A Few Minutes with… Digital Health Expert Dr. Job Godino
Job Godino, PhD, is an epidemiologist whose work focuses on mobile and wearable technology (e.g., smartphones, accelerometers, and heart rate monitors) that promotes healthy lifestyle changes for the prevention of disease. Dr. Godino met TRIBETIC co-founders Dan Donlevie and Suzanne Stites through a mutual friend and says their vision for TRIBETIC really resonated with him. Seeing the potential to help people around the world, he joined them as a member of the TRIBETIC Advisory Board. Here he talks about how digital health technology has exponentially improved over the past decade, the promise of what’s to come, and why he’s excited about TRIBETIC giving people with Type 2 diabetes an opportunity to take an active role in improving their own health.
Q: Five or six years ago, everybody was tracking their steps, proud to be getting in their 10,000 steps every day. How has the digital health landscape changed since then?
Dr. Godino: Luckily it’s not just about steps anymore. The digital health landscape has grown incredibly quickly, and the capacity that we've developed over the last four or five years in terms of wearable sensors is excellent. The sensor suites today allow us to get a high-resolution look at your physiology. We're able to focus on energy expenditure, heart function—not just heart rate but heart rate variability and other metrics that derive from heart rate variability in really precise ways. We’re able to better utilize information so that we can gain personalized and actionable insights.
Q: And what’s the potential promise for how these personalized insights can help people get healthier?
Dr. Godino: Digital health technology allows us to seek out what combination of behaviors—sleep, physical activity, diet—will optimize an individual's metabolic health, which reduces the risk for chronic disease. Digital health products like TRIBETIC can train any individual to be healthier, in a more personalized and precise manner than they would on their own. And that means a whole wide range of individuals could be more successful in achieving their health goals.
Q: TRIBETIC is focused on reversal of Type 2 diabetes through behaviors that achieve optimal metabolic health. Why is metabolic health the key?
Dr. Godino: Optimizing metabolic health has a broader and more longterm impact on an individual's health than any one parameter. Unless we get serious about the multiplicity of the targets that comprise metabolic health, we're just going to be mildly improving people's health for brief periods of time. There are multiple behavioral targets and multiple physiological targets that all need to be addressed at the same time in order to achieve the outcome we want, which is a life that has less pain and suffering from Type 2 diabetes. Maneuvering through this complexity is exactly the task of TRIBETIC. It's an approach that people can take even when they are just starting to see elevated glucose levels, elevated blood pressure. The physiological changes that are starting to appear that are often termed pre-hypertension or pre-diabetes can be improved through the TRIBETIC program.
Q: You mentioned exercise, nutrition, and sleep. Exercise and eating are activities where we can consciously make healthy choices, but sleep is a little different. How can a person sleep well—how can they actually control that?
Dr. Godino: Evidence on how to get good sleep centers on a combination of things that you're doing during your waking hours. So things like being physically active, eating a healthy diet, not consuming things that are known disruptors of sleep like alcohol and caffeine at the times that would disrupt your sleep is utterly critical. And then there are the thing that characterize your process for preparation for sleep. Are you going to bed relatively consistently, at the same time at night? Are you relatively consistently waking up at the same time? That consistency is really important for habit formation, and for your body's physiological response. There's a lot of research showing that what we do during the day and before we sleep has a direct impact on our quality of sleep. TRIBETIC lets you look at all of these factors and determine what is the biggest disruptor to your sleep so that you can make changes if you need to.
"Digital health products like TRIBETIC can train any individual to be healthier, in a more personalized and precise manner than they would on their own." —Dr. Job Godino
Q: So tell us, from your perspective: Why is TRIBETIC different?
Dr. Godino: Oftentimes, you get a device, you see your data coming in and it's devoid of actionable insights. With TRIBETIC we have developed the actual insights derived from your high-resolution data, and then overlaid that with health coaches who are able to provide everything else you need on your journey. That's the piece that’s been missing. And there are individuals out there who really do want to take an intense lifestyle-centered approach to managing their Type 2 diabetes, a sort of a high-performance approach. TRIBETIC is that high-performance approach. I've worked in the chronic disease management space for a long time now, and we've developed digital therapeutics in the research context that are outdated the moment we launch them. Similarly, the existing landscape of approaches for chronic disease management claim to be personalized, claim to be for those interested in optimizing their outcomes, but in reality they fall short. The TRIBETIC approach allows for adaptation and being responsive to evolving evidence.
Q: How does the coaching help someone achieve optimal metabolic health?
Dr. Godino: I personally believe we could all use a health coach. So many areas of our life we have social support, we have accountability. It’s as a norm in our everyday life in other areas, and I think we need a similar sort of thing when it comes to our personal health. Someone who's knowledgeable about your health behaviors and your physiology in a more personalized way who can provide you with actionable insights. In the case of Type 2 diabetes, it can be very complicated to manage, so having someone who's trained to understand your data and the variation it contains and help coach you through what changes could be made or what goals should be set, plus providing social support and accountability; that's where you really start to see the benefit of health coaching.
Q: The other great thing about TRIEBETIC is people can access it no matter where they are. People who are pre-diabetic or have Type 2 diabetes may not have the greatest hospitals near where they live or the greatest doctors—TRIBETIC can help coach them towards a healthier lifestyle.
Dr. Godino: Yes, the geographically unbounded nature of digital health is fascinating. Societies across the world are becoming more and more alike, so more and more people are going to have to be equipped with the ability to navigate through a highly obesogenic, highly chronic disease-possible environment. That’s why I think digital health approaches that are widely scalable and sustainable—like TRIBETIC—could be a game changer for the globe.