Diabetes and the iPhone

There’s a bright future for diabetes iPhone applications.

| Jul 13, 2009

People often ask me, "Why limit diabetes-related services to the iPhone when there are so many other cell phones out there?" I always answer them by asking, "How many applications have you downloaded onto your cell phone?" 

"None," is usually the response. 

After all, how many times have you downloaded an application? Even with rapidly expanding online stores like Blackberry's App World, Google's Android Market, Nokia's Ovi Store, and Palm's App Catalog, the answer is still usually "none"-unless you have an iPhone.

The iPhone's platform and its user demographic create the perfect mobile device for integration. So let's talk about how we, as people with diabetes, have prospered from mobile integration and what we have to look forward to as the integration progresses.

The overall trend in the diabetes software market is that the big meter companies create software in order to keep up with the status quo. Software doesn't increase test strip sales enough to put any real money into it. What that also means is that no one wants to rock the boat-if Abbott (FreeStyle) starts upping their software, then LifeScan (OneTouch) will do the same thing. Before long, everyone is spending money just to end up in the same status quo spot. 

This approach won't work for the iPhone. Creating software suites that look like they were designed for Windows 3.1 just won't cut it. Today, there are a lot of diabetes iPhone applications (apps) out there, none of which was created by a large meter manufacturer. Many of these apps do similar things - manually record blood glucose numbers, medication, food, and activity entries using an array of scroll wheels and dial pads. These apps range from free resources like Glucose Buddy to $11.99 for Diabetes Pilot (see comparison chart).

Response to these organizational tools has been enormously positive, and keep in mind that these are still manual entry tools...no true integration has been rolled out yet. Luckily, the big meter manufacturers are seeing the potential and starting to focus on software, which only means wonderful things for people with diabetes like you and me. For instance, OneTouch presented a prototype of their OneTouch meter communicating with iPhone Software that looked very user-friendly and helpful.

LifeScan's participation in the March 2009 Apple Keynote was the first example of a meter manufacturer comprehending the potential of mobile integration. (Or perhaps Apple was making them "get it.") It has been well publicized that Apple approached LifeScan only weeks before and invited them to participate in the event. However, it's important to recognize that both the meter integration and the respective iPhone software presented by OneTouch was only a prototype and is certainly not for sale.

In response to questions for more information, LifeScan would only say that the application is "still in development." No one knows when it could reach consumer's hands.

Other meter manufacturers are waking up to the possibilities, too. For instance, my company, MYLEstone Health (beta.glucosebuddy.com), is in development on a future feature for our app Glucose Buddy, based upon the ACCU-CHEK Testing in Pairs tool from Roche. This tool allows people to record their blood glucose values in a unique, structured way in order to help them think about how recurring events in their lifestyle may affect their blood sugar levels. Roche has recognized the importance of getting into the space, and even though Testing in Pairs is certainly not meter integration, it is a step in the right direction.

Most recently, at Apple's Worldwide Developers Conference, Apple continued to display their interest in applying medicine to their iPhone, again confirming that third-party hardware like glucose meters will be able to communicate with the iPhone, via Bluetooth. Meter integration is what people with diabetes want and, at this point, what they expect. In January of 2009, MYLEstone Health ran a survey and presented a mock-up picture.

The response we got back was amazing. Of the people with diabetes who were surveyed, 87 percent told us they would buy the plug-in (which featured test strip storage internally) for $50. This means that large companies can actually expand their revenue streams by charging for the meter, rather than trying to hook people with diabetes with a free meter in an attempt to rake in cash from test strip sales.

Unfortunately, the actual implementation of integrating a meter and the iPhone is a process filled with tribulations-mostly internal factors like budget reviews, business development, marketing, hiring of iPhone developers, legal counsel approval, and so on.  Everything moves very slowly at the large corporate level. Plus, external factors such as FDA regulations provide extreme liability for a company at this level.

The Future

With the growth of the smartphone, the emergence of large diabetes corporations, and the demand for innovation from people with diabetes, we will be seeing tremendous strides in this sector. Unfortunately, true medical innovation by major companies takes time. To shorten this time gap, large corporations should look for partnership and acquisition opportunities with small developers from within the App Store. The App Store presents the perfect arena for smaller innovators to create diabetes solutions and get these solutions out to people with diabetes much sooner than large corporations can. As big companies partner with smaller, more flexible companies, the mobile diabetes sector will continue to boom. Eventually, you will be able to control your insulin pump, your continuous glucose monitor, and your glucose readings all from your mobile phone.

Even if this isn't readily available through your iPhone just yet because of liability issues, enough companies are seeing the potential of this market to make it happen in the near future.

Good things to come for the diabetes community!

Matthew Tendler left his background in finance at Merrill Lynch for something more meaningful and close to his heart. Formally trained in business management and entrepreneurship at the Kelley School of Business at Indiana University, Matthew designed and implemented financial strategies for ultra high net worth clients at Merrill Lynch. He is in charge of marketing and long-term strategies for MYLEstone Health. Matthew has had type 1 since 2003.

