Enhance-d: A Software Solution to Simplify Glucose Management

After a type 1 diabetes (T1D) diagnosis, all at once, you’re forced to make significant choices, lifestyle changes, and self-care alterations to adapt to your health and well-being.

There are so many components to diabetes management—and exercise doesn’t come easily to people living with diabetes; from balancing carbohydrate intake to coordinating insulin dosing to managing stress and sleep disruptions, the sheer magnitude of responsibility can seem overwhelming.

Fortunately, technology is accelerating rapidly with the advent of smart insulin pens, artificial pancreas devices and especially continuous glucose monitors (CGMs). Moreover, health and fitness wearables and trackers can offer a more comprehensive view of one’s behavior around diabetes management. This technology is having a positive effect on the lives of many people living with diabetes. However, so much data can be difficult to interpret and understand. Software development companies like Enhance-d are creating pathways to help make sense of all this data being generated and improve the user experience by allowing the user to track their CGM data alongside monitoring their food intake, exercise habits, sleep, and stress patterns.

Type 1 Strong had the pleasure of speaking with scientist and entrepreneur Federico Fontana, Ph.D., CEO and co-founder of Enhance-d, a software platform designed to decode diabetes data for better health and enhanced self-care.

Enhance-d Design

Enhance-d, the revolutionary diabetes dashboard, allows individuals with diabetes to discover innovative approaches and methodologies for analyzing their data around glucose and exercise management.

The site’s tracking tools help users visualize diabetes data at a glance and then provide guidelines for nutrition, exercise and real-time blood glucose insight reports sent directly to healthcare professionals. This valuable information traces patterns and trends that can lead to improved treatment strategies and training approaches.

“The vision for Enhance-d is really creating an intuitive, quick, and comprehensive platform,” says Fontana. “To be the solution of choice when dealing with behaviors around diabetes management, starting with exercise, because that is our core expertise, but then expanding into other domains like sleep and stress management.”

Dr. Fontana co-founded Enhance-d with Felipe Maturana, Ph.D., CTO, Fabio Saviozzi, MBA, CCO, and Sam Scott, Ph.D., CSO. The team aims to help individuals with diabetes understand and use the collected data to their benefit. Their mission is to become the one-stop shop, leveraging all available technology in the market.

“We also feel that software has been left a bit behind. Where there is a big push with hardware and not enough on software, and this is where we want to go after,” said Fontana. “We know how important itis to manage stress, for example, but then we also know how untapped the market is for exercise.”

Clinical Decision Making; Made Easy

Enhance-d is developing AI-driven analytics to encourage individuals with type 1 and 2 diabetes to better understand their information by unlocking glucose data quickly to spot patterns and set new goals around their exercise habits.

In addition to nutrition, fitness and health tracking is one of the main areas on the dashboard. “To contextualize diabetes management around your own behavior,” said Fontana. “Whether it’s your diet, exercise routine, or sleep hygiene.”  

The four co-founders launched the startup and incorporated the company at the beginning of 2023. Enhance-d is now accessible through the website. However, the release of a mobile app is scheduled for Android and iPhone users in early 2024.  

Fontana and co-founder Sam Scott worked together previously for many years as academics researching strategies to help people living with diabetes exercise without barriers. The pair also have unique experience working with professional athletes living with type 1 diabetes.

“We had been working largely around an exercise and type 1 diabetes program for a team of professional athletes living with diabetes,” Fontana said.

For six years, Fontana was Head of Performance for a professional cycling team consisting of athletes with type 1 diabetes, in charge of creating a hybrid network behind the training and performance. Fontana oversaw data gathering and analysis involving advanced statistical techniques tracking the performance of these athletes. He was also in charge of coaching the entire team and overseeing a group of four professional coaches.

His belief that there had to be an easier way to interpret data more clearly and concisely around exercise and diabetes carried over to the creation of Enhance-d. One of the main goals of Enhance-dis to put data together in a usable, simple format. While making it actionable to exercise safely and more spontaneously.

Enhance-d: Four Simple Steps

The Enhance-d dashboard provides goal-oriented, colorful widgets that display your Time in Range (TIR), Glucose Variability, and Average Glucose.

1)     The first step is integrating your data. With Enhance-d, you can seamlessly integrate devices you use, from wearables and diabetes technologies, to track events such as insulin intake, exercise, nutrition, sleep, and menstrual cycle.

2)     Next, users can analyze and display data. The data goes deeper to show your personalized management with statistics, percentages, graphs, and a calendar of daily TIR. 

3)     The AI summary accelerates the process, unveiling crucial insights and taking advantage of unexploited data and patterns to support a better and quicker decision-enabling process.

4)     Last, individuals can deliver data to doctors and clinicians. With enhanced coordination between patients, the in-depth summaries help facilitate better decision-making, putting you in charge of your health.

