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Designing Diabetes Gear?
Joe asks: "I'm a grad student studying medical product design. My thesis work is being done on devices used in the monitoring and treatment of Diabetes. I'd like to solicit feedback from the Slashdot community regarding the state of the art in the field. Are you a Type One who loves the OneTouch UltraSmart, or a Type Two that swears by the multi-strip AccuCheck Compact? My goal is to develop products that meet the varied needs of diabetics, in a manner closer to the iPod, rather than the current products which resemble crappy 2-button Tiger electronics videogames. What features in these devices do you like and dislike?"
but my dad probably has adult onset and I'm at risk for it. I'm deathly afraid of getting it not because diabetes is such a terrible disease but because I won't be able to prick my own finger (or any other body part, probably) to get a blood sample. Surely there's another way, say with urine samples, or an embedded monitor or something.
If you are going for the cool stuff, a reader that store the results, timestamps them and can display graphs of the sugar levels would be a great tool for doctors. You can bring in the unit to the doctor and he/she can get all the information they need. Adding wireless or USB/Firewire connectivity would let the doctor download the data file directly.
Fear Is the Only God
Implants constantly monitoring blood chemical levels and reporting to your PDA would be kinda nice.
A tattoo on your arm that responds chromatically to insulin, sugar, etc. etc. levels in the blood and that could be read by something like a barcode reader would be good. Doesn't even have to be visible to humans, just the machines.
The whole puncturing yourself to get at real actual blood thing is Not Good(tm).
...an Englishman in London.
One thing I've noticed is that though I test regularly, I only create overviews of test results every now and then. Those overview are important to gain insight in how well I'm regulated, though, so I should do that more often.
Now the blood-test device has a serial cable link to my computer (linked to windows-only software, unfortunately), so I can load all the past results on my laptop (the only machine in the house that has windows installed), and create a few nice looking graphs.
The D-Tron pump actually has an infra-red port, but for some reason no software has been released to actually make use of that. This is a shame, since my glucose-level graphs would gain a lot from the extra data of my pump's insulin extrusion.
Then there's the additional data that can be very useful when reviewing blood glucose levels, such as 'right after a hypo', or 'ate too much ice-cream', or '1hr prolonged bolus to compensate for pasta', and such. The only way to store that, a the moment, is good old fashioned paper. Which means that I often don't...
So for me a good device would:
Other things that are appreciated are: small size, inclusion of the finger-pricking thingy in the same package, being able to load a set of control-strips, backlight for checking in the dark, NO SOUND option (my wife is sleeping next to me, and I don't want to wake her just because I want to check my blood sugar).
The freestyle also allows one to check from blood on the arm, instead of the finger. This is significantly less painfull, so encourages checking. It also lags a bit; The values from the finger will be more up-to-date than those from the arm, so it's not good for when you feel a hypo coming up. Still, a good feature.
This is the one I use. Frankly who cares about style? The main thing is cost. I am lucky and my insurance pays for most of my cost of strips but I know some people that even with insurance have a hard time making ends meet. It needs to be acurite, reliable, and cheap. The cheaper it is the more people can afford to test and the better control they will have over their blood sugar. Reliable means they can use the same meter for a long period of time. I so do not care about what it looks like. A back light on the screen might be nice for those with failing vision. Open specs on the dumping system so open source can make FREE tracking software to help keep the cost down as well.
BTW I would recommend that most slashdoters get there blood sugar checked at least once a year. Some of the risk factors are over weight, are not very active, have a waist size greater then 38", eat crap, and being a member of one of these racial groups , Native American, Hispanic, Asian, or African American.
I was over weight, and Native American and even though I was right at 38" I won the lotto and got it. Another big risk factor is if it runs in your family the problem is that it might run in your family and you might never know it. It is a sneaky thing.
See my blog http://ilovecookes.blogspot.com/ for light hearted technical information.
And I suppose since you're interested in doing this to begin with you already know that there are some very big and very predatory players in that market who tolerate competition less than Microsoft and are significantly less friendly. Still it's a great technology to get started with, it's very easy implement and there is a large market.
Fair disclosure: I work for one of those big companies who may either sue you out of existence or buy you so the world can forget about you.
Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity.
The UltraSmart is pretty good. Nice, highly readable. The backlight only comes on when you hold the button, so it saves on battery time. Those are all good things.
Annoyances: Although it remembers the values used for previous days, it doesn't default them. Eg, if I take 2u Humalog and 8u NPH for breakfast on one day, it will use those values as the default for breakfast the next day, but it won't automatically select them; instead, I have to press the insulin button, add NPH, and add Humalog. Since the majority of the time I'm taking the same amount (or minor variation) of insulin each day, this is annoying.
There's a serial cable to download the data, but it's Windows only. The charts and graphs that the app produces are nice, but I'd like the ability to be able to import them into the database of my choice, rather than having to open the Access file it generates. Also, the settings between the UltraSmart and the program are seperate; it doesn't transfer over (even one way) on the serial cable, which means I had to enter my ranges on the UltraSmart, and then again on the app.
No numeric keypad. The Ultrasmart has the capability to record fat, carbohydrates, and protein entries, but it's a real PITA to enter the number "36" when you have to scroll to it (also, no way to enter exactly what it is that you ate, but a keyboard may be way too big). Hence, I don't use this feature at all, which is too bad.
The Accu-Chek Complete from Roche Diagnostics has most of the features you ask for, with the exception of wireless and/or USB/Firewire.
It does feature a 19,200 baud serial port, so it's faster than most wired meters (most are 9600 baud). It is their geek's choice of meters.
Most doctor's offices already have the software and cables necessary to download and review their patient's data. Similar software and cables are available (and included with Complete) for consumers to use at home.
A computer once beat me at chess, but it was no match for me at kick boxing -- Emo Phillips
If you are going for the cool stuff, a reader that store the results, timestamps them and can display graphs of the sugar levels would be a great tool for doctors.
The Onetouch UltraSmart does this, though on the tiny screen it's difficult to make things out. The info can be downloaded via a serial cable and then printed out, much more readable. USB would be much easier, though.
there was a watch debuted about a year or two ago that read your blood sugar through your skin. however, it wasn't 100% accurate and recommended still doing your regular needle based sugar checks. i'm sure any innovations that can eliminate blood-based checking (and the loss of circulation to the fingers that goes with it) would be welcomed with open arms by the diabetes community.
...and that's all there is to it.
My mother is blind due to diabetes-induced glaucoma. She is stuck using a crappy end-of-life'd One Touch Profile, because all of the new, nifty meters can't be used by blind people (that is, there are no devices to help them guide the blood onto the strip, there are no voice boxes available, etc.). It's a serious issue that most of these companies (One Touch, Accuchek, Freestyle, etc.) never address. How many diabetics are blind, people? A good bunch. Why don't they design monitoring devices for their use too?
Personally, I have a One Touch Ultra Smart, and I love 90% of it. I hate the fact that I can't edit the labels for "Health" and "Exercise" for instance. I love the graphing. I love the capillary-action strips. The 5-second test time is amazingly convenient, as well.
My dad uses an Accuchek of some variety--he swears by it, even though it takes 10x as long for him to get a reading than I do.
I'd love to see something that has a built-in voice box for blind people (seriously, how hard would this be nowadays??). I'd love to see that same model allow them to use the newer capillary-action strips, as well.
Lucky for me I always have Emergency Pants!
I'd agree with the above poster who said Diabetics are mostly pathological liars, we are. Believe it or not, testing your blood sugar SUCKS. It hurts, I don't care if it's your finger or your arm. (By the way, 20 minutes ago isn't good enough for Humalog insulin, so arm testing is risky at best.) If you have a tester with an IR port, there IS software that will read and input the data, but you might need an M.D. to get it. My doctor has some really nice software for the Accu-Check, but as a "user" I'm only able to get a really really dumbed down version of it for 50 bucks from the manufacturer. >:( I don't like implants, which is why I don't pump. But if you can give me a way to test my sugar that doesn't hurt all the friggin' time, I'd use it. I like feeling good as much as the next guy, but being in pain my entire life just isn't worth it, to me. That's what I care about. With the technology and resources available today, there has got to be some way to remove the pain from treating this damn disease. At least until we can convince the Bible belt to allow continued research in stem-cell technology... But I think we'll have to destroy a lot of drug and equipment manufacturer's before that'll ever come about. :(
As an EMT, I'd love to see timestamped results with some sort of authenticity - it's burdensome enough to do all the paperwork, but it's all the more tedious trying to read the number you scrawled on your glove sometime between marking on scene and clear-available in district.
