Can digital therapeutics be the ‘no pill solution’ to reversing diabetes?

Diabetes and related conditions remain the biggest lifestyle health issue in India, with 170 million people having either pre-diabetes (90 million) or diabetes (80 million). The Covid-19 pandemic has led to further escalation of numbers, but side-by-side advancements in medical technologies such as “digital therapeutics” have helped make diabetes treatment more personalised and patient-centric. A necessary outcome of this new approach is enabling even reversing diabetes in many.

Worldwide research has shown that ‘how to reverse diabetes’ is the single most important aspiration or dream for every person with diabetes. Reversing diabetes is scientifically known as ‘diabetes remission’. Diabetes remission is clinically defined as a state of normal blood glucose with HbA1c of less than 6.5% without medications for at least 6 months.

First step in applying principles of Digital Therapeutics for diabetes reversal is to understand who the right people are for it. From our internal research done at Diabefly Digital Therapeutics program, we realised that the following factors are important for diabetes reversal:

1. Duration of diabetes less than five years and in some cases up to 10 years.
2. BMI: People who are overweight with BMI of over 25
3. Medications: People on 1-2 pills have a higher reversal chance
4. Highly motivated

Our learnings also show that reversing diabetes is a journey, and it requires an intensive multidisciplinary approach.

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Keys to a successful diabetes reversal journey are:

1. Precision nutrition and personalised approach to diet
2. Strong motivational and mental wellbeing support
3. Physical fitness support to remain in remission
4. Doctor involvement to taper medications

While these services may be available individually, it is best to have a single platform for this multidisciplinary support. Also, frequent monitoring and intensive monitoring can be cumbersome for the client. 

Digital therapeutics (DTx), a subset of digital health comes as a solution to the problem with scientifically proven outcomes. They are evidence-based therapeutic interventions driven by high-quality software programs to prevent, manage, or treat a medical disorder. 

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DTx solution can be very powerful for diabetes reversal. For example, cutting-edge methods such as Ambulatory Glucose Monitoring (AGM) with flash technology is used to track the blood sugar levels of patients painlessly over 14 days. These readings enable nutritionists to create a personalised diet plan to keep blood sugar rise to the minimum. 

It also allows the doctor to understand the exact causes of blood sugar fluctuations (Personalised Glycemic Response). Secondly, one-on-one coaching by a clinical psychologist keeps the patient accountable and motivated through the journey. Thirdly, a physiotherapist does the video-based fitness assessment and creates a fitness plan to fight insulin resistance, which is a hallmark of diabetes. Working together, all of these experts are able to help patients bring about diabetes reversal safely and in a sustainable manner.

The remote nature of intervention makes digital therapeutics an accessible and easy-to-use tool for diabetes reversal. The future of diabetes will be powered by technology. With the arrival of digital therapeutics, beating or reversing diabetes is not fiction anymore, it’s a fact.