

My friend Dan Hon was diagnosed with Type 2 diabetes. The news shook him. He resolved to do something about it. Being a geek, he decided to measure and quantify the health factors (weight, body fat, activity, blood sugar) that contribute to diabetes. He's lost 30 lbs since the new year, and has gotten pretty far into reversing his diabetes. He's detailed his experience with various kinds of monitoring tools, and written a bit of a rant about what needs to be fixed in order to make this easy for anyone with a diabetes diagnosis to follow in his footsteps.

Incumbents rarely produce great experience design. They don't have to, and they typically are dealing with historical monopolies on consumers or audiences. But there are also some first movers who don't seem to have improved their experience over time. I'm looking at you, Withings. It's a bit embarrassing that Weightbot has a much better mobile app than you do, and you're selling the hardware.

In the blood glucose testing market, it looks like patents (as ever) are acting to stop newcomers to the market, particularly patents in the device and strips. It's complicated: they have a very heavily integrated solution and, from what I can make out, rely on insurance providers in the US. The copay I'm charged for 100 blood sugar testing strips is $10. If I'm paying retail, it's about $110. When I'm testing up to six times a day, that's nearly 200 strips a month.

Now, if I were being overly cynical, I'd say that the interests of a company producing blood sugar meters and strips aren't necessarily aligned with the interests of a patient who wants to stop having diabetes. From my absolutely scientific sample size of one (me), testing before and after every single meal, and testing a fasting blood sugar in the morning has been vital to me getting my blood sugar under control. It's meant that I've learned what I can eat and how much, and crucially, that I can still have burgers. If I eat less burger. And more salad. But: I can still eat burgers.

What people with diabetes should have — especially people diagnosed with type 2 diabetes — is access to cheap blood testing monitors (oh, but they are cheap! The manufacturers give them away, and then charge you for the strips in a model you might be familiar with) that are easy to use and help you see trends over time, and, cheap blood testing strips that let you test at least before and after each meal every day. If you're on, say, Medicaid, and you can afford one testing strip a day, I don't think the success rate of people learning trends and altering their behaviour is going to be that high.

If I were still in the startup game, I have a pretty good idea of which industry I'd want to disrupt.