And the form factor is all wrong, too - at least for the portables. The strips are too tiny, the glucometer device itself, too large and too circular. Of the hosts, the AccuCheck is the best, but it's got a lot of room for improvement.
And the device has to be rugged.
And the display backlit with super nova-degrees of intensity and contrast.
And do something about the strips - they yield poor results when it's cold, inflexible to the point of breaking, difficult to remove from sterile packaging without contaiminating and when combined with lancets, present yet another set of tiny sharps to be sat on by firefighters.
And did I mention make it rugged?
All the features mentioned so far, Graphing, download to computer (preferable in an open format), and noting insulin ammounts are key to me as well.
But the key "feature" I'd like to see is low cost test strips. When you have no insurance coverage the strips get expensive and tend to discourage regular testing.
I gotta say, as a Type II diabetic, the biggest issue I see is that pricking myself is the biggest pain, both physically (not _SO_ bad) and psychologically. Find a way to get over that - tatoos, urine analysis, whatever - and you've solved the biggest problem. The prick is by far the biggest obsrtuction to diabetics doing self-monitoring.
What is really hurting the meters IMHO is feature creep. What I'd be interested in is the equivalent of the open-source radio. That is to day: put the mechanics on a pcmcia card, compact CF appliance, or even a modified SDIO card. Then wrap it in a really simple meter that just gives you a one shot readout. All too often, the data goes into a 'proprietary trap-door' in that the patent can get it into the meter (a major accomplishment for many) but the clinic cannot access the data because that can't afford the plethora of cables/cradles/ports and or software products to access the data and do something useful with it. Maybe it's time to have the meters all have a standards compliant infra-red connection based on HL7. Then the devices can be plugged into handhelds, laptops, or even smart phones for the convenience of the patients and still be accessible to the health care providers.
"Can there be a Klein bottle that is an efficient and effective beer pitcher?"
What is important is to understand the makeup of the people who aer using diabetes testing equipment. In my wife's case she had at one time a device that could upload readings into a computer, I dutifully set it all up and showed her how to use it. She's not the nerd that I am however, and only used the upload did the graphing one or two times.
She said it was more time that she had to spend managing her diabetes and was not interested in that. My take is that it's about as fun as balancing your check book.
So my suggestion, as the spouse of a type 1 diabetic, is to keep it simple. If you have the bells and whistles, my guess is that maybe 10% of the users of the device will try them, and probably 5% of your users will use them regularly. Some market research can validate or refute these SWAG numbers.
As as others have mentioned - non-intrusive monitoring is the thing to shoot for. Then tie that into automatic dosing of insulin and you've got the artifical, external, closed loop replacement for diabetes.
Not 100% accurate is an understatement - it was apparently severly inaccurate if you were sweating.
It also caused significant skin irritation (People preferred the occasional pinprick) and was insanely expensive. I was looking forward to it greatly but when it was released, the reviews were so horrible I didn't even bother.
I believe the company is out of business now. The company didn't even come close to selling enough units to pay for all the R&D, the watch bombed so badly.
retrorocket.o not found, launch anyway?
Go to the Zaurus User Group forums (I think www.zaurususergroup.net), in the Off-Topic section there's a thread with data dumps of the Compact's protocol and a Perl script I wrote to dump the data. Right now it just prints time/date/reading to stdout, but it would be easy to modify to dump into a MySQL DB.
retrorocket.o not found, launch anyway?
Type I here, Minimed Paradigm 511 and One-Touch Ultra.
Minimed's new pumps have RF interfaces (better than infrared - no line-of-sight), and there's a meter that can integrate with the latest pump to automatically calculate boluses. Extremely cool, I want one.
What I would like is completely automatic downloading - I sit in front of my computer, and it transfers all of the blood sugar and bolus data. I can deal with a few clicks to actually print it out, but I wish the download itself was completely automated.
