David Klonoff: 0:03

Hello, this is Dr. David Klonoff. I'm here with Diabetes Technology Report Starts. This is our new podcast for startup companies. I'm here with Dr. David Kerr, and he's going to introduce our first guest. This podcast is for startup companies that have either presented data at the Diabetes Technology Meeting or who have published in Journal of Diabetes Science and Technology. Our guest today from Switzerland has done both. Now I'll turn this over to Dr. David Kerr.

David Kerr: 0:46

Thanks, David, and a huge welcome to everyone to Diabetes Technology Starts. I'm David Kerr. I'm speaking to you from the sunshine and warmth of Santa Barbara, California. Whereas our first guest, Aurelian Briner from SNAQ, is based in Zurich, Switzerland. Aurelian, welcome to the podcast. Thank you very much for having me. It's a pleasure to be here. Great. Well, we're going to be hearing about your company and what you've been up to and where you're going. But I'm always curious, how did you end up being interested in diabetes technology?

Aurelian Briner: 1:16

Yeah, as uh many founders in the in the diabetes industry, uh my story in diabetes actually also started from a personal relationship. Uh, in in our case, uh my wife got diagnosed with type 1 diabetes over 10 years ago. Um, I was uh previously working in software. Um, and yeah, that that was really that uh the moment how I got into into the topic of diabetes um and hopefully can can make a difference there.

David Kerr: 1:45

Great. And what is the fundamental problem that you're trying to solve?

Aurelian Briner: 1:50

Yeah. Uh so with SNAQ, uh we uh want to make mealtime decisions easier for or simpler for people living with diabetes. And um, yeah, the fundamental problem is really um around better managing meals. And that's what we uh are working on for actually close to eight years, uh, or about eight years right now uh with SNAQ. Uh and it's still, I mean, even though in the uh as as you know uh very well in the last eight years, a lot of things have been changing uh in the in the industry to the positive. Um and also a lot of things have been changing in on the technology side. Yeah, it's it's a very different place compared to 2017 when we got started where we are these days. But somehow the problem of matching meals still uh exists in in one or the other way. Um, and we're still happy to contribute to solutions.

David Klonoff: 2:41

Oh, Rellan, could you describe what your product does and how does it make measurements? How does it know what it's doing?

Aurelian Briner: 2:48

Sure. Uh so with SNAQ, basically the three components to uh to the product. Uh it is a mobile app um where people uh can lock their meals. Predominantly they can lock their meals by taking a picture of their meals and it will identify the different food components. And depending on a camera, it would also uh estimate uh the portion sizes. We've done a number of studies, uh peer-reviewed studies on on the accuracy as well as on the clinical efficiency, uh efficacy on that. Um then the second part, I mean, there are all ways these days on how you can log meals. Taking picture is one, you can scan barcodes, you can actually voice log things. You we have a verified nutrition database and so on. Uh so the meal logging is one part. The second part is we combine that with uh diabetes data. So uh you essentially can connect your CTM, um, your incident pump, your variable device to really have the meal data in context, essentially, um, because all these variables matter. Um, and then the third uh piece is more the insights uh and the coaching aspects um that people can get really deep on how different meals impacted their glucose levels, how other variables around meals impacted their glucose levels, um, and and yeah, help them ultimately achieve their goals um in managing the meals.

David Klonoff: 4:09

If someone logs that they had a certain meal, do they have to log what the ingredients are, or do you figure out what are the components, how much carbs, protein, and fat?

Aurelian Briner: 4:19

Yeah, I mean, uh actually that's where the latest technology advances came in uh were very helpful. I think uh compared to when we started, it it evolved a lot from uh being able to more and more automate uh from I mean, depending on how accurate you you want it, that there can be more or less user intervention, but these days it's uh you get to a pretty decent uh estimate in in some cases by just taking a picture and the output already is like fat, protein, carbs, calories. Um, if you want to have it very very accurate, you might want to give it a bit more inputs, uh, or you have some dependencies on special camera sensors. That's it it's it's phenomenal the amount of automation which is possible to see.

David Klonoff: 4:59

Let's say I eat a turkey sandwich and I take a picture of the turkey sandwich. Do I write down turkey sandwich or does it uh know that I ate a turkey sandwich from the picture?

