interesting about OneDrop was not necessarily the device, the app or even the Shave Club for Men revenue model as quite frankly none of this is all that new. The OneDrop twist is they believe that people with diabetes want to share not just their data but other personal information with fellow diabetics who in turn will help each other better manage their diabetes. That it takes a village to better manage diabetes. Which when you think about it really isn’t a new idea either as web sites like Children With Diabetes have been doing this exact same thing for years. What’s different with OneDrop is the platform not the idea.

Given his background don’t be all that surprised if Mr. Dachis is able to raise a ton of money or get companies like Apple or Google interested in working with OneDrop. As we noted just the other day while we’re not sure who will win this race to develop the winning IDM system, we do know that if patients don’t achieve better outcomes this is just an exercise in futility. This is not about way cool devices with way cool apps this is about improving patient outcomes. If sharing data with other diabetics helps achieve this goal then great if not who cares.

Now with all this whiz bang way cool technology on the horizon from these newbies to BGM combined with the changing dynamics to reimbursement one just might think the majors don’t stand a chance. That it’s just a matter of time before Johnson and Johnson (NYSE:JNJ), Abbott (NYSE:ABT), Roche and Bayer fold up their tents and exit the BGM business. Well this may be true for some but we’re not sure it’s true for JNJ. Yes Diabetic Investor still believes that if the right offer came along JNJ would be out of diabetes faster than Iowa State was out of the NCAA tourney.

Yet short of that JNJ should be commended for actually developing a simple very patient friendly glucose meter which doesn’t send readings to cloud nor does it come with a fancy app. For the past few weeks Diabetic Investor has been testing the new OneTouch Verio and frankly have been very impressed. Yes a user can upload readings to the cloud and then share this data it’s just not done automatically and quite frankly it’s still cumbersome to do so. No what Diabetic Investor liked about the system was it use of colors and simple messages sent to the user right on the meter.

Now to be clear here we are not for a moment saying this meter is the end all be all. Yet for an educated patient, someone who understands what all this data means and how to use this data, this does the job nicely without all the fancy bells and whistles. Perhaps one of the most overlooked factors by every company in diabetes management is what we like to call ‘diabetes fatigue”. As we have stated on many occasions properly managing diabetes is job, a job with no days off and quite frankly a job which at times can be very stressful. And if diabetics are honest about it there are times when we are either lazy or get sick of constantly managing our diabetes.

Although the messages the system sends can be annoying at times, they do serve a purpose as they remind a patient in a non-threatening way of how they are doing. The messages are simple, positive when the data warrants and not condescending when the data isn’t what it should be. All this without hooking up to a smartphone, sending readings to the cloud or having a way cool app. The beauty of this system, at least for the educated patient, is its simplicity.

Again let’s be clear here, this system works for Diabetic Investor because we understand what these numbers mean and know how to use them. This unfortunately is not the case for the majority of patients which is why some of these new systems just might not work. The big question then becomes can a company like OneDrop, TelCare, iHealth, Livongo or Glooko with all their way cool whiz bang technology solve the toughest problem of all – getting patients to test their glucose on a regular basis.

As we have noted on many occasions if there is no data to analyze it doesn’t matter which system a patient uses. This is something that is consistently overlooked with all these new systems as they are facing the same problem as their larger competitors. How do they convince people who aren’t testing as frequently as they should to change their behavior?  For without this data or enough data there is nothing for the app to analyze and it doesn’t matter how many people are in the village.

Now this points to the next obvious issue in that while all these companies say they want to help everyone with diabetes, insulin and non-insulin patients, their marketing efforts are focused on patients who use insulin. This is understandable but also limiting in terms of future revenue potential plus it’s also a highly competitive market. IF and this one huge IF, IDM has any chance at all it must produce better outcomes not just for insulin using patients but all patients with diabetes.

As it stands today Diabetic Investor believes that there aren’t enough insulin using patients nor is the number growing fast enough to support all these newbies who have way cool whiz bang systems. We also see growth limited even further as more non-insulin patients who are failing oral therapies move onto not insulin but long-acting GLP-1’s, drugs which don’t require regular glucose monitoring.

Listen we know how exciting all this seems and yes it’s easy to get excited about way cool whiz bang technology. However this market is not about way cool whiz bang technology this is all about outcomes. Diabetic Investor admires the passion these newbies have but it will take more than passion or money to succeed in the increasingly crowded IDM space. Just because we have new technology does not mean some very old issues have gone away.