Maybe it's accuracy would have been higher if there was a matching blood-sugar sensitive implant?
*Hmmm...now that I think about it. Dispense with the insulin pump, and put in a permanent sugar catalyst.
Thanks!
Fear Is the Only God
If you can create something like this without the high price, I and millions of other diabetics will pray to you. Imagine: Inexpensive glucose monitoring without bloodletting. These guys did it, why can't anyone else?
- Just my $0.02, take with a grain of salt, your mileage may vary.
Things I would like in my PDA (Personal Diabetic's Assistant):
I have heard that Medtronic will be enrolling patients next year at a number of clinical sites in trials to look at the performance of their new pump + sensor technology vs. standard pump vs. intensive therapy.
One complication that I see is that the glucose sensor measures the glucose concentration in interstitial fluid, which equilibrates with blood glucose and lags behind it by 20-30 minutes (or perhaps more?). This hysteresis would complicate the models used to match insulin infusion rates to dynamically changing blood glucose levels. Still, with conservative models and a bit of common sense, like checking blood glucose with a fingerstick if you do feel hypoglycemic, I'm sure this thing would be a vast improvement. Just the idea that I could sleep at night and not wake up to high BGs from the dawn effect would be worth anything. Yes, I know that can be done with pumps today, but the constant waking, monitoring and tinkering is such a disruption I can't handle it.
T1 for, um, a decade or so. I use an Esprit Glucometer (now sold as an Ascencia I think), lispro (Humalog) with a pen, and currently glargine (Lantus) with a syringe. I don't mind testing at all, it's no problem, but y'see I still don't do it. The reason is I'm lazy, and forgetful. What I really need is an insulin delivery device combined with a glucose measuring device and a lancing ("finger prick") device. They don't have to interact with each other, just as long as when I have the insulin pen in my hand, I also have the glucose meter and lancer in my hand. That way, when i go to take some insulin, I can't help but pick up the meter at the same time and if I do that I am much more likely to test, right at the time I should be testing (before meals). The meter should of course be cartrige (multi-strip) capable, the Esprit takes ten strips at a time and is near a perfect meter for me.
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...but my idea for a diabetic testing supply would be a small device that was implanted along side one of the user's veins, where it would have access to the blood stream. This device would then have a short range wireless interface that allowed the user to monitor their blood glucose levels without needing to draw blood.
I thought the the idea would also hold great promise for body builders or anyone else who was really concerned with controlling their nutrition.
As far as I know I haven't seen anything like it, but if anyone else has please let me know, I'd be extremely interested in the design and implementation.
Those who know, do not speak. Those who speak, do not know. ~Lao Tzu
Get a meter and use it yourself for two or three months.
Find out what is a pain and what is not about using one and go from there.
See my blog http://ilovecookes.blogspot.com/ for light hearted technical information.
I'm Type II. I have 2 meters which I never use, mainly because I can't stand sticking myself every day. Diabetes and heart disease run in the family ... When my grandfather was my age, he had been dead for 2 years.
I'd just keep going until I keeled over, but I have 3 young kids and a (much) younger wife who would really miss me... shit! Time to give up the wine, desserts and actually pay some f*ing attention to my health. ... Sucks.
-- Binayak.
but, having been exposed to the Atkins diet, and being somewhat overwieght, Id love to monitor my own blood sugar to correlate against the foods I eat. With the prevelance of fast food, its damn difficult to pick out low GI carbs. I want constant, non invasive, blood chemistry monitoring gadgets - they must be simple, but programmable.
It's not necessarily strips that matter, but overall cost. Monitoring is very $$$ intensive now.
Continuous monitoring would be VERY nice. If not continuous monitoring, something that was convenient and cheap enough that I could test every twenty minutes or so would be great. That pretty much rules out an invasive meter; I wouldn't poke myself that often under normal circumstances. Bonus points if I can attach it to my finger or arm or whatever and have it continue to function test automatically in the night time.
A few words on insulin pumps. I don't have one, but my younger brother does. As a student, I can't afford one. Meter-pump integration would be nice, but you would obviously need reliable and regular monitoring for that. For anyone developing such a thing, a big part would be to convince insurance companies to pay for it.