Aurelian Briner: 5:10

Um I mean what with sandwiches can be a bit tricky, right? Because even if you give it to just a dietitian, like eventually it's just purely from a picture, you would also not perfectly be able to tell what's everything in there. But uh, I mean, it might say that it it is a turkey sandwich, it might say sandwich and like propose a couple of ingredients which you then need to confirm. Yeah, it it it it depends. Rillian, who is this for?

David Kerr: 5:34

I mean, people with diabetes vary enormously. There's no one person with you know it's the same as another. Who so who is this for? And also is the expectation that people will have to use this forever, or do they use it now and again, or what's the vision for its use?

Aurelian Briner: 5:52

Yeah, so I mean this the the story originates from from the type one uh space. When we launched in the US, uh we saw much broader usage, particularly we got significant uptake in the type two market as well. Uh and uh, I mean a smaller portion in in pre-diabetes and cessational diabetes. But overall, uh, I mean we have we have a user base of 250,000 uh people and like 90% of them have some sort of diabetes. So we're really heavy on the on the on the diabetes uh side. Actually, what I would currently at least uh make more as a denominator is that they use um some like glucose monitor, whether it's a BGM or a CGM, that's actually where you know where we are really strong at the combination of meal and glucose and and the combined insights, to some extent irrespective of of the actual diagnosis. We see very sim actually similar engagement across the diagnosis types. And um to your second questions on on the usage and frequency, um it there are really different patterns. But what you're actually seeing also in some of the published studies is that um I mean the improvements in time and range come very quick. So even after a couple of weeks, you already see an improvement in time and range. And then though, when people stop using, unfortunately, uh it the effect doesn't maintain. Uh I mean, unfortunately, from a perspective of the user, I mean, from an industry perspective, um, yeah, it might be more okay. You really need to continue to to engage with the product in order to see uh sustained benefits.

David Klonoff: 7:25

How much of the benefit comes from the picture and how much comes from the logging?

Aurelian Briner: 7:32

It's an interesting question, um, which I uh we didn't specifically do a study on that, and so therefore, unfortunately, I I cannot answer it to you, but um for sure it's it's something to be uh like explored at some point.

David Klonoff: 7:46

But you you provide both and then you combine them.

Aurelian Briner: 7:49

Exactly. Um I mean so far, well, I mean what we see in the distribution on what type of logging people use, whether they use you know search or barcode or voice or or image, like image is the the most used. So even in those studies which we published, uh like uh the image taking part was the most used modality of locking links.

David Klonoff: 8:12

How large is your reference library so that you can match pictures with reference foods?

Aurelian Briner: 8:18

Yeah, um I mean it these days it uh everything got a bit more open, but it's in in the hundreds of thousands uh of uh on the image recording side, and then in in the food database, it's more it's in the millions. But interestingly, also from our observation, I mean, with with food logging, um I mean not many items make up like the 80% bucket basically of uh like they're always or all frequently logged. And but the 20 remaining percent, so there's a really, really long tail with hundreds or thousands or in the millions of different like smaller food items. But in the end, um, you know, you really need to support the the whole bandwidth uh in order to have a great experience.

David Kerr: 9:04

Um here in the United States, um food choice is a red hot political discussion at the moment. Major changes in a recommendation. I'm I'm just curious, looking at at all these people with diabetes who have lulled, are people are they adhering to guidelines or are they kind of doing their own thing, or are people putting in common foods or people deciding that, hey, I don't know what about this weird thing I've just chosen in this restaurant, so I'm gonna put it into SNAQ. What's the kind of behavior, what's your impression of people's behaviors?

Aurelian Briner: 9:41

Well, actually, that could be an interesting study question, and we we probably would have the data to to answer it. But I mean, just I mean, looking at in chat just purely on a frequency scale, like looking at the most like five, ten uh logged food items, it's it's very common things like bread, banana, coffee, rice, uh things like that, uh which which make it up uh high on the list. Um, so not to too many surprises on on the really on the top picks.

David Kerr: 10:11

Okay, I always wonder whether people hide if they're eating a lot of red meat or drinking a lot of beer or or something, or whether they're very honest with SNAQ.

Aurelian Briner: 10:24

Honestly, I think in general, maybe people are a bit more honest with with with software. Also, if you think then a bit further on like AI and AI agents and companions and things like that. Um I think they they might be a bit more honest compared to to really like human interaction because yeah um it's still perceived as being digital.

David Klonoff: 10:45

Do you need uh does a person need or do you need FD approval for your product to be used in the United States?

