It is truly remarkable to now think back at how old-school most diabetes devices were, even three years after the iPhone came to market. Back then, our medical gadgets still required clunky cables and barely connected with anything, while all the data was locked in to proprietary platforms.
Flash forward to 2019, and built-in connectivity allowing diabetes data sharing has become the norm, thanks to Bluetooth technology.
Among the groups and companies championing these changes is Northern California-based Glooko, which started out by introducing a universal cable for glucose meter data capture in 2011. Over the years, Glooko has evolved to a data platform that now supports more than 100 devices, with a mobile app for easy viewing and uploading data. It has also helped pioneer the use of insulin dosing algorithms for decision support, through a partnership with DreaMed.
Most recently, the company made several key announcements: they will offer their mobile app free to all users to allow for widespread access; they have entered into a new partnership with Companion Medical, makers of the new InPen smart insulin pen; and they have begun exploration of AI-enabled predictive analytics for glucose data.
Also, in May 2019 the company named as new Chief Medical Officer Dr. Mark Clements, a well-respected pediatric endocrinologist at Children's Mercy Kansas City, who previously served on their governing board.
“What became apparent to me, in deciding to take on this greater role, was the impact potential for Glooko to make for people with diabetes,” Clements said. “I think it’s huge because Glooko has solved a problem that was significant in the field around data-sharing and visualization for better insights. But beyond that... I see a number of opportunities for the future. That’s what drew me here to this role.”
"Lots of Opportunities" for Diabetes Data Connectivity
Not so long ago, each glucose meter, insulin pump, and D-device had its own connection cable and software platform, and they didn't communicate with each other. Glooko was one of the early champions of change. First, their universal cable allowed connectivity and downloading data to a single platform, and later their Bluetooth-enabled product allowed users to ditch all the cables for wireless uploading of diabetes data presented in an easy-to-view format. Not only did this provide PWDs more insight, but healthcare professionals didn't have to spend as much time and effort trying to connect the right devices and cables just to see data.
As noted, Glooko is now compatible with more than 100 meters and diabetes devices, with an ever-expanding list at the company site. Recent additions include the implantable Eversense CGM and Companion Medical's connected InPen.
And as of March 2019, the Glooko mobile app is now free! That means no more subscription fee or necessary "activation code" before you can start using the Glooko platform on your iOs or Android smartphone, something that was previously required if you wanted to get Glooko directly, without going through a doctor or health plan.
"It added friction to the system, an additional step people had to overcome," Clements says. "That created some confusion, by people who were trying to download the mobile app but then saw an opening note about an activation code. It's a way to have a direct influence on people in going to them as the consumer, rather than through the payers or employers or healthcare system providers."
The free access for patients can become an incentive for clinics, because patients can simply bring in thier Glooko data reports to the provider's office, Clements says.
He says that many diabetes clinics across the country have started using Glooko for population health insights, to predict outcomes as to whose A1C might go up or who's at highest risk for DKA.
"We're changing the way we deliver care, based on those predictions," he says. "The fact that (healthcare providers) have this way to share data easily means patients can have a conversation or app chat with them between visits to take steps to help prevent A1C rises or address potential problems."
He also mentions the potential to deliver diabetes education through the Glooko mobile app. That's not something Glooko would likely take on itself, but it's an interesting possibility through potential partnerships.
"There are just a lot of opportunities that haven't been tapped," he says. "We're moving toward an ecosystem where you, as the person with diabetes and your healthcare providers can choose from a menu of options that work best for you -- whether it's just remote monitoring, or mobile health coaching. I don't think Glooko wants to become a single intervention program or a coaching program, it wants to be the vehicle for many programs to connect with PWDs."
Clements says it can sometimes be challenging for industry to go through the hard work of crfting these agreements, but many companies are responding positively. There will also be new products with features we haven't seen before, at least one of which will be powered by their partnership with DreaMed creating decision support tools.
"If you’ve got a platform that’s trusted by people with diabetes, and that platform is willing to partner with new entities, then we can see a lot of innovation delivered through that. Hopefully, it serves as an accelerant in the field,” he says.
