Memorandum

mySugr passes 1 million registered users! Interview on the user base, future, and becoming a “digital diabetes clinic” – May 10, 2017

Executive Highlights

  • mySugr now has more than 1 million registered users worldwide, solidifying it as the most popular diabetes app globally. What a milestone! The strong uptake quickly follows the company’s founding in 2012, and reinforces the app’s excellent design, differentiated value-adds (reports, bolus calculator, coaching), device integrations, diversified business model, and focus on gaining regulatory clearance.
  • mySugr has stellar 4.6-star average ratings on the iOS App store and Google Play, and is  available in 52 countries and 13 languages (~50% of users in the US, ~45% in Europe, and ~5% in rest-of-world). Notably, ~52% of users are on Android and ~48% are on iOS, a reminder of how critical it is to develop and maintain apps on both platforms.
  • mySugr is in discussion with partners to bring its EU-approved bolus calculator to the US market. Discussions are also ongoing with payers around the world, following the two deals signed in Germany earlier this year (providing unlimited strips, a connected BGM, population management, and coaching for $850 per year).
  • In our Q&A with the team, the company emphasized its vision to work more with payers, bring more clinical outcomes data to digital health, and become a digital diabetes clinic.

mySugr announced early this morning that it has passed 1 million registered users worldwide, an incredible milestone for a diabetes digital health company started in 2012! mySugr believes it is the “first mobile diabetes platform to reach such a huge landmark,” a testament to the app’s excellent design, differentiated value-adds (bolus calculator, data analysis and reports, coaching), growing device integrations (Roche, Medtronic, Abbott, Dexcom, Beurer), commitment to publishing outcomes data (see ATTD), diverse revenue streams (consumer, industry, payers), drive to secure regulatory clearance, and drive to “make diabetes suck less.”

A mySugr registered user is someone who has downloaded the app, opens it, and creates an account (email address + password). Hitting 1 million registered users is an enormous achievement in a world where the barriers to developing apps are low (lots of competition), consumers’ expectations are sky high, and attention spans are shorter than ever.

mySugr could not disclose how many of the 1 million users open the app monthly or weekly or daily, but based on the stellar 4.6-star average ratings on the iOS App store and Google Play, it’s clear the value-add is very high. The app is now available in 52 countries and 13 languages, with ~50% of users in the US, ~45% in Europe, and ~5% in rest-of-world. Notably, ~52% of users are on Android and ~48% are on iOS, a reminder of how critical it is to develop and maintain apps on both platforms. We’ve always been impressed with mySugr’s colorful, non-clinical design; sleek data displays; and customization options – the app stores (iOS, Play) have the latest screenshots.

Though mySugr started out as a “logging” app, it has grown its device integration partnerships over time, which now include agreements with Roche (Accu-Chek BGM integration; launched in six countries), Medtronic (pump and CGM via direct CareLink; not launched), Dexcom (via Apple Health; launched), Abbott (FreeStyle Libre; launched where LibreLink is available), and Beurer (BGM; launched) in Europe. The app is not quite optimized for sensor data yet (in our view), but this should obviously change over time. mySugr and Novo Nordisk also have a collaboration related to the new Fiasp insulin (we didn’t know about this!), which focuses on education around postprandial glucose.

The company’s diverse business model is notable – the Pro version of the app is sold direct-to-consumer ($2.99/month or free with the Roche BGM integration), and mySugr also gets revenue from industry and now from payers. mySugr is in discussions with additional insurance companies around the world, following the signed deals with two German payers (announced at JPM) to provide usage-based unlimited strips, a connected BGM, population management, and coaching for $850 per year (of course, pricing may change over time with different deal structures). We see massive potential for this offering, particularly in the US.

Read more details below, including a great Q&A with the team and a cool infographic!

