Laurence Girard, CEO and Founder of Fruit Street, shares the story of the company’s diabetes prevention programme and how their experience on the DigitalHealth.London Evidence Generation Bootcamp programme provided them with the tools they need to move into the UK market.
In both the United States and the United Kingdom, approximately one in 3 adults are considered to have prediabetes. Prediabetes is when someone has blood sugar levels that are higher than normal, but are not high enough to be classified as Type 2 diabetes. Approximately 70% of people with prediabetes are likely to develop Type 2 diabetes in their lifetime. The good news is that peer-reviewed research has proven that prediabetes can be reversed through diet and lifestyle changes.
I am the CEO and Founder of Fruit Street Health and we deliver a diabetes prevention program through telehealth and live group video conferencing with registered dietitians.
How it began
The history of the program is that Medicare in the United States spent $175 million on a clinical trial to determine if a pharmaceutical drug or lifestyle modification program was more effective at preventing someone with prediabetes from progressing to Type 2 diabetes. The lifestyle change program in the study included classes on topics such as diet, exercise, sleep, and stress management. Participants tracked their diet and physical activity in an effort to achieve 5% weight loss.
The results of the study were historic in that they found that participants in the lifestyle change program where able to reduce their risk for Type 2 diabetes by more than 58% and people over the age of 60 reduced their risk for Type 2 diabetes by more than 71%. This research was published in the New England Journal of Medicine and let to payors such as Medicare, Medicaid, employers, and health plans in the United States paying for the program.
The CDC (Centers for Disease Control and Prevention) also developed a national public health initiative to encourage more than 2,000 organizations to deliver the program. Most of these programs are delivered in-person at churches, hospitals, and other community centers such as YMCAs. Fruit Street’s program eliminates the barrier of physical classes by delivering the program online through telehealth and live group video conferencing with registered dietitians. We also issue the participants wireless scales and Fitbits so they can track their weight loss and physical activity in our mobile app. The app also allows participants to take photos of their food and receive feedback from their dietitian throughout the week.
Entering the UK market
Fruit Street is well established in the United States and has enrolled more than 44,000 patients since we started our diabetes prevention program in 2017. We heard that the National Health Service was paying for a diabetes prevention program similar to the one in the United States which spurred our interest in expanding into the United Kingdom.
We first tried entering the United Kingdom market in 2019, but it was difficult because we were not connected to DigitalHealth.London at the time and the pandemic also derailed our international expansion plans.
The DigitalHealth.London Evidence Generation Bootcamp
This time around we were lucky enough to be accepted into DigitalHealth.London Evidence Generation Bootcamp. The Bootcamp was a thrilling experience where we connected with physicians from the National Health Service, health economics and university professors, and fellow digital health entrepreneurs who already had some success in the United Kingdom.
We learned so much in the program, but one of the best pieces of advice we were given was to hire a local registered dietitian to help us translate our program from “English into English.” While both people in the US and UK speak English, the language people use on a day-to-day basis can be different and the cultural and social norms around diet and exercise can differ. As a result of this advice, we will be hiring a local registered dietitian to assist us with ensuring that our curriculum is appropriate for the UK market.
The other great piece of advice we received is that while it may not be necessary to do massive numbers of clinical trials, it would be useful if we could partner up with a university in the UK to produce some local evidence that would prove that our program works in the UK.
The team at DigitalHealth.London also did a great job at pointing us towards various funding opportunities with different government agencies that support digital health research. We will definitely be pursuing these types of opportunities as we try to get a foothold in the UK market.
The program provided Fruit Street with wonderful scientific guidance, but equally important was the opportunity that we had to ask business questions to various stakeholders across the healthcare system. We also learned from fellow entrepreneurs what business models have worked for them in the UK market.
We look forward to continuing to stay in touch with the DigitalHealth.London team as we try to help people in the UK living with prediabetes avoid developing Type 2 diabetes through our digital diabetes prevention program.
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Fruit Street is part of the first cohort of the DigitalHealth.London Evidence Generation Bootcamp programme.
The DigitalHealth.London Evidence Generation Bootcamp is a collaborative programme funded by two of London’s Academic Health Science Networks – UCLPartners and the Health Innovation Network – MedCity, CW+ and receives match funding from the European Regional Development Fund.