(If you have Diabetes, get your leg arteries checked for poor circulation known as peripheral artery disease. Learn more at PADhelp.org or call the Leg Saver Hotline at 1-833-PAD-LEGS)
Between the bustling terminals of Paris Airport and a layover in Dubai, Alfred Arambhan’s life changed forever. What began as a minor incident with a baggage trolley escalated into a nightmare that would claim half his toe and confine him to a wheelchair for 13 years. Yet from this personal tragedy, a healthcare innovation was born—one that could prevent millions of similar stories worldwide.
When Healthcare Fails Its Most Vulnerable
“My foot went gangrene,” Alfred told me during our recent conversation on The Heart of Innovation. “The doctors decided they would have to cut me from the ankle down. I am now without half of my right toe. But this is something that could have been completely avoided.”
As a high-risk diabetic since his early teens, Alfred had diligently monitored the known complications of his condition. He regularly checked for diabetic retinopathy affecting his eyes. But no one—not even his doctors—had warned him about Peripheral Artery Disease (PAD), a silent killer that restricts blood flow to the extremities and leads to tissue death, ulcers, and ultimately, amputations.
What makes his story more shocking is that Alfred had experienced three heart attacks and undergone bypass surgery just two years before this incident. “24 months before that, he had three heart attacks,” explained his daughter Pooja during our interview. “Ideally, he should have been told… when he had a bypass, when he had two stents, he should have been warned then.”
This critical gap in preventive care became the catalyst for a mission: to democratize early detection of PAD, especially for diabetics.
The Second Heart You Never Knew You Had
After his ordeal, Alfred became obsessed with understanding why PAD detection wasn’t routine for diabetics. His vision was deceptively simple.
“It should be something like the weighing scale by the side of my bedside,” Alfred explained. “It should be so convenient, accurate, and affordable.”
Through extensive research, Alfred discovered something fascinating about human physiology—the calf muscle functions essentially as a “second heart,” pumping blood through the lower extremities. This insight led him to technology that could measure minute temperature variations resulting from capillary blood flow in this crucial muscle.
The result is FootPlus, an innovative device that measures blood flow patterns through waveform analysis rather than traditional pressure readings used in Ankle-Brachial Index (ABI) tests. This distinction is critical because diabetics often have calcified arteries that render conventional tests unreliable.
“Our device ‘FootPlus’ makes it affordable and easily convenient to regularly check for PAD in a non-invasive manner,” Alfred noted in our pre-show conversation. “We designed it to bypass the flaws in pressure-based readings, which are unreliable in diabetics. Our waveform technology picks up early signs of blood flow restriction—even in asymptomatic patients.”
The Invisible Epidemic
The urgency of their work becomes clear when we examine the statistics. In India, nearly 77% of PAD patients also have diabetes—a staggering correlation that underscores why targeted screening is so crucial.
What makes PAD particularly insidious is its silent progression. Approximately 70% of diabetics with PAD experience no symptoms until it’s often too late. By then, the options narrow dramatically, frequently ending in amputation—a devastating outcome that affects not just physical health but mental wellbeing.
Research has shown that the depression someone experiences after losing a limb is equivalent to losing a spouse of 40 years. Yet in both India and the United States, detection remains inconsistent, and missed diagnoses are common.
“We had three patients this week that literally went undetected with their PAD,” I shared during our show. “They were misdiagnosed. They had an ABI, which you put the blood pressure cuffs on the legs, you put them on the arms, you measure the differential. But especially for those who are diabetic, there are a lot of false readings on it, a lot of false normals.”
A Technology Designed for Real-World Constraints
What sets iiV Health Systems’ approach apart is their deep understanding of healthcare delivery challenges, particularly in India. They’ve designed their technology not just to be effective but to work within existing constraints.
“The doctor is also so busy,” Pooja explained. “There are queues of people waiting for him. That’s where the innovativeness of our device comes in. While the patient is waiting, seated, even under a tree in a rural area, this test can be done.”
This consideration extends to their business model, which removes barriers to adoption. “To the doctors, we provide this device free of cost,” Alfred shared. “It doesn’t occupy space, which is very, very relevant to doctors in India in small clinics. He doesn’t pay anything for this. He pays us only when he does a test, and that too over the cloud.”
