I remember when I first graduated from university, I only wanted to work in a hospital. Clinical dietetics was the cool thing to get into for almost everybody, and almost all my classmates aspired to score the much coveted (and rare) graduate positions at the hospitals. I jumped at my first job offer at a hospital in Singapore before I even graduated, worried I may not have gotten a job in Australia and thirsty for an overseas adventure (although just a few months later, I was offered a hospital job in Brisbane which I had to decline!).
Fast forward 4.5 years later: I’ve left the hospital scene, exploring other innovative ways of delivering healthcare. I’m now working in a digital healthcare start-up called Holmusk, with their app called GlycoLeap which was launched in August 2016.
Healthcare costs associated with diabetes continue to be a major concern worldwide. Diabetes-related complications are a major cause of hospitalisation. Singapore’s healthcare spending for diabetes rose above US$1 billion in 2010, and is expected to soar beyond US$2.5 billion by 2050.
The high costs of diabetes – both for the individual and the healthcare system – and the personal nature of diabetes management, presents an opportunity for technologies that can provide scalable and engaging solutions for better diabetes management. The epidemic of chronic disease is too large for hospitals and acute care systems to handle. GlycoLeap has the potential to fill this gap and prevent problems before they escalate.
The app acts as a “mobile dietitian” and gives users customised advice on how to prevent or control diabetes and other chronic diseases. Users upload photos of meals, input glucose levels, track weight and physical activity, attend interactive online lessons and receive personal coaching from GlycoLeap’s in-house dietitians on gradual lifestyle changes. The dietitians provide a star rating (from 1 meaning an occasional choice, to 5 meaning an everyday choice), as well as counselling the clients on how to improve.
GlycoLeap uses concepts from behavioural science to drive positive health outcomes for those with chronic disease. Through small and sustainable lifestyle changes, users can achieve moderate weight loss and improve glucose control (as measured by HbA1c) within six months of the GlycoLeap programme. Although a research study is under way to provide empirical evidence, so far pilot results have shown promising outcomes.
One reason the app works is because there’s a bit of a competitive element; the clients against themselves! We find that many people want to get a 4-5 star rating most of the time, as it makes them feel good when they’re on the right track. GlycoLeap is also looking to expand to investigating the impact of positive nutrition on reducing the risk of dementia in a research study.
It’s also really encouraging for clients to know they can do this in their own time, at their own pace. In traditional consultations, we often either bombard motivated clients with a lifestyle overhaul, or for less motivated clients, focus on only one or two few unhealthy things they need to change. Often during follow-ups a few months later, we found they eventually went back to their old habits without any guidance and reminders. But through GlycoLeap, patients are given insights and a few small tips gradually over time and encouraged to continue the positive things. This slow, gradual positive change and encouragement, is what spurs people to continue the healthful habits they’ve developed in a sustainable way. It also helps clients gain deeper nutrition knowledge and cultivate intuitive eating in their own time, as it’s difficult to absorb and change everything in just a 30-minute consultation.
This image from the Diabetes Hands Foundation visually represents the average time a patient spends in their life across different settings. The tiny white line on top symbolises the miniscule <1% time a patient spends speaking to a medical professional). The remainder (>99%) is spent on self-management at home, at work or in the community – often with no one reliable to turn to for help. So they instead Google their way through, often relying on inaccurate myths or unqualified ‘expert’s’ generic advice without taking into consideration holistic factors for the patient. We’re not here to replace traditional care, but rather, to support people on the 365 days a year when they’re not seeing the healthcare professional. Because that’s when people are making lifestyle choices that actually affect their health! All in the comfort of their own home, conveniently located on their mobile, in a setting that they are most familiar with.
Another beautiful thing about digital healthcare is that I have the opportunity to influence the lives of anybody across the globe in a scalable way. Anybody from across the world can download and use the app, and it presents an interesting challenge to see what people across the world are eating and tailoring feedback within their cultural and geographical considerations.
Perhaps the traditional dietitian can see about 8-10 patients a typical day. About half of the consultation is about breaking down the food history. But over the GlycoLeap app, at one glance, I can just see the food without having to probe much further. How large the portions were, what were the exact ingredients, brands and nutrition panels of packaged foods, or how food was eaten and cooked. That saves a lot of time.
I’d say the biggest challenge I’ve faced in this mode is keeping patients engaged. As it’s an everyday thing that people eat and face lifestyle challenges, clients may bore of always talking to us. The coaches need to be on their feet innovating new ideas and keeping things interesting. For the engaged clients, it feels as if someone is out there looking after and cheering them on, and that relationship builds into the interaction. After a while, the engagement becomes a habit and a part of a person’s day-to-day life.
Currently GlycoLeap is offering a 14-day free trial of the programme which includes the dietitian coaching and website lessons. After the trial, users can still use the app for data logging (food photos like a food diary where they can comment on their own food, weight and blood sugar and exercise logs), although they will not be able to get any dietitian coaching/feedback or scoring after the trial until they subscribe. The prices start from an affordable16.67 USD /month for a 1-year subscription. Considering a typical private practice dietitian typically charges over $100 for just a one-off consultation, this offers great value, convenience and effectiveness for clients.
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Author profile: Bonnie Lau is an Accredited Practising Dietitian, with over 4 years working experience. She has worked in two hospitals in Singapore, and currently at GlycoLeap. GlycoLeap is an effective programme that offers everyday support from a dietitian to lose weight or lower HbA1c (https://glycoleap.com).