Of Macs and medicine

For nearly a dozen years now, I’ve carried around an incredibly advanced technological wonder of a device, first in a belt-clip holster (so you know how long ago that was, since I’m not part of the khaki-and-tucked-golf-shirt squad) and then in my pocket. Did I have some preternatural, supernatural access to an insanely early iPhone prototype? No. A pocket laser shark, perhaps? If only. No, for the past 12 years, my pancreatically challenged body has benefited from the use of an insulin pump. And for 12 years and over three models from two different manufacturers, those pumps have said diddly-squat to my myriad of Macs or iDevices. Until now.

Back in day, when I was still a kid being shooed off old folks’ lawns, my pancreas packed up its Islets of Langerhans, gave me a third-finger salute, and Kevorked itself. I was 20 years old, a junior in college, and—I had wrongly assumed—past the age when heredity would hunt me down and permanently jack my Pop Tarts. For next seven years, I injected insulin in the morning and then followed a strict schedule of eating for the rest of the day. I kept my blood sugar under fairly tight control, but I lived under the constant threat of a hypoglycemia time bomb. So, I got a pump. And I’ve been counting carbs and eating poorly ever since. (Note to insurance adjusters: that’s a joke. I consume nothing but berries and herbal tea. And the occasional tofu Ho-Ho on special occasions.)

My first insulin pump was a 507C from Minimed (now owned by Medtronic). It came with a lovely CD-ROM that allowed you to download things to your computer, assuming your computer ran whatever flavor of Windows was around at the time—probably a minimum of 3.1 with a 286. Which, as you can guess, I did not own. My glucose meter was the same way. For those unfamiliar with the fun that is a glucose (sugar) test, you basically get to stab your fingers several times a day, put a drop onto a test strip that costs about a buck, and wait for the meter to spit out a number at you. Hopefully, that number is between 70 and 120. Otherwise, you’re spiraling out of control, your endocrinologist will frown sternly, and your HMO will send you endless flyers about symposiums and support groups (but never once offer to fly you to Geneva for a pancreas transplant).

Anyway, I never owned a pump or a meter that spoke Mac. Not even after the iPhone came out. Seriously. How ridiculous is that? When I was looking for a new pump a couple of years ago, one new version was controlled wirelessly. By an iOS app via Bluetooth? No. It was controlled by a proprietary PDA that was about 30% bigger than an iPhone even though it required about 1/100th the processing power. What a waste. How silly. Even the fact that a Jonas brother used it could not convince me of its worth. So I went for what I now have: a Medtronic Paradigm 700-series and its accompanying glucose meter, both of which have wireless connectivity—but only to each other. Not to my Mac. The quaint CD-ROMs they included were of no use, either.

I don’t know why it took so long for someone to address the issue, but a company called Glooko (get it?) finally did. They created a syncing cable that attaches to the data port of your glucose meter and plugs into your iPhone or iPad. The free Glooko app then syncs all of your tests and sorts them into several lovely charts. You can add notes about your diet, exercise, or Vanilla Crème Pop Tart dalliances if you like. You can email PDFs or even eFaxes (because doctor’s offices are still decidedly stuck in 1997) of this data. Très nifty.

I just like that it works and only costs $40 (cheap in the land of diabetes management). I’ve never been one to make charts or Excel spreadsheets about my blood sugar readings. I’d test and have a pretty good idea of how I was doing in between my more intense lab visits. But being able to glance at my numbers whenever and wherever is nice.

Glooko is a small company, a tech startup, in the parlance of these times. They’re still looking for more rounds of funding (I think) and growth momentum. I hope they succeed in an area the big companies have chosen to ignore. I hope other companies join the fray. Use Bluetooth or NFC or something. And quit assuming every person with diabetes is over 80 years old and calls it die-uh-beet-us.

After all, why should the $600 phone in my right pocket not be able to speak with the $5,000 pump in my left?

Kickstarter project, anyone?

Later,

Fox

 

Update, 2/22/2012 – I just received an email from Medtronic, the makers of my pump, who inform me that their CareLink Personal software was made Mac-compatible in April of last year.

Comments closed
    • vargis14
    • 8 years ago

    My mother has a compatible meter already.Just might grab her one.It will be much better then her chicken scratch book, plus the fact she can send a pdf to her dr perhaps visits will he halved saving money in the long run.