People can now sign up for a free 14-day trial – no credit card is needed. After that, the cost is only $2.99 per month. “We decided to keep the cost as low as possible to facilitate an option, especially at the beginning where we really don’t want to be just another app to add on your toolbar,” said Fontana. “Hopefully, if the community will adopt our system, then we can impact broad user-based management, at least on the exercise side.”

Enhance-d User Friendly Approach

The information is intentionally displayed in a user-friendly, non-judgmental format for the ultimate empowerment practice.

“Based on our experience, we feel and have heard that the current approach is very clinical; there is a tendency to over complicate CGM data, even on the digital side, so we want to create something more user-friendly and more consumer-based, where users don’t have this feeling of being judged,” said Fontana. “So, the use of colors, the use of interface, these are things we thought a lot about to create or shape a different user experience."

Exercise Event Mapping

Technology today allows individuals to visualize and reshape their lifestyles toward better health and fitness. With tools, particularly continuous glucose monitoring devices, you can aggregate the data and map behaviors.

“One component is mapping your behaviors because we wanted to create a simple way to seamlessly track everything that would impact your glucose levels and management,” Fontana explains. “If you are able to map everything – you can theoretically explain each glucose fluctuation. So, the idea would be to map your behavior and then adjust your behavior to promote better diabetes management. One example around exercise is minimizing the risk of hypoglycemia after you work out, whether you can optimize eating habits or fuel up with carbohydrates during exercise.

Fontana went on to say, “There are certain areas that have a great impact on your health and by tracking glucose levels during exercise and after—you create all the information you need to exercise safely, to sleep safely, to promote stress management, to eat accordingly to your needs in terms of glucose management.”

By adding both insulin and nutrition data, you can interpret your glucose fluctuations. Syncing your CGM data with heart rate or power data is simple. Seamlessly integrate your activity trackers or apps to the Enhance-d dashboard, and instantly analyze your exercise and glucose data together for a complete picture of your performance.

Enhance-d Partnerships

Over the years, Fontana and his co-founders have developed a great network of individuals to help grow their company—not just experts in the field but good people to work with who have the same vision. The company comprises clinicians, scientists, and business leaders, some of whom are living with type 1 or type 2 diabetes.

Direct Partnership with Dexcom

Enhance-d is now one of Dexcom’s connective partners, which is how Dexcom defines the alliance. To help get the most out of your Dexcom CGM, software developers like Enhance-d offer customized pairing to log and keep track of your TIR for seamless diabetes management.

Enhance-d is also talking to a large number of athletes for partnerships with professional and amateur teams. “We’re in the process of developing these partnerships, also with patient associations, working with a cycling team and a running club.”

Pairing with Devices

Right now, Enhance-d pairs with Libre and Dexcom systems, though not yet, with insulin pumps. However, there is the possibility to add insulin logs manually. For example, if you are doing multiple daily injection (MDI) therapy, you can add your injections manually to the platform. Fontana said, “We are also working toward automatically integrating insulin pumps and smart pens– it’s a mid-term, long-term process."

Long Term Vision for Enhance-d

 When asked what his long-term vision for Enhance-d’s platform is, Fontana believes that expanding the app to help people living with type 2 diabetes will really make an impact in terms of encouraging exercise and helping to interpret CGM data. “It seems that increasingly, people living with type 2 diabetes will have access to CGMs. Also, the fact that different countries are now covering the cost of CGM in the type 1 community–is an incredible step forward in making this technology accessible. The work the UK is doing, the US, Australia, and France is doing as well—access to technology is game-changing.”

“Exercise can have a really positive impact for the health and well-being of people living with diabetes. With enhance-d, we hope that it will empower more people with the possibility to start an exercise program or just a physical activity program, whether it’s walking every morning or running a 10K; this is impactful and significant for a person living with diabetes, both type 1 and type 2 and so we see how the world is trending toward more active behavior.”

“This healthier behavior would impact diabetes management itself,” Fontana said. “Also, if you think about how easy it is to track exercise nowadays with wearable devices – you can track heart rate and spontaneous physical activity continuously and seamlessly, but no one is really leveraging these data gathering abilities in conjunction with diabetes data abilities, so that is something we are really trying to access—a new market between diabetes wearables and fitness wearables; that’s exciting.”

Through fundraising, more partnerships, and team growth, Fontana said they hope to expand the company even further.

“Our vision is really to try and create a solution that simplifies the life of people living with diabetes. A world where people are not stopped by their condition, but they are empowered to take amore active role. As you become more responsible and independent, developing this attitude toward taking care of yourself—will benefit your life in the longer term. And if we can facilitate it, through the use of our system, guiding your training plan, to achieve your exercise goal, to kind of be a partner, it’s something that we feel would define success for us.”