Two other features that other people have mentioned that I second (or third, or so on) are alarms for bad results (or results that are headed in a bad direction, if the monitoring is regular enough to detect a trend) and easy to read displays that have some lighting. I would rather have that than ultra-long battery life, particularly if the meter can take some type of rechargeable battery (such as NiMH AA or AAA cells).
Whoever corrects a mocker invites insult;
whoever rebukes a wicked man incurs abuse.
--Proverbs 9:7
My wife has reactive hypoglycemia- which appears to me (an engineer) as an under-damped differential equation- if her blood sugar goes too high too quickly, it will then go low quickly, which has led to intoxication like symptoms, and occasionally, unconsciousness.
A device that can accurately measure rate of change of blood sugar would go a long way towards helping her out- since it could help her predict and avoid the dangerous crashes. Right now, the only way is with test strips, and as many have pointed out, it gets really expensive.
I have Type II diabetes and have tried just about every meter out there, but am now using the OneTouch InDuo meter which I love. (Not in the biblical sense though.) It combines a OneTouch Ultra meter with the Novo Nordisk insulin pen. http://www.lifescan.com/products/meters/induo/
Also there needs to be more software for Mac users. I used to use Vigora's DiabetesMentor which would grab the data from my meter but it hasn't been updated for OSX yet and it looks like it never will be.
You're keeping me alive because you don't know DOS?
A way to view numerically, graph, and analyze trends in sugars and insulin injections up to 6 months. An automatic pager to notify parents and Dr.'s when kids have complications. (highs, lows, coma, ect.) A way for Dr.'s to update them remotely and upload the data from them. Projected A1C's. Automatic insulin dosage calculation based on perscribed ratios. Cheap test strips (GOOD LUCK). Recharge dock Ability to take normal batteries as well as rechargeables for the just in case -ALL- other medical data needed for emergencies with quick access for the ER's and clinics Pedometer to measure exercise and calories Intigrated IPod and digital camera Remote detonator in "James Bond Limited Edition"
My wife is a T1 diabetic. She is currently using a Glucometer DEX. One thing that I have noticed is that when her blood sugar is real low she looses all sense of time and her cognative abilites diminish considerably.
What all this adds up to is that if low blood sugar sneaks up on her (usually in the middle of the night), she will take her blood sugar before doing anything else. If everything goes smoothly this is usually ok, but if any little thing breaks the routine, such as the cartrige being empty (it only holds ten strips) it can take hours for her to figure out what is wrong, if her blood sugar is low enough. This wasn't near as much of a problem when the test strips came in jars of 100 and even an adled brain could see the jar was empty. But, for some reason she focuses on getting that blood sugar result, to the exclusion of all else. This way I have found her nearly unconscious a couple of times.
Please keep the operation simple!
My brother was diagnosed with juvenile diabetes about 6 years ago, he was 10 at the time. He went for almost two years on shots and then started using the Mini-Med insulin pump. He had some problems with it to begin with, but the pump has been one of the best things for him in getting his life back. He now has to use special lotions on his hands and fingertips because of the caluses that have grown from him having to test his blood sugar. He tried the testers that you can take blood from your arm or leg, but he didnt like them, and they were more costly than the tester he uses now. I have thought about the pump and how part of it is always inside of him; I'd think it should be possible to do something similar with any range of diabetic requirements, including blood sugar testing, glucagon kits (for dangerously low blood sugar), as well as insulin delivery. Good luck in your studies, I hope that they lead to something that can help my brother in the future.
... are inaccurate up to +- 50.
My daughter is five years old and was diagnosed with Type I when she was 15 months old. She was on injected insulin 3-4 times per day until this past October when we got her a Medtronic MiniMed Paradigm 712 insulin pump. Along the way she used the Bayer Glucometer Elite (now Ascensia), the OneTouch Ultra and now the Paradigm Link meter (by B-D) that works with her pump. Her first two meters both had the ability to connect to a Windows-based PC using a proprietary cable to a serial port. I bought both cables, and used them a total of maybe four times. It was cumbersome to get to the serial port on my computer, and the software provided was not good (although the Bayer WinGlucofacts wasn't too bad). Perhaps a USB connection would make more sense.
