MedGizmo - MedGizmo: Wearables and Diabetes (Part III)
24.02.2016, 09:28   MedGizmo

MedGizmo: Wearables and Diabetes (Part III)

This is the third post of a series. The first described in general the issue of wearables and diabetes and provided some reference information on non-invasive blood sugar testing developments. The second – Diabetes Applications . Now we discuss  what is going on with platforms that help people to manage the diabetes data, as well as some specific wearables.

A non-profit entity, Tidepool Project has developed a cloud-based, open-source, HIPAA-compliant platform that allows aggregation of data across all diabetes devices.
The Tidepool Platform is secure and HIPAA-compliant. It has:
  • Tidepool Uploader to make it easier to get data off of diabetes devices.
  • Blip  provides opportunity to see all data in one place.
  • With Blip Notes you can add context to your data.
  • Nutshell is in development to make it easier to learn from past meals and exercise.

Glooko Diabetes management platform
Allows patients to download glucose readings to their smartphones and send it to their doctor.

Livongo Diabetes management app
Livongo for Diabetes empowers people with the right information and tools to live better. That's good for all of us: the person, their family and friends, their employer, their physicians and those who pay for the care.
Connected Device
A cellular, connected device that is much more than a traditional blood glucose meter. It's really a communciations tool that puts your healthcare data, trends and messages in the palm of your hand and provides a simple way to stay in touch with your care network.
Smart Cloud
Our smart cloud receives the data and develops the insights based on clinical rules and your own personal health history. It analyzes your data, turns it into useful, actionable information, and provides instant feedback about what to do next.
Care Team
The connection between the device and the smart cloud is surrounded by a care team of Certified Diabetes Educators that is always there to support you.

Smartphone Enabled Continuous Glucose Monitoring (CGM)
DexCom SHARE: Keeping tabs on diabetes, as easy as checking your email
The DexCom solution: DexCom is a medical device company focused on the design, development and commercialization of continuous glucose monitoring (“CGM”) systems for ambulatory use by people with diabetes and by healthcare providers in the hospital for the treatment of people with and without diabetes.
To make CGM more effective, the company developed its SHARE app, which was approved by the FDA in October 2014. SHARE allows patients with the G4 system to view information about their blood glucose levels on their smartphone and send it to family and friends.
 DexCom SHARE product is the only device on the market that fully integrates CGM into a smartphone environment. Given that people routinely check their smartphone, this platform allows patients to constantly and discretely check their blood glucose levels.

Dexcom G5TM Mobile Continuous Glucose Monitoring (CGM) System
Completely mobile continuous glucose monitoring system. With Bluetooth® technology that is now built in to the transmitter, your glucose data is sent wirelessly from the Dexcom G5 Mobile transmitter to your compatible smart device.
The Dexcom G5 Mobile app gives you the information you need quickly at-a-glance. Simply turn on your compatible smart device with the Dexcom G5 Mobile app and stay one step ahead of your diabetes. With readings every 5 minutes, Dexcom G5 Mobile will give you the glucose information you need so you can just focus on where you’re headed in life!

Using Dexcom CGM technology, the iLet offers its own, built-in, continuous glucose monitor. All that is required is a Dexcom sensor and transmitter and the iLet will replace your regular CGM receiver.
No longer do we need a laptop or an iPhone to run our insulin and glucagon dosing algorithms; the iLet brings with it a dedicated platform to run all of our dosing algorithms on a single, handheld device. Since our dosing algorithms adapt to your insulin requirements very quickly, the iLet truly becomes a personalized diabetes management tool that automatically learns your insulin requirements and manages your diabetes, allowing you to focus on other things in your life

The Dario Personalized Smart Meter
A compact, personalized glucose meter, including lancet and disposable test strips, lets you test sugar levels in seconds. Take this pocket-sized, all-in-one device with you wherever you go, and plug it into your smartphone or tablet to see your results. The Dario All-in-one smart meter is specially designed to fit your lifestyle. This sleek, all-in-one glucose monitoring solution includes a simple-to-use glucose meter, disposable test strip cartridge and lancing device – and comfortably fits in your pocket. Connecting to your mobile device, the smart meter makes it easy to manage your health, automatically log results, and always stay connected with your caregiver – whether you’re at home or on the go.

