12 Responses

  1. Jasmine
    Jasmine July 15, 2010 at 1:09 pm | | Reply

    It would be amazing if all of these were interoperable (and thanks for the new word!). While I don’t have a ton of diabetes STUFF yet (my diagnosis was only 6 months ago), it would make me feel less locked in to the pump I decide on and would allow me to make choices based on what I think works best for me rather than what seems most convenient because of integration.

  2. riva
    riva July 15, 2010 at 1:48 pm | | Reply

    While I can certainly appreciate technological devices and components working in concert with each other, saying ” Medtronic, Roche, Bayer, Abbott and others are among the big industry players talking about more of a “systems approach” to diabetes…” is not actually true.

    A “systems approach” to diabetes would include optimizing all the systems within which a patient lives. The device stuff (meter, pump, CGM etc) is only one system in a “systems approach.” Other systems are the access one has to healthy food, whether your neighborhood is safe enough to be physically active outdoors, do you have support at home, one’s family dynamic… etc. In other words, the social system which a PWD is part of.

    While we all want our devices to work seamlessly, I think it’s telling that pharmas are so singly focused on the hardware. We know for a fact if a person’s life systems aren’t supporting the daily management of diabetes it doesn’t matter a lick how advanced and seamless our devices are. So, a good step on the part of pharmas, and now let’s look at the other half of what patients need – the behavioral tools to change and sustain new habits.

  3. David
    David July 15, 2010 at 2:19 pm | | Reply

    Re IOB, I see no reason why this can’t be a user-programmable default so that each person can choose for himself whether he wants meal boluses included in IOB.

  4. Michael Ratrie
    Michael Ratrie July 15, 2010 at 2:26 pm | | Reply

    Great post Amy! Given the standards like USB that have evolved in the computer world, you have to wonder(?) at the continuing efforts of pharma to create islands. Surely it would be less expensive to design to standards wouldn’t it? (I am NOT calling you Shirley, BTW!)

    Somewhat similarly, I never understand WHY it takes the FDA so long to approve the ability of our pumps and meters to send DATA(!) from one device to another or to a computer. Now if the FDA was pushing back on the pharmas by saying, make this device communicate using standard USB/Blue-tooth protocols, then I would understand.

    Fair Winds,

  5. Bernard Farrell
    Bernard Farrell July 15, 2010 at 2:44 pm | | Reply

    Pharma is where the technology companies were a few decades ago. Remember when you couldn’t connect modems from two different companies? Once standards were in place, modem sales took off and everyone won.

    Michael, the FDA is not involved in data standards issues. They can only look at efficacy and safety when deciding to approve something. In terms of efficacy (does it work), if the readings from a device can be downloaded accurately to software from the device maker, then it’s a pass. They can’t disapprove a device because of a lack of a standard protocol. Look at the early OneTouch UltraMini meters, they had no download ports.

    I have a suspicion that the artificial pancreas work will drive some type of standards. It would need to so the CGM and pumps can communicate effectively with software that’s figuring out how much insulin to give you.

    After writing my paper (PDF) proposing a standard, simple, diabetes data interchange format, I started a diabetes data wiki to try and document the current formats that are used by different meters. I’m hoping that someone will take this information and use it to develop and interchange converter…if only I had the time myself.

  6. Bob S
    Bob S July 15, 2010 at 3:51 pm | | Reply

    Just curious but wasn’t it Medtronic that sued Smith Medical for infringement on their bolus calculations that ultimately put the Cosmo out to pasture? I know that Medtronic uses their bolus calculations as a unique feature of their pump. Regardless, if that it the case, standards will never be set across companies.

  7. Bennet
    Bennet July 15, 2010 at 7:16 pm | | Reply

    I agree Amy. I made similar comments back in this post:

    And Bernard was my hero back then too.

    More recently I have been looking at the Continua Health alliance as a possible source of standards. Some of the big D firms are members. I post information on it as I see it but they didn’t have insulin pump standards last time I talked with them (they were scheduled for a release this year I think) They also had no CGM data standards on the map and to be honest they probably spin off so much data that they are hard to deal with.

    So that isn’t a realistic path for standards anytime soon.

  8. Michael Ratrie
    Michael Ratrie July 15, 2010 at 8:28 pm | | Reply


    Too funny! “A device that listens to the device that goes PING!…”


    Yes, I get that the FDA is not involved in data standards, only efficacy and safety, yet manufacturers often get held up trying to show the efficacy of sending DATA – pretty cut and dried I would think – maybe even binary sends the data or it doesn’t, NEXT!

    Fair Winds,

  9. Fran
    Fran July 16, 2010 at 10:51 am | | Reply

    About that, I’m working on something similar to that, I mean, I’m developing an Android app which upload your BG to your Google Health profile in order to save and share your data.
    The data can be read using your glucose meter connected by bluetooth to your phone.
    It’s more or less the same concept and there’s a prototype on Android Market. Right now I’m working on adding features and fixed some bugs, but after I finish that I’d like to begin with thinking about giving more useful information (regarding Real Diabetes Management Part 1: Making Our Data Speak to Us).

    Any help to reach that goal will be appreciate, the project website is : for more information or drop me an email :)

  10. diabetes information
    diabetes information July 16, 2010 at 12:24 pm | | Reply

    loved the post and series as well and i remember once you have posted a diabetes gadget competition on some innovative ideas where some university students won it i think ! I really appreciate the work you have done in making diabetics live better and longer ! Needed more posts like this from you !

  11. Scott K. Johnson
    Scott K. Johnson July 27, 2010 at 8:15 pm | | Reply

    Another great post Amy – thank your for spurring on some additional conversation around this. There’s a long way to go, but we have to start somewhere, right?

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