PROVIDENCE – Dr. Osama Hamdy, medical director of Joslin Diabetes Center’s obesity clinical program, calls diabetes a “global health crisis” wreaking havoc on an individual’s eyes, kidneys, feet, nerves, heart, reflexes, etc., and reducing one’s longevity. “I usually say [diabetes] is like termites; you don’t see it, but, in reality, it affects every single organ in the body,” said Hamdy, who also directs the inpatient diabetes program at Joslin, which is affiliated with Harvard Medical School, and who served as the keynote speaker at the Rhode Island Business Group on Health’s “Summit on Diabetes Prevention,” which was held Jan. 20 at the Providence Marriott Downtown.
Across the country – and in Rhode Island – the situation is dire. Every year, approximately 69,000 Rhode Islanders are diagnosed with diabetes; currently, approximately 108,000 Rhode Islanders have diabetes, only some of whom know their diagnosis. Data from the Centers for Disease Control and Prevention indicate that diabetes has an approximately $1.1 billion annual impact in Rhode Island – an estimated $800 million was spent in 2012 on direct medical expenses for diagnosed and undiagnosed diabetes, pre-diabetes and gestational diabetes, and another $300 million was spent in 2012 on indirect costs from lost productivity due to diabetes. Further, CDC data show that medical costs for people with diagnosed diabetes incur an average of 2.3 times the medical expenses of their non-diabetic peers. Approximately 43 percent of employees in Rhode Island diagnosed with diabetes are responsible for an estimated 87,000 work days lost due to diabetes in any single year.
“After Joslin enrolled prediabetic patients several years ago in a randomized clinical trial to prevent Type 2 diabetes and followed their progress for several years, we were shocked by the results,” said Hamdy. Lifestyle changes – consume less fat and fewer calories, exercise at least 150 minutes a week and maintain a loss of 7 percent of body weight – led to a 58 percent risk reduction in developing diabetes, while taking Metformin, an oral diabetes medicine, achieved a 31 percent risk reduction.
Discovering that group intervention and social interaction, engagement with a health coach and regular follow-up helped ensure compliance with nutrition and exercise lifestyle changes, Joslin developed Why WAIT, a program offering those resources that earned an American Diabetes Association award in 2015. Why WAIT is expensive, Hamdy acknowledged, and not easily accessed by people across the country.
Enter Healthimation, a Boston-based company that licensed the Why WAIT program from Joslin to offer individuals the program’s key elements via a mobile phone app. Available in multiple languages, the app includes an avatar named Lena, online learning, personalized schedules, customized food and fitness choices, and access to a human coach.
An individual consumer’s subscription cost for the app is $50 a month for the first three months, with a monthly maintenance fee thereafter, said Healthimation Chief Executive Officer Alaina Adams. As for employers and health insurers, Healthimation, whose board president is Hamdy, seeks to create “win-win” scenarios to share in those companies’ financial successes derived from the progress employees and insureds make to improve their health. “We’ll talk to them about some shared business model [for the cost],” said Adams, who expects to release news soon of some major companies’ interest in the Healthimation app.
The app, which will continue to evolve and offer new features, is convenient and simple to use, said Adams. “We’re pushing the envelope in integrating with wearable technologies and GPS,” by recommending nearby restaurants and grocery stores with healthy food choices and offering incentives and discounts. The Why WAIT program can integrate with employees’ electronic medical records and help drive down health care costs, asserted Adams.
Healthimation, which hired individuals from the video game industry, is one of 31 entities, chosen from more than 430 applicants, named to the first digital health startup cohort established by MassChallenge, a technology accelerator in Boston. Healthimation and other participants in the PULSE@MassChallenge initiative will work in MassChallenge’s innovation lab for six months, receive advice and counsel from Boston-area advisers and compete for more than $100,000 in awards.
“The statistics on diabetes are shocking [and] unacceptable… 80 percent of Type 2 diabetes is preventable,” Robin Bouvier, co-chair of the RIBGH Health & Productivity Committee, said at the summit. “We’re not seeing the public outcry the way we have with tobacco. … [Diabetes] is killing our workforce and driving down results in Rhode Island and across the country.” Obesity – closely correlated with diabetes – has supplanted tobacco as the number one cause of preventable death.
With approximately one in 11 people in the country having diabetes – more than 29 million –diabetes is the most common disease in U.S. hospitals, Hamdy said. Noting that obesity and diabetes is on the rise, he attributed the genesis of this growing problem to the U.S. Department of Agriculture’s food pyramid from the 1980s, which pushed carbohydrate consumption.