Aurelian Briner: 10:53

Um as long as we don't make insulin dose recommendations, which we which we don't do, and we clearly disclaim that at several places in the app that's not uh intended to be used for for such. Uh we as actually most other diabetes apps as well, which which are not bonus calculators, uh um fall in the into the the FDA enforcement description of uh like lower-risk medical um software. Um which is to to be honest, is a huge advantage for innovators uh in general. Uh I I really appreciate that framework by the FDA because it doesn't exist in such a way in Europe.

David Klonoff: 11:29

Um so uh do you feel that your product has some advantages over other apps that people could use for a diet?

Aurelian Briner: 11:37

Well, just I mean, look looking at the usage numbers, we really have a very significant user base in the diabetes community. And I mean those individuals figured probably looked at different options in the marketplace and and figured that that SNAQ might might be the one which works best for them. But like where we where we feel we you know we have a strong edge is really at the combination of of food, strong food login capabilities and and strong diabetes focus slash device integrations and insights and things like that compared to maybe in my fitness poll, which is much broader, or compared to just a lock, which is not that strong on the food component side.

David Kerr: 12:16

You're focused on diabetes. Correct. Aureline, you're the face of SNAQ. I mean, you're the every time I go to a meeting, you pop up. But how just tell us a little bit of the team. I mean, is this a are you a one-man band, or do you have gazillions of dollars in your war chairs, then you've got huge team? Just give us some insight into what's how SNAQ functions on a day-to-day basis.

Aurelian Briner: 12:41

Uh yeah, we we're a really like small and nimble team. We're sex uh in like including including external resources, we're six people. Actually, like these days with um with AI and coding agents and all this, like we really feel we are more like a 10 to 15 person team because every aspect got so much more efficient, and particularly because we're so a small team, we can also you know adapt very quickly. So yeah, we're actually pretty happy. I mean, you know, on a monthly basis, we roughly deal with 20,000, 25,000 uh uh users. So I mean the product uh has to be pretty self-explanatory and things need to like work decently well that you're able to like deal with that amount of users on a monthly basis with that small of a teacher.

David Kerr: 13:26

Yeah. And my the final question for me is looking back at where you've come from and where you are now, there's like there's likely to be some budding entrepreneurs listening to this podcast. What would be your kind of lesson of the week you'd like to give to people so that they don't make that mistake or they take that big opportunity? What's have you got a have you got a killer piece of advice?

Aurelian Briner: 13:48

Well, first of all, start with a problem you really, really believe is worth solving. And don't fall too much in in in in love. Eventually we have the solution, but really more of the problem. Because the journey always takes much longer than than what you think. And there there is will be like a significant roller coaster ride uh with ups and downs. And you know, you you need to be passionate about about you're doing to to stick it through, but uh ultimately, you know, it's it's it's also rewarding to to see the the impact you you're having that that uh like people reach out and and and say like you know what what a significant difference it made in in their life and or how much they improved on a medical side.

David Klonoff: 14:28

Brian, I have one uh last question for you. Has your company announced any plans for the future?

Aurelian Briner: 14:34

Um actually not not too much recently. Uh so uh what we actually what we are right now though the working on, which we released briefly before Christmas, um, is our what do we call uh coach. It's basically an AI agent uh specifically uh developed for diabetes care. So it means that it is able to personalize, um, it is able to memorize um and uh contextualize basically very diabetes specific and also follow guidelines and regulatory uh requirements along the way. And it's extremely exciting. We we believe there is huge opportunity for having uh more care immediately in your pocket, in our case, more like uh on the nutrition side, like having kind of like a nutritionist in your pocket. Um for for the everyday questions, I don't believe it uh will like you know um uh or substitute the real professionals, but there is so high demand and sometimes the access is really not there, and we really believe there is an opportunity uh for digital uh to help those individuals which might not as easily or not even not able to afford uh traditional care these days.

David Klonoff: 15:49

Thank you for speaking with us today. Um this was an interesting, unusual product, and it's a digital health product. So, on behalf of Dr. David Kerr and myself, thank you for being interviewed on Diabetes Technology Starts. This diabetes technology report is our first starts. You're the first one, and we will be talking to people from other startup companies. A diabetes technology report starts is available at the Diabetes Technology Society website at Apple and Spotify and other sites, and we look forward to connecting with you and others in the future. So for now, goodbye.

Aurelian Briner: 16:28

Goodbye, thank you. Thank you. Always a pleasure speaking with you today.