Advances in Management Technology for Diabetes From personal reminders to digital doctors. By Kristina Grifantini
ng publishi by ingram censed images li
Digital Object Identifier 10.1109/MPUL.2014.2309579 Date of publication: 14 May 2014
40 ieee pulse ▼ may/june 2014
2154-2287/14/$31.00©2014IEEE
B
glucose information and user data in easy-to-digest charts and ack in 2004, Scott Johnson, a type 1 diabetic, could graphs and offers encouragement and goal-setting features. find plenty of online information about the sympDespite the app’s success, the lack of interoperability between toms and complications of the disease that prevents diabetes devices and apps presents a challenge to companies like his body from producing the blood-sugar-regulating MySugr and others in bridging the gap between hormone insulin. What he couldn’t data, communication, and patient usability. find was anything written by someone When patients have a blood glucose reader, insuactually living with his disease. So he started “The mobile phone lin maker, and cell phone that can’t talk to each his own blog, eventually attracting thousands is a landmark for other, patients are saddled with the time-conof page views a month. His blog became a place diabetes.” suming burden of logging their own data, which where he could share stories with other diabetoften leads to errors. ics and find support, encouragement, and even “If devices such as the glucose meter, insulin a sense of normalcy. pump, insulin pen, and the software to read all of the data at a “Diabetes is, for the most part, invisible,” says Johnson. “I glance could be interconnected into one platform, it would be wouldn’t know someone had diabetes unless they told me. It’s incredibly powerful,” says Dyer. “It’s like dealing with VCR, TV, very isolating to have to do extra work to survive every day and and Xbox remotes when you want a universal remote.” not be able to talk with others who understand.” Some companies have started to move toward this integraAs the prevalence of diabetes continues to grow worldwide, tion, as creators like ActiveCare, iHealth, LifeScan, and others researchers and patients like Johnson are increasingly turnoffer wireless glucose meters with Bluetooth connectivity. Other ing to a growing number of social networks, online support app developers ask patients to input their own data to avoid the groups, and mobile apps to help them manage a disease in which lack of interoperability. it is especially important to keep track of carbohydrate intake, One company has gone as far as to create its own way of conblood sugar levels, and insulin injections. Apps in particular are necting with the majority of devices to assist patients with health becoming an important way for patients to more easily log and data logging. The Silicon Valley-based diabetes platform developer contextualize the complex balance of diet, exercise, and insulin Glooko developed an FDA-approved app and cable that connects needed to maintain normal blood sugar levels. More open data between 28 types of mobile phones and 29 types of glucose meters, collection and analysis through apps and online systems may which account for roughly 85% of the existing meter market, also help researchers better understand and track demographic according to Glooko CEO Rick Atlinger (Figure 3). The MeterSync trends underlying the disease. “The mobile phone is a landmark for diabetes,” says Jennifer Dyer, M.D., a pediatric endocrinologist and creator of the EndoGoal diabetes management app, which rewards users for checking their blood sugar. “It offers convenience and portability for diabetes data management, it has your social media connections, and it offers other opportunities to connect diabetes to other parts of your life.” There are challenges. Many of the diabetes-monitoring technologies—glucose meters and insulin pumps—have proprietary platforms that don’t talk to each other, interface well with smartphones, or give patients and providers user-friendly access to the full spectrum of data. But as the industry sees larger patient and provider demand for more open, useful data, this is starting to change.
