Blood Sugar

This is a post about glucose meters, but it isn’t just for diabetics. I don’t talk about my diabetes much. It is one of those things that I just “get on with”, and having a bit of good kit can make that a lot easier. I was diagnosed in 2004 and have gone through late teenagerhood, university and starting a career with just a little bit more organisation and care needed with regards to my health.

Quick catch up – a glucose meter measures the amount of sugar/glucose in your blood. There are different units of measurement; in the UK we go for millimoles per litre and you want to keep roughly between 4 and 8. Below 4 and you can die, above 8 and you can die (I simplify - read Wikipedia for an actual summary). The point is, you need to keep in the middle; you shouldn’t go too high or too low.

My first meter was a Freestyle. It didn’t need a lot of blood for a sample and supported “alternative site testing” (testing on places that aren’t your fingertip). It was a great starting meter, sturdy and easy to use and get the hang of. To give some context, the other gadgets in my bag at this time were a 3 megapixel Kodak camera, a Handspring Visor, a MiniDisc Player and a Nokia 3310. This was about a year before affordable colour screens on PAYG phones and broadband providers including wifi routers as standard.

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 I loved that MiniDisc player though…

Fast forward to the present - this year I have used four different meters, the Freestyle Lite Mini, Contour XT, Countour USB and Freestyle InsuLinx. Some were recommended to me by other diabetics, some were legacy meters and others I was just curious to try.

I have a list of everything they are doing wrong from my point of view. My day job often involves working with outputs of big data, looking at data governance processes and hearing developers scream about crappy APIs. I’m not a programmer, but I’m a bit more involved with tech than your average punter. This being said, the points I’m making would make any diabetic’s life easier and a bit more manageable. Also, I’m not going to go into the points to do with consumables etc. - that is more an engineer’s question. I’m addressing these things as gadgets, tools and lifesaving tech.

Mo’ sugar, mo’ problems

Problem 1 – Wires/wireless

My first few meters (all freestyles, freestyle minis or freestyle lites) had a port at the top that you could export from. Problem was that you had to register and send off for a free cable if you wanted to get your data out because it wasn’t a generic wire. I can’t remember much about the software, because I didn’t use it. It was a faff to find this one cable in an age of proprietary cables, connect it up and wait half an hour for the java based software to load.

This year I’ve had a go at using the Contour USB and the Freestyle InsuLinx. Both of these have addressed the proprietary wire issue quite well – the Contour USB is a USB stick so just plugs straight in to my laptop, the InsuLinx has a micro USB wire and as I am an Android owner, I have about 40 of those already. Well done.

The issue with that is that I’m not near my laptop very much now. I work off tablets and phones or my work laptop (which I don’t have admin rights on, so I can’t install the software). So fixing the wires issue brings us slap bang up to date in 2008.

Problem 2 – Software

Oh god. Here is a screenshot from the latest offering from Abbot with the InsuLinx. I don’t have a netbook, but it is a non-resizable window that is too tall for my laptop screen. This is the biggest screen I have. Next time TEST YOUR SOFTWARE ON MORE THAN YOUR OWN MACHINE.

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Often the software is built in Java yet won’t work on anything other than Windows; I once spent a frustrating hour trying to get things to work in Ubuntu. Never again.

This is another screenshot from the installation of the “latest” software from Abbot. It is the version of installshield you would have used in 1998. This doesn’t fill me with confidence.

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Problem 3 – Data

Great. You will only give me data as a PDF so I can dutifully print (and really, it offers “print” as the primary option before “view”) the report and give it to my consultant. I’m exporting my data, I want to do something better with it myself. I appreciate that the meter tech is proprietary, but you don’t own my results. Make the meter export in a choice of XML, PDF and CSV/TSV with an open standard across manufacturers.

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No, seriously, it makes a B&W PDF. Because it is meant to be printed.

Problem 4 – Batteries

If you put disposable watch batteries in your meter, you are doing it wrong. The Contour USB was at least rechargeable by plugging it in. I don’t want to have to register and send off a week in advance for replacement batteries from your customer loyalty scheme. In order to run my diabetic life, I already have to talk to maybe three different sets of people to get my equipment sorted. Don’t make me talk to your customer support team and complicate what is already quite an arse ache.

Solutions

Bluetooth/wifi syncing

I recently bought a Spotify Premium sub, not because I needed more music; I have just shy of a terrabyte of MP3s sitting on hard drives around my flat, I just can’t be bothered to get the cables, wires and USB hubs together to sync them with my phone. Spotify Premium does it over wireless. If I can’t be arsed to wire-sync something fun like music, imagine how far down the list my glucose meter comes. Use a secure bluetooth connection.

Software and data.

Make an XML export standard. Open source project to a build cross platform reader with backing from all the manufacturers to ensure continuity of monitoring. Done.

Batteries.

It is almost 2013. Make the batteries rechargeable please.

Conclusions

This is an absolute sitting duck of a market. Diabetes is a huge and growing constituency. Creating a meter that is just about on the scabbing edge of tech would make me happy, one that adheres to the changes we’ve seen in acceptance of open standards over the last 10 years would be even better. I think the biotech companies involved need to realise that they can’t code for shit and would be better off standardising the outputs and making the differentiation in amount of blood needed to test/accuracy of reading/etc. as I am unlikely to buy a meter because it has home coded software. The same way that I never used Sony’s MiniDisc software to manage my music collection.

The gadgets in my bag today are a Galaxy S2, a Win7 laptop, a Nexus 7 and my meter. All of them except the meter can (just about) talk to each other. The manufacturers need to look at users today and how they work and not rely on past assumptions and really inappropriate vendor lock-ins.

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