Current Diabetes-Monitoring Systems

Mara Hemminger

University of Maryland

Department of Information Studies

HCIL Conference, 2004

Overview

• What is diabetes?

• What meters are currently available?

• What record-keeping systems are currently available?

• What research initiatives exist?

• What are some user-interface issues?

What Is Diabetes?• Body cannot process sugar properly.

– Insulin controls the amount of sugar in blood.

– Diabetics’ pancreas cannot produce / properly process insulin.

• Types– Type 1

• Body produces little/no insulin (insulin injections needed)• Typically hits people under age of 30

– Type 2• Body produces insufficient amounts of / improperly processes

insulin (no insulin injections needed)• Typically hits adults over age of 40

– Gestational (during pregnancy)

What Is Diabetes?

• Can cause: – Blindness– Heart attack– Poor circulation– Gangrene– Kidney disfunction– Death.

• No cure, but monitoring can prevent long-term problems

What Meters Are Currently Available?

• Types:– Blood glucose

monitors *• Blood-pricking

• Minimally-invasive

• Non-invasive

– Urine glucose monitors

– A1c monitors

• Features:– Testing location

– Testing speed

– Blood amount required

– Storage of readings

– High/low values

– Size

– Cost of meter

– Cost of strips

Blood-Prick Meters: Hand Logs (Accutech)

• Drop blood onto meter

• Wait 2 minutes

• Read results on thermometer-like display

• Compare reading with chart of average readings

Blood-Prick Meters: PC-Based (LifeScan)

• Meter• Arm or finger prick• Digital display of reading

• Record-keeping system • Glucose

• Measurements before and after meals

• Colors indicate levels above/below target

• Medications• Meals (carbohydrates)• Bar/pie charts, graphs

• By date• By time-of-day• By target levels

Blood-Prick Meters: PDA-Based (Therasense FreeStyle)

• Meter– Multiple testing sites– Digital display of

reading

• Recording-keeping system– Glucose levels– Medications– Meals– Exercise

Minimally Invasive Meters (MiniMed CGMS)

• Insert sensor under abdominal skin for 72 hours

• Sensor reads interstitial fluid glucose level

• Patient can enter meals, exercise, meds in monitor

• Physician reads sensor results

• User must calibrate sensor via a finger prick 4x/day

Non-Invasive Meters (Cygnus GlucoWatch)

• Auto-Sensor fits on back of watch

• Monitors glucose (u/i method); no blood-pricks

• User can enter meals, exercise info

• User can set high/low alert• Biographer stores 8,500

readings• Data can be downloaded

to PC as graphs, charts, stats

What Record-Keeping Systems Are Currently Available?

• Types– Hand logs– Spreadsheets– Internet logs (hand)– PC-based (here) *– PDA-based

• Here: (WinGlucoFacts) – Daily/weekly/mo stats– Bar chart, dot graphs

What Research Initiatives Exist?(MIT/Frost & Smith)

• Web-based tool• Patients photograph

daily habits• Glucose readings

stored and color-coded (red=high, blue=low)

• Glucose readings mapped to photos

• Goal: highlight bad habits

What Research Initiatives Exist?(University of Pittsburgh/Schultz & Ballerstadt)

• Sensor implanted below skin

• Sensor fluorescence reflects blood sugar level

• Photometer sits atop skin• Photometer measures

intensity of fluorescence

• Reminiscent of CGMS, but measurement method is known here

What Are Some User-Interface Issues?

• Meters– Eliminate blood-prick strips

– Show test countdown

– Show more than one reading at a time

• Record-Keeping Systems– Show personal high, low and average

– Track several factors (glucose, ketones, A1c, insulin)

– Provide analysis (only a few do)

– Multi-task: Measure, log, analyze, and inject insulin -- all in one fell swoop!