At a medical meeting in 1956, Dr Priscilla White of the Joslin Clinic asked: ‘Do you think patients should learn to do their own blood sugars?’ This was greeted with laughter from the audience who clearly regarded it as an outrageous idea. Nowadays, self monitoring of blood glucose levels has become a routine activity for the vast majority of people living with diabetes. Traditionally, the recording of achieved blood glucose levels has been with a pen and paper –the ritual handing over of a messy, blood stained log of hundreds of random numbers at each clinic visit. However, changes in consumer electronics have altered markedly methods of communication.
With this in mind, VoyageMD has recently had an opportunity to review the Glooko Logbook app and Glooko Metersync cable (http://www.glooko.com/). The concept is very simple - plug the Glooko MeterSync Cable into most standard self-monitoring blood glucose meters and sync it with a variety of iOS devices (iPhone, iPod Touch) to create a digital logbook of readings. The advantages are (a) being able to create an instant error free logbook (b) recording carbohydrates, insulin doses, medications, when they happen (c) accessing nutritional information from the integrated food database and reviewing trends with the integrated meter readings and notes. The results can then be summarized as a pdf, exported to a spreadsheet or emailed to a doctor or nurse. The Glooko MeterSync Cable is very easy to use and compatible with a number of exisiting meters:
ACCU -CHEK® Aviva, ACCU -CHEK® Aviva Nano, ACCU -CHEK® Compact Plus, ACCU -CHEK® Nano
Bayer’s Breeze®2, Bayer’s Contour®
FreeStyle Freedom Lite®, FreeStyle Lite®
OneTouch® Ultra®2, OneTouch® UltraLink®, and OneTouch® UltraMini®
On a negative side the system lacks the ability to create custom graphs and images but hopefully these will come with later versions. More significantly, this is a device which adds some value but misses the opportunity of being a truly disruptive technology which will radically improve the lives of people living with diabetes.
At VoyageMD we would like to see device manufacturers include tools that will:
Enable patients to act on their blood glucose results by translating blood glucose test result into usable information and advice for diabetes management and also including bolus and basal insulin calculators for insulin users
Assist with interpretation of glucose data by adding software for pattern recognition of high and low blood glucose levels including prompts about potential reasons for these events occurring (e.g. wrong time of administration of a bolus dose, or insulin stacking due to too frequent dosing)
Create a structured approach to testing for specific needs, e.g., the use of paired pre-meal and post-meal testing to help with weight management
Develop web and mobile phone applications to take into account an individual’s achieved level of numeracy and literacy in addition to native language, culture, and age
An additional approach would be to create technologies based around common “life events” for individuals living with diabetes such as travel, shift work, or in-hospital care, where it may be possible to predefine frequency and timing of testing to maximize benefit and reduce risk and costs. It is also anticipated that future technologies will be personalized to current treatment regimens.
By adopting new, actionable monitoring technologies, we believe people will be enabled to self-manage their condition better and, in the longer term, potentially reduce the burden of diabetes on the individual and society.
