Dreams of Consolidation..
I popped in to the office of a customer yesterday, and heard the sound of laughter coming from the back room. I followed the sound, and found the diabetes education staff sitting around a table with their very pregnant boss. From the looks of the decorations, I had unwittingly crashed her baby shower! Luckily, these are customers I know well and they promptly told me to have a seat and join in the festivities.
“Have some pie!” one of the nurses said. “It’s home-made and so good.”
“Oh wow, thanks,” I responded. Then I looked down at my work bag. All I had with me were samples, my Blackberry, and work materials. No pump controller, no CGM. I’d left them in my car. Since my job involves me ducking in and out of doctor’s offices for short intervals at a time, I don’t usually bring my dia-gear unless I’m heading in for a lunch or breakfast appointment and will be eating.
“Um. Actually. Shoot. I can’t have any. I don’t have my stuff with me - so I can’t dose any insulin and I just ate lunch at my last appointment and I don’t know what my sugar is.”
I got a look from the nurse and the doctor that definately said “Holy unprepared diabetic. How can you not have your stuff with you in case of spontaneous pie offerings?”
And this is the part where I hate all the stuff we have to carry for this disease. Look, it’s not that I’m encountering homemade pie so often that I need to be ready for anything, it’s just the simple fact that I should be able to do whatever I need to do without carrying around yet another bag full of diabetes gear (or my purse, which is usually holding all stuff). Is this a cry for an iPhone-integrated PDM/CGM/glucose meter system? You bet it is.
We’ve all been saying this and blogging about this for years: we need combined and integrated devices like, yesterday, because I guarantee you patient compliance will go straight up. Many people would choose to have the pie and bolus later when they got back to their car, leaving them with a high in between those steps. I know a lot of men with diabetes who don’t take a meter out with them because it’s too bulky - but they always have their smartphone.
The new pump controller/DexCom receiver combo was supposed to be out early this year. We’ve been reading about it and hearing rumors for months. And guess what? Thanks to the FDA, we’re still waiting. Same goes for the smaller pump pods from OmniPod - held up in FDA approval. I want the safest product possible, but being an industry insider to this process has shown me that sometimes the hold-ups are purely political and red-tape oriented, and that’s simply not ok to make patients wait because we’re slaves to government institutions. Heard about this integrated CGM/pump? Yep, it’s available in Europe. It’s just so frustrating to have patients clamoring for this stuff and knowing it’s held up in a process that’s been broken and backed up for years.
Plus, I really like homemade pie…..just saying.
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Comments
Elizabeth - SO true! They can make an iPhone that can find your location, play movies, and probably cook you breakfast, but we can’t get the PDM/CGM combo? Come ON!
Here’s an iPhone clip on GM, basically just displays the reading and uploads it on the iPhone http://tinyurl.com/2bx2hhd . Working in the industry as I do, I believe a major challenge to an integrated phone-CGM-pump controller is the validation of such a system is nearly impossible. Medical devices have to guarantee performance 100% of the time - if they can’t control part of the system, they aren’t safe. How can they know for sure how your running another app they don’t know about or getting a phone call might interfere with a CGM reading or a pump command? e.g., Pandora changes the tune you’re listening to and your pump boluses “50 Ways to Leave Your Lover”. Can’t have unknowns in a medical device controller.
Rich - wow - thank you for that comment, because I really didn’t think about that part of it. Of course they can’t put it on a phone - what would the FDA do with that? That makes me think the best we’ll get is just apps like the one you mentioned. Thanks for the insight!
And about the song choice on your hypothetical Pandora station….really??!
song choice: a. wanted something with a 50-unit number, b. Paul Simon is playing here this week. c. my generation, my song choice 
…. you’d rather have “99 Problems” by Jay-Z??
Every morning when I go through my checklist, PDM, Dex, iPod, phone, UGH I just wish they would combine them. Then I get SO frustrated because we are in the 21st century and I KNOW we have the technology to do it…We shouldn’t have to carry 4 multi-hundred dollar gadgets, one would be just fine. (Rant over but now I’m all worked up! lol)