Another ask for help/talking w/ first year med students & engineers

I have been asked again to speak to a group of students at UCSD who are first year med students, engineers and business majors.
They will get a basics talk about diabetes and technology over the years. I am being asked to give my perspective on how things have changed over the years. This year they are looking for challenges with technology, things that need to change or things we think are missing.
My biggest frustration with technology is how nothing talks with everything. You know how each pump only works with one type of CGM or meter. I know there is work happening to make this no an issue but I’m guessing this is kinda of what they are looking for. I would imagine as part of their semester project, they need to come up with some ideas to help with some issues we are having.
Anyone have some tech issues that are driving you nuts? Let me know and I will pass it along. Thanks!

Please include the smartphone in your list of “not compatible” devices.

For example. I would like my Omron BP machine to comunicate with my phone but the Samsung cheap phone does not have Bluetooth Smart. Same is true for other health monitors like FitBit , etc.

I would like phone to read Libre sensor but phone does not support NFC .

Of course the current solution is to pay more. But I can’t afford that solution.

Ohhhh why a smart phone? It is a handy almost universal way to collect and carry information. And most of us “Don’t leave home without it”.

Downside is that most apps make a smartphone NOT private or secure.

Incompatible technology is a HUGE problem!

The REAL issue is that COMPATABILITY is not profitable!

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My first thought when I read your topic title was of a more general nature. The fact that you are not only addressing medical students but also engineering students caused me to think about a troubleshooting capacity and mindset.

Doctors, due to limited time, resource, and an underdeveloped troubleshooting skill can learn some things from the better engineers about how the best solutions turn out to be searching for the root cause of a problem instead of stopping short at verifying a symptom, making a diagnosis, throwing a drug at it and turning their backs. Identifying and addressing the root cause will often not only resolve the symptom that triggered the patient’s distress but also improve a whole host of issues. It fixes the system instead of simply covering up one symptom with a drug “fix” that carries a list of worrisome side effects.

But that may be too general to suit your situation. A more technical but highly useful improvement would be to fix the undependable Bluetooth communication technology. Many people who are using automated insulin dosing systems need solid bluetooth communication between a phone app, a pump, and a body-mounted glucose sensor/transmitter.

Many people of the do-it-yourself Facebook Looped group complain about intermittent and undependable radio or bluetooth communication, especially when an Omnipod is involved. Data dropouts and extended periods of failed communication prevents the data stream needed to make an insulin dosing decision every five minutes.

This group is comprised of the patient-lead and patient-inspired #WeAreNotWaiting movement who have grown tired waiting for technical solutions from the current private company/regulatory environment that seems to move at a snail’s pace. This group of innovators leads the for-profit health technology companies by leaps and bounds. Their rapid iterative improvements outpace private industry while they do without the better resources of the medical technology companies.

In summary, perhaps this group of talented young minds can remove some of the bluetooth confusion in the patient-lead do it yourself closed loop automated insulin dosing systems. It would also be nice if these developing minds will see that a health care revolution would unfold if future clinicians could bring to their clinics a robust trouble-shooting skillset that always homed in on the root cause instead of merely being satisfied with a diagnosis to identify which drug to use. This is idealistic but I know that is often considered a strength in young people.

Good luck with your talk!

The class is a technology/innovation class. It is open to all students but most taking it are engineers, med students and some business students. Last year when I did this, the presentation before me was orthopedics and the changes in hip replacements. (Side note- don’t want to go down that road! Wow, it was scary!) Diabetes is two years running now and I’m guessing because of how much the tech side is helping us do this better.
The professor asked for the patient to be using a CGM and insulin pump and since I have been doing this for a long time and am using some of 5e newest stuff, I get to talk about the old and the new and what we want in the future.
Of course we all want a cure! And I will continue to do studies to ry and move that forward, but in the mean time, I want easy. I mean easy,I don’t need to think about it all the time easy! And if we can get a pump that allows me to not worry about what I’m eating, that’s what I want EASY! Just like all those “normals”!
I do kinda like how these starter classes are out there so young students can see what is out there and see if this is the path they want to take.
Who knows, one of these students may solve all our problems!
Thanks for the input. I am speaking this afternoon so if anyone else wants to pipe in, please do!

Might sound silly but I’d love engineers, medical professionals and others in this space to have to “have diabetes” and wear the technology for a couple of weeks, the way high school students carry around baby dolls. Letting them brush up against the pain points themselves may spark some ideas, with a side helping of empathy.

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I agree! And I have had some medical professionals who do this and one person during one of the studies I did actually wore the devices and also logged all the darn info in the tablet (that was the worst! I would have preferred a paper log to that stupid tablet!)
So, yeah if you think you have the answer, wear it for awhile and deal with the site issues, pain, alarms, trying to dress around it etc. Great idea!

It’s no use just wearing the devices, they need to have a full simulation of the interactions a T1 would have with the devices, including simulated real alarms as well as simulated false alarms. Give them a simulated Dexcom which gives urgent low alarms 1 - 4 times a night (typical number of compression lows my son has), gives a ‘fall rate’ alert then drops out with “???” and has it’s calibration drift all over the place so you never know whether you can trust it or not. Make them do the “calibrate three times 15 minutes apart” thing at 3 am, including having to do the finger pricks, and get their glucometer to throw some wildly high readings because they didn’t wash their hands after eating lollies to treat the simulated low. Then give them the “you shouldn’t calibrate more than twice a day you know” talk in a really patronising voice and see if they can come up with a proper solution that will stop the sensor reading low for 8 hours straight (on a BG that is nicely in range) without messing up the calibration.

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I want a cgm approved for underwater for more than a half hour and in the ocean!

I also want the availability to be able to read my BG’s while swimming! Other exercise you get to look at your levels and snack or stop if needed. Swimming is a guessing game. No readings, no alarms, no alerts. Something I could take into the water to get a reading would be nice! And the Dexcom I have to wait for it to catch up with the data to know my reading once I am out. The Libre I could at least immediately wave and get a reading right after.

My Dexcom and Omnipod pod have actually been fine for an hour in the ocean, I do wear an ace bandage around my arm covering the dexcom to keep it on. I have a feeling this probably helps protect it from sand etc getting in it.