Reversing ‘Diabesity’: Jana Care using new weapons to tackle diabetes and obesity
India is not the first country that comes to mind when thinking about the growing problem of diabetes across the world, but it has more than 60 million diabetics, plus another 70 million so-called “pre-diabetics” – individuals at such an elevated risk for this condition that the odds say they’ll become full-blown diabetics within a few short years.
It is clear that the burden of chronic diseases such as diabetes in the developing world is rapidly becoming unmanageable, and India, a country where one in four deaths can be attributed to diabetes, is a perfect example. At Jana Care, we are based at the epicenter, in the bustling city of Bangalore, where we are attempting to combat this epidemic in a way that was not possible until recently, using the fast spread of new technologies such as mobile phones and Internet access across the developing world.
Moving to India to tackle this problem now seems like a foregone conclusion, but it was anything but a straightforward path. For me, this journey began sitting in my comfortable office at the Massachusetts Institute of Technology. I had just completed my master’s, during which I worked on medical image analysis algorithms to help cardiologists draw more informed conclusions from magnetic resonance images of their patients’ hearts.
It was the culmination of several years of focusing my engineering skills on solving medical problems and helping the lives of real patients. The genesis of this interest was actually my first stint at MIT as a Killam Fellow, when I got my first opportunity to work on medical technology applications as a part of an elective course. After that, I never looked back in choosing to fully pursue this interest in my career.
However, as I was about to continue this work as my Ph.D. thesis topic, I had an uneasy feeling. Inspiring institutions such as MIT teach you to strive toward ambitious goals, and always question yourself while doing so. My graduate work involved cutting-edge medical technologies, so even in the most optimistic scenarios it would have a modest impact only years down the line, on only a select few patients who would have access to the newest and costliest treatments available.
I wanted to have impact sooner and on a much wider population. This is how Jana Care was born.
We started Jana Care with the broad goal of addressing the spread of chronic diseases in the developing world, and soon singled out diabetes in India as our focus. Initially, as we were a team of engineers, we were certain that the answer to any problem, including medical, was technology. Our thinking was as simple as it was flawed. The problem with health care in the developing world was that patients did not have access to affordable medical technology, as most of it is developed in and imported from Western countries. If we could only develop lower-cost alternatives to products such as glucose meters for Indian diabetics, we would, of course, greatly improve their lives.
We realized this was a naïve approach after repeated lukewarm reactions from doctors in Bangalore and around India – something we would have certainly missed sitting in the comfort of Boston coffee shops. Diabetes is a complex condition, and its rise in India and other developing nations is in large part a consequence of recent socioeconomic shifts. The migration of a significant portion of the population from rural to urban areas, which brought about a move toward increasingly sedentary lifestyles, as well as the increase in individual wealth and with it a spread of unhealthy eating habits, are two of the numerous cultural factors to blame.
We took a step back and began working on a more complete approach to this problem. In addition to building an affordable mobile phone-based blood glucose monitor, we started developing an online health program to help guide Indian diabetics and individuals at high risk of developing it toward healthier behaviors – in particular in their diet and exercise. The idea was to piggyback on the recent spread of mobile phones and the Internet in India to educate patients as well as to change their behaviors in a scalable and cost-effective manner.
To address our need for credibility within the Indian medical community – a crucial partner in this endeavor – we began working with some of the top Indian researchers and physicians in the field. We transitioned from a group of young techies building electronics and software to avid readers of any behavior change literature we could get our hands on.
Two years into this journey, we have partnered with some of the most reputable organizations in India, including the All India Institute of Medical Sciences and the Public Health Foundation of India. During this time, we have received financial backing both through grants from highly regarded organizations such as the Department of Biotechnology of India and Grand Challenges Canada, as well as private angel investors. (We have begun charging customers for our service, but cannot disclose these numbers publicly right now.)
After months of piloting and fine-tuning with several hundred participants, we will be scaling our online health program with the help of our partners in the coming months.
It has been an exciting ride so far and we learned many lessons through the process, including how important it is to adapt quickly to new situations, be as close as possible to the people whose lives we are trying to improve and partner with established organizations. Most importantly, however, we discovered that taking risks and getting out of our comfort zone are essential steps toward creating truly impactful products.
Michal Depa is the co-founder and CTO of Jana Care, a health technology startup based in Bangalore, India.
Editor’s note: This article first appeared on the Fulbright Canada Blog and is reprinted here with permission.