Clinical Recommendations and the Messy Interoperability of Devices Last year, Johnson joined the MySugr team, an Austrian app company that offers one of the few U.S. Food and Drug Administration (FDA)-approved diabetes management apps for Android and iOS operating systems. The app has attracted more than 86,000 users since its inception in 2011 and winning of FDA approval in 2013 (Figure 1). The MySugr app encourages patients to enter health data by rewarding them with points that “tame the diabetes monster,” a metered representation of how well the patient is logging data (Figure 2). The app then interprets blood
FIGURE 1 The MySugr diabetes management app uses a points system to encourage patients. (Image courtesy of MySugr.) may/june 2014 ▼ ieee pulse 41
patients and providers. The Joslin cable, which contains a microprocessor, memory Diabetes Center, which sees chip, and battery, and runs about US$40, pulls hisThe MySugr app around 25,000 patients, toric data from diabetes devices and displays them in encourages patients aims to bring mobile a free Glooko app within “30 seconds.” The app then to enter health data information to both allows users to select food and medication informaby rewarding them type 1 and 2 diabetes tion to assist with logging. Data are also pulled into with points that patients and clinicians, a cloud where providers or caretakers—anyone the “tame the diabetes says Harry Mitchell, patient gives permission to—can access it, offering executive director of patients and caregivers the potential for real-time monster.” the Joslin Institute for health alerts to respond to emergencies. Technology Translation. “By illustrating this data, you can look back at The center is developing pattern-based data clusters and see if there are any patterns, such as any times of algorithms that will interface with gluday when blood glucose levels get out of control,” says Atlinger, cose readings to provide information related who adds that the app has thousands of users and focuses on to potential hypoglycemia events, where blood both type 1 and type 2 diabetes. sugar levels fall dangerously low and can lead to In January 2014, Glooko and the Joslin Diabetes Center in unconsciousness, seizures, and potentially death. HypoglyBoston announced a partnership to introduce a hybrid platform to cemia is the type of incident that constant monitoring and predictive software could help prevent, e.g., by sending an emergency notice to the patient or caretakers. “Providing real-time data will improve efficient and effective communications between physicians and patients. Doctors will have more timely and relevant information to review, and patients will feel more engaged with managing their diabetes,” says Mitchell. Glooko and Joslin are currently rolling out the system to patients and clinicians in the Boston location. The Glooko system doesn’t make medication recommendations, but rather, through the collaboration with Joslin, will learn to look for patterns in patient data, provide behavioral prompts to patients, and summarize historical data for review by clinicians. “The Joslin/Glooko system is not developed for the purpose of practicing medicine using mobile devices. We’re tryFIGURE 2 The MySugr logging app in action. (Photo courtesy of ing to get the right data for review by the patient and clinician to MySugr.) have an impact on diabetes care, resulting in a favorable impact on health care costs,” adds Mitchell. Another platform, which offers the first prescription-only app, strives to make clinical recommendations based on users’ experiences. Last June, WellDoc, a Baltimore-based company that creates chronic disease management software, announced its BlueStar app, which is FDA approved for adults with type 2 diabetes and will be available this year. A doctor prescribes BlueStar to a patient, whose pharmacy alerts WellDoc to set up the account for the patient and provider. BlueStar analyzes a patient’s medical data—including blood sugar readings, medication, diet, and exercise—and offers personalized recommendations and behavioral coaching. It also sends contextualized information to providers to help assist with providing care. As for interoperability hurdles, BlueStar does not interface with diabetes technology at the moment but asks patients to log data.
