Memorandum

Fitbit and Medtronic partner, launch myLog app to capture exercise, food, fingerstick data while wearing iPro2 professional blinded CGM – December 7, 2016

Executive Highlights

  • Medtronic and Fitbit announced a partnership to integrate Fitbit activity data into the iPro2 professional CGM (blinded, retrospective). The iPro2 myLog app has launched on Apple iOS and Android, allowing patients to manually log fingersticks, food, and exercise (plus auto-sync with a patient's own Fitbit tracker) over the six-day blinded iPro2 CGM wear.
  • The goal is to bring more behavioral context to retrospective CGM data. Events are automatically sent to CareLink iPro, giving providers a broader picture of glucose drivers. A new section of the one-page Pattern Snapshot report will now show how exercise affects a patient’s glucose levels.
  • The bigger news here from our view is that Fitbit is moving into diabetes more formally – it issued a joint press release with Medtronic (same language), and its new VP of Digital Health Adam Pellegrini is quoted.  

This morning, Medtronic and Fitbit jointly announced a partnership to integrate Fitbit activity data into the iPro2 professional (blinded, retrospective) CGM. Medtronic has launched the iPro2 myLog app on Apple iOS and Android, which allows patients to manually log fingersticks, food, and exercise (or auto-sync with a patient's own Fitbit tracker) over the six-day blinded iPro2 CGM wear – the goal is to bring more behavioral context to retrospective CGM data. The myLog app was mentioned vaguely at the 2016 Analyst Day Meeting (“Logbook” app) and comes on the earlier side of plans to launch by April 2017.

The press release implied that patients will see their real-time CGM and exercise data together in the app, but based on the screenshots (see below), that is not the case – iPro2 remains a blinded CGM, and the initial myLog app will simply add behavioral context to the retrospective CGM data. Users with a Fitbit will be able to sync their own tracker with myLog directly (a nice seamless add-on for those that happen to own a Fitbit), and providers will see the combined exercise and CGM data in CareLink iPro. Medtronic has added a new section of the one-page Pattern Snapshot report to show how exercise affects a patient’s glucose levels – hopefully a nice teaching tool. Patients can also manually log meals in the app, which would add context to retrospective CGM data alone.

According to Medtronic’s myLog app page, “Nearly 90% of patients will log more events using the myLog app” (Medtronic Marketing Research, n=109 diabetes patients). The quality, quantity, and sustainability of manually logged data is always a big question, though it should hopefully be easier in this case, since iPro2 is only six-day wear. Plus, it’s better than paper logs.

The bigger news here from our view is that Fitbit (!) is moving into diabetes more formally – it issued a joint press release with Medtronic (same language), and its new VP of Digital Health Adam Pellegrini is quoted. This is consistent with remarks on Fitbit’s past few earnings calls that have emphasized plans to move into healthcare (particularly as consumer demand has slowed). This partnership is excellent news, since walking is so underestimated for improving blood glucose. We hope this is the start of much more Fitbit involvement in diabetes, and it certainly continues growing ties between consumer tech and diabetes companies. It also adds to a growing list of Medtronic Diabetes partnerships, including Canary Health (diabetes prevention – very relevant here), IBM Watson, Samsung, Qualcomm, BD, DreaMed, Glooko, and mySugr.

  • Upon completion of the first iPro2 CGM evaluation, Medtronic will provide patients with the opportunity to purchase a Fitbit “at a preferred price.” We assume that is in the range of $20-$50 off. Patients have to use their own Fitbit to take advantage of the new data integration, so the discount will presumably benefit those who wear iPro2 but don’t own a Fitbit. We hope one day, a Fitbit could be co-prescribed with professional CGM wear.
  • The iPro2 transmitter/recorder doesn’t include Bluetooth, though Medtronic’s partnership with Qualcomm does plan to launch real-time viewing for its iPro4 professional CGM by April 2019 (per the 2016 Analyst Day Meeting). We also assume the Fitbit partnership could expand to automatically add exercise data to the Sugar.IQ app with IBM Watson, to inform future closed loop algorithms, or even to drive diabetes prevention through the partnership with Canary Health.
  • The press release is focused on type 2, since the iPro2 sits in Medtronic’s non-intensive diabetes therapies division, but we assume future Medtronic-Fitbit products could equally benefit type 1s.
  • We’re not sure if the ability to log fingersticks in the app will eliminate the need to download a meter to retrospectively calibrate the iPro2 in the clinic. As a reminder, raw CGM data from the iPro2 is retrospectively calibrated using fingerstick data taken during wear. (This is a significant drawback relative to Abbott’s factory calibrated FreeStyle Libre Pro, which is much easier to prescribe and use than Medtronic’s iPro2.)
  • The Fitbit integration is pretty tight, as patients can directly use the iPro2 myLog mobile app to sync their tracker (i.e., no need to also run the Fitbit app). Of course, if patients have to own their own Fitbit anyways, they will already have the Fitbit app.

Close Concerns Questions

Q: How useful will the behavioral context be for providers? Will it provide meaningful new data to change therapy?

Q: Will Fitbit and Medtronic eventually sell more bundled services and programs together? For example, a professional CGM + behavior change program? Will providers ever prescribe a Fitbit with CGM wear? 

Q: What percentage of type 2s in the US have a Fitbit? What percentage of type 1s? What are the best ways to engage a very diverse range of patients? What incentives are planned to ensure patients sustain logging over the six-day wear?

Q: This partnership is focused on the type 2 business and iPro2, but could it expand to type 1s and prediabetes (e.g., Sugar.IQ app with IBM Watson, closed-loop algorithms, Canary Health partnership for diabetes prevention)?

Q: When did talks start between the two companies?

Q: Can Medtronic and Fitbit improve provider knowledge of glucose and exercise? Our sense is that HCP awareness is low related to how exercise impacts activity (at a deeper level than just “It’s beneficial”) and how to adjust insulin accordingly.

Q: What is Medtronic VP Laura Stoltenberg’s (non-intensive diabetes therapies) fondest wish for this partnership? How about President Hooman Hakami’s? How about Chief Medical Officer Fran Kaufman and Dr. Robert Vigersky? What does Fitbit management want to see?

Q: What's the average number of daily steps Fitbit sees for America? What about in people with diabetes? What have the trends been?

myLog App Screenshots

-- by Adam Brown and Kelly Close