A sample of low-income patients engaged with Omada Health’s digital diabetes prevention program (DPP), achieved weight loss but no major difference in HbA1c levels after a year of use, according to study data recently highlighted by the company.

The results — published late last year in the CDC’s Preventing Chronic Disease journal and first previewed at a 2018 public health conference — suggest an alternative approach to diabetes prevention for a population that more often has difficulty accessing in-person health services.

“The Omada program lowers the barriers to access, and ultimately increases preventive health engagement among any population,” Omada Director of Clinical Research Cynthia Castro Sweet, who was also an author on the paper alongside researchers from the University of Southern California, Los Angeles, said in a statement. “Our program was developed to serve the needs of participants from all backgrounds, and all walks of life. The results of this trial dispels the myth that people with economic or educational disadvantages can’t or won’t use technology to engage in their health care.”

TOPLINE DATA

From the 227 participants recruited and evaluated at baseline, 111 completed a follow-up roughly around the half-year mark (T1), 104 completed a roughly 12-month follow-up (T2) and 76 completed both follow-ups. One hundred and nine participants who completed the T1 follow-up were also matched to an unenrolled control patient using de-identified records.

At baseline, 81.3% of the participants were women, 51.5% identified as Hispanic/Latino and 43% had limited proficiency in English. The average age was 48.2 years. All groups and subgroups within the trial demonstrated similar sociodemographic variables, with the exceptions that those eventually lost to follow-up were significantly less likely to have Medicaid at T1 and T2, and more likely to be working full-time at T1.

At the first and second check-in, 41% and 37% of reporting participants, respectively, had lost more than 5% of their weight. The average loss was significant at both check-ins, with mean weight loss reported as 4.2% at T1 and 4.4% at T2. Similarly, mean BMI also dropped significantly by −1.5 from baseline at T1, and −1.6 at T2.

At both check-ins, completion of nine or more lessons was significantly associated with increased weight loss. HbA1c levels mostly remained stagnant, however, with roughly similar proportions of participants falling within a prediabetic range. The only decline came at the T1 check-in (but not the T2 check-in) among participants who lost more than 5% of their baseline weight.

HOW IT WAS DONE

Between February 2016 and March 2017, researchers recruited adults enrolled in Medicaid or another safety-net insurance plan who had evidence of prediabetes within their EHR.

These participants were enrolled in Omada’s digital DPP, which includes virtual group support, lessons, personalized support from a live health coach and other tools to track their progress. It was modified for the study’s low-income target population by reducing the reading level of the curriculum, introducing Spanish translation and cultural components, and by featuring bilingual and bicultural coaches.

The researchers recorded patient outcomes of interest at baseline, at 24 to 35 weeks (T1) and at 47 to 65 weeks (T2). Controls were generated by searching de-identified EHRs with an algorithm that sought cases of a similar age and sex within 12 months prior to the beginning of enrollment.

THE LARGER PICTURE

Omada isn’t the only digital diabetes program maker in town. Solera Health and Livongo both offer a variety of tech-driven programs aimed at managing or preventing diabetes, while Virta Health often boasts of its product’s ability to reverse Type 2 diabetes.

But digital DPPs are just one of Omada’s offerings, which include hypertension management, mental health support and other chronic disease products. The company raked in $73 million in funding last summer, which it said at the time would help scale its digital care program efforts.

ON THE RECORD

“This study demonstrates that Omada achieves real outcomes with this difficult-to-reach population,” Omada Health CEO Sean Duffy said in a statement. “Digital health tools should be offered to all populations, especially when sufficient evidence shows that they can be as effective as in-person programs. By making virtual alternatives less accessible, we deny low-income patients an opportunity to lead healthier, more productive lives.”

Researchers are focusing on new health tech for some of the youngest patients. Recently two academic institutions published experimental design reports around baby tech. One focuses on a smart suit for tracking a babies movement, and the second revolves around the concept of a smart diaper from MIT. 

Researchers from the University of Helsinki have developed a new smart jumpsuit aimed at keeping track of babies with possible neurological abnormalities, such as cerebral palsy and autism spectrum disorders. 

The new suit, which is designed like a swim outfit, includes multiple sensors that collect mobile accelerometer and gyroscope data during movement, according to a recent concept of use report published in Scientific Reports. 

"The smart jumpsuit provides us with the first opportunity to quantify infants' spontaneous and voluntary movements outside the laboratory. The child can be sent back home with the suit for the rest of the day. The next day, it will be returned to the hospital where the results will then be processed," Sampsa Vanhatalo, professor of clinical neurophysiology at the University of Helsinki and one of the paper’s authors, said in a statement. 

The results are processed by a “machine learning algorithm, based on deep convolutional neural networks (CNNs),” which was trained to detect certain movement and posture biomarkers.  

Meanwhile researchers at MIT have been working on a new smart diaper. The latest tech includes a sensor that detects dampness in the diaper. This can then prompt a message to be sent to a caregiver's smartphone or computer. 

The new sensor is comprised of a passive radio frequency identification tag that is triggered by a super absorbant polymer, and was designed to be reusable. While the tech could be used to monitor babies in the NICU, the researchers also note that it can be used for bedridden and elderly patients in the hospital as well. 

"This could prevent rashes and some infections like urinary tract infections, in both aging and infant populations," Sai Nithin R. Kantareddy, a collaborator on the project and a graduate student in MIT's Department of Mechanical Engineering, said in a statement. 

WHY IT MATTERS 

Both of these tools focus on remotely monitoring babies for better care. 

The smart suit specifically focuses on identifying a baby’s long term needs and care to provide support. 

"The early identification of developmental disorders and support for infants' everyday functional capacity in interaction with the family and the growth environment constitute a significant factor on the level of individuals, families and society," Leena Haataja, author of the paper and professor of pediatric neurology, said in a statement. 

THE LARGER TREND 

This isn’t the first smart diaper to be developed, or even commercialized. Over the summer Purdue University researchers have developed a disposable, urinary tract infection-detecting sensor that is self-powered and can be embedded into diaper. The autonomous sensor activates upon exposure to urine, checks for compounds often associated with the infection and then wirelessly transmits the results to a smartphone if positive.

Big tech has also been working on this challenge. In May of 2018 Verily Life Sciences filed a patent application for a “smart diaper” carrying a sensor for detecting and differentiating between feces and urine. The diaper would contain a transmitter capable of wirelessly communicating whether waste is present to a separate device via Bluetooth, WiFi or other means. The product was shown off by Verily and diaper maker Pampers at this year's CES.