Isabella Degen Q&A: reducing diabetics’ anxiety around insulin

Chloe Kent 15 January 2020 (Last Updated January 17th, 2020 10:17)

The mental strain of diabetes is hard to imagine for those who don’t have the condition, with 25% of diabetics reported to have depression and 40% diagnosed with anxiety. Verdict Medical Devices speaks to Isabella Degen, one of the minds behind the Quin diabetes management app, to find out more about how the technology could make the condition easier to manage.

Isabella Degen Q&A: reducing diabetics’ anxiety around insulin
Quin is designed to help diabetic people manage their insulin intake more efficiently. Credit: Quin

Quin chief technology officer Isabella Degen has been managing her diabetes with insulin for 26 years, and co-founded Quin five years ago. A portmanteau for ‘Quantifying Intuition’ – something, the company’s website notes, that people who take insulin have to do several times a day – the app is designed to help diabetic people manage their insulin intake more efficiently.

The app tracks many different factors, such as food and insulin intake, alongside data from diabetes devices and phones, to help patients decide how much insulin to take and when based on their past experience. Instead of being locked into a constant guessing game, app users can pull up an objective assessment of how different insulin doses have previously affected them in different circumstances, to make a more educated assessment of what the best course of action will be for them.

Unlike similar health management apps, which use an algorithm to correlate the input of all users’ data into a single consistent average, Quin’s management techniques are based entirely on a patient’s own data – crucial when it comes to managing a condition as individualised as diabetes. Chloe Kent spoke to Degen about how the app works and where the company hopes to see it head in 2020.

 

Chloe Kent: How does the Quin app work?

Isabella Degen: The app observes the trial and error of people who take insulin. They tell us when they eat something and tell us how much insulin they’re taking. The app itself is observing in the background how active they are, what time it is, and eventually things like location and menstruation and other stuff we can observe about them from the phone. Quin is essentially taking all that information and correlating it to people’s glucose outcomes.

Let’s say you’ve had 100 lattes, and every time you’ve had a latte you’ve logged that and said how much insulin you’ve taken. Sometimes you may have taken it ten minutes earlier, sometimes later, and you take one to five units depending on what else is going on. The next time you come and say ‘okay, I’m going to have a latte right now’, Quin is looking to show you past decisions that worked well for you when having a latte and that match you right now, so the user can make a much more informed decision.

CK: Why does diabetes management need such individualised data?

ID: Diabetes is an umbrella term of high blood glucose. People are diagnosed with Type I and Type II, but these are umbrella terms as well. One person takes one unit of insulin with a latte but another may have a very different result to that. Our bodies are fundamentally different. For that reason we only look at remembering a single person’s outcomes and what they do.

We do have a second part of our business model. Between all this different customer data, we’re interested in seeing whether we can tell just by looking at what people do and the outcomes they achieve if there are groups of people who have very similar ways of treating diabetes? They perhaps have a more similar base of what’s broken in the endocrine or metabolic system. We can then work with researchers to further target these subgroups so we can get more targeted treatment.

CK: How does Quin compare to an ‘artificial pancreas’ type system?

ID: It’s actually a very different approach. Quin focuses on people who take insulin using multiple-dose injection therapies, and the artificial pancreas is for people who use a pump. And really, there is no artificial pancreas on the market, we’re talking about products that take over autoregulation of insulin at certain points in time. That’s had immense regulatory challenges because nobody knows how much insulin to take.

It’s very hard to recommend insulin doses. What we are doing is essentially saying let’s learn from people in self-trials to get us to a point where we’re able to close the loop.

CK: How can Quin change the life of a diabetic patient?

ID: Our vision is that they become more confident. They can see something they’ve achieved in the past that they should be able to achieve again, because the data is personal to them and not just averages across many people which may not be relevant. It’s hard to set confidence on what works or not, so the next step is just to release the burden.

Taking a drug where nobody knows how much of it to take, it’s quite stressful. To not have to do all the thinking and the fine tuning, to think ‘what should I do at this time’ or to even remember to make a decision, reduces the burden so that they can focus on what they want to focus on in their life.

CK: What sort of user feedback have you had so far?

ID: We did a questionnaire in our user base and 76% said they’re more relaxed and more confident, and 35% have said that they have improved outcomes. On the medical side they’ve learned more about how insulin works – they can see that their blood sugar is still high, but they can also see that they’ve taken insulin and know it’s going to come down, so I think that’s where the confidence comes from.

CK: How can people access Quin?

ID: Right now we have a closed research project, so people can apply through the site to participate if they own the right kit and they’re on a treatment that we support at the moment. We give them access to a version of Quin that changes every month, and then we work together with these users to give us feedback.

CK: Where do you see Quin heading once you’re out of the test stages?

ID: We’re planning to do a launch of the app in late 2020, which will then become available via the App Store. It will be a subscription-based business model, initially paid for directly by the customer but maybe also picked up by insurers in the future. We’re launching geographically in the CE mark [region], and we’re looking at starting the FDA approval process in the middle of this year.