    • mdfrncs
    • 8 years ago

    I have a number of type 1 diabetics in my family – including my sister and father – so I was shocked when I saw you write that your blood glucose levels were normally between 70-120. If theirs were that high, they’d be dead!

    Turns out you silly Americans just have a different unit for measuring it (mg/dl). Most (all?) other countries use the standard mmol/L, which gives a “normal” range of 4-7.

      • vargis14
      • 8 years ago

      Sounds like 4-7 is a lots smaller scale then 0-400 or whatever usa meters go up to,i am sure it works out around the same, seems that 4 points is a pretty rough estimation of your blood level.But i dunno.

        • mdfrncs
        • 8 years ago

        That’s like saying Celsius is a “rough estimation” of Fahrenheit. It’s just the units of the measurements that are different – where one would display 80 the other would display 4.4. The information conveyed is the same.

    • toastie
    • 8 years ago

    There’s also iBGStar: [url<]http://www.ibgstar.us/[/url<] It is a small glucose monitor that plugs into an iPhone. Its been out in Europe for a year or so, and has been recently approved for use in the US, although it hasn't yet been released. I've been waiting for it since it came out.

    • ludi
    • 8 years ago

    Having once (briefly) spent time in the bizzare alt-universe of medical device testing and FDA audit requirements, I’m going to guess that apps like this will be coming from third parties only for a good while yet, and that non-proprietary wireless synching simply won’t happen — not because the companies can’t think it up, but because the hurdles for proving that it works consistently and reliably while maintaining patient privacy are too great, particularly when one of the devices is not controlled by the product vendor.

    • Ragnar Dan
    • 8 years ago

    I think the pump maker’s liability would be worrisome if anyone could write an application to control it.

    Patient N: “Gee, it seems to work just great. And it’s cheap!”
    Coronor X, December, 2012: “Patient N appears to have died from a massive OD of insulin.”

    As for merely reading the data, well, less so, but who knows what misfortune might arise? But I think one can emulate Windows on a modern Mac with little trouble these days.

    BTW, your pancreas is missing what they apparently now call beta cells (Islets of Langerhans [i<]is[/i<] the correct term, but I suppose the geniuses thought it would be easier for their poor, ignorant patients to use a simpler one). But if your body's immune system would quit destroying them as invaders with its last-ditch T cells (they're what make a sore throat sore), they would grow back, I think I last read. Maybe you'd have to have an implantation of your own stem cells, I forget any more. But a new pancreas you definitely would not need, thankfully. And there are newer things coming, eventually, something about a matrix to grow things back properly. Medicine's advances appear to operate at approximately 1/5th the speed of normal science, and I think it's much to do with the God-complex among physicians. They don't consider their own frailties, and of course the feedback/gushing from some patients/relatives is likely difficult to ignore. Regulation, taxpayer subsidies, etc. account for a large portion of the problem as well. And there aren't millions of insurance companies, which do just about all of the buying/subsidizing of the insured. Which is why your test strips are so absurdly overpriced.

      • ew
      • 8 years ago

      [quote<]...if anyone could write an application to control it.[/quote<] Relevant: [url<]http://www.washingtontimes.com/news/2011/oct/26/insulin-pumps-other-medical-devices-vulnerable-to-/?page=all[/url<]

    • FireGryphon
    • 8 years ago

    The idea is great. I’d be too afraid of my medical data being compromised by a computer virus of some sort so I wouldn’t replace regular doctor visits, but it’s good for personal use. Also, keep in mind that if you sync a personal medical device with your iPhone, this starts to compromise the integrity of your medical health’s privacy. On the flip side, maybe you want to chart your medical data and seamlessly stream it off to a marketing company for some extra money. Who knows?

    • tfp
    • 8 years ago

    Nice little app.

    The biggest hurdle for things like this is going to be if the communication with medical devices are open and available for people to write small apps to ask for an then record the data sent back.

    There are a number of reasons a medical company might not what that communicate pipe to be completely exposed to any application. I wonder if this Glooko company is working with said medical companies or just went out on their own to do this.

