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Tuesday, December 11, 2012

A Start-Up Sees an Opportunity in Diabetes Prevention

There is no doubt that diabetes is a national health crisis â€" and a costly one.

In the United States, diabetes is diagnosed in a person every 17 seconds, according to the medical journal Clinical Diabetes.

Today, one in five health care dollars is spent caring for people with diabetes. A third of Medicare spending goes to treat diabetes and its complications.

That spending is focused on the nearly 26 million Americans who have diabetes. Yet the potentially larger, looming problem is the estimated 79 million who have “prediabetes,” meaning they have elevated glucose levels in their blood and run a high risk of developing the disease.

Anything that can slow the alarming advance of the disease would be a medical triumph, and a potential moneymaker. Omada Health, a San Francisco start-up, certainly hopes so. On Tuesday it is introducing a diabetes prevention program, Prevent, for marketing to the general public.

Omada joins a flurry of young companies that focus on health and wellness programs including Keas, RedBrick Health and Virgin HealthMiles. But these businesses typically sell their offerings to corporations that want to encourage their employees to be healthier and to curb medical bills.

Omada sets itself apart from these other companies, first, by focusing specifically on diabetes, and second, by marketing its program to the general public. The program is intended as the online version of a landmark government-financed project that showed a behavioral weight-loss program could help people prevent diabetes more effectively than medication.

That project, the Diabetes Prevention Program, was a clinical trial sponsored by the Nationa l Institutes of Health. It helped participants improve their eating and exercise regimens, hit a weight-loss goal of 7 percent and reach an exercise target of 150 minutes a week of moderate physical activity, like brisk walking. The people in the 2002 study on average reduced their risk of progressing to diabetes by 58 percent. A 10-year follow-up study recently found the participants had a 34 percent reduced risk.

A major reason that study is relevant today is Obamacare. The Affordable Care Act included a National Diabetes Prevention Program, and the Centers for Disease Control and Prevention is setting up community-based programs modeled after the original N.I.H.-financed project. In a public-private partnership, the C.D.C. and UnitedHealth Group, the big insurer, have sponsored diabetes prevention programs at 178 Y.M.C.A. sites in 23 states.

Omada is positioning itself to ride both the rising national concern about diabetes and the government-backed community efforts. “We're a Web-based program that complements the ground-based programs,” said Sean Duffy, chief executive and co-founder of Omada. “The C.D.C. is catalyzing real efforts to address this problem.”

Omada is a Greek word that Mr. Duffy said most closely translates as “group” in English. “Our model is small-group-based behavior change in health.”

Omada is seeking partnerships with medical providers and insurers, but the product being introduced on Tuesday is for the general public. Its Web site includes a series of questions - about gender, height, weight, physical activity and family history - to help the user determine if he or she is at risk of becoming diabetic.

The four-month program costs $120 a month. At the outset, customers are shipped a scale with a wireless transmitter, and later a pedometer. Participants send in a profile picture, and write a personal introduction to the group. The weight and activity measurements are sent au tomatically to a personalized Web site. Each group has a coach, who makes presentations via Web video and answers questions online.

Groups of about 12 are determined by age, location and body-mass index. “Social connections and accountability lead to success in behavior modification,” Mr. Duffy said. “So you want groups that have a sense of being in a similar state in their lives, going through the experience together.”

Omada ran a 230-person pilot test earlier this year in five cities across the country. On average, the people lost 13.7 pounds, or 6.4 percent, after 16 weeks.

Mr. Duffy, 28, a neuroscience major at Columbia University, worked at Google before deciding to pursue a joint M.D.-M.B.A. program at Harvard. He was on a summer internship at IDEO, the design and innovation consulting firm, working on health care products, when he decided to start the diabetes-prevention venture. (He took a leave from Harvard.)

Another founder is Adrian James, the company's president, who led the medical products division of IDEO's health and wellness practice. The third co-founder is the chief technology officer, Andrew DiMichele, who was an early employee at Lattice Engines, a data analytics company for sales and marketing.

Mr. Duffy said recruiting for the one-year-old start-up had not been a major challenge. “The Valley is full of people who want to use their Web talents to make the world a better place,” he said. “We point them toward health care. It's a really easy message.”