Using technology to provide real-time data-driven nutritional advice to people with type 2 diabetes, the young company Clear.bio offers an alternative to medication. The company is about to exit the startup phase. From 1 October, Clear.bio will officially be a healthcare provider. Talks are also ongoing with health insurers to get treatment reimbursed. Director Piet Hein van Dam, this year voted as one of the top 50 health tech CEOs by US Technology Innovators, talks about the success.
Published at the Dutch Health Hub and written by Pieter Verbeek.
After years at Unilever in functional foods and after several startup successes as a data entrepreneur, Piet Hein van Dam wanted something different. “I wanted to be more meaningful to a lot of people in our society,” he says. “We all have great technologies like Artificial Intelligence, Internet of Things and behavioural science, but these are mainly used by the multinationals.
Piet Hein van Dam, founder and CEO of Clear.bio
Data instead of medicine
“I would like to start using these tools directly for individual people. The seed was planted and took shape when I could buy a can of cola in Boston with one dollar in my pocket, but not a bottle of water. I am not from a healthcare background, but have always found it striking that cola is sold most often in neighbourhoods where diabetes is most prevalent. Reducing Western diseases of affluence such as obesity, diabetes and cardiovascular disease became for me personally the biggest imaginable problem to which I want to and can make a significant contribution. With data instead of medicine.”
Measuring sugar peaks
And so Van Dam started Clear.bio three years ago. For two weeks, Clear.bio users continuously measure their blood sugar levels with a sensor on their upper arm and log everything they eat and drink. In the app, they immediately see how their blood sugar levels react to food. In the process, they get advice on what they should and should not eat. Through small, smart adjustments and help from dieticians in the app to change eating behaviour, users improve their blood sugar and health.
Van Dam explains: “The sensor is designed for diabetes patients to measure sugar spikes in real time. That way you can take and dose your medication in time. We thought: ‘That peak comes from somewhere; from your diet’. We wanted to calculate this at a personal level. We saw in practice what has already been proven in science; everyone reacts differently to food and with the right food choices you can reduce sugar peaks and your levels. Without extra care or medication. We found that angle interesting.”
The company launched a test in which a thousand people participated. From athletes, biohackers, entrepreneurs, the elderly to people with type 2 diabetes. “The data showed that especially the last group had the greatest need,” Van Dam says. “That’s where most people are eager for this product. That’s why we decided to focus entirely on this target group, people with type 2 diabetes.”
Raymond van Barneveld
Encouraged by the regional Care Innovation Award that the young company won, and by one of the test participants, darter Raymond van Barneveld, Clear.bio decided to further investigate the product’s impact on the treatment of type 2 diabetes. Van Dam looks back: “Van Barneveld could no longer play darts because of his diabetes and asked us for help. Thanks to Clear.bio, he regained control of his health and was able to compete in the World Darts Championship again. That opened our eyes. There are millions of people like that in the Netherlands.”
“With this new research, we wanted to figure out how to use a sensor and 100 per cent personalised nutritional advice to tackle this disease in a few months. Because type 2 diabetes you get through your lifestyle and so you should also be able to reverse it through your lifestyle.”
Hundreds of people with type 2 diabetes participated. Van Dam: “Within three months, we wanted to improve their situation so much that they were almost patient-free. The results are now coming in and look promising. So now is the time for us to market ourselves properly; either as a tool or as a healthcare provider. We chose the latter.”
From 1 October, Clear.bio will officially be a healthcare provider and part of the primary chain. GPs can then refer patients to Clear.bio. And patients can get it partially reimbursed as non-contracted care. “Then it goes fast,” Van Dam says enthusiastically.
“The next step is for us to somehow get into basic insurance. We are already working with local healthcare groups, such as in Almere and Rotterdam, cities with a high incidence of diabetes. The GPs there want to reduce chronic care more with digital care solutions, including for diabetics. Someone with diabetes has to return to the GP up to four times a year. With one million diabetes patients in our country, this is a huge burden on GP practices. And a thousand new ones are added every week.”
Available to everyone
Meanwhile, Clear.bio consists of a team of ten professionals, including dieticians, data scientists, app developers, online marketers and co-founder Madelon Bracke. “As Head of Biosciences, she ensures that we achieve maximum clinical results. Health insurer Zilveren Kruis and Diabetes Vereniging Nederland are already hooked. Thousands of people have already used Clear.bio and 150 new ones are added every month. Van Dam really hopes that Clear.bio will enter the basic health insurance package as a healthcare provider. “We don’t want this product to be accessible only to people who can afford it, but to everyone,” he says.
Not only technologically is Clear.bio a success. “One of our advantages is that people can always reach us. Our users really appreciate that. If they send an app on Friday evening, they have an answer back in 15 minutes from one of our dieticians. A welcome addition to the care provided by the GP, regular dietician and practice manager during the week. Special after all: we are a digital data-driven product and score very high on participant orientation and motivation. In addition, this product is super scalable and, because of its impact, a serious alternative to medication. That’s why I’m in the list of the top 50 health tech CEOs.”
Lessons from Clear.bio
What can other startups learn from Clear.bio? Van Dam: “I have learned that the bigger the problem is, the more patience you have to have. We are tackling a huge social problem: a million people have type 2 diabetes and a million people are in its early stages. You have to understand very well how the healthcare sector works. In our case, for example, that’s understanding how and under what conditions GPs work.”
“Unburdening them is key. Also with a digital healthcare solution. Understanding, applying or prescribing the product should not cost them any extra time. They are really very busy. That’s why we took the step of becoming care providers. This way, they can easily refer to us. We also notice that there is more and more resistance among GPs to prescribe more and more expensive medicines. And with Clear.bio, they now have something in their hands that can effectively help patients at home.”
Van Dam further argues that innovations need to be more consumer-oriented. “It’s too much about process efficiency. Someone with diabetes has to make as many as 180 decisions a day about his food and drink. We need to look at how we can help him do that. With personalised recipes and shopping lists or barcode scanners for the supermarket that help him choose the right products. We want to make people’s lives healthier, easier and better.”