    • dpaus
    • 8 years ago

    You rightfully decry the practice too many companies had of making Windows-only apps (when they could have been writing it all in Java to also run on Macs, Linux, whatever), but are happy that they now write an iOS-only app instead of a universal Java (or Javascript, or HTML5, or pick-your-cross-platform-tool-of-choice) app?

      • derFunkenstein
      • 8 years ago

      This is a third party, not the manufacturer. Different circumstances entirely.

        • dpaus
        • 8 years ago

        Is it? We write software for lots of hardware made by other firms, and we manage to do it all in Java (for desktops) or ZK (for mobile/web devices). True, we sometimes have to write a little stub in C/C++, but even that we use cross-platform compilers for.

        Call me a curmudgeon if you must (and if you do, get off my lawn!!), but I’m sick of seeing companies bring out single-platform ‘apps’ that could easily, easily have been done with cross-platform tools and enjoyed a much wider audience. I guess the older I get, the less tolerance I have for Kool-Aid….

          • bthylafh
          • 8 years ago

          Is iOS even capable of running Java? 2 minutes of searching says not, so there’s not any reason to target it.

          Besides, with a native app you usually get a nicer interface.

            • dpaus
            • 8 years ago

            Java, no, but as I said, we use Java for desktop programs; for mobile devices, we create a simple web interface. Sometimes a bit of low-level code is required to talk to hardware, for that we use a cross-platform tool, and keep that code to the bare minimum (and really, we rarely use it at all).

            To be clear: I’m happy that Jason has support for his device now. I was simply struck by the irony that when the option was Windows-only, he was upset that a cross-platform version wasn’t offered, but now that it’s iOS-only (i.e., his prefered platform), he’s OK that it’s not cross-platform.

          • derFunkenstein
          • 8 years ago

          It is. It’s great that a 3rd party is fixing a deficiency with the device, a deficiency the device should never have had in the first place.

            • tfp
            • 8 years ago

            It isn’t a deficiency if it is working exactly as they intended. The might not want the device to be accessible or open.

            • derFunkenstein
            • 8 years ago

            but they do, because as he said they bundle PC-only software for reading it. They just only support the single platform.

      • ltcommander.data
      • 8 years ago

      Since it’s talking to an external device wouldn’t you need to deal with platform-specific drivers or I/O APIs anyways? Do browsers whether on computers or mobile devices even allow access to tethered devices using Javascript or HTML5 since that could potentially be a security risk? Beyond a preference for native UI, there may well be legitimate technical limitations preventing a one-size-fits-all platform-agnostic application.

      • indeego
      • 8 years ago

      [quote<] universal Java (or Javascript, or HTML5, or pick-your-cross-platform-tool-of-choice) app?[/quote<] [i<]Jack of all trades, master of none.[/i<]

        • dpaus
        • 8 years ago

        [quote<]Jack of all trades, master of none[/quote<] A fair jab, but it's not like any of the little 'apps' on mobile devices represent a virtuoso programming performance.

          • mdfrncs
          • 8 years ago

          I agree with dpaus. Java is perfectly adequate for 90+% of applications (I made that number up but it seems reasonable). And there is a lot to be said for “write once, run anywhere”.

            • Arag0n
            • 8 years ago

            Sorry, but using Java for all apps would mean that we use more CPU than is required…. higher CPU utilization means higher battery use, and higher battery use means more electricity bills. think about 300 million iOS devices using Java apps instead of native code and you will get a full picture about the price of “being lazy” and targeting all devices with a single java code…. humans time is a resource, but is reneweable and helps to reduce jobeless problem!, energy by the other side, it’s not, and just helps to increase bills and pollution problems.

            • dpaus
            • 8 years ago

            [quote<]using Java for all apps would mean that we use more CPU than is required[/quote<] Source? We've been using Java for over 12 years now, and find that the efficiency of Java code [i<]can be[/i<] every bit as good as C++ or even C code. If you can cite a reputable source for your claim, then I might concede you the point on power usage (although I'd bet it'd be less than a 1% difference, and probably waaayyyy less), but your concern about CPU cycles....?? Yeah, CPU cycles are in such short supply these days.... Even if true, I'd argue that the benefit of 'write once, run anywhere' far outweighs any minor inefficiencies.

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