The Internet is buzzing with talk about the new Apple Watch that you can now pre-order and will hit the market later this month. And a big part of that buzz is about new mobile health apps, including some aimed at diabetes.
CGM (continuous glucose monitor) vendor Dexcom already has two FDA-approved apps ready to go for viewing CGM data on the Apple Watch, and we've reported on others including the BG monitoring and sharing app OneDrop and the GlucoSuccess app from Massachusetts General Hospital.
Of course there's already a myriad of diabetes apps available in the iTunes store, most of them with limited success, but the launch of the Apple Watch will certainly bring a slew of renewed interest.
One new app we recently learned of that's debuting in a couple of weeks for both Apple and Android is Sugar Streak, aimed at motivating people with diabetes to check their sugars more often -- to build a 'streak,' as it were.
"For so many years, the app store was pretty stagnant for diabetes, but now it's an exciting time to be involved again," says Dr. David Ahn, the inventor of Sugar Streak who is an endocrine fellow at UCSD. "We're not trying to become the best or beat everybody, we just want to encourage people to use the tools available to them now and be more engaged in their diabetes health."
Note that Ahn hopes to submit Sugar Streak to the iTunes store on April 21, which means it unfortunately won't be ready for the Apple Watch release on April 24. But he hopes that within a month or two, Sugar Streak will get approaved and be compatible with the Apple Watch and HealthKit. From there, at a date to be determined, they'll pursue the Android Wear watch and Google Play store.
Yes, in one sense Sugar Streak is just another way to log blood sugar data and keep track of trends. But it takes a different spin on that concept by focusing less on individual numbers than on a stream of continuing checks. If you keep up your streak, you get rewarded regardless whether your BG results were "good" or "bad."
You decide how many times a day you want to check your BG and commit to that, and then build up your number of stars and eventually get rewarded with "virtual coins" called Glucoins as you progress (think Bitcoin). A circular progress bar shows how close you are to reaching your next streak goal, and along the way you can of course view your glucose data in log format, colorful graphs and other statistical views. Unfortunately, you do have to manually log in your sugars, which is certainly a downside to any app in 2015.
Accumulated Glucoins can then be redeemed for various prizes such as gift cards at Amazon and iTunes. At launch, you can earn a $5 gift card at iTunes just for using Sugar Streak on a regular basis for two months running and accumulating 2,000 Glucoins. If you continue your streak past that point, you can earn more gift cards about every 5 weeks. Later in 2015, Ahn and his San Diego-based team (including medical advisor Dr. Steven Edelman of TCOYD) hope to launch an "Offers" section where they'll partner with other diabetes/fitness product vendors to offer discounts -- for example 500 Glucoin could net you a $5 discount towards a particular diabetes supply case.
"You have some positive reinforcement for checking sugars and can be rewarded with bonuses, but you're not necessarily doing this for that reason," Ahn tells us. "But maybe with these bonuses in mind as motivation, it will keep you doing blood sugar checks and keep you more engaged. And by checking more frequently and keeping that streak alive, that can be meaningful for your health."
It's an interesting concept, one that will probably spark controversy among the D-Community -- as some don't believe in the "carrot or stick" approach to diabetes management. Parents often deal with this question intensely during the teen years: should they consider offering privileges or money when D-management is maintained, or taking those away if not? As with everything, Your Diabetes (and D-Management Philosophies) May Vary, of course.
Seeped in mHealth
Ahn's personal story is the key to how Sugar Streak was developed.
He spent the past five years writing for mHealth publications like iMedicalApps.com, where he found a focus for his medical career entwined with digital health. He's a self-described "techy guy" and through the years has done online reviews of many diabetes devices including the Telcare, Livongo, iHealth and other modern meters.
"I reviewed the iBGStar in 2011 and was fascinated by it. Diabetes tech and medicine is the perfect intersection, so that's why I decided to pursue endocrinology."
He is currently working at UCSD with well-known experts Dr. Steven Edelman and Jeremy Pettus, and in July he' ll be starting a new position at UCLA.
In talking to patients, Ahn found that many PWDs (people with diabetes) focused on their current glucose results and on their latest A1C, but that many didn't check their sugars as often as they should. Many patients he saw didn't bring in meters at all, and a large number who did had meters that his office wasn't equipped to download. And in recent years, he found that even those who said they'd used diabetes apps tended to not keep that up for more than a few days or weeks.
"There's a disconnect. You go to conferences and events and see all these presentations about fancy new meters, but then come back to the office and wouldn't see anyone with those," he said. "And this is San Diego, which we tend to think of as kind of a hip and techie place! That disconnect is striking for me."
Ahn also found that for himself, the only health app that seemed keep his attention was that paired with the GymPact app, which keeps track of your fitness activities. He's been using that for four years now, and it inspired his development of Sugar Streak -- except for one key aspect. With GymTrack, you get punished or may even have to pay small dollar amounts when you miss a workout. Ahn didn't want that with Sugar Streak, but instead wanted a positive, rewards-based system to motivate PWDs.
Room to Grow
Eventually, he also hopes to build relationships directly with manufacturers creating cloud-based meters, such as Livongo, Telcare and iHealth. He also thinks working with other d-tech partners like like Tidepool and Glooko could be a good move, to open this app up for more people using various products. His core hope is that Sugar Streak will drive more PWDs to use the latest technology.
"This could be a stepping stone for those advanced meters, making people aware of them and what's available," he said.
Down the road, Ahn said his team hopes to add a social media aspect where you can share BG data and streaks with people in the community (like OneDrop's approach). And they are considering adding in quizzes or other challenges, to take the app beyond rewards simply for testing; they're even thinking of creating a LeaderBoard-style feature to help include live-scoring on challenges and a competitive aspect.
"We have a lot in store for the future, but we're taking a similar approach to how you manage diabetes -- hopefully learning as we go, and expanding from there," Ahn said. "There's a lot of room to grow."
Don't we know it.