mHealth and Diabetes

Hi - I am both personally and professionally involved with the development and deployment of wireless technology to help diabetics live better informed lives. I hope to being this discussion with a basic inquiry - “If I could better manage my Diabetes through my Smartphone, would I do it?”

I know this is a very open question, but it is the starting point that is the most essential to answer.

Next question - what features and functions are ones that you think would have value on a Smartphone application?

Lastly, what devices would you like to see that communicate to your Smartphone? BG Meter? CGM? Pump? Scale? Other data collection devices?

I look forward to hearing your opinions…



I just got a 4G phone a couple of weeks ago and thought the new toy factor of having OnTrack to play with would make logging stuff easier but I really dislike logging. For me the key would be some type of interface w/ the telemetry from my pump that would log everything but food? And, for food, I would like something like R2D2 that would follow me around and log everything I eat?

I just got an omnipod and I would love a smart phone pdm app (to ditch the controller) for and then use something like the ibgstar (to ditch the meter). I am looking into a cgm, so I would like that to talk to the smartphone as well. This would literally lighten my load (i.e. massive handbag) by at least a pound!

Yes, in fact I am already doing that since 2007 with my free Glucosurfer project. I clearly see the benefits for me. Especially the early detection of negative trends is a good reminder to reinforce the commitment to good control.

The non pumper will not have more gadgets than the meter. In my view the communication between meter and phone is not so important. Many TuUsers will disagree but I like to look at it very rationally. The log must be filled with much more information than just the blood glucose. If the meter would talk to my phone that would be nice but this will just save me from entering 3 digits. I can understand that this is still a relief with pumps because of their interface. But with the convenient touch friendly SmartPhones I do not see the need. Furthermore for these easy to enter 3 digits my meter would send the data wireless and the SmartPhone has to listen for data (background process etc). This is just a waste of batterie life and todays SmartPhones are already critical in their power consumption. Worse I would have to use the software on my SmartPhone that can communicate with my devices. Personally I prefer to not be bound to a specific metering device. This allows me to switch to better or cheaper products. This way I do not have to argue with my insurance company about test stipes because I do my part to reduce the financial burden.

The pumpers on the other hand have much of the data in their pump - also the carbs and blood glucose. The only parts missing are physical activity, textual notes about food and a food database. But for analysis the information can even come from different sources: Pump and iPhone apps etc. The really ugly part is the data exchange: different formats, different approaches, different levels of skilled and less skilled IT developers. Luckily these things start to change and the companies start to offer well formed XML at least. But some big players still just play the CVS game: here is your comma separated file and now be happy with it. Some even translate their CVS files so you have to develop different filters for all the possible variants of data (very bright for data exchange, LOL).

Well, this was the negative view from me. I hope the others will lighten up your mood.

I’m with you! I HATE logging and mostly don’t do it. I don’t even have a SmartPhone – I just have my 2 year old clamshell phone, and the company wants me to upgrade to a new one – then I would have to get it set up all over again. Sigh…

I hear you; but a girl can dream, can’t she? :slight_smile: Having one dedicated device that would display and integrate each of the pieces that I use would be ideal. Throw in a phone and mp3? Heaven, I tell you!

You crack me up!

I appreciate all the comments and I can see a pattern - most can see the value of capturing as much info (or data) about the multitude of items that go into the management of our chronic condition, but not have to be constantly focused on it. It is my belief that the web, or “the Cloud” is the perfect means to communicate a lot of this data almost invisibly to a SAFE 'Health Locker" on the web that can store this data for further evaluation with your doctor, diabetic educator, endocrinologist, exercise couch, or Family and Friends that you GRANT viewing rights to . Now, the issue is how to most conveniently transmit such info to the web in a real time or near real time manner. There are many devices in the pipeline now that are being built with an embedded CDMA or GMS transmitter chip that can talk to the web ANYTIME it wants to - anywhere you are. The economic issue, in my opinion, is why do I need to pay for 3 or 4 or 5 web access points when I already have a few accessible ones. Obviously, if I am near my computer or my iPad, I have immedaite access to the web - devices like my pump, my CGM, etc. can communicate to my Google Health account anytime I am within range of those devices. But, if I am out at the beach, or hiking, or even in the car - I ALWAYS HAVE MY SMART PHONE and that device is always communicating to the web. So, it is my contention that both on a costing and on a practical basis - if our devices can talk to the most prevalent Smart Phone I/O method, we should be able to accomplish this.