An Open Movement
FIGURE 3 Glooko syncs blood sugar readings with an Android or iPhone app for easy diabetes management. (Photo courtesy of Glooko.) 42 ieee pulse ▼ may/june 2014
One thing that has been missing to tie apps and the technology together is a more universal software platform. The Silicon Valley start-up Tidepool aims to fill this gap by being the first opensource system meant for diabetes management. “Type 1 diabetes is really the only disease where the doctor prescribes a deadly hormone—insulin, which can lead to seizures,
comas, or death—and gives you general guidelines on how to take it, but you’re partially Closed 150 mg/dl CGM Pump 4:15 on your own to figure out hour-by-hour how much of this deadly hormone to 150 mg/dl 1 Min Ago give yourself,” says Howard Look, CEO of Tidepool. Last Bolus: -Look, who helped found TiVo Start Start and developed major products Pump Safety Only for Pixar and Amazon, banded together to found Tidepool with Stop Low Hypo High computer scientist and entrepreneur Steve McCann. Both have teenage daughters with type 1 diabetes. The FIGURE 4 A screenshot of the diabetes management system DiAs developed by the University of Virginia, which helps alert users to nonprofit organization of 11 people (seven a medical emergency. (Image courtesy of Patrick Keith-Hynes.) of whom have diabetes) is creating what Look calls the “first open-source open platform that makes it easier to get data from diabetes devices.” monitoring system, and intelligent software to make the deliv“We’re hopeful that’s going to help researchers in the diaery of insulin automated and ideally improving over time. Many betes space come up with better therapy recommendations,” companies and universities are working on prototypes, slowly says Look, who was also involved in developing making headway toward a consumer product. two apps: blip, which provides snapshots of inteA team at the University of Virginia, which grated behavioral data and Nutshell, which lets has worked on the closed-loop system for Hypoglycemia is the users log how they react to insulin dosing and almost a decade, strips an Android phone of type of incident that meals, with the goal of making it easier to adjust its features and uploads over a dozen apps that constant monitoring doses in the future. typically use Bluetooth for interconnectivity and predictive But the ultimate goal for Tidepool’s platform with major pump brands. The team has already software could help is to enable the use of closed-loop systems curbuilt software ready to interface with the Tideprevent. rently in development in the hopes of creating pool system. an automatic glucose meter and insulin pump. “Presenting data by itself is not terribly use“We want to write great software that helps ful to people at first; plots and graphs are cool, accelerate trials and commercialization of the artificial panbut what do you do with that?” says Patrick Keith-Hynes, assiscreas,” says Look. tant research professor at the Center for Diabetes Technology at the University of Virginia, one of the groups working on a closed-loop system. “But things that can function as a warnA Panacea for Diabetes Management ing system would be incredibly useful. One of the things our The closed-loop system, commonly known as an artificial or system does in real time is estimate the risk for too high and bionic pancreas, promises to take the decision-making burden too low blood sugar.” fully off the patient by connecting an insulin pump, a glucose
Pump CGM Pump Mode 1 Min 140 mg/dl Ago Low
Last Bolus: --
High
FIGURE 5 The University of Virginia’s diabetes management system, DiAs, can discreetly alert users of their blood sugar status through Google Glass. (Photo courtesy of Patrick Keith-Hynes.) may/june 2014 ▼ ieee pulse 43
As an example of the closed-loop system, the University of Virginia’s Diabetes Assistant (DiAs) rests on a stripped-down Android and uses Bluetooth connectivity to monitor blood sugar and insulin balance (Figure 4). If it predicts a hypoglycemic emergency, within 20 minutes, it will cut all insulin and sound an alarm. The alerts are also transmitted to cloud and database systems and can be forwarded to alert parents, partners, or physicians of emergency situations. The team plans to test the system on a large scale—with 50 patients and for a two-week period at home—this summer and will also run DiAs on Google Glass, where it can visually or vocally alert the user of an impending health emergency (Figure 5). So will these and other closed-loop systems negate the need for sophisticated apps that offer to assist patients with diabetes management? “Right now, nothing is available to consumers, but that will change in a few years,” says Keith-Hynes. He adds that the automated systems are more for type 1 diabetics, who must constantly account for the insulin their bodies do not make. Type 2, which makes up around 90% of cases, is often associated with obesity, lack of exercise, age, and other factors. Although those with type 2 must also keep track of health factors to avoid complications, the disease can typically be controlled by diet and exercise. “Type 2 is bigger and more complicated, and different systems might be helpful,” says Keith-Hynes. Once closed-loop systems are commercialized, apps will still be needed to assist with monitoring. And not everyone will trust a closed-loop system right away or, as Keith-Hynes points out, even have a need for it if they are already managing their disease effectively.
