Tag: Data

The Diabetic Jornal for iPhone and iPod Touch

Nial Giocamelli and I have something in common. He has Type 1 diabetes. Like me, his brain now needs to do the work that his pancreas and endocrine system used to do. He has to calculate the amount of carbohydrates in each meal, compute the correct amount of insulin he needs, test his blood glucose, and inject that insulin.

This is part of diabetes management. All this data on what we eat and when we eat and what dosage of insulin we took and what the blood glucose is at any given time is useful when we visit my doctor. It can be used to adjust treatment or just to make sure things are under control. It's a lot of data.

A single entry for breakfast involves knowing the amount of carbohydrate, the BG reading, the insulin injected and the time of day. There are a few apps in the iOS App Store for entering this data but it's a manual process. Very few of them have any graphing or charting and there is no easy way to share the data with the doctor. They are difficult to use, ugly and expensive -- anywhere from $2.99 to $.799. They don't learn user habits or provide any real analysis. in my opinion the apps in the App Store are no better than a digital version of pen and paper.

Nial wants to change all that. Imagine if an app could use my diabetes facts to suggest a reduction in dosing because it knew that my blood glucose drops just before lunch based? Imagine if that app understood that since I ate pizza that I might be in for a roller coaster BG effect in a few hours? Imagine if that app was FREE?

Most of the existing diabetic applications on the App Store make it tedious and difficult to keep your journal up to date. After all, my disease takes up so much of my life already that I didn't want to spend any more time than necessary recording data. So I built my own diabetic journal application, and I made it fast. More importantly, I made it intelligent.Nial Giacomelli

Features include:

  • The ability to track and report on daily athletic activities, meals (and carb intake), as well as medication and blood glucose readings.
  • A system which monitors your medication schedule and intelligently pre-populates fields to save you from monotonous typing!
  • A blazingly fast autocomplete system.
  • Fully internationalised, with automatic BG unit conversion between mg/dL and mmoI/L. The journal works everywhere.
  • Medication reminders (including a geofence that'll remind you to take your medication when you leave the house)
  • View entries across a rolling six month period or break it down by entries entered within the past 7 or 14 days
  • A fast and beautiful gesture-based interface

Nial hopes to accomplish something great with his app, the Diabetic Journal. He wants to make it so that everyone has access to top notch diabetes management software. I want to help him.

Nial has the support of noted web gurus Cameron Moll, Jeffrey Zeldman and others.

Unfortunately he is running into issues raising the initial capital to get the project funded. He has started a Kickstarter project to raise money but time is running out. Please visit the Diabetes Journal Kickstarter page and help fund this project.

Spread the word.

The Glooko cable is now part of my daily diabetes kit

About two weeks ago I posted about my decision to stop using the iBGStar glucose meter. I love the iBGStar. It is perfect in every way. It's small, light and connects to my iPhone for data download. I ranted and raved about it to everyone I know. People in my family were starting to think I either owned significant stock in the company or were on the payroll. However, for budgetary reasons I had to stop using the meter.

Someone on a social network suggested the ACCU-CHEK nano. However, the nano doesn't isn't OS X compatible so I ruled that one out right away. Someone from Glooko commented on my blog post and I remembered that I already had the cable.

Take a look at a photo of my daily diabetes management kit:

It's neither convenient nor elegant. The LifeScan OneTouch mini connects to my iPhone via the Glooko cable. The cable is also compatible with my Abbot FreeStyle Flash but the system is much bulkier than the small sleek iBGStar. The Glooko software is functional but lacks the user interface finesse that I've come to expect from iPhone software.

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Like the iBGStar software, I can download and track my blood glucose (BG) and add a note about a number of carbohydrates in my meal and my insulin dosage. I can tag each BG entry as before or after a meal. This is useful for spotting trends.

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The Glooko has a database of foods. I can look up nutritional information on brand-name foods but also generic things like raspberries. That's something the iBGStar can't do (yet). I don't eat much-packaged food or chain restaurant food — who wants bland, high sodium, fatty, HFC laden food? — so the food database is not of much use to me. However, I could see why it might appeal to the other people with diabetes.

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I can export the downloaded information from the Glooko app to email (CSV), eFax (really!!??), AirPrint or any app that supports the "Open in…" feature of iOS such as Dropbox, Box or iBooks (PDF). I think my favourite is going to be Dropbox. I'll have access to my information from my Mac, iPhone, iPad or any computer with a web browser.

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There is an opinions tab in the app. Click that and I'm taken to Glooko's Facebook page. I guess they wanted some social media around their product but I won't be using this feature.

