Diabetes app best practices: mySugr uses gamification to gain more than 90,000 users. Interview with Frederik Debong Co-Founder of mySugr

The majority of diabetes apps do not meet best practices standards. mySugr is a diary and monitoring app that leverages gamification and communication features in a best practice style to keep users engaged.

61% of iOS and 39% of Android diabetes apps fall into the category “Diaries & Monitoring”. This is one of the results of the new report “Diabetes App Market 2014”, published in January 2014.


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“Diaries & Monitoring” apps allow diabetics to keep track of their blood sugar levels, insulin dosages, meals, activities, mood and other information which normally would have been captured in a paper diary. The way they most current apps are designed they often overburdens users with time consuming data input, complex result presentations and the lack of motivational aspects which are important to keep users engaged.

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Frederik Debong Co-Founder and community relations lead of mySugr explains what they try to achieve with mySugr, how they make money, what needs to be changed for the market to take off and much more.

Enjoy the interview.

research2guidance (r2g): As a short introduction for mySugr, could you please explain what you do and how your apps are different from the rest of the diabetes apps on the market?

 Frederik Debong (mySugr): mySugr is based in Vienna and we define ourselves as a “patient-centric diabetes services company”. We are people with diabetes ourselves and we build solutions for us and our customers, or if you want, our brothers and sisters. We aim to change the philosophy of diabetes therapy.

Defining diabetes therapy, we need a basic toolset, the basic knowledge and the right attitude to be successful. We feel that the world is lacking in all of these departments. The first app we launched about 1.5 years ago: the “mySugr Companion” which is a mHealth app available on iPhone – and since a few months also on Android. The mySugr Companion motivates people to follow their therapy, gives users direct feedback and tells them how their blood glucose behaves.

We must remember that type 1 diabetes therapy is very data driven, and chronic – it never ends. To keep on top of it, you really need someone behind you. You need someone to pat you on the shoulder when something goes bad, and someone to congratulate you when you are doing well. It is very much for us, the patients, to take care of ourselves. Yet this is a big responsibility we at mySugr take: Helping you to manage a chronic condition, which is why the app is listed as a class I medical device, registered with the FDA as well as the notified bodies of the EU.

r2g: So you are focusing on mySugr Companion and then you have also released mySugr Junior, is that right?

Frederik Debong: Yes, our flagship product is mySugr Companion which is a robust diabetes app for insulin-treated diabetes.

The mySugr Junior app aims to help younger children and caregivers with day to day life and diabetes therapy. I myself remember when I was a small child, I was diagnosed at the age of 4, off at a birthday party — I had no clue what to do with that cake in front of me. That is exactly where mySugr Junior comes into play: All of a child’s entries are synchronized with parents’ or care-takers’ smartphones. So when a child does not know what to do, they can get a notification from their parents or care-takers via a call or text messages. Our kids are also rewarded with points and feedback from their very own diabetes monster. It builds a sense of independence and self-care in the children (which is a huge step in their diabetes journey) while also providing caregivers with the safety and security they need.

r2g: You have mentioned that the first app was released 1.5 years ago. When did you decide to start your business?

Frederik Debong: We got together some time in 2010, but we formed the company in 2012, prior to the release of the application.

r2g: And could you let us know how many users your apps have today?

Frederik Debong: I think we have just reached 90,000 users in the US and EU.

r2g: 90,000 are monthly users?

Frederik Debong: 90,000 registered users, actually 90,259! This figure is dynamically updated and publicly available on mysugr.com.

r2g: And the users where are they coming from? From which countries?

Frederik Debong: The majority of our users come from German speaking Europe as well as the US — but we also see very healthy traction in Sweden, Italy and France.

r2g: What is your business model?

Frederik Debong: If you like you can have the basics for free, but you can go PRO for an extra fee. This enables you to use about 10 more features, such as the very popular PDF report or the search feature, which helps you make more use of the data. BG reminders, multi-device sync, and pro challenges (designed to push you to improve your therapy) are a few others worth mentioning.

We also work with companies such as Sanofi-Aventis, one of the biggest insulin producers in the world, Abbott Diagnostics, as well as T-Mobile, A1 and JDRF! Thanks to their challenges, our users can use the app without paying — our partners take care of the costs.

r2g: And when you work together with those companies, do you have a distribution partnership with them?

Frederik Debong: No, they are really happy to work with us since they become so well known within our ever-growing community — we are also about to integrate with some of their hardware, which makes sense on several levels!

r2g: I imagine that you are focusing on behaviour change with your app. Do you have proof that it actually changes how diabetics are taking care of themselves?

Frederik Debong: We already see an indication of behaviour change looking at how people use our apps. We see that people test their blood glucose more often and that they change their attitude regarding the therapy. They go away from a negative, what we call a ”diabetes monster”. In our apps the monster becomes friendlier as you learn to live with it.

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We have 2 big clinical trials, RCT’s, starting this year which are going to validate what we see in an unbiased way.

r2g: Frederik, there are already quite a few very good solutions out there for diabetes patients. With solution I mean an app, not only as a stand-alone app, but also as a package together with sensors or services. But even with those best practices apps, the penetration within the target group is very, very limited. Do you see a reason for that?

Frederik Debong: First of all, you have to make a distinction between Type I and Type II Diabetes where the needs are totally different. Type II diabetes, unless it is insulin-treated, is not as heavily data driven as Type I Diabetes. Second, we have to keep in mind that a very large portion of people with diabetes live in developing countries where there is a much lower smartphone penetration rate as well as an older kind of diabetes treatment (without carb counting or functional insulin therapy). Furthermore, if you are serious about what you do — and implement ISO 13485 and develop the app as is required by the authorities you must also comply with local regulations. This is a major barrier.

r2g: What needs to be changed for the market to take off?

Frederik Debong: The pre-requisite is a high quality product. A diabetes app would have to successfully go through rigorous testing and design/development processes. It has to be developed following certain rules. After this is done, physicians can really push these apps, and confidently recommend them to their patients. Interestingly, there are now only about three diabetes apps that have gone through FDA registration or approvals. In addition, if a mobile app takes itself seriously, it also has to go through many other regulatory hurdles, such as providing services in the required language. For example, you cannot enter the Swedish market unless you are available in Swedish, according to the European regulations. Once you get around that, once you can handle that load of work for a company, then you can make it big.

Apps in diabetes also must find a way to integrate this plethora of devices existing out there, which help us measure our blood glucose? Currently, this is very tricky for companies focused on software.

There is also slight naiveté in many tracking solutions — where the software is simply a complex replacement for a paper journal. The mHealth-industry needs to consider how we can yield a high amount of value, directly, in the day to day life of our potential users.

r2g: Would you now tell me what is your personal favourite app?

Frederik Debong: Apart from mySugr Companion and the other apps we are working on? Another app I use every day would be Evernote. If you consider mHealth apps, then I’d go for Moves, an activity tracker which I have used since it was launched. It gives me good feedback on my personal activity and I look at it pretty much every day.

r2g:   Thank you very much and good luck.

Read the fact based “Diabetes App Market Report 2014” to get input for your business plan, understand competitor performance and which business models will work best for diabetes apps in the next 5 years, and much more. Click here to see the preview and the table of contents.