Digital Innovation for Prediabetes in Saudi Arabia: An Analysis of System Readiness and Implications for Willow Laboratories

Abstract

Introduction: Prediabetes (intermediate hyperglycemia) is a high-risk state that is defined by glycemic variables that are higher than normal, but lower than the diagnostic threshold for Type 2 Diabetes Mellitus (T2DM). Nutu, a mobile application developed by Willow Laboratories, provides daily nudges to help users monitor their lifestyle and adopt healthier behaviors to reduce their risk for prediabetes. Willow Laboratories plans to expand into the Saudi market and is interested in understanding the current regulatory and policy infrastructure to support the launch of Nutu. Objectives: To identify the key factors under which a digital prediabetes prevention platform can achieve successful adoption, scaling, and sustainability within the Saudi healthcare system, thereby addressing the disparity between policy ambition and implementation. Methods: This study used a qualitative, exploratory research design with semi-structured interviews conducted with 35 senior leaders across the health care system, including policymakers, industry leaders, clinicians, and academics. The data were analyzed using a two-stage approach: Framework Analysis and NASSS (Nonadoption, Abandonment, Scale-up, Spread, and Sustainability)- structured synthesis. Results: Prediabetes is a condition of public health importance that is not currently prioritized in National Clinical Guidelines and Care Pathways. From a policy perspective, the regulatory environment for new products or services aimed at the prevention and management of obesity and diabetes is considered positive, with strong political commitment to meeting Vision 2030 targets. However, several issues need to be addressed, including over-regulation, limited capacity to conduct clinical trials, poor health information systems, a price-oriented procurement system of health products, and the general lack of dialogue and coordination among stakeholders. Conclusion: Even though Vision 2030 has made a huge difference in how the Saudi Healthcare system and innovation are changing, my assessment of the Saudi Ecosystem found that the majority of the NASSS domains will need significant work to deliver an effective prediabetes intervention. However, with the right engagement with regulators, a culturally relevant value proposition for the Saudi market, and the right partnership, I believe that Nutu can be successfully adopted, validated, and scaled for the Saudi market and for sustainable impact.