The things I liked about the meters was their simplicity. I like the fact that all of the graphing and trending requires data upload to a computer. On the meter itself, about all you could do was see a 14- or 30-day average, plus recall (through monotonous pushing of the single multi-function button) the last few hundred readings. We only ever need to check the most recent one anyway, so scrolling through wasn't much of an issue. But the fewer the knobs and switches on the meter itself, the fewer things can go wrong.
I'm neutral on the question of one strip at a time versus the cartridge-loaded multiple strip meters. I can see how that could be handy, but all of her meters have been one at a time and it doesn't really bother me. What is more important in terms of the strips is the smaller the amount of blood they require, the better. It's tough to get a decent amount of blood out of an infant's finger, and even now it's nice that her current meter needs only 0.3 microliters since it allows us to use a lower setting on the lancet device, which reduces the likelihood of calluses.
The one improvement I would make to all of the meters is the addition of a backlight for the primary display, and perhaps an LED light for the "business end" where the strip is. We have to check her blood at 2:00 AM to watch for lows, and turning on the lights in the room sometimes wakes both kids.
I would also echo the suggestion another poster made about getting a meter and performing checks on yourself for a while. It's really the only way you can truly understand.
I used OneTouch Ultra for the last few years and I hated it.. It would always start counting before I had enough blood on the strip, which led to countless wasted strips, which led me to throw the machine across the room.
When I finally broke it last month, I went out and got the new Freestyle Flash meter.
It is much better. Only starts counting when enough blood is on the strip, has a back light, and even has a light that illuminates the test strip area. Best of all, it's extremely compact. As most diabetics will tell you is important
because you are always carrying it with you.
The OT Ultra is smaller and very easy to use just for a quick check. The ultimate tool should be able to work without any puncture needed...
Multiple strips are a must have for any diabetic on the go, the smaller you can make the meter the better, but the display needs to be easy to read. One word, BACKLIGHT. Glucose tracking is a must, advanced displays for tracking are nice but are usualy better for a desktop computer or palm app that can communicate with the meter (I know that I personaly never even look at the memory on my meter except to see if I remembered to do a test). Food intake & Insulin tracking, very few meters have this (2 that I know of do insulin and 1 does food), it is a handy feature to have and one that I have been begging for in meters for a while. My biggest complaint is that there are NO meters on the market with multistrip capability that do insulin tracking. You should be able to program the meter to sugest insulin dosage based on food intake and glucose entry (usualy 1 unit per every n carbohydrates, and 1 unit per every m mg/dl over x). These days the meter must be able to communicate with the desktop, some can communicate with palmos devices. It is my belief that the meter should come with whatever tools you need to connect it to a computer or they should be free. Many manufactures do not feel the same. Every meter I have seen uses its own connector on a cable that attaches to the computer, accu-chek uses a serial ir devices that talks a custom protocol. One way to make the tools to access the meter via a desktop easy to obtain would be to use a mini-B usb plug. If the meter were just a usb device and the software were freely downloadable (or on cd for a low price ~$5) that would be exelent. I think that is all the input I have, and if you ever create a meter close to this PLEASE let me know.
I've had type 1 diabetes for 6 years and just got an insulin pump in October - I love it! In choosing my pump, one of the main draws to the CozMore System http://www.cozmore.com/ was the Cozmonitor. This is a glucometer device that clips on to the Cozmo Pump and shares data between the devices using IR. The glucometer just tests your blood sugar, all of the screens and interface actually happens on the pump itself - so I never need to enter my current blood sugar reading into the pump when figuring out how much of a correction bolus to take...the pump knows my blood sugar as soon as I do.
