I was reading Forbes magazine this evening and noticed a full right-page advertisement that started with this statement.
3rd Law of Healthonomics Soaring healthcare costs are only the symptoms. You've got to start treating the disease.
The remainder of the advertisement reads.
Most employers are rethinking their responses to escalating healthcare costs. Why? They recognize chronic diseases are the root problem. Example: An employee managing his diabetes might cost $5,000 per year. An employee not managing his diabetes could cost up to $45,000. The win-win here is that by providing employees incentives to lead healthier lives an helping them to manage their chronic diseases, you reduce your healthcare costs. And you'll have healthier employees. Sure beaths the alternative.
The DTCC FAQ page includes the following summary of how the DTCC works:
The Diabetes Ten City Challenge establishes a voluntary health benefit for employees, dependents and retirees with diabetes, provides incentives through waived co-pays for diabetes medications and supplies, and helps people manage their diabetes with help from a pharmacist coach in collaboration with their physicians and diabetes educators.
I like the idea of waiving co-pays for meds and supplies to help with better diabetes management. I just wonder whether this program is aimed at people with all forms of diabetes, or just those with type 2? Given that one of the sponsors is GlaxoSmithKline, I'll bet I'm right. Will is lead to better benefits for insulin pumps and continuous glucose monitors, or will the focus on cost reduction mean these important technologies are less covered?
This program is being tried by a number of employers in the following cities: Charleston/Spartanburg; Cumberland; Chicago; Colorado Springs; Dalton; Honolulu; Los Angeles; Milwaukee; Pittsburgh; and Tampa Bay.
Have you been enrolled in this program and can you give any feedback on how it works for you? I'm interested in seeing if this is the start of a new approach to diabetes care across the country. And I'd love to know whether or not it includes all types of diabetes.
PARADE Magazine (which comes in some Sunday newspapers) is holding this contest where the 8 charities that attract the most individual donations will receive $50,000 and be featured in PARADE magazine article. This is a great opportunity to raise visibility for diabetes research.
To help you donate to JDRF through the Network for Good organization. Your donation can be of any size. You'll have to register with Network for Good to do this (I just did) and then you can donate via Paypal or with a credit card.
To me, this seems like a relatively inexpensive way to raise awareness of the importance of diabetes research and the search for a cure. I hope you'll agree because right now JDRF is not even on the top 10 list for this contest.
Would you be willing to give up some of your life to avoid treatments?
According to a short article in yesterday's Washington Post that's how some folks with Type 2 diabetes feel about their illness.
Those of us with Type 1 don't have that luxury. Giving up insulin for even a short amount of time could literally be deadly. And maybe that's something else to be thankful about. Reading this article reinforces my belief that Type 2 is a much harder disease to live with than Type 1. And I know just how difficult Type 1 is to deal with.
I completely agree with this quote from the article:
The study findings show "that we need to find better, more convenient ways to treat chronic illness," Huang said. "It is hard to convince some patients to invest their time and effort now in rigorous adherence to a complex regimen with no immediate reward, just the promise of better health years from now."
Type 1 diabetes treatment is 'easier' than in the good old days. But then the 'experts' go and change the rules on us, so I feel like I have to work harder at better control. No wonder taking care of diabetes is so tiring!
Update: (August 19, 2007) I'm now using the latest Dexcom, the Dexcom SEVEN. The software that comes with the Dexcom SEVEN (Data Manager 2) has much better support for statistics and it allows you to export the readings in two different formats. This software also works with existing Dexcom 3 systems. Given this solves the problem for me, I'm not doing any more work in trying to understand their crazy data format!
Still no success getting data from my Dexcom STS CGMS. But my recent challenge post about decoding the Dexcom data format seems to have drawn a lot of attention.
Several people have jumped in to have a try at cracking the problem. I sent some e-mails to Dexcom technical support and customer support about this issue. So far, I've received no response. On June 5th I had a conversation with Dexcom which indicated they aren't about to open up the data even in their new version of the software.
I loaded up another Dexcom R2Downloads data file. From looking carefully at the graph in the Dexcom software it seems that there must be at least four types of records in the data stream. These are:
Start of use. With date (MM/DD/YY) and time (HH:MM:SS) values.
Gap in use. With time (HH:MM:SS) value.
Sensor reading. Glucose value, date (MM/DD/YY) and time (HH:MM) values.
Meter reading. Glucose value, date (MM/DD/YY) and time (HH:MM) values.