He writes:

At 25 years young, I know type 1 diabetes on a deeply personal level. I know what it feels like to prick myself 20 times per day. I know what it's like to wake up in the middle of the night with a 35 mg/dL reading. I laugh with friends about how much "stuff" I have in my bulging pockets, when all the while I'm frowning on the inside because of this disease that's plaguing my pancreas. So, I set out to make a difference in the lives of people who know the same things that I know and deal with the same issues that I deal with everyday.

Steve Jobs once said about Apple's product development initiatives, "We figure out what we want. And I think we're pretty good at having the right discipline to think through whether a lot of other people are going to want it, too."  

I know what I want, and I think other people with diabetes want the same thing.  With the partnership of Tom Xu, a leading health and fitness developer in the iPhone App store, we created the Glucose Buddy App and began collaborating with major players throughout the diabetes industry.

Through the iPhone, our company MYLEstone Health has changed the way over 50,000 people with diabetes take care of themselves-a feat we are definitely proud of.  But there's a long way to go. Our total vision is to integrate "everything diabetes" with your smartphone. This starts with basic manual entry within an iPhone app, which then pushes that data to your desktop-a process available on Glucose Buddy. But it's not only entry logging software...our partnerships within the diabetes sector will help Glucose Buddy have education and entertainment features, such as dLife TV and Testing in Pairs by ACCU-CHEK, all in one place. Imagine a glucose meter attachment that is hooked into your phone, which stores your glucose numbers, lets you participate in education programs, and watch dLife TV, and even allows your doctors to sync in. That's the goal.

This means no more jokes about bulging pockets. And it also means accessible help in reaching lower A1c's and consistent numbers. Actually, not just accessible-in the palm of your hand.

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Categories: A1c Test, Blood Glucose, Blood Sugar, Diabetes, Diabetes, Food, Insulin, Insulin Pumps, Losing weight, Meters, Products, Research, Software, Type 1 Issues

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Posted by mikeinspain on 14 July 2009

Great article. I so wish one of the big boys can open the market up a little and create some useful software, particularly for devices such as the iPhone.

Having a "app" that not only records your blood sugar levels, but also the medication that you are taking at the time (e.g insulin, pump etc..) together with other useful information will only be of benefit to persons with diabetes.

So come on all those manufacturers lifescan, roche.. Please do something as I'm pretty sure it will be popular...

Posted by Anonymous on 14 July 2009

As a former Palm OS Software developer, from 2000 to 2007, I can say NOBODY was interested in any Diabetic software that I proposed to create. I also suggested making Diabetic software for Nokia and Motorola. Again, NOBODY was interested.

I was diagnosed with Type 2 Diabetes in 2003, and from 2003 to 2007, not even one person was interested in ANY diabetic software I would create. No ideas received from anyone, worldwide. I even offered FREE diabetic software and there were no takers.

The article here was miswritten. It is NOT what's available, as the article was written. It is what people choose to download to their phone. It's about choice and not obligation. Most diabetic are stubborn to record their readings in a paper journal. Do you think they will be inclined to record it, electronically? Especially in the day that data theft is popular among mobile phones?

Posted by kmcmahon on 15 July 2009

As a healthcare provider, before we release anything into our patients hands we make sure it's done in a way that ensures patient usability, accuracy, physician acceptance, complies with FDA regulations, etc...

I'm not sure that a basic iPhone app without meter integration doesn't already fall within the definition of a medical device. From fda.gov: http://tinyurl.com/fdaiphone

"...A device is an instrument, apparatus, implement, machine, contrivance, ... or other similar or related article, including a component part, or accessory which is ... intended for use in the ... mitigation, treatment, ... of disease, in man ..."

Posted by Anonymous on 20 July 2009

I am a diabetic, insulin dependent for over 45 years..Telecomm Engineer. I use Medtronics MiniMed pump and products and with it comes my abiliy to use CARELINK.COM. A fantastic software useful to what is happening to me but nothing about food or carbs unless I personally install that information. That's ok because I do not require anything about food or specific Carbs.. Currently I am not a iPhone or iPod user however that too will change. Tomorrow I would buy an iPhone if the tester was available. Software? It's available and usable on the iPhone if you know how to use it. Communication with my pump? If not I can use what is available. Yes, Mr Job I would buy it tomorrow. Written on my iMac.Retired happily in Colorado.

Posted by Better Cell on 20 July 2009

Apple has many things going for it in order to market a device that will record Glucose data, control Insulin Pumps, and more.
In fact, this software does not even have to be on a iPhone. An iPod with Blue Tooth capability and enough memory storage can do the same thing and be more cost effective for most people.
Apple has a very intelligent and creative core of Developers as well as the best design in Technology with the addition of a great Customer Service Department. All these factors and more make for success and growth in any area.
Besides, when the meter companies were designing and offering software along with their meters, they only made it available for a Windows OS Platform.
I have T1DM and use use Mac OS as does many many other people.......but the meter people did not care and do not care about us, just a way to make a fast buck.