Mining Through Data With the rise of smarter apps and cloud storage, more knowledge about patterns and particularities of the disease will come from combing through aggregate data in a secure and anonymized fashion. Some companies already do this. Medtronic’s CareLink aggregates a patient’s own data and offers FDA-approved analysis to physicians regarding their patients’ patterns. And Unitio’s TD1 Exchange, MyGlu platform, combines an online community and aggregate patient outcomes with the goal of increasing drug development. “It turns out that outcomes in clinical care for diabetes are not as great as we’d expect, based on data from academic research
44 ieee pulse ▼ may/june 2014
papers,” says Aaron Kowalski, M.D. and vice president of treatment therapies at JDRF, a global nonprofit that funds type 1 diabetes research. “This lets us go to the FDA and ask to move therapies along faster because the need is greater than we thought.” Kowalski, who has type 1 diabetes, says aggregate data can also reveal other areas for public health efforts to focus on, such as a trend of teenagers not taking insulin to not gain weight, at a risk of medical emergencies. “The hope is that systems like the artificial pancreas, predictive apps, and intelligent aggregators can comb through that data and give people real useful concrete advice,” adds Johnson. “They will tease out the longer patterns and recognize trouble spots to make life easier for everyone with diabetes.”
Recommended Online Resources Communities ▼▼ TuDiabetes: http://www.tudiabetes.org/ ▼▼ Children with Diabetes: www.childrenwithdiabetes.com ▼▼ American Diabetes Association Community:
http://community.diabetes.org/ ▼▼ TypeOneNation: http://typeonenation.org/ ▼▼ MyGlu: https://unitio.org/pages/t1d-exchange/ ▼▼ Diabetic Connect: http://www.diabeticconnect.com/
Blogs ▼▼ ▼▼ ▼▼ ▼▼ ▼▼ ▼▼
Diabetes Mine: http://www.diabetesmine.com/ Sixuntilme: http://sixuntilme.com/ The type2experience.com: http://thetype2experience.com Ninjabetic.com: http://ninjabetic.com Textingmypancreas.com: http://textingmypancreas.com Scott’s Diabetes: http://scottsdiabetes.com/
Twitter ▼▼ Diabetes Social Media Advocacy #DSMA: http://diabetessocmed.
com/about/ Kristina Grifantini ([email protected]) is an award-winning science and technology writer who specializes in health. You can tweet her at @kgrifant or find more of her work at www.KristinaG.com.
ng publishi by ingram censed images li
Digital Object Identifier 10.1109/MPUL.2014.2309579 Date of publication: 14 May 2014
40 ieee pulse ▼ may/june 2014
2154-2287/14/$31.00©2014IEEE
B
glucose information and user data in easy-to-digest charts and ack in 2004, Scott Johnson, a type 1 diabetic, could graphs and offers encouragement and goal-setting features. find plenty of online information about the sympDespite the app’s success, the lack of interoperability between toms and complications of the disease that prevents diabetes devices and apps presents a challenge to companies like his body from producing the blood-sugar-regulating MySugr and others in bridging the gap between hormone insulin. What he couldn’t data, communication, and patient usability. find was anything written by someone When patients have a blood glucose reader, insuactually living with his disease. So he started “The mobile phone lin maker, and cell phone that can’t talk to each his own blog, eventually attracting thousands is a landmark for other, patients are saddled with the time-conof page views a month. His blog became a place diabetes.” suming burden of logging their own data, which where he could share stories with other diabetoften leads to errors. ics and find support, encouragement, and even “If devices such as the glucose meter, insulin a sense of normalcy. pump, insulin pen, and the software to read all of the data at a “Diabetes is, for the most part, invisible,” says Johnson. “I glance could be interconnected into one platform, it would be wouldn’t know someone had diabetes unless they told me. It’s incredibly powerful,” says Dyer. “It’s like dealing with VCR, TV, very isolating to have to do extra work to survive every day and and Xbox remotes when you want a universal remote.” not be able to talk with others who understand.” Some companies have started to move toward this integraAs the prevalence of diabetes continues to grow worldwide, tion, as creators like ActiveCare, iHealth, LifeScan, and others researchers and patients like Johnson are increasingly turnoffer wireless glucose meters with Bluetooth connectivity. Other ing to a growing number of social networks, online support app developers ask patients to input their own data to avoid the groups, and mobile apps to help them manage a disease in which lack of interoperability. it is especially important to keep track of carbohydrate intake, One company has gone as far as to create its own way of conblood sugar levels, and insulin injections. Apps in particular are necting with the majority of devices to assist patients with health becoming an important way for patients to more easily log and data logging. The Silicon Valley-based diabetes platform developer contextualize the complex balance of diet, exercise, and insulin Glooko developed an FDA-approved app and cable that connects needed to maintain normal blood sugar levels. More open data between 28 types of mobile phones and 29 types of glucose