Insulin Pumps

According to this source, Pump Systems has the following common features:
  •     24-hour toll-free helpline
  •     Internal safety checks
  •     Child button lock-out
  •     Full Training Included
  •     Simplified programming
  •     Extended bolus options
  •     Temporary basal rate options
  •     Programmable reminders
  •     Downloadable
  •     Low battery warning
  •     Low insulin warning
  •     User-set active insulin time
Here is the Comparison of the systems with their Unique Advantages/ Potential Drawbacks
  • Tandem t-Slim
  • t-Flex/t-slim
  •  G4Roche
  • Accu-Chek
  • ComboInsulet
  • OmniPod
  • Medtronic 530G With Enlite
  • Animas Vibe
Some of them - in detail:

Animas® Vibe® Insulin Pump
Colour screen, waterproof, CGM-enabled insulin pump.
The Animas® Vibe® Insulin Pump is the first Dexcom G4® PLATINUM CGM-enabled insulin pump to have a high-contrast colour screen. It delivers rich information, too. Coloured trend arrows and lines show where your glucose is heading and how fast, so you can consider this information, along with the results of fingerstick testing, to help guide therapy adjustments
The Animas® Vibe® Insulin Pump is the only Dexcom G4® PLATINUM CGM-enabled pump that works with a sensor approved for up to 7 days of wear.
The Dexcom G4® PLATINUM Sensor introducer needle is the smallest available in comparison to Medtronic® Enlite®

MiniMed 640G insulin pump with SmartGuard®
SMARTGUARD®: One step closer to The Artificial Pancreas
SmartGuard®, our exclusive technology, mimics some functions of a healthy pancreas to provide advanced protection against hypoglycaemia.
    Based on your sensor glucose values, SmartGuard® can predict when you are approaching low glucose levels 30 minutes in advance and automatically stop insulin delivery
    When your glucose levels recover, SmartGuard will automatically resume insulin delivery.
    You have the possibility to set multiple low limits throughout the day to give you increased protection when you need it most.

t:slim® Insulin Pump

The t:slim Pump is the slimmest pump on the market and has a sleek, modern design. A patented pumping mechanism and the latest rechargeable battery technology allow it to pack a 300-unit reservoir and up to seven days of power into its slim, sleek case. The smooth, compact design allows it to easily slip into a pocket or be worn discreetly under clothing.
The t:slim Pump was built using the most advanced technology, with your lifestyle and safety in mind. Tandem's patented Micro-Delivery® technology delivers insulin in the tiniest increments available. The t:slim Pump also incorporates familiar technology such as an integrated micro-USB port for convenient charging and fast data transfer speeds.
t:slim G4™ Insulin Pump
The first CGM-enabled, touch-screen insulin pump. Fully integrated with the Dexcom G4® PLATINUM CGM.
t:flex® Insulin Pump
The largest insulin capacity of any available pump makes t:slim the right fit for greater insulin needs.

Libre Flash Glucose Monitor
Abbott Diabetes Care's new Libre Flash Glucose Monitor (FGM),
The system consists of a little round sensor worn on the skin, and a "receiver" that looks similar to a handheld PDM, which you wave over the sensor to wirelessly pick up data
    The disposable, water-resistant round sensor is the size of a silver dollar and the width of a finger, similar to a traditional CGM sensor. You can wear it for up to 14 days on the back of your upper arm.
    No finger prick calibration is needed, since that functionality is all embedded into the core technology.
    Glucose readings can be taken as many times per day as needed or desired, with only a painless one-second scan. Results are transmitted to the receiver via wireless radio frequency tech.
    The scanning device is a wireless touchscreen color reader, which looks similar to a traditional meter, or more specifically an OmniPod Personal Diabetes Manager (PDM). Just wave the reader over the sensor as often as you want to get real-time glucose values, along with a trend arrow and graph showing the past 8 hours of data. It holds 90 days worth of blood sugar data.
Read this paper