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I'm not diabetic, but I am a CS grad student who will soon be working on a thesis regarding medical technology (though in an area totally unrelated to yours). Obviously I have no personal experience with either type of device you mentioned, but one thing I've seen from my own research is that people who may have comorbid diagnoses are often going to require medical devices whose user interface is more flexible than that of an entertainment device or a device meant to be operated by medical professionals. For example: users of hearing aides are normally alerted to the fact that the device is turned to an inappropriate volume for their settings/not inserted correctly/left turned on when taken out of the ear by a feedback noise. However, for users whose hearing loss is more severe in the high frequencies, they may not be able to hear this sound at all (even with an aide of the proper power & settings to aid their hearing in low-frequency ranges), and may (for example) leave the hearing aide on for extended periods of time while it's stored in a drawer, potentially causing damage to these extremely expensive devices. However, having a visual alert (say, a small LED) alone would not be sufficient, as many hearing aide users are elderly and thus may also have vision problems. Although this is a relatively simple example, I guess you can see my point of why people designing a medical device meant for people who are elderly and/or frequently present with comorbid diagnoses must keep these facts in mind.
My thought: make it as simple as possible on the user end; perhaps have a few different modes. For example, a mode for the sight-impaired with large text, backlighting, and/or a voicebox; and another mode for hearing-impaired users (or just for people needing to use the device in a place where loud sounds are inappropriate). Keep the options in the user interface to a minimum; maybe just a startup screen with a "check sugar" option, a "view history" option, and a "test device" option if applicable.
I agree with what other people have said about having some sort of method to upload the data from this device to a PC; it would be great if there was a "doctor mode" as well, wherein the physician could link the device up to his PC, upload the data, and view graphs and other reports in a quick and concise manner. Of course, this option could also be accessible to users who had the desire to view it.
Ok, i think I've rambled on for long enough now....sorry, this is what happens when it's Friday and I'm at work yet have no actual work to do:).
I've been type I for 22 years, use a MiniMed 501 and work in Healthcare IT at Stanford. Cost of strips is an issue, I test 6-8 times/day and a strip is $1. I'm fortunate to have health insurance now and therefore pay a co-pay but when I use too many I must pay out of pocket, and it's a bundle.
:)
-Simple meters for lackadasical type IIs or those who test once a week are already on the market. Believe me when I tell you that you take care of Diabetes like an obsessive or it takes care of you. I read accounts of people with AIDS, hepatitus and type I, they think type I is the worst of the 3. You really gotta stay on top of this motherfsker.
1)No or very inexpensive strips.
-I was impressed with the glucometer Dex because it had a pancake strip magazine that made it easier to load the machine and dispose of used strips.
-Single button meters suck. Too many things to configure with 1 button. I sit there and press it 12 times to change mmol/L to mg/dL.
-Rugged as all hell, small with a good carrying case and backlight. BTW a good case saved my pump when a paintball hit it. It's now brightly splotched yellow.
2)Real time glucose monitoring, I don't care how invasive. I want to be able to look at my watch or belt and get an accurate real-time recordable reading. It would be nice if I could bluetooth it to my pump for closed loop and store data/progs in a keyfob.
3)I don't like writing stuff down. During pump training I killed large forests recording everything I ate, what time and how many carbs. I'd like to dictate that into something, maybe with voice recognition. There's PDA stuff that will search a database for carb counts, but honestly that's too much of a hassle when eating. I wanna say "Tea, Earl Grey, hot with 1/8 cup 2% milk" and it say back "3g carb" and record it with timedatestamp.
4)I want to plug my keyfob into my laptop, and print a few tables and graphs for the doc. I'd like to be able to file attach the data (encrypted) and email it to him. (Encrypted HL 7)
-Simple,small,durable,dependable,accurate,easy to use,expandable,feature rich for those who want/need it...affordable. No problem.
Type II, diet controlled. I use an Accucheck because that is what the hospital gave me even though the related endo clinic can't read the machines data. dooh! I like charts, graphs, bells and whistles, most don't. So a modular system would be nice, the modules could be hard or software. It should talk to my PDA and my MAC laptop preferably without a cable or have a pull out connector. I want to be able to enter food, exercise and other variables such as having a cold or being on a steroid. Alarms, multiple strips, lower pain testing (I test infrequently because the results are always good and I hate the finger pain so if the levels went bad I would be less likely to know), built in injector. Heck build a module that attaches to the end of my PDA.
I am IDDM for about 15 years. I have used mostly some model of Accu-Chek and currently using the Active because the test strips are least expensive. I would like to see a meter that uses light or sound passed through the finger to read glucose levels. Light sensors are already commonly used to measure blood Oxygen levels. Seems like something similar could work for glucose.