Posted by Keithcrozier on 20 July 2009

Our software, the Glycemic Index Meal Planner, is for diabetics (type 2, like myself) helps users control their diet and blood sugar. It is available for the iPhone, Android, Blackberry, and soon the Nokia Ovi store, Palm Pre, and Windows Mobile. It also is available for PCs. See glycemicdietsw.com.

Posted by Anonymous on 21 July 2009

I sense a strong conflict of interest here between the writer's business interests and diabetics generally.

The overwhelming majority of diabetics are not interested in gadgets.

Posted by Anonymous on 21 July 2009

There is an outstanding Diabetes management program that can be used on the iPhone or with most smartphones and PDAs. Sync with your PC or a secure on-line web component. The program can import from most meters or pumps -- not restricted by manufacturer.

You can also share the data with your doctor or health care professional.

The program is SiDiary 6 from SINOVO, a German company. SiDiary was created for Diabetes management by people with Diabetes. It is available in many languages.

I have used the program for over three years. It is easy to use but powerful and inexpensive. There is a freeware version too. Find more information at sinovo.net, from your PC or mobile phone browser.

This is a personal recommendation for the best program I have found. John Conrod (Type I, ICT), California, U.S.A.

Posted by Anonymous on 21 July 2009

I have read through all these comments and I think the main point is being missed: "Hassle Free". I have been involved with technology (product development, etc.) for most of my life and since being a Type 1 since 1981, I personally evaluate diabetes products on the "Hassle Scale" ... I have been a Pump user for 5 years now and I am amazed at how these products "could eliminate a LOT of hassle", if designed correctly but that is not the case at all in 2009. IF the Apple iPhone/iTouch talked with my pump AND I was able to insert a SMALL blood tester in it to record sugars, geese ... think of it: a very small packet with strips, lancet and glucose meter dongle for the phone, phone and pump talking together, upload to Mac/PC - fully portable! No solution exists today with pumps which can come close to hassle free portability and use ... the PING and Medtronic is no where close to this type of portability and flexibility! The meters are both are too big and bulky to fit in my pocket - and the sw is limited at best.

Posted by Anonymous on 21 July 2009

It is ridiculous that research has demonstrated time and again since the mid-80's that computer programs are able to provide better dosage levels of insulin yet non have become available for use. Why not have the same bolus calculators available on an app as currently exist on insulin pumps? And why not have an app for pump users that calculates pump settings throughout the day and a basal profile? It will produce better control.

Posted by Pauline Barrett on 25 July 2009

I use a Accu Chek 360 glucometer and download readings. From the computer I can hand-enter dietary information. I do not like the horrendous amount of paper used to print a report from the Roche software so created my own spread sheet from the info. I am not a techie but an advanced user of the technology and am pleased that Microsoft exists to gives us "every-day" thinkers tools to capture and manipulate information.

Why would I want this info attached to my phone? I prefer my technological toys as individual units, but am going to give in when replacing my PalmPilot.

Posted by Sweet Tooth on 20 December 2009

This type of device holds tremendous promise for someone like me. I'm Type II and test my glucose throughout the day. I carry my test kit everywhere with me, as well as my cell phone. A device that allows me to use my phone AS A test meter (instead of merely a storage/display system for my readings) would make my life SO MUCH easier.

I'm not really sure what the hangup is because a few years ago, Freestyle (formerly made by TheraSense but now bought out by Abbot Labs) came out with an attachment for the Handspring PDA (see image here: http://www.childrenwithdiabetes.com/gifs/products/tracker_white.jpg). If they could come up with something like this for a PDA, I'm certain it's possible to create a similar device for a cell phone. Cell phones today can do almost anything, and I hope it's only a matter of time before someone comes up with a test-meter attachment for them.

Posted by Anonymous on 9 April 2010

What is the role FDA will play here? If we are talking about some kind of device that can be attached to iphone and function, what if your iPhone runs out of battery and you won't be able to get your readout? There is a reason why a lot of medical devices do not have 'fancy' UIs.

Posted by Anonymous on 12 April 2010

Does anyone know of a recent "scientific" evaluation of how diabetics are keeping track of their diabetes? How many are already using mobile application?

I am 28 and have DM 1 for 15 years. Currently i am writing on a paper about health games and have to reference my very personal impression that most of the diabetics are still using hand written log books.


Posted by smellhannah on 5 November 2011

my mum tried to tell me 5 years ago as a young teenager that she was going to invent a blood sugar machine for teenagers. one that has a security code. and at every meal time id need to sick my strip in the end and do my sugar levels before i could use my mobile phone again. now as a 19 year old im reading this article and thinking to myself what a great idea it would of been in my teenage years. its great to hear more about how our everyday technology is making living with medical conditions alot easrier and hassle free.

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