Full disclosure, I work with Entra Health System and we have a Bluetooth-enabled BG meter that is the 1st FDA approved device that sends the user’s test results to a secure web platform AND can communicate with you if there is anomalies detected. The best example is my test results are at 50 - - I get an immedaite Text message back reminding me to eat some glucose tabs - IF I DO NOT RESPOND TO THE MESSAGE WITHIN 5 MINUTES, it will send out a text message to my co-workers that I have assigned to monitor me if it is work hours or to my family and friends if it is off hours to check to make sure I am OK… to be honest, I DO NOT want those secondary messages to ever go out, so even if I am in a most important meeting, I DEAL WITH THE ISSUE NOW.

This is but one of many examples of a communicative diabetic management system. The other is to notify my health providers if I am having problems over a few days - my doctor may have a member of his staff call me to come in to make adjustments, etc. There can also be other data points gathered to help determine how best to control diabetes - like knowing what my blood pressure is, what my daily weight is, what foods I have actually consumed - not been served.

We are at the forefront of this changing approach to heath care delivery and I am excited about the possibilities. Again, I hope to hear from my fellow diabetics on what things would you like to see IF you had such services available??

Thanks! G.

I’m probably the outlier here but I have no interest in having my smartphone be my all in one Diabetes manager, wireless or not. I feel like there are too many potential security issues with phones, not necessarily keeping the data safe, but limits on when and where I can use my phone that I don’t want placed on myOmnipod PDM hardware, for example.

I do use my iPhone to log BG data using an app. Better apps to manage my data are always welcome, but also, I really would like the capability to transfer data from my smartphone to my desktop, and back again so that I can have easy to manage permanent records. I’m not married to any particular phone. With the pace of advancements and upgrades in smartphone technology, I don’t plan on having my iPhone, or any other phone, for more than two years. My most immediate concern is how I’m going to transfer my BG data from my iPhone app to a Google phone, if that’s the direction I choose to go, without having to enter two years worth of data by hand. Even if I decide to upgrade to the next version of the iPhone, I have no idea how I’m going to be able to transfer the data from the app on my current iPhone to the same exact app on a newer iPhone.

I understand such concerns - but, in my mind, ff any device has web access - data is always available. As far as security, I contend that my medical records are as secure as my financial records, I only allow those I want to have access to specific information the right to information. Back to my question, though, is WHAT FEATURES WOULD YOU WANT TO SEE IN AN APP THAT WOULD BRING VALUE TO YOU AND YOUR PERSONAL DISEASE MANAGEMENT APPROACH. If you had a wish list of things, what would be on it??

Verry well then,

Since the idea is to upload data to the cloud from a smartphone, that takes care of half the issue, being able to save data elsewhere.

The other issue, then, is portability between the various operating systems working on the different smartphones and computers. I DO NOT WANT TO HAVE TO ENTER MY DATA MORE THAN ONCE. Once the data are entered into my smartphone app, desktop program, or whereever else, I want the ability to move seamlessly from one device/operating system to the next to view and manipulate my data.

One thing about having all of this data is that it would be discoverable were you to be involved in some sort of litigation? I haven’t seen this but I think of it in cases I’ve run into @ work…

Built in ability to import and export as a csv (comma separated values) file would help, for those with the necessary skills. But this is beyond most users. I could do it, but I’m not sure I’d be willing to go through this every few years. Of course this is exactly the position I’m in now when I download my meter data onto my computer.

In the end an agreement on a common format would be needed, which probably isn’t going to happen any time soon.

Working with csv files is a royal PITA, but it is infinitely better than having to enter the same data multiple times. I have a hard time believing that my iPhone app doesn’t even have the rudimentary ability to export data as a csv??? I absolutely love the ability to use a simple iPhone app to collect data and have them presented as percentages, graphs, BG variation, etc, but the closer I get to my next smartphone upgrade, the more I’m starting to look at using my smartphone as a diabetes management device as a monumental waste of time.

I did once export data from a blood pressure monitor into Access (using csv) because the reports were a joke. It took about an hour but I got the reports like I wanted them.

I have contemplated exporting the data from my meters PC program to generate some different reports, but the PITA factor has discouraged me to this date.

All these mobile apps need to at least be able to export as csv.

Perhaps one of those glucose monitoring sites in the cloud could then write import routines for at least the most popular mobile apps, and a person could get all their data in one place long term. I can see the ability to do this as being a very real selling point for both the app and the website. Developers, hint hint.

I agree at present it seems to be a waste of time despite the very real cool factor. Most people don’t have the necessary skills and people change phones fairly frequently.