It is truly remarkable to think about how old school most diabetes devices were, even years after the iPhone came to market. Until very recently, 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 today, when built-in connectivity allowing diabetes data sharing has become the norm, thanks to Bluetooth technology.
Northern-California—based Glooko is among the companies championing these changes. It started out back in 2011 by introducing a universal cable for capturing fingerstick meter glucose data. And over the years, it’s evolved into a data platform that now supports more than 100 devices, with a mobile app for easy viewing and uploading data. Glooko has also helped pioneer the use of insulin dosing algorithms for decision support through a partnership with Israel-based DreaMed Diabetes.
Most recently, Glooko acquired a German health machine-learning company developing an intervention-based technology to support patients and their healthcare teams in predicting behavior and managing diabetes.
This follows key announcements in recent years:
- collaborating with Johns Hopkins on a digital diabetes health management program with healthcare providers and health insurance companies
- partnered with Medtronic on smart insulin pen technology created by Companion Medical
- exploring use of AI-enabled predictive analytics for glucose data
- on the access and affordability front, Glooko opted to offer its mobile app for free to all users, allowing for more widespread access
Given how much people with diabetes pay for technology and supplies, not to mention the outrageously expensive insulin and other medications, this is an important move by Glooko that shows they care.
When Dr. Mark Clements, a well-respected pediatric endocrinologist at Children’s Mercy Kansas City, took on the role of chief medical officer in 2019, he essentially said Glooko’s potential for impact on people with diabetes was immeasurable.
“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,” he told DiabetesMine at the time. “But beyond that… I see a number of opportunities for the future. That’s what drew me here to this role.”
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. 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 patients 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 continuous glucose monitor (CGM) and Companion Medical’s connected InPen.
Another important point was Glooko’s decision to offer its mobile app for free. That meant 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 their Glooko data reports to the provider’s office, Clements says.
He says many diabetes clinics across the country have started using Glooko for population health insights to predict outcomes as to whose A1C levels might go up or who’s at highest risk for diabetic ketoacidosis (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 people with diabetes.”
Clements says it can sometimes be challenging for the industry to go through the hard work of crafting 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.
Glooko’s been around for over 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 data platform for Animas insulin-pump users.
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.
The list is vast — from WellDoc to the short-lived Ditto device to startups like mySugr (now part of Roche) — not to mention platforms offered directly 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 its Omnipod users, and the many meter-centric companies like Livongo and One Drop.
A huge champion came along in 2013 in the form of open-data nonprofit Tidepool, which 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.
In January 2022, Glooko acquired a startup company based in Berlin, Germany. That company is xbird, developing what’s dubbed Just in Time Adaptive Intervention (JITAI) technology to improve the effectiveness of a particular intervention and reduce the burden on the person using the intervention with timely support.
Per Glooko, xbird’s technology uses the latest Artificial Intelligence (AI) and machine learning to help identify health risks for people with diabetes. This is done by interpreting medical and behavioral data in a targeted manner to provide customized recommendations and “behavioral nudges.”
Glooko with xbird uses sensors embedded within smartphones and wearables (think additional capabilities of a CGM like Dexcom or Libre) to record a user’s movements and analyze the data to create those individual, personalized profiles and interventions to help change someone’s lifestyle and health decisions.
Before the acquisition, xbird was already partnered with companies like Ascensia Diabetes Care and Novo Nordisk, and no doubt Glooko’s partnerships across the diabetes industry will just add to the options in using other diabetes devices.
Glooko is integrating the xbird JITAI digital coaching software into its already-established platform, which is used each day by more than 7,500 clinics worldwide and more than 1 million users. Glooko also plans to enable people to use these solutions to better manage their diabetes and related chronic conditions.
“Our investment in xbird represents Glooko’s strategic commitment to machine learning and customized digital coaching for patients with chronic conditions,” Glooko’s Chief Executive Officer Russ Johannesson said in a statement. “Among the many JITAI companies in the digital health landscape, xbird clearly has a superior solution and has built successful partnerships throughout diabetes device manufacturers and clinical institutions. The combination of Glooko’s established global footprint and xbird’s exciting JITAI capabilities will allow us to improve patient outcomes.”
From the start, Glooko’s motto was “free your data!” — something many in our D-Community had been screaming from rooftops for years, initially without much reaction from the 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 the summer of 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. Soon after, Glooko finally persuaded Medtronic to allow backend accessibility through the proprietary CareLink software, a big win for patients, given the number 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, which 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 (now Cecelia Health) and T1D Exchange — all the while showing that their platform and data connectivity offerings improve health outcomes and shift clinical care practices toward improved data analysis.
They soon obtained FDA approval for their long-acting insulin titration app for people with type 2 diabetes and began work on new predictive data analytics tools that offer personalization and future AI capabilities.
With his pediatric endo experience, Clements said Glooko has solved a lot of problems for both patients 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 healthcare providers were all over the map, with every provider and educator using different software to upload devices and looking at different reports. Glooko has paved the way for them to get the gift of time back,” he told DiabetesMine. “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 this type of technology continues to change care as we move forward.