The test itself takes just eight minutes, requires no medical training to administer, and transmits results via Bluetooth directly to the doctor’s devices. Results appear as intuitive color codes: green for healthy, yellow for pre-PAD, and red for PAD.
Surprising Discoveries
The team’s screening efforts have already yielded surprising results that challenge conventional thinking about who’s at risk.
“One of the surprising ones was a young, healthy 28-year-old boy,” Pooja shared during our show. “Out of curiosity, he wanted to get himself tested but didn’t believe something was wrong with him. He comes and gets himself tested, and both legs are red.”
Despite having no known comorbidities, this seemingly healthy young man had developed PAD. The only risk factor? His sedentary lifestyle as an IT professional who sat at a desk for extended periods.
Another case involved what Alfred described as “an epitome of fitness” who ran five miles daily. “When we did his test, he was shocked to know that one of his feet had a blockage,” Alfred recounted. “He said, ‘Alfred, thank you so much. I would have never thought that this was breeding in me and a calamity about to happen.’”
These stories underscore how PAD can lurk beneath even the most seemingly healthy exteriors, particularly in our increasingly sedentary modern lifestyles.
Scaling Impact Through Public Health Infrastructure
To reach beyond urban centers, iiV Health Systems is strategically engaging with India’s existing public health infrastructure, particularly the mobile medical units that serve rural populations.
“In order to reach the patient, the government has a very successful model called mobile medical units,” Alfred explained. “These are units on wheels, on trailer wheels. They go right up to the village or the village outskirts. The standard is that each one of these mobile medical units has to cover at least 25,000 villagers.”
The company is now partnering with the government to integrate PAD testing into these mobile units across 26 districts, potentially reaching millions who would otherwise have no access to such screening.
“Because the government has recognized how PAD will help diabetic and diabetic comorbidity patients,” Alfred noted, “PAD dovetails into it to be a mandatory testing.”
Beyond PAD: A Comprehensive Vision for Diabetic Care
While FootPlus remains their flagship innovation, iiV Health Systems is rapidly expanding their portfolio to address other diabetic complications.
“Our immediate objective is to get a scanner for the eye without dilating your pupils to be able to scan your retina,” Alfred shared. “This is to help towards diabetic retinopathy. Then we have people, diabetes also end up with hearing impairments. So for very early detection of hearing.”
They’re also developing a smartphone-based urine test to detect early kidney problems by measuring albumin and creatinine ratios, along with comprehensive non-communicable disease kits.
This holistic approach reflects their understanding that diabetes affects multiple body systems simultaneously, and that early detection across all potential complications is the key to preventing devastating outcomes.
From India to Global Impact
While currently approved by India’s regulatory authority (CDESCO), the company is rapidly expanding internationally. They’re moving into neighboring SAARC countries like Sri Lanka and Bangladesh, ASEAN nations including Malaysia and Indonesia, and pursuing European CE certification.
For the American market, they anticipate FDA approval within 3-4 months, potentially bringing this innovative approach to PAD detection to the United States, where diabetes affects over 37 million people.
A Personal Mission, A Global Vision
What makes the story of iiV Health Systems particularly compelling is how deeply personal it remains for its founders. Alfred still lives with the consequences of his delayed PAD diagnosis, with his own device showing red (indicating PAD) for his right limb and yellow (pre-PAD) for his left.
Yet he’s transformed this personal tragedy into a mission that could spare millions from similar fates. In a healthcare landscape often dominated by pharmaceutical interventions and expensive treatments, the Arambhans have chosen to focus on the often-overlooked power of early detection.
“Every life or limb saved through early screening reinforces why this mission matters,” Alfred noted in our pre-show conversation.
As their technology spreads globally, it offers hope that the devastating complications of diabetes—particularly the preventable amputations that change lives forever—might one day become a thing of the past. Not through miracle cures, but through something perhaps more valuable: the timely knowledge that empowers both patients and providers to act before it’s too late.
Sources:
Centers for Disease Control and Prevention. (2023). National Diabetes Statistics Report. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services.
Armstrong, D.G., et al. (2023). Digital health and medical bioengineering applications for peripheral artery disease detection. Medical Health and Bioengineering Journal.
Natarajan, S., et al. (2022). Epidemiology of peripheral arterial disease in India: Current perspective and future directions. Journal of Vascular Surgery.
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