ITCA 650
ITCA 650 (continuous subcutaneous delivery of exenatide) is being developed for the treatment of type 2 diabetes. The investigational therapy employs Intarcia’s proprietary technology platform involving a matchstick-size, osmotic mini-pump that is placed sub-dermally to provide continuous and consistent drug therapy, and the company’s proprietary formulation technology, which maintains stability of therapeutic proteins and peptides at human body temperatures for extended periods of time. Exenatide, the active agent in ITCA 650, is a glucagon-like peptide-1 (GLP-1) receptor agonist currently marketed globally as a twice-daily and once weekly self-injection therapy for type 2 diabetes, and a member of a drug class called incretin mimetics.
ITCA 650 could transform the way type 2 diabets is managed today, as ITCA 650 would be the first and only once or twice yearly, non-injectable GLP-1 therapy.
Intarcia is developing ITCA 650 to provide type 2 diabetes patients with long-term steady state dosing of GLP-1 therapy. Exenatide and other GLP-1s have demonstrated effective glycemic control and weight loss as single agents and in combination with oral antidiabetic drugs. Like other GLP-1s, exenatide is limited by pharmacokinetics that require self injection and cause side effects such as nausea that often lead to poor compliance or premature discontinuation of treatment. ITCA 650 is designed to deliver a continuous and constant dose of exenatide over an extended period of time. Due to the inherently short half-life of GLP-1s, extended duration delivery options are an important consideration to facilitate patient compliance and convenience. Our proprietary delivery system has the potential to provide continuous treatment with the flexibility of near immediate reversibility.

Diabetes Helpers
Diabetes Helpers is a help network on mobile and desktop where people help each other navigate life with diabetes. People with type 1, type 2 diabetes, gestational diabetes and their caregivers answer each other about the symptoms of diabetes, how to lower their a1c, and learn more about diabetes diet and management.
Having a supportive community of Helpers is awesome. But informing family and friends is just as important. HelpAround also provides users with quick access to an immediate circle of trusted caregivers and contacts.
Meet Alert by HelpAround. In moments of physical or emotional trouble, Alert creates a virtual
huddle by text and voice, making it easy to quickly notify a circle of the user's most trusted helpers before reaching out to other Helpers in the community.


KiMS: Kids’ Health Monitoring System at Day-Care Centers
A novel integrated system for monitoring children at day-care centers in order to facilitate proper care of health issues and overall wellbeing, including early detection of symptoms for various diseases, posttreatment monitoring as well as encouraging healthy habits and activities. The proposed “Kids Health Monitoring System”, referred to as KiMS, is built around a wearable acoustic sensor with embedded digital signal processing capabilities in order to detect various audio signals of interest, such as coughs, sneezes, and cries. It is also equipped with wearable body temperature and pulse rate sensors, along with on-site processing and a Bluetooth unit for communicating alerts and activity on a timely basis. The record of a child’s activities can be used by daycare specialist, parents or the healthcare provider for understanding the probable cause or time of onset of symptoms and encouraging healthy habits. This paper also presents a signal processing framework for feature detection and classification of various audio signals, under varying Signal to Noise Ratios (SNR).


What is lumind?
is a connected desktop light for diabetics that reminds you to check your blood glucose levels regularly. The color of the light represents your glucose status: Blue means that the sugar is too high, red signalizes that it's too low and green indicates that your in a good range. A slight pulsation of the light suggests a new checkup on your levels. You can easily enter your blood glucose readings into the lumind-app on your smartphone. The app will synchronize with lumind wirelessly. That way close partners or family members can remotely be involved into your life with diabetes.
lumind comes with a super fast and easy to use app which allows you to enter you blood glucose readings and other diabetes in a few seconds.

Finally, here are some good links

What Diabetes? – a page with answers to many questions
UW Hospital and ClinicsSchool of Medicine and Public Health, University of Wisconsin-Madison
Website has a lot of practical information:
  • Resources and
  • Gadgets & Applications
  • List of Android Apps  and iPhone Apps
  • Link to a summary pages for Android and iPhone Apps
  • Diabetes calculator for kids
Medword Medical Sales
Diabetes Information & Glucose Readers

This concludes our series of three posts. You may read our previous posts

24.02.2016, 09:28   MedGizmo
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