Thursday, 21 June 2012

5 steps to improve my #mobile #diabetic life

Since March 2011 I am a diabetic type 1. This means that my pancreas is no longer functioning and I have to take 4 insuline shots per day (Novorapid and Lantus (glargine)).

In the past 6 month I have bought a Continued Glucose Monitor (CGM) produced by Medtronic. The CGM enables me to keep an almost real-time overview of the glucose in my blood. This is great for me, as I have a various activities (so glucose use varies) and I have a small child (now 1 year old) which makes me more aware of my child his safety. I use the CGM without an insulin pump, so I just use the monitor to keep me informed on possible hypoglycemics (low blood sugar with a risk of getting in coma when too low).

The CGM has greatly improved my ease of mind. But, as a mobile learning adapt, I feel the CGM could be improved with some simple technical and training modifications. So this blogpost is in a way a call for action from Medtronic and all CGM building companies. And the model can in itself be used as a generic mobile health (mHealth) model. How, easy in 5 steps
  1. The CGM is currently sending glucose information to a Medtronic monitor, but it would be an improvement if it would send information to a smartphone (BYOD type of development). Security might be an issue, but the CGM monitor has been hacked also, so well. Getting your blood sample info to an iPhone is already possible (see movie below), so getting CGM info to my/any smartphone is feasible.
  2. Now add to this a carbohydrate smart scale that is connected to my smartphone or other mobile device (e.g. the wireless scale in combination with iPad/iPhone). This does require a scale that has options to choose from: buttons for different carbohydrate foods and fruits to allow the scale to immediately convert the weight into the right amount of carbohydrates. This way, the mobile device can calculate the amount of insulin you will need and add the meal information to a offline/online synchronized personal database. 
  3. When the CGM sends encrypted information to a smartphone as mentioned above, additional health applications can be build. For instance one that keeps you up to date on how your glucose is changing throughout the day in relation to your food intake. For instance, which foods allow you to do a more strenuous workout, or are better at keeping your glucose stable when doing nothing (airplane, daylong meeting,etc). For this an algorithm must be build that monitors different variables and can indicate what type of food gave good results overtime (in my case brown pasta is always giving me problems, so I would love to know if it is linked to anything else). Of course there are many diabetes related apps out there already: Android based, iPhone based, other, or check out this one EndoGoddess which seems to give points for putting in your diabetes info an in exchange you can download iTunes music - interesting business support model. But these apps miss the personalized, more semantic type of algorithm.
  4. Add to this a training application to inform diabetic newbies: YouTube movies, cause and effect information, food advice, workout advice (e.g. eating olives and avocado's helps in increasing good cholesterol levels because they influence the take in of bad cholesterol in favor of the good one). 
  5. And finally, provide a newsletter URL or RSS feed that is mobile enabled. It is easy and promotes all that deliver information, so win-win situation.
So how would this improve my mobile diabetic life?
  • It saves time in putting the information of weighing food into any paper notebook or smartphone app, because the scale is connected to the smartphone.
  • I can work with the device I like to use and am comfortable with
  • It saves time in calculating, as the smartphone can immediately calculate how much insuline you need for the amount of carbohydrates you have weight in relationship to the time of day.
  • And it saves quality time as I learn continuously (or when I am willing). 
So if any of you Medtronic managers/developers would be interested, I will gladly share my ideas/tech knowledge to get this realized (no fee, just fly me to your headquarters and let the meeting begin).

For sure Medtronic is amazing at leading research to a fully closed, artificial pancreas. See for instance their latest news on the path towards an artificial pancreas in their newsroom article here.

Thanks to Domingo Liotta I am also a bit at ease about my night insulin that is glargine  (which has said to increase the cancer risk), but now three new study is out indicating that glargine would not increase the cancer risk (let's hope so, for long-term studies are still running).

And last but not least the linkup between blood level updates and iPhone.