meters, collection and analysis through apps and online systems may which account for roughly 85% of the existing meter market, also help researchers better understand and track demographic according to Glooko CEO Rick Atlinger (Figure 3). The MeterSync trends underlying the disease. “The mobile phone is a landmark for diabetes,” says Jennifer Dyer, M.D., a pediatric endocrinologist and creator of the EndoGoal diabetes management app, which rewards users for checking their blood sugar. “It offers convenience and portability for diabetes data management, it has your social media connections, and it offers other opportunities to connect diabetes to other parts of your life.” There are challenges. Many of the diabetes-monitoring technologies—glucose meters and insulin pumps—have proprietary platforms that don’t talk to each other, interface well with smartphones, or give patients and providers user-friendly access to the full spectrum of data. But as the industry sees larger patient and provider demand for more open, useful data, this is starting to change.
Clinical Recommendations and the Messy Interoperability of Devices Last year, Johnson joined the MySugr team, an Austrian app company that offers one of the few U.S. Food and Drug Administration (FDA)-approved diabetes management apps for Android and iOS operating systems. The app has attracted more than 86,000 users since its inception in 2011 and winning of FDA approval in 2013 (Figure 1). The MySugr app encourages patients to enter health data by rewarding them with points that “tame the diabetes monster,” a metered representation of how well the patient is logging data (Figure 2). The app then interprets blood
FIGURE 1 The MySugr diabetes management app uses a points system to encourage patients. (Image courtesy of MySugr.) may/june 2014 ▼ ieee pulse 41
patients and providers. The Joslin cable, which contains a microprocessor, memory Diabetes Center, which sees chip, and battery, and runs about US$40, pulls hisThe MySugr app around 25,000 patients, toric data from diabetes devices and displays them in encourages patients aims to bring mobile a free Glooko app within “30 seconds.” The app then to enter health data information to both allows users to select food and medication informaby rewarding them type 1 and 2 diabetes tion to assist with logging. Data are also pulled into with points that patients and clinicians, a cloud where providers or caretakers—anyone the “tame the diabetes says Harry Mitchell, patient gives permission to—can access it, offering executive director of patients and caregivers the potential for real-time monster.” the Joslin Institute for health alerts to respond to emergencies. Technology Translation. “By illustrating this data, you can look back at The center is developing pattern-based data clusters and see if there are any patterns, such as any times of algorithms that will interface with gluday when blood glucose levels get out of control,” says Atlinger, cose readings to provide information related who adds that the app has thousands of users and focuses on to potential hypoglycemia events, where blood both type 1 and type 2 diabetes. sugar levels fall dangerously low and can lead to In January 2014, Glooko and the Joslin Diabetes Center in unconsciousness, seizures, and potentially death. HypoglyBoston announced a partnership to introduce a hybrid platform to cemia is the type of incident that constant monitoring and predictive software could help prevent, e.g., by sending an emergency notice to the patient or caretakers. “Providing real-time data will improve efficient and effective communications between physicians and patients. Doctors will have more timely and relevant information to review, and patients will feel more engaged with managing their diabetes,” says Mitchell. Glooko and Joslin are currently rolling out the system to patients and clinicians in the Boston location. The Glooko system doesn’t make medication recommendations, but rather, through the collaboration with Joslin, will learn to look for patterns in patient data, provide behavioral prompts to patients, and summarize historical data for review by clinicians. “The Joslin/Glooko system is not developed for the purpose of practicing medicine using mobile devices. We’re tryFIGURE 2 The MySugr logging app in action. (Photo courtesy of ing to get the right data for review by the patient and clinician to MySugr.) have an impact on diabetes care, resulting in a favorable impact on health care costs,” adds Mitchell. Another platform, which offers the first prescription-only app, strives to make clinical recommendations based on users’ experiences. Last June, WellDoc, a Baltimore-based company that creates chronic disease management software, announced its BlueStar app, which is FDA approved for adults with type 2 diabetes and will be available this year. A doctor prescribes BlueStar to a patient, whose pharmacy alerts WellDoc to set up the account for the patient and provider. BlueStar analyzes a patient’s medical data—including blood sugar readings, medication, diet, and exercise—and offers personalized recommendations and behavioral coaching. It also sends contextualized information to providers to help assist with providing care. As for interoperability hurdles, BlueStar does not interface with diabetes technology at the moment but asks patients to log data.