To use the Glooko, I purchased a cable that was compatible with my brand and model of meter. The list of meters isn't comprehensive but it does include the major brands and meter models. I have a LifeScan OneTouch Ultra mini and Abbot FreeStyle Flash so those are the meters with which I tested. I plugged one end of the cable into the data port on the meter and then plugged the other end — the one with the iPhone dock connector — into the iPhone. I had to go into Settings in the app to select the brand and model of meter I was using then back to the Home screen and tap the Sync button. I wish this step was automated. I wish the software could auto detect the meter type so I just plug in the cable and tap sync.

One the data is downloaded from the meter, I can add other information.

The setup isn't pretty and I don't like carrying around the cable but it works for now. The OneTouch strips are covered by insurance so my endocrinologist can send a prescription directly to my mail order pharmacy service which covers everything for a nominal c-o-pay. However, the Glooko can connect to the range of glucometers I already have and is inexpensive compared to buying a bunch of new meters. I always have multiple meters. I like to have a backup.

Before I decide on a long term solution I want to try the Contour USB. The Contour USB (and strips) are covered under my pharmacy benefit so my endocrinologist called in a prescription. Until I have that device and I have used it for awhile I'm sticking with the Glooko cable.

My wife fired my endo

Last year my endocrinologist, the one I had seen since I was diagnosed with Type 1 (LADA) diabetes, moved to Palm Beach, Florida1. He did not retire. He and his wife wanted a slower pace and better weather. His assistant Chris, did the same.

Dr. Feldman and I got along very well. On each visit he would take my glucose meter and download the data. He didn't care which meter I used. He would find the right cable and plug it in. We would spend the time reviewing the data — he would always graph it — looking for any patterns. He would ask about my overall health and quite often we would discuss the latest diabetes tech. He lent me a CGMS for two weeks so that we could collect data to help set our strategy. Notice I said, our strategy. Dr. Feldman and Chris made me feel like we working together.

Dr. Feldman was just one doctor of two other endocrinologist in the
Princeton Medical Group2. I decided to stay with the practice because I thought it would be easier than filling out the paper work to move my medical records. I started seeing Dr. Gabriel Smolarz .

Dr. Smolarz and I immediately got off to a bad start. My very first visit I handed him my meter and he said, "I don't download meter data. Let's keep a paper log". I stopped listening after that.

Paper!? Was this doctor a complete ass. I pushed back a little. Was it because the practice no longer used the software that Dr. Feldman used? No, everyone in the practice has access to that software. Then why …!!?? He just didn't want to. Was this a technology age related thing3? We came to an agreement. I could dump the data from the meter myself and bring print outs on my subsequent visits. There was definitely no "us" in his "Let's".

The challenge was that NONE of my meters — all of which are OneTouch meters from LifeScan — have software that works on a Mac. I contacted LifeScan but received a form letter telling me what I already knew. Their software is compatible with Microsoft Windows only.

I had a Wavesense4 meter so I contacted AgaMatrix. Almost a year ago I had an email exchange with someone at the company who indicated they were working on something special that would work with my Mac. Apparently they must have decided against it. The Wavesense devices don't have any Mac based management software. Same for the Freestyle.

I started looking for a solution and I thought I had found one. When the Glooko was announced I immediately bought one. The Glooko is a cable that attached to an iPhone and a specific brand of meter5. The user is able to download all the data of the device and import it into an iPhone app. I could also enter how much carbohydrate I had consumed and how much insulin I had injected. I started using it with my OneTouch devices. I was great at first but I was soon tired of using it. The Glooko was one more thing I had to take with me and attaching and detaching the cable became a chore. Sure, I could download my data at the end of the data but by then I might not remember how much I ate or how much insulin I had used.

As my wife watched me going through so much frustration trying to solve my problem, a problem caused by my endocrinologist's refusal to download data, she kept suggesting that I find a new endocrinologist. "The medical group has another doctor", she would say. "No", I said, "I'll find a solution".

After the iBGStar was released I bought that. I was very excited. A small, lightweight unit that plug directly into my iPhone and allowed me to track BG, carbs and insulin. I could even add little notes to each entry. I love the iBGStar. However, after a few months the cost started to add up quickly and I realized that the I could no longer use the iBGStar.

In frustration my wife called the medical group and had a lengthy conversation with the other endocrinologist's nurse. Dr. Cathleen Mullarkey, the only other endocrinologist in the practice, is very willing to download data from any meter I own. My wife was quick to rebook all my appointment and Dr. Cathleen Mullarkey will be my endocrinologist for the future. My wife fired, Dr. Smolarz. I love my wife.

  1. Dr. Feldman is at the South Florida Endocrine Center ↩
  2. The Princeton Medical Group is rather large with offices in many New Jersey locations. ↩
  3. Dr. Gabriel Smolarz is actually younger than Dr. Feldman. ↩
  4. I'm an engineer and a geek. I love trying out new diabetes tech. ↩
  5. While the Glooko is a product trying to meet an unmet need, having to buy a new $40 cable for each brand/model of meter I used limited its long term utility. ↩