Global positioning systems have made enormous changes in the way we travel and now this same technology is making great strides in helping individuals manage their type 2 diabetes. Thed-Nav is an innovative device created by Hygieia that automatically maps out a patient’s insulin treatment by charting his or her glucose readings. The creators term the device a “Diabetes Insulin Guidance System” (DIGS).
Eran Bashan is the CEO and co-founder of Hygieia, Inc. He states that just like a GPS for a car, the user tells the device where he or she wants to go and DIGS creates a master plan, adjusting the plan according to current blood-sugar levels. Bashan continues, stating that the benefit of a global positioning system is not its ability to tell you where you are, but its ability to tell you what you need to do next. According to Bashan, glucose readings in and of themselves are not necessarily of value, it is knowing what to do with the numbers that matters.
The d-Nav System
Hygieia has been developing the d-Nav system since 2008. The system consists of three components: the device, the software (used by the consumer and health care professionals) and d-Nav’s Care Center service.
The digital monitoring and insulin delivery device is relatively small (the size of a BlackBerry) and uses cloud-based software to provide health care professionals and primary care doctors with the information they need to analyze their patients’ blood glucose levels: Once analyzed, patients receive information indicating what dose of insulin they need to take.
United Kingdom Study Finds d-Nav Effective in Dropping Average Blood Glucose Levels
According to a study conducted by the South Eastern Health and Social Care Trust in the United Kingdom, which is part of the country’s National Health Service, patients who used the d-Navservice had a substantial decrease in their average blood sugar levels (HbA1c); furthermore, there was a significant reduction in the costs associated with diabetic care during the 12 months of the study.
Ann Baker is Blue Cross/Blue Shield’s (BC/BS) vice president of wellness and care management: She states that BC/BS evaluated the data from the United Kingdom study and they are eager to explore the potential d-Nav has in reference to patient care and cost reductions for their members in Michigan who have type 2 diabetes. Blue Cross/Blue Shield of Michigan is the first health plan within the U.S. to evaluate the d-Nav as part of their mission to provide their members who have chronic conditions with innovative solutions.
March of 2016 – Hygieia and Blue Cross/Blue Shield (BC/BS) of Michigan Teaming Up for d-Nav Study
Type 2 diabetes is the most common form of the disease and occurs when the body rejects or does not produce enough insulin. There are more than 3 million people within the U.S. who have this condition and 20 million globally. The Ann Arbor-based medical device company Hygieia is teaming up with Blue Cross/Blue Shield of Michigan to perform a 12-month long study designed to test the benefits of the d-Nav device for individuals who have type 2 diabetes.
The goal of the study is to determine whether the d-Nav device can help 1,000 patients who have type 2 diabetes effectively manage their condition.
Bashan states that this study’s approach is relatively unique in that it demonstrates the power of the economic and clinical data that has been amassed to date, in conjunction with the dramatic need for innovative technologies and clinical pathways designed to improve care for individuals who have type 2 diabetes and use insulin.
BC/BS Study Participants
Initially, participants will be selected via the Oakland-Southfield Physicians, eventually expanding to other practices. Baker states that this effort is part of BC/BS continuous efforts to find new, innovative programs to improve the service and care they provide their members.
Blue Cross/Blue Shield officials state that they intend to evaluate the cost savings associated with using the d-Nav device and service in comparison to the current standard of care. Results will be determined using an independent health-economics organization. An assessment will be made as to whether the patients who participated in the study had a better or similar outcome at a lower cost when compared to patients who received the traditional standard of care.
Hygieia claims that implementing the d-Nav services for diabetic patients in Michigan could save up to $100 million in health care costs (including pharmaceutical supplies).
From a Patient’s Perspective
John Ralph is a 63-year-old sales associate who has been using the d-Nav services for two years. He states that this new device has transformed his life. Ralph says that prior to the d-Nav his insulin doses were a guessing game. He continued, stating that sugar levels need to be monitored regularly and before he began using the services he would forget to check his glucose level; however, the d-Nav makes it easy for him to remember because it provides him with a set regimen that reminds him when it is time to check his levels.
Ralph adds that the machine knows what time of day it is, as well as what meal he is about to eat and the amount of insulin he needs to take.
Ralph also says that if an individual is more physical than usual on any given day, his or her blood sugar levels drop and the risk of hypoglycemia increases. Hypoglycemic individuals may begin to feel dizzy, their hands may start to shake and he or she may actually faint. Ralph concludes by stating that keeping his blood glucose levels as normal as possible lessens the amount of damage being done to his internal organs.
The d-Nav – Explained
Just as with any other glucometer, patients place a drop of blood on the strip and wait for their reading; however, instead of focusing primarily on the blood glucose readings, the d-Nav takes it one step further: once the result is calculated, using pre-programmed settings obtained from the patient’s physician, the device calculates the amount of insulin the patient should take. When necessary, the d-Nav also calculates corrections (insulin on board (IOB) and food bolus).
Once the recommended dose of insulin is displayed, the patient can follow or ignore the recommendation. Just as with traditional glucometers, insulin pumps or continuous glucose monitoring devices, the d-Nav includes software and a connection cable that allows patients to upload data for themselves and their physicians to review.
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