Ozempic and other weight-loss drugs like Wegovy have created a massive hype since their effectiveness in reducing body mass became evident. Novo Nordisk developed these drugs originally to treat type 2 diabetes. The drug consists mainly of a synthetic version of the GLP-1 hormone produced in the intestines. The semaglutide drugs mimic GLP-1 by stimulating insulin release to help reduce glucose levels for type 2 diabetes patients.
As a side effect, they increase feelings of fullness and slow digestion, which fuels the rush on these medications to treat obesity or reduce weight for vanity reasons. The hype is concerning because it reinforces the belief in the population that these drugs, developed to treat a severe clinical condition, can miraculously help with weight loss.
Using these drugs for weight loss comes with consequences. They are costly and create a significant dependency because as soon as the patient stops injecting them, all benefits evaporate, and the weight returns.
That’s why drug manufacturers, healthcare professionals, and the FDA highly recommend pairing these drugs with significant lifestyle changes, such as dietary changes and increased physical activity.
Climbing an insurmountable mountain
Everyone understands how difficult it can be to get into an exercise routine after prolonged periods of no physical activity or without a prior exercise history. For people living with diabetes, this is even more complex as they already need to manage their blood glucose levels throughout the day and understand what makes their blood sugar leave healthy levels. If they don’t, the consequences can be fatal.
Our team experienced first-hand how difficult it can be to understand glucose responses when we tested continuous glucose monitors (CGMs) on ourselves during the UX research phase of this project. Many factors, such as sleep, stress, diet, medication, hormones, and even non-obvious ones, such as the weather, can influence blood glucose.
Adding exercise into the mix makes it even more complex to understand the influencers and make adjustments along the way. Diabetes patients who exercise need to manage their blood glucose in anticipation of an exercise session, during and especially after exercising. The effects of an exercise session on insulin sensitivity can still impact glucose responses the following day. Frequently exercising can further improve the overall insulin sensitivity, requiring additional adjustments in diabetes management from the patient. Managing this complexity can feel overwhelming, making some patients more comfortable skipping exercise altogether.
"Patients managing clinical conditions such as overweight and diabetes can find it particularly tough to start exercising because they feel left alone."
The benefits of exercising for diabetes patients are undisputed: lowering blood glucose levels through increased insulin sensitivity, maintaining healthy body weight, reducing cardiovascular risks, improving health and overall well-being, and lowering the risk of diabetes-related complications like nerve damage or kidney disease. For some type 2 diabetes patients, it is even possible to achieve remission.
The reality of exercising with diabetes
As we spoke to more than 30 people with diabetes and healthcare professionals across the globe, it became evident that there is one overarching reason that makes it unnecessarily challenging for them to exercise: Lack of guidance.
Routine is very important for people with diabetes because it provides a basic level of predictability. Events that deviate from the routine, such as a travel day or some other unexpected event, force them to adapt quickly to manage their glucose levels. The same is true for exercise. Starting to exercise creates many of these new responses, which are individual, and need to be understood and managed. Additionally, the benefits of exercising also mean that the previous regular day routines likely need to be adjusted along the way.
Patients can consult their doctors about exercising, but the recommendations they receive are often generic or limited. Hence, they turn to the diabetes community online to seek guidance. Sharing experiences and learning about basic rules of thumb can be a starting point, but glucose responses to the same exercise can vary greatly, leaving patients again on their own.
Lack of guidance also means a lack of contextual information. As we’ve mentioned before, a multitude of factors influence glucose responses. Understanding what causes a drop or a spike is only possible for diabetes patients if they know the context.
How did yesterday’s training influence my glucose response this morning?
Why do I spike once but usually don’t after having the same meal?
How does my menstrual cycle influence my insulin response?
Today, most patients don’t have access to this contextual information - neither do their doctors.
The lack of available guidance also stems from the plethora of setups across patients; some use pumps, some pens, some have a CGM, and some don’t, not to mention the various hardware providers and their different software offerings. Most apps from CGM manufacturers allow users to add events manually but lack functionality to automate tracking or generate patient insights. Conversely, the different setups make it impossible for doctors/clinics to understand the context well enough to analyze or recommend adjustments from a standardized dataset.
We have to do better, and we can
Solving the lack of guidance problem seems pretty obvious, especially for a team of exercise and diabetes specialists, physiologists, and engineers.
Enhance-d is a community platform to engage, support, and guide people living with diabetes and their doctors around exercise.
The enhance-d dashboard, currently in beta, integrates glucose sensor data (CGMs), insulin, and more than 30 other services such as Strava, Whoop, Garmin, and diet apps to automate tracking for users. Bringing this data together allows patients and doctors to see episodes and patterns within the essential context. The platform is software- and hardware-agnostic, which enables the unified data source required for informed decisions on a patient’s journey. Enhance-d also works with higher education institutions on an AI-layer to detect patterns in the data and surface them to patients and doctors. In parallel, Enhance-d also tests a community app in an alpha release to facilitate further sharing of contextualized data and learnings for diabetes patients who exercise.
Enhance-d offers patients much-needed guidance through adaptive, personalized exercise plans to support their medical journey. While their own journey is only starting, the tools built by this young company have already convinced several clinics to enable their doctors with the dashboard, making exercise an integral part of the treatment process.
Enhance-d is a 2023 headbits Product Camp winner
