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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?"
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.
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
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.
He is technically a type 1, but did not develop diabetes til he was about 19 or so. As I understand it most type 1 are usually diabetics earlier than 19, while most type 2 are usually not affect till they are older 50ish, but that is not always the case.
The biggest problem he has had has not been calibration, as I think he uses a "OneTouch UltraSmart", but the test stips not working. Test stips suck for several reasons. If they do not get the right amount of blood on them then they fail. If the machine is not correctly calibrated then the test was useless.
What I'd like to see, and I have seen someone making this, is a watch like device. You could wear it on your wrist and it uses ultrasound or something to test your bloodsugar. I would think that in this day and age we would be able to use some kind of ultrasonic wave or something to examine the blood without having to blead a person first. Yes its kinda startreky, but so are combined PET/CT scans. How about a mini-PET/CT scanner like device?
The toughest part for me as the roommate of a diabetic, is dealing with all the blood all over the place. Think 5 pokes a day to test, and then bleed on the test strip, then bleed on the kitchen counter and napkins. Its really unappitising.
If I had the knowledge I'd develop a watch or handheld device that did not need a blood sample to test the blood sugar. I believe it is possible, hey the PET/CT scan can look inside a body and give a 3d view and tell where there is cancer, so why not recalibrate and look in and see what the rest of the body is doing. Then shrink the machine lots.
Only 'flamers' flame!
Does slashdot hate my posts?
Type 1 here, no pump.
:(
I've used three meters in my life:
The One Touch II (a classic, and for a long time THE meter used by diabetics.) Big, clunky, single-strip design.
Glucometer Dex (There is a Dex II now, I can't see what the difference is.)
Accu-Check Compact
I would never use the One Touch again - Lifescan still has no cartridge-based meters, and being able to load the meter with multiple strips is REALLY nice.
The Glucometer was a damn nice meter. 10 strips per cartridge (they were the first company to release a cartridge-based meter), you could order the interface cable for free and their software (WinGlucofacts) was pretty nice, and it was free (free as in beer, that is) too.
The Accu-Chek Compact is also really nice.
Pros: IR data transfer
17 strips per cartridge
Formulary with my insurance company. That's $30 per strip refill. (You'll see a common theme that the insurance company dictates what type of insulin/meter you use to some degree. Although I'm using a Novo Nordisk insulin pen with Novo cartridges because there are no pens for Lilly insulins that dispense half-unit increments anymore.)
AA batteries - the button cells in the Dex were annoying.
Form factor and carrying case make it great to put in a jacket pocket for a night out.
Adjustable puncture depth lancet device. (The other meters had this too but you had to change tips to do so.)
Cons:
Battery holder is loose. I often find myself having to push the batteries back in. Meter loses its time frequently because of this and has to reset the drum. The "find next unused drum slot" feature is nice in cases where you accidentally take the batteries out for too long or accidentally hit the cartridge chamber release.
Cartridge chamber is too easy to unlatch, and comes unlatched often just by removing the meter from its case.
No open protocol documentation, software is $30 and may be rigged to only work with their external serial-to-IR adapter instead of a normal serial IRDA port (they do not mention IRDA ports at all, they ALWAYS try to sell their $30 adapter even though I know the meter can speak to a normal IRDA port.) There are protocol dumps linked to from the Zaurus User Group forums, I think the "off-topic" section. I wrote a Perl script from those dumps, it's posted to those forums.
Form factor of the meter/case is good for a night on the town but not as good for extended trips. The Dex case had lots of extra pockets for pen needles, extra lancets, etc. and was very flat. The Compact case has no extra pockets, just an elastic band to hold a spare test strip drum and one to hold the lancet device.
Lancet device is not compatible with half the lancets on the market, including my personal favorite, the B-D Ultra Fine. Most lancet devices have a round holder that can also hold "flat" lancets via a friction fit. The Accu-Chek lancet device can only hold "flat" type lancets, not round ones like the B-Ds.
The Compact also allows "alternative site" testing (i.e. not the finger) but has so many restrictions on when you can do it (see parent posts' mention of lag in the reading) that I never bother.
Don't try to go too fancy. People say they will want it, but so far every attempt at a meter that "does everything" (onboard statistics/data collection) has bombed. Non-invasive testing is a VERY desirable feature, but so far no one has succeeded in making an accurate NI meter that wasn't more trouble than it was worth. (The Glucowatch was expensive, known for causing skin irritation, and not very accurate. Due to the skin irritation, people preferred the occasional pinprick, which with a good lancet and properly adjusted lancet device depth, you barely feel.)
My advice: Try and convince Lilly and Novo Nordisk to bring back their 1.5 mL pen cartridges. Pens for 3 mL carts such as my new NovoPen Junior are fucking huge.
retrorocket.o not found, launch anyway?
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?
The trick is to test on the sides of your fingers and not the tips. Yes I have to test twice a day.
See my blog http://ilovecookes.blogspot.com/ for light hearted technical information.
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):