SugoSure's Design

Outcomes from Type 2 Diabetes Mellitus in Singapore and other parts of Asia are not where they should be.  SugoSure aims to drive a transformation of care delivery for chronic diseases which will both improve outcomes and, in the longer term, reduce healthcare expenses.

Diabetes is a major problem since many patients still progress to develop complications which can be severe.  Singapore has among the highest % of end stage kidney failure caused by diabetes of anywhere in the world.

%ESRD with diabetes as primary cause
Bending the Cost Curve

Transformation is imperative for several reasons: the rising prevalence of chronic diseases, limited human resources to provide care, cost (diabetes is expected to cost the Singapore economy S$1.8 billion annually by 2050).

Straits Times Dec 19 2018

Be mindful when using apps to monitor diabetes as many don't track all the important areas: Study
App in hand

"A new study by local researchers has urged people to be mindful when using apps, as not all have features that enable comprehensive diabetes management.

The problem arises when people are misled into thinking that just a few of these functions are enough when controlling diabetes needs an all-round approach."

Addressing Overlooked Areas

SugoSure has been designed from the start to address areas which have been overlooked by the many diabetes app on the market.1

This has involved detailed discussions with our Medical Advisors and reviews of Clinical Best Practice - see 'IDF Recommendations' below.2

Our protocols are designed to build patient engagement and adoption of self-management behaviours - which has been proven to lead to better outcomes.3

Our health coaches are diabetes-trained registered nurses who play a critical role in ongoing patient support and education.

1 Jimenez G, Lum E, Car J. Examining Diabetes Management Apps Recommended From a Google Search: Content Analysis. JMIR Mhealth Uhealth. 2019;7(1):e11848. Published 2019 Jan 16. doi:10.2196/11848

2 Self-Monitoring of Blood Glucose in Non-Insulin Treated Type 2 Diabetes.  International Diabetes Federation 2009

3 Klonoff DC. Improved Outcomes From Diabetes Monitoring: The Benefits of Better Adherence, Therapy Adjustments, Patient Education, and Telemedicine support. J Diabetes Sci Technol. 2012;6(3):486–490. Published 2012 May 1. doi:10.1177/193229681200600301

Comprehensive, Coordinated Team-Based Care

Patient interactions are guided by SugoSure's alerts and analytics, powered by ConnectedHealth's cloud-hosted Clinical Data Platform.

This single platform also hosts SugoSure's diabetes EMR and assists coordination of Lifestyle and Clinical Plans. 

In this way SugoSure enables comprehensive, coordinated team-based care - a proven approach to improving outcomes in diabetes. 

Wiring diagram

Key Features of SugoSure's Design

Clinical Best Practice

Guides physician through a full review at the Initial SugoSure Consultation

Rules-based decision support for lab tests, medication and changes in monitoring frequency

Operational dashboards monitor physician compliance with review schedules

Closing the Loop

Dashboards and alerts feed back real-time progress vs targets to the patient

Feedback is reinforced by ongoing health coach support and physician Remote Reviews 

Allows swift problem resolution through lifestyle or medication changes as needed

Quick Problem Resolution

Glycaemic control, Lifestyle and Compliance problems identified early through the pattern of logged patient data 

Triage by chatbot and health coach with physician alerted when necessary and only if needed

Protocol-driven problem resolution for lifestyle and compliance issues is entirely led by health coaches

Coordinated Care Plans

Clinical Plan setting and tracking designed around Singapore MoH Clinical Practice Guidelines

Lifestyle Plan (complementing Clinical Plan) developed by health coach following initial 2 week assessment 

Coordination assisted by messaging through the system and linked to alerts

SugoSure assembles these features into a comprehensive tool for physicians and patients with coordinated health coaching.  The result is a system which is sophisticated and clinically-relevant yet easy to use.

                     

This is the future of diabetes care: coordinated, data-driven and based on best clinical practice

IDF Recommendations

The following summary is taken from 'Self-Monitoring of Blood Glucose in Non-Insulin Treated Type 2 Diabetes' published by the International Diabetes Federation (IDF).  This outlines best practice use of self-monitored blood glucose - the approach to improving blood glucose control around which SugoSure's design is built.

1. SMBG should be used only when individuals with diabetes (and/or their care-givers) and/or their healthcare providers have the knowledge, skills and willingness to incorporate SMBG monitoring and therapy adjustment into their diabetes care plan in order to attain agreed treatment goals.

2. SMBG should be considered at the time of diagnosis to enhance the understanding of diabetes as part of individuals’ education and to facilitate timely treatment initiation and titration optimization.

3. SMBG should also be considered as part of ongoing diabetes self-management education to assist people with diabetes to better understand their disease and provide a means to actively and effectively participate in its control and treatment, modifying behavioural and pharmacological interventions as needed, in consultation with their healthcare provider.

4. SMBG protocols (intensity and frequency) should be individualized to address each individual’s specific educational/behavioural/clinical requirements (to identify/ prevent/manage acute hyper- and hypoglycaemia) and provider requirements for data on glycaemic patterns and to monitor impact of therapeutic decision making.

5. The purpose(s) of performing SMBG and using SMBG data should be agreed between the person with diabetes and the healthcare provider. These agreed-upon purposes/goals and actual review of SMBG data should be documented.

6. SMBG use requires an easy procedure for patients to regularly monitor the performance and accuracy of their glucose meter.