The Evolution of Diabetes Data Platforms
Glooko's been around for almost a decade now and made incredible progress, but they're not alone, and weren't even the first on the scene.
You can find remnants of early D-data platforms going back decades, using spreadsheets and forms in the earliest days of computing. Once more sophisticated software emerged, people really started speaking up about the lack of interoperability of diabetes devices and the need to "free the data" from proprietary platforms.
One of the first patient influencers to make real noise on this issue was technology guru Scott Hanselman, who created the GlucoPilot for Palms back in the early 2000s when those were big. Many probably also remember Sweden-based Diasend that came around in 2004, which grew by leaps and bounds and became the third-party platform that Animas insulin pump users used.
Over the years, we've witnessed the incredible rise of modern diabetes data platforms that have evolved into interactive tools with features that include health coaching and behavioral interventions. From WellDoc, to the short-lived Ditto device to startups like mySugr (now part of Roche) -- not to mention more sophisticated offerings from device makers, such as Medtronic's CareLink platform, initially launched in 2004, Tandem Diabetes Care for t:slim pump users, Insulet's platform for OmniPodders, and the many meter-centric companies like Livongo and One Drop.
A huge champion came along in 2013 in the form of open-data non-profit Tidepool, that spurred new collaboration and data-partnerships. They've been huge change-makers and an integral part of our DiabetesMine D-Data Exchange events where the grassroots #WeAreNotWaiting movement of DIYers was born and exploded into a movement that influenced manufacturers.
Meanwhile, Glooko's kept plugging away and growing as a third-party hub, playing in the sandbox with as many partners as possible.
Behind the Scenes at Glooko
From the start, Glooko's motto was "free your data!" -- something many in our D-Community had been screaming from rooftops for years, but without much action from established industry. Behind the Silicon Valley mHealth startup were a trio of smart tech guys: Internet pioneer Yogen Dalal, mobile-web app developer Sundeep Madra, and former Facebook VP Chamath Palihapitiya.
They formed the company in Summer 2010 and debuted their first product in November 2011: the Glooko MeterSync Cable and Glooko Logbook app for iOS, with a $40 cable allowing easier downloads of meter readings from multiple FDA-cleared fingerstick glucose meters into their mobile app and desktop platform.
They launched the next-gen "MeterSync Blue" in 2014 that brought Bluetooth-connectivity to "tens of millions of blood glucose meters worldwide" without a need for clunky cables. By the following year they were compatible with 35+ meters for data to be seen and shared on Apple and Android phones, and soon after Glooko finally persuaded Medtronic to allow back-end accessibility through the proprietary CareLink software -- a big win for PWDs, given the amount using Medtronic devices as well as other CGMs and meters that didn't connect with CareLink directly.
A huge diabetes data milestone came in September 2016, when Glooko merged with an even older startup company, Sweden-based Diasend that had been around for more than a decade at that point. With that merger into a unified company, they created the largest and most dominant force in diabetes data-sharing platforms anywhere on the globe.
Since then, they've continued inking and expanding deals with CGM and meter makers, as well as insulin and medication manufacturers, plus orgs like Fit4D and T1D Exchange -- all the while showing that their platform and data connectivity offerings improve health outcomes for PWDs and shift clinical care practices toward improved data analysis. They soon obtained FDA approval for their long-acting insulin titration app for T2s, and began work on new predictive data analytics tools that offer personalization and future AI capabilities.
With his pediatric endo experience, Clements believes Glooko has solved a lot problems for PWDs and diabetes clinical centers, who previously had to navigate multiple devices with differing connection cables and data displays for each one.
“The truth is, we HCPs were all over the map, with every provider and educator using different software to upload devices and looking at different reports,” he says. “Glooko has paved the way for them to get the gift of time back. What you have at the end of the day is more time to spend creating a stronger therapeutic alliance between the person with diabetes and their care team.”
That's a win if we ever heard one. We can't wait to see how technology continues to change care, as we inch closer to the next decade!