Limburg digital solutions ease the burden on diabetics care

There are currently around 1.2 million people with diabetes in the Netherlands, and this number is expected to rise to 1.5 million by 2040. An increase in the number of diabetics means more visits to the doctor, check-ups, and medication. Diabetes also increases the risk of cardiovascular disease, eye problems, and foot problems.

Solutions are being sought in several areas to reduce the pressure on healthcare. For example, Erik Duijsens and his company Chipmunk are working on reliable data for remote care. Ernest Lempers and his colleagues are developing a simpler alternative to the orthopedic shoes that diabetes patients with foot problems often have to wear. Both companies received financial support from the regional development agency LIOF to help them enter the market. We spoke with the entrepreneurs about how their products are easing the burden on healthcare.

Most expensive ailment

Patients with type 2 diabetes can suffer from foot problems. Ernest Lempers, CEO of Procs Medical: “Uncontrolled sugar in your blood causes your veins to clog up,” he explains. "The further away from your heart, the worse it gets. The nervous system in the legs dies off, as it were, reducing muscle tension in the foot. The foot sags, losing its cushioning function. As a result, the sagging foot bones protrude through the skin from the inside."

He continues: “Foot problems are not the most common conditions in type 2 diabetes, but they are the most expensive.” If a patient has an inflamed foot, constant care is needed until the wound has healed. This can take a long time, and the patient has to visit the hospital regularly. In addition, patients with foot problems are often prescribed orthopedic shoes, which come at a high price. What's more, fitting such shoes takes a lot of time. “That's a problem, because the feet of a type 2 diabetic patient become increasingly vulnerable over time,” says Lempers. If patients are less mobile, they are also at greater risk of complications affecting the heart and eyes.

Silicone foot protector

Procs Medical is developing a foot protector called the Procs. A 3D printing process developed specifically for the Procs prints an exact copy of the foot from silicone. This silicone mold completely encloses the foot and provides targeted support. The Procs help prevent sagging and reduce the risk of blisters. Patients wear the foot protector in a semi-orthopedic shoe. Fitting such a shoe takes much less time than a fully orthopedic shoe. “So we already have an advantage for both the patient and the specialist,” says Lempers.

Originating in the Netherlands Antilles

The idea for the Procs originated from the work of Thomas de Windt, an instrument maker who spent 15 years handcrafting foot protection for diabetics in the Netherlands Antilles. “It took us almost three years to industrialize and digitize the manual process,” says Lempers. The team developed the material at the Brightlands Materials campus in Geleen. The product is now ready for clinical testing.

Eliminating human error

The idea for Chipmunk also originated abroad. Erik Duijsens, founder and CEO of Chipmunk, moved with his family to Canada in 2010, where he began to view remote care differently. To this day, he is surprised by how little attention is paid to the reliable collection of patient data, even though healthcare is becoming increasingly digitized.

Together with his partners, he therefore developed the Chipmunk, a smart box that connects the patient to the internet at home. “This creates a secure data tunnel from the patient's living room to the doctor's office.” Various measuring devices, such as scales, glucose meters, and blood pressure monitors, automatically transmit the necessary data. The patient does not enter any data themselves. “This eliminates human error,” explains Duijsens. The data is made available to the healthcare provider and the patient via Chipmunk's medical cloud.

Duijsens and his partners deliberately chose Limburg as a testing ground. “Healthcare demand is relatively high here,” he explains. “There is also a lot going on from a socio-economic perspective. For us, it's the best place for product development, because if it works here, it will work in other regions too.”

Complex market

Both entrepreneurs agree that bringing medical innovation to market is a long process. Duijsens: “Everything has to be backed scientifically. In addition, it is a complex market in which the user is not the payer. That makes it very difficult.”

Golden move

A key move in the development of the Chipmunk was the collaboration with Meditta, a large group of general practitioners active in the Sittard, Roermond, and Weert region. This group of general practitioners comprises around 200 doctors and approximately 350,000 patients. “We immediately got five GP practices that made 50 patients available to us, with whom we could test every step we took.”

The test group grew to 200. That was when health insurer CZ showed interest. “CZ wanted to know what would happen if it were used by a larger group.” Duijsens and his team then scaled up to 600 patients and agreed on a rate with CZ. This makes it the only insurer that reimburses the application for the time being. Other insurers are expected to follow suit soon, says Duijsens. In the meantime, Chilpmunk Health is expanding into other regions. “We have already started in Utrecht and will start in Eindhoven this fall.”

Expanding into other markets

This expansion is also happening in a completely different market. Duijsens: “We take measurements in people's homes, so a housing association asked us if we could also measure air quality. With our Chipmunk Home label, we are already measuring the quality of the indoor climate in the rental properties of several associations.”

Simplicity

Whereas Chipmunk has already been validated and is entering the market, Procs Medical is still in the phase just before clinical trials. Over the next 12 months, the startup will embark on that journey together with the Maastricht University Medical Center (UMC+). The researchers are designing the tests so that the results can also be used for the Health Technology Assessment (HTA) that will be required later to substantiate the value, effectiveness, and possible reimbursement of the Procs. “We want to work as efficiently as possible,” says Lempers.

The expectations are promising. “The principal investigator at UMC+ spent half an hour looking at our foot protector and said, ‘This is going to be the solution.’ He was simply amazed at its simplicity.”

Together with LIOF

Both entrepreneurs have noticed that having LIOF on their side strengthens their reputation in the eyes of other stakeholders. “Thanks to the financial support, other potential partners quickly see that everything is in order. They are more likely to do business with you,” says Lempers. Duijsens adds: “Once you're in, LIOF really acts as a partner to the entrepreneur. I notice that now that we are growing into a scaleup. Having LIOF as a shareholder helps.”

During the conversation, Lempers suggested connecting the Procs to the Chipmunk in the future. We're not there yet, but both men are driven to find solutions to structurally relieve the healthcare burden.