In a conversation with ETHealthworld’s Rashmi Mabian, Dr. Arabinder SinghalCo-Founder and CEO, Butterflyspecifies the growth of Digital therapy in the management of Diabetes And new initiatives are being launched by the company.
Do you see diabetes management through digital therapeutics in India?
According to statistics, the digital therapeutics market is growing at a CAGR of 31.4 percent and will be valued at $35.78 billion by 2030. Among other factors, behind the pandemic is widespread awareness of the benefits of digital healthcare’s impact. This growth. Due to the fact that diabetes is seen as a problem that can worsen covid and other infections, people realize 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 routines and continuous monitoring that has been proven to reverse diabetes in newly diagnosed patients. Even in long-term diabetes, doctors are recommending digital therapy as it can help in better medication adherence and sugar control.
The popular belief is that living with diabetes means a lifetime of constant medication, food restrictions and lifestyle changes. There is also mental stress about a potentially harmful condition in many other ways. So, once one is diagnosed, the first choice is to explore drug options. Ironically, crash diets, emphasis on weight loss and the like do not prove to be sustainable in the long run. This underscores the need for a scientifically researched, validated, convenient and digitally administered therapeutic option that can appeal to audiences across India.
In your opinion, what are the main challenges that exist in diabetes management and how is Butterfly working to solve them?
There are four main challenges surrounding the management of diabetes: poor outcomes due to a one-size-fits-all approach to treatment; zero motivation or interest in workouts; managing stress and sleep cycles; Ensuring compliance and regular monitoring. We address these challenges through a four-pronged approach. We have created a Sugar Response Engine (Personal Glycemic Response) for 37,000 Indian foods by calculating their effect on blood sugar through a continuous glucose monitor. This helps identify and recommend specific foods that will help a person manage and reduce their sugar levels.
This type of smart technology-based diet plan is completely personalized and treats people on an individual level. We ensure that they eat not only the foods prescribed to them, but also the right quality and quantity for better results. In terms of maintaining physical fitness, our coaches help people start exercising, manage pain and get used to a structured workout plan.
Any successful diabetes care plan should integrate stress management into its fold and emphasize the importance of sleep quality and quantity. Our panel of psychologists and counselors help patients reduce stress and overcome challenges like fatigue, poor sleep quality, etc.
Finally, we recommend that people monitor their sugar levels regularly and share the data with their doctors to ensure that specific medications help where needed. The whole system is working very well, and we see the blood sugar levels coming down in 3-4 weeks, after which we consult the doctors to reduce/change or change the medicine.
How will the real-time CGMS Insights Engine, to be launched in October, enable Diabetes?
Managing diabetes requires regular blood sugar monitors. The traditional method of doing this is by using a glucometer. The problem is that while people may have glucometers at home, they don’t use them often because it’s painful to pick up and test blood. On average, most people with diabetes check their sugar once or twice a month. Even in patients with uncontrolled diabetes, the frequency of examination is not more than once or twice a week. Thus, given the current ecosystem where adherence to appropriate regimens is very low, painless sugar monitoring with CGM or continuous glucose monitoring becomes an enabler. According to reports, India’s CGM market is expected to register a CAGR of over 17 percent during 2022-27.
CGMS devices have been available in India for the past 5 years and are only used to understand blood sugar variations and change medications. We were the first company in 2019 to start using CGM data to plan better meals. Although the CGM provides data every 15 minutes we collect it every seven days and then retrospectively correlate it using our proprietary meal mapping technology to generate personalized glycemic response insights. This lets us know how different foods and activities affect sugar levels and what can be done to lower blood sugar or medication.
With the launch of the real-time CGMS insights engine, people will be able to view their sugar data multiple times a day and monitor their sugar levels in a smart way. Suppose if blood sugar is elevated, our technology can suggest ways to bring it back to normal first. Real-time insights will enable them to make quick changes to their meal and exercise plans on a daily basis. This will result in a rapid drop in blood sugar. Also, this will increase engagement and significantly improve results.
Can you tell us about the Heart Health DTX program to be launched in April 2023.
Among all chronic conditions in India, heart disease and hypertension are the top two problems, and both are associated with diabetes. Poor management of diabetes, unhealthy diet, smoking and sedentary lifestyle are some of the main causes of these problems. Even in our current diabetes cohort, 40 percent of people with either hypertension or early heart disease, their BP medications come down and lipid profiles improve. Thus, many of our learnings are being translated into heart health programs and we believe that if we can make people understand their heart health and condition through advanced technology and make them aware of ways to age and improve their heart health, it can lead to collective change. can This includes reducing the prevalence of heart disease, better management of health conditions, and reduction of medications for problems such as hypertension and high cholesterol.
We are starting our heart health clinical study in November 2022, and the program will be completed in March. After that, we plan to enroll 1000 to 2000 patients per month in our heart health DTx from April 2023 onwards. We expect a very positive response from patients and doctors as this program will be able to bridge the huge healthcare gap in this area. This program will also be of great help to corporates and insurance companies.
As a digital therapeutics company, how much market share do you want to gain in the next 5 years?
While the overall estimated number of people affected by diabetes and pre-diabetes is expected to be around 170 million, the percentage of net and digital technology literate people is expected to be around 20 percent of them. We hope to capture 10 percent of this market of around 3 million people. Heart health overlaps with this, and we plan to reach another two million people with heart disease over the next five years with our programs.