An Open Movement
FIGURE 3 Glooko syncs blood sugar readings with an Android or iPhone app for easy diabetes management. (Photo courtesy of Glooko.) 42 ieee pulse ▼ may/june 2014
One thing that has been missing to tie apps and the technology together is a more universal software platform. The Silicon Valley start-up Tidepool aims to fill this gap by being the first opensource system meant for diabetes management. “Type 1 diabetes is really the only disease where the doctor prescribes a deadly hormone—insulin, which can lead to seizures,
comas, or death—and gives you general guidelines on how to take it, but you’re partially Closed 150 mg/dl CGM Pump 4:15 on your own to figure out hour-by-hour how much of this deadly hormone to 150 mg/dl 1 Min Ago give yourself,” says Howard Look, CEO of Tidepool. Last Bolus: -Look, who helped found TiVo Start Start and developed major products Pump Safety Only for Pixar and Amazon, banded together to found Tidepool with Stop Low Hypo High computer scientist and entrepreneur Steve McCann. Both have teenage daughters with type 1 diabetes. The FIGURE 4 A screenshot of the diabetes management system DiAs developed by the University of Virginia, which helps alert users to nonprofit organization of 11 people (seven a medical emergency. (Image courtesy of Patrick Keith-Hynes.) of whom have diabetes) is creating what Look calls the “first open-source open platform that makes it easier to get data from diabetes devices.” monitoring system, and intelligent software to make the deliv“We’re hopeful that’s going to help researchers in the diaery of insulin automated and ideally improving over time. Many betes space come up with better therapy recommendations,” companies and universities are working on prototypes, slowly says Look, who was also involved in developing making headway toward a consumer product. two apps: blip, which provides snapshots of inteA team at the University of Virginia, which grated behavioral data and Nutshell, which lets has worked on the closed-loop system for Hypoglycemia is the users log how they react to insulin dosing and almost a decade, strips an Android phone of type of incident that meals, with the goal of making it easier to adjust its features and uploads over a dozen apps that constant monitoring doses in the future. typically use Bluetooth for interconnectivity and predictive But the ultimate goal for Tidepool’s platform with major pump brands. The team has already software could help is to enable the use of closed-loop systems curbuilt software ready to interface with the Tideprevent. rently in development in the hopes of creating pool system. an automatic glucose meter and insulin pump. “Presenting data by itself is not terribly use“We want to write great software that helps ful to people at first; plots and graphs are cool, accelerate trials and commercialization of the artificial panbut what do you do with that?” says Patrick Keith-Hynes, assiscreas,” says Look. tant research professor at the Center for Diabetes Technology at the University of Virginia, one of the groups working on a closed-loop system. “But things that can function as a warnA Panacea for Diabetes Management ing system would be incredibly useful. One of the things our The closed-loop system, commonly known as an artificial or system does in real time is estimate the risk for too high and bionic pancreas, promises to take the decision-making burden too low blood sugar.” fully off the patient by connecting an insulin pump, a glucose
Pump CGM Pump Mode 1 Min 140 mg/dl Ago Low
Last Bolus: --
High
FIGURE 5 The University of Virginia’s diabetes management system, DiAs, can discreetly alert users of their blood sugar status through Google Glass. (Photo courtesy of Patrick Keith-Hynes.) may/june 2014 ▼ ieee pulse 43