You can now find on my site two example data files, plus a hand-captured text file containing the values that are probably at the start of one of these data files.
How You Can Help
Maybe you know something about encoding or encryption. These skills may be enough to crack the problem.
If you can't do this, perhaps you can help in an indirect way. And I'll admit this is a little devious. :-)
If you search on Google for Dexcom my blog comes in around the 15th position in the results. I think I might get more attention from Dexcom if my blog came in as the number 1 search term for Dexcom on Google.
Impossible you say? Well, maybe not.
Here's where you come in. Can you post a blog entry on your blog which points to this blog post, and has Dexcom as the word in the link? Maybe write a note explaining that I'm trying to crack this problem for the Dexcom, highlight the Dexcom word and then add http://www.bernardfarrell.com/blog/2007/05/decoding-dexcom-data-format-update.htm as the hyperlink.
This way I'll get the word out about this challenge, plus Dexcom marketing may wake up and realize that this is important to many folks.
Can you tell I'm a little impatient to get to my data? How do you feel about a system that captures data that's important to you, but that doesn't let you get to it? Am I the only one who feels this strongly about this?
Update June 7th 2007: As of today, many people have linked to this post. When you Google search for Dexcom, this post is now about number 8 in the results, which puts me on the first page of Google results for Dexcom. I'm have still to write a letter to Jorge Valdes, VP Engineering, at Dexcom asking him to release the data format so that we can use it to access our data. First I want to hear what they say on the June 11th conference call.
If you'd like to help me, please post about this issue (setting our data free) and link to this blog entry using the word Dexcom, as I've just done here. Thanks.
Note: I currently own shares in Dexcom, I work not to let this ownership influence what I say about the company or its products.
Readers Challenge: Help me decode the Dexcom data format
I've been using a Dexcom STS continuous glucose monitor system for about a month now.
For day to day use, it's really wonderful. I can see highs before they happen and take the edge off them, and I can also watch much more easily for lows and reduce their impact.
But the software continues to be a major annoyance. Basically all it gives me is two very simplistic graphs of the blood glucose data collected by the Dexcom system.
The Glucose Trend graph shows up to one week of glucose readings from the system.
By choosing a smaller number of days, I can see the readings a little more spread out. For me, this makes it easier to look at the values.
However the software shows no summary statistics, and the only way I can actually see that values is by holding my mouse over them.
The other graph is the Modal Day one, which lets me see a number of days worth of data superimposed over a 24-hour period. This makes it a little easier to see patterns.
Again there is no summary data for the selected time period, and I can only look at one time segment at a time. So if I wanted to see what was happening for the last two weekends, I'd need to produce one report for each weekend and then look from one to the other.
OK. Now this is where I ask for your help. I've sent some e-mails to Dexcom asking for more information on how to get the data out of the system. So far, I've heard nothing back. Maybe one of you format hackers can help me in decoding the actual information itself.
Warning, it's fairly technical below this point. And I'm really hoping that someone can help with this problem.
Using some tools such as the wonderful FileMon from SysInternals, I've finally figured out where the receiver data is being stored on my PC. Trust me when I tell you that this is not easy.
For example, on my system, a lot of information is written by the software to various folders in this location: C:\Documents and Settings\Bernard Farrell\Local Settings\Apps\2.0\TO260ZDW.VE3\JGBRCCZA.X12
But the actual receiver data is written into a number of .R2Download files in this location: C:\Documents and Settings\All Users\Application Data\DexCom\DexCom DM - Consumer\ReceiverData\
For example one of them is named {2E6B7BE9-DA8F-42FA-8337-29404D84A829}.R2Download.
The files contain XML structured data, part of which is the readings themselves in some compressed form.
The data is contained in the DataBaseRecords object in this XML file. And from looking at the Signature object later in the file, it may be encoded using some sha1 approach.
I've uploaded the contents of one data file to my server. If you'd like to have a look at the file and see if you can figure out the data portion, then download the data file from here.
And if you can give me any suggestions as to how to decode this, I'd be thrilled.
Diabetes: technology, devices, software, and other stuff.
About Me
Name: Bernard Farrell
Location: Massachusetts, United States
I was born in Ireland and now live in the US.
I have had Type 1 diabetes for over 35 years. I struggle with my blood sugar, the same as most people with diabetes.
I wear a Cozmo 1800 insulin pump and a Dexcom SEVEN CGM to track my blood glucose levels. I also take Symlin to help control my post-meal blood sugars.
I'm blessed by God, and every day brings the possibility of a cure.
