New App Demos at the DiabetesMine D-Data Exchange and Innovation Summit

By Brian Levine and Adam Brown

Glucose, food, exercise, and even DIY closed loop on the phone

Last month, diaTribe attended the 2016 DiabetesMine D-Data Exchange and Innovation Summit at UCSF. The two-day meetup, organized by DiabetesMine, attracted an impressive roster of diabetes movers and shakers to discuss the “today” and “tomorrow” of diabetes care from the perspectives of technology and digital health. It was particularly encouraging to hear about upcoming diabetes apps and an educational video resource called Diabetes – What to Know, along with great motivation advice from Kaiser’s Dr. David Sobel.

1. New Apps
Noteworthy app developers gave demos of their products – five of which are featured below. It is great to see apps gradually moving beyond step one – gathering data passively – to step two: doing something valuable with it.

• Sugar.IQ: (Medtronic & IBM Watson collaboration): The app uses Medtronic CGM and pump data, paired with meal information that users manually enter, to “find hidden patterns in diabetes data.” The pattern recognition is very actionable, making it a great tool. For example, it may say: “[At 7 AM] Planning your day? I see you tend to go low on Saturdays between 12 PM and 3 PM” and “Having Tuna salad? Be aware that you tend to go low when you eat this meal.” Sugar.IQ is currently in a limited launch and is scheduled for a wider launch later this year. 

• Loop: This iPhone app substantially reduces the hardware required for running a do-it-yourself artificial pancreas system. Loop provides a user interface for hybrid closed loop on the iPhone and requires just one small relay device (a “RileyLink,” about a tic-tac box in size), an old Medtronic pump, and Dexcom CGM. It automatically adjusts basal insulin delivery, but still needs mealtime boluses. It is an open source app, requires technical expertise to install, and is not FDA approved. diaTribe’s Adam Brown has been giving it a try over the past week and found it very helpful overnight.

• Nutrino: Users log food manually and can integrate various data sources into the app (Medtronic or Dexcom CGM, exercise, sleep, etc.), which then provides a picture of how daily food intake and other measures impact glucose levels. It is currently available for iOS and Android. Adam has found that the app can be a bit buggy, but does a nice job of showing CGM values before and after a meal.

• Suggestic: Shares personalized eating recommendations for a variety of occasions, including restaurant eating, grocery shopping, baking, cooking, and snacking. The app has a unique Q&A-based chat interface. It is currently available for Apple iOS.

• Glucose Advisors with Engine 1: This exercise decision support assistant for type 1 diabetes recommends how much to eat based on planned exercise start time, insulin on board, and current glucose level. CEO Mr. Cliff Scherb is an Ironman triathlete with type 1 diabetes. Engine 1 is currently available on Apple iOS in the US, with anticipated globally availability on both iOS and Android very shortly.

2. The very compelling Ansley Dalbo shared her experience creating Diabetes – What to Know, an educational website for people with type 2 diabetes with a focus on video. She spoke about the potential for online resources to fill voids in the healthcare system, which can potentially increase access to educational diabetes resources – exactly what Diabetes What to Know works to do! Some of the most popular clips from this impressive, engaging group include: “The Positive News About Diabetes,” “Why to Take your Medication,” and “The Five Diabetes Numbers to Track.”

3. “Most of the time, people are not unmotivated; they are overwhelmed.”Dr. David Sobel, from Stanford and Kaiser Permanente, provided an outstanding talk on the psychology of diabetes, and urged the audience to look behind “boring” health education and think about “prescribing success” – understanding what truly motivates people, making it easier for people to do what they already want to do, and identifying and celebrating what they are doing right. To illustrate his point, he listed the best way to prescribe failure: undermine happiness and health; make a “general” prescription; focus on the long-term; and deprive people of something. Prescribing success, on the other hand, involves behavior change that is personal, specific, easy (70-80% confident), rapid and immediate, pleasurable, environment-focused, and celebrates even small victories. Dr. Sobel told three memorable stories to make the case: (i) a man who didn’t change until the benefits of caring for his diabetes were connected to his greatest love (trout fishing); (ii) a woman who couldn’t remember to take her medication until she suggested her own solution (a sticky note reminder on the Tide laundry detergent); and (iii) an unexpected compliment from a mechanic that he had done “a great job” of protecting his tires (“I love to be acknowledged for something I’m doing well”). He summarized the motivation examples – Trout, Tide, Tires – beautifully:

• Trout: Discover your passions. What do you really enjoy?

• Tide: Invite personalized solutions. What do you think might work for you?

• Tires: Celebrate successes. What a great job you have done!

Watch the extended video of Dr. Sobel’s talk, Behavior Change and Beyond, as presented to an audience of health educators and other healthcare professionals.

Thank you to a phenomenal DiabetesMine team for what they make happen at this meeting every year as a result of all their education and advocacy efforts. To see more of their great work, check out the Diabetes Challenges Patient Community Research Report.