As an example of the closed-loop system, the University of Virginia’s Diabetes Assistant (DiAs) rests on a stripped-down Android and uses Bluetooth connectivity to monitor blood sugar and insulin balance (Figure 4). If it predicts a hypoglycemic emergency, within 20 minutes, it will cut all insulin and sound an alarm. The alerts are also transmitted to cloud and database systems and can be forwarded to alert parents, partners, or physicians of emergency situations. The team plans to test the system on a large scale—with 50 patients and for a two-week period at home—this summer and will also run DiAs on Google Glass, where it can visually or vocally alert the user of an impending health emergency (Figure 5). So will these and other closed-loop systems negate the need for sophisticated apps that offer to assist patients with diabetes management? “Right now, nothing is available to consumers, but that will change in a few years,” says Keith-Hynes. He adds that the automated systems are more for type 1 diabetics, who must constantly account for the insulin their bodies do not make. Type 2, which makes up around 90% of cases, is often associated with obesity, lack of exercise, age, and other factors. Although those with type 2 must also keep track of health factors to avoid complications, the disease can typically be controlled by diet and exercise. “Type 2 is bigger and more complicated, and different systems might be helpful,” says Keith-Hynes. Once closed-loop systems are commercialized, apps will still be needed to assist with monitoring. And not everyone will trust a closed-loop system right away or, as Keith-Hynes points out, even have a need for it if they are already managing their disease effectively.
Mining Through Data With the rise of smarter apps and cloud storage, more knowledge about patterns and particularities of the disease will come from combing through aggregate data in a secure and anonymized fashion. Some companies already do this. Medtronic’s CareLink aggregates a patient’s own data and offers FDA-approved analysis to physicians regarding their patients’ patterns. And Unitio’s TD1 Exchange, MyGlu platform, combines an online community and aggregate patient outcomes with the goal of increasing drug development. “It turns out that outcomes in clinical care for diabetes are not as great as we’d expect, based on data from academic research
44 ieee pulse ▼ may/june 2014
papers,” says Aaron Kowalski, M.D. and vice president of treatment therapies at JDRF, a global nonprofit that funds type 1 diabetes research. “This lets us go to the FDA and ask to move therapies along faster because the need is greater than we thought.” Kowalski, who has type 1 diabetes, says aggregate data can also reveal other areas for public health efforts to focus on, such as a trend of teenagers not taking insulin to not gain weight, at a risk of medical emergencies. “The hope is that systems like the artificial pancreas, predictive apps, and intelligent aggregators can comb through that data and give people real useful concrete advice,” adds Johnson. “They will tease out the longer patterns and recognize trouble spots to make life easier for everyone with diabetes.”
Recommended Online Resources Communities ▼▼ TuDiabetes: http://www.tudiabetes.org/ ▼▼ Children with Diabetes: www.childrenwithdiabetes.com ▼▼ American Diabetes Association Community:
http://community.diabetes.org/ ▼▼ TypeOneNation: http://typeonenation.org/ ▼▼ MyGlu: https://unitio.org/pages/t1d-exchange/ ▼▼ Diabetic Connect: http://www.diabeticconnect.com/
Blogs ▼▼ ▼▼ ▼▼ ▼▼ ▼▼ ▼▼
Diabetes Mine: http://www.diabetesmine.com/ Sixuntilme: http://sixuntilme.com/ The type2experience.com: http://thetype2experience.com Ninjabetic.com: http://ninjabetic.com Textingmypancreas.com: http://textingmypancreas.com Scott’s Diabetes: http://scottsdiabetes.com/
Twitter ▼▼ Diabetes Social Media Advocacy #DSMA: http://diabetessocmed.
com/about/ Kristina Grifantini ([email protected]) is an award-winning science and technology writer who specializes in health. You can tweet her at @kgrifant or find more of her work at www.KristinaG.com.