  • mySugr is in discussions with partners about bringing its EU-approved bolus calculator to the US. The team works with the highly regarded John Walsh and has written a couple of fun blog posts sharing recent design improvements and updates – see here and here. These posts are well worth a read alone for a look at how deeply the company takes design and its process for making improvements.   
  • The mySugr team is more than 45 employees between Vienna and the just-opened second office in San Diego. With half of its users in the US, focusing stateside is obviously critical, and we’re glad to see CEO Frank Westermann has moved to San Diego to lead efforts there. We’ll be interested to see if Dexcom partnership gets tighter, since the current integration is not nearly as tight as the Roche offering.
    • Notably, one-third of mySugr employees have diabetes, which clearly shows in the app’s friendly design. This is reminds us of the team Bigfoot has built to automate insulin delivery.  
  • At ATTD in February, mySugr and Prosciento (formerly Profil) presented a retrospective analysis suggesting a 1.3% estimated A1c reduction over six months in 440 randomly selected high-risk Logbook app users (baseline estimated A1c: 9.0%). To be in the retrospective analysis, patients had to have a mean baseline blood glucose of ≥183 mg/dl (estimated A1c >8%) and high engagement on the mySugr Logbook app (logging ≥5 days/week for ≥6 months). Mean blood glucose fell 18%, from 211 mg/dl at baseline to 173 mg/dl, an impressive drop. Both high blood glucose index (HBGI) and low blood glucose index (LBGI) improved (see the poster here). It’s great to see the company digging into data from its one-million strong user base, especially through this important research partnership with Prosciento to clinically validate digital health. We look forward to seeing more outcomes, especially when the Logbook app is coupled with coaching.
  • mySugr Coaching on iOS launched in the US with Gary Scheiner’s clinic in early October and was characterized as “a definitive win” in users that have tried it (initially $19.99 per month). No further outcomes have been shared since our coverage last fall, but this is definitely a program to watch. From what we can tell, mySugr Coaching is more hands-on and personalized, so we’ll be interested to see how it scales. Expanded distribution of mySugr Coaching was previously expected in 2017.

Q&A with the mySugr Team

Q: What would be a home run for mySugr in 2017? 2018? 2019?

A: Following up on recent wins in Germany, more traction with payers is the first thing that comes to mind. Additionally, further expanding our products to seamlessly digitize all of the relevant touch points in diabetes will be important for us. We’ve made progress with connected BG devices and backend connections, but there’s still a lot of unrealized potential with insulin delivery devices, glucose sensors, and more. With mySugr’s pipeline of products pulling these pieces together, we’re on the forefront of making the digital diabetes clinic a reality for more than a million people with diabetes around the world. 

We're also working closely with ProSciento. In addition to questions about whether using mySugr helps, we also want to look at the bigger picture – can we make a difference in the economic landscape of diabetes? Perhaps a shift that incorporates a strong digital diabetes platform like mySugr can make people healthier and happier, can help HCPs be more efficient and effective (and better able to handle the large influx of patients), and save the system money overall. A homerun in this path would be a resounding YES to those questions! 

Q: What is the biggest threat(s) digital diabetes care faces in the next five years? 

A: I might say a reluctance from established systems to adopt new paradigms. Those of us living with diabetes know all too well that the current systems are far from ideal and that we have to work way too hard to get even the most basic tools we need and support/information/education/advice to live healthier. Something big needs to change, and those of us who are pushing the envelope need to see more willingness to adapt to the current and rapidly changing environment. 

Q: What has been the biggest learning/surprise in mySugr coaching?

A: When we can help get the technology burden out of the way, there’s a remarkably beautiful relationship that develops between the coaches and the users. And while that trust and open communication was a core part of our vision, we have been pleasantly surprised by how it’s grown and developed. Additionally, CDEs are amazing – but that’s no surprise! 

Q: If you could ask five leaders in diabetes digital health one question, what would it be?

Fredrik Debong, Head of R&D: “What drives you to focus your career and life on this subject?"

Kyle J. Rose, Business Development USA: “How do you define value based healthcare and outcomes?”

Marlis Schosser, Product Owner: “Where do you see diabetes management in the next 5 years?”

Anton Kittelberger, COO: “ What's the most important thing you’ve learned in your journey around product, business model, team and your strategy?”

mySugr Infographic – 1 Million Users

-- by Adam Brown and Kelly Close