Bayer Contour USB meter big step forward for design
Bayer USA sent me one of their Contour USB blood glucose meters to review some time ago. For me the summary is easy: this is a great meter with slim design that's easy to use. I like it a lot. Read on for the details and lots of pictures.
LifeScan created a buzz when they released the OneTouch UltraMini a few years ago. Given their sizes, looking at the two meters together is a good way to get a quick comparison point. In the picture both meters have a strip inserted and are prompting for a blood sample. Note the Contour uses standard strips that need a 0.6 microliter drop of blood, by comparison the OneTouch needs 1.0 microliters. Both meters provide results in 5 seconds. The Contour meter is auto calibrated with each strip, while you have to calibrate the OneTouch meters each time you get a new batch of strips.
I'm comparing the readings with my WaveSense Jazz meter, and they are usually within about 10% of each other. So I believe the Contour USB accuracy is good. I need to use the meter over several A1C tests, to do a real comparison.
The color is really eye catching, and the text is very readable. Here's a picture of the Contour USB meter showing a low blood sugar reading of mine.
The designers have used this high resolution screen and color very effectively. When your BG is lower or higher than a range that you set, the result is displayed in an salmon color.
One the right hand side of the meter are three buttons, in the picture above they're between the column reading Reminder|Notes and the Bayer symbol. You can press the button to set a reminder for a later test, or to add some basic notes from a small selection list.
The next picture shows the meter immediately after you apply a blood sample. You're prompted to mark the reading as before or after a meal, or just to continue on to the results. While you're doing this, the result is being calculated. So this step makes the whole thing seem faster.
And don't worry, if your blood glucose is out of range the meter won't wait longer than 5 seconds (time to calculate result) for you to make a choice, it will just display the value.
In case you're wondering where the USB part of this meter is, here's a picture.
The meter has a rechargeable battery that gets powered up whenever you connect it to a standard USB port. They also provide a standalone charger you can plug into an standard outlet (which also works for charging an iPod).
One last picture. If you're testing in the dark, it's really easy to see the results on the screen. But you know how difficult it can be to get the strip into the meter and a sample on the strip. If you click the button at the top of the meter (not visible in my photos) twice, then the area to insert the strip lights up. Note I deliberately took this picture in low light conditions to show you the overall results.
Bayer arranged for me to talk with Rick Case, the project director, and Eric Nelson. These folks were leading the design team, which was completely within Bayer. We had an interesting discussion about product design and some technical issues.
Their target audience for this meter was people in their late teens or early 20s. (Which means that folks like Bennet and me can't get too excited about it!)
They wanted to get the product into the market, so initially it's only in black. But they're considering different meter colors and hope to have these available before too long.
If you use the GlucoFacts software that's provided on the meter itself, it doesn't actually remove the readings off the Contour USB. As the meter holds 2000 readings, you'll get almost a year's worth of readings if you're testing 6 times a day.
You can register at the Bayer site and download a different version of the GlucoFacts software that does take the readings off the meter. The built-in software doesn't allow you to manually enter new values, or A1C readings, but the installed version does. Both pieces of software are written in Java and run on Windows and Mac operating systems.
Because of speed to market, they purchased an off the shelf charger. When you use it, the meter is facing away from you, a minor annoyance. They plan to fix this in later models.
They are reading the sites of many diabetes bloggers, so they're taking note of suggestions and complaints for future versions of their products. One suggestion from me is to enable me to download the readings in some standard format (CSV), so I can look at them using other software. I hope the next version will also include an ability to upload readings to a central server like the MyGlucoHealthMeter.
For the first meter from this team, I think Bayer have done a superb job, and I'd recommend having a good look at this meter.
I blogged last week about the approval of the Medingo Solo insulin pump by the FDA. This week Medingo is showing it at the AADE conferenceand they've finally unveiled more details at the Medingo Solo website solo4you.com.
While the technical specifications are not available, they do have this video that shows some of the features.
The PDA part (Solo Remote) comes with different colored skins. There are four parts to the Solo pump itself: Solo Remote; Reservoir; Pump Base; and Cradle.
The pump base is described as a '3-month insulin Pump Base that stores all your pump parameters'. Medingo says it last 90 days. Medingo provides you with a spare pump base, which will make replacement much less of a problem.
The reservoir holds up to 200 units of insulin and has a single mercury-free battery (grey circle to the upper right of the picture above). So each time you change the reservoir you get a new battery, it's not clear how recyclable it is. The cradle is the part that's attached to you, it's got the cannula. According to the site, a bad insertion can be fixed by just replace the cradle without losing much insulin. Changing the 'set' means replacing the reservoir and cradle. It's not clear how waterproof the base/reservoir are, so you need to detach these if you're swimming.
The Solo Remote has a color screen. It downloads settings to the pump base so that it will operate to some degree without the remote. The pump base has buttons (highlighted in orange in the picture) that allow bolusing without the remote. I assume this is like other pumps where you set a predetermined bolus amount and press a certain number of times to get a bolus of a certain size.
The Solo website does have a page to sign up for "Size Up Solo" demo kit. I've already done this, just be aware that the address entry fields are front to back and you'll be all set.
I'll update this post as I learn more. There are no posted specifications for the Medingo Solo system that I can find, from the video it looks very slim but I'll suspend judgment until I can get a copy of the user manual.
From what I've seen online, this looks like an improvement in usability and design over other pumps. I think we're going to see more of these insulin patch pumps over the next few years.
I had an interesting conversation last week with Dick Rylander of Enject. We spoke at some length about their product, the GlucaPen, that they hope to have on the market before long. It's a simpler way to give people Glucagon injections.
Glucagon is a hormone that's produced in the pancreas. When it's released by the pancreas it causes the liver to take it's glycogen reserves and convert it into glucose. So it rapidly raises blood sugars levels. In emergencies, the glucagon reserve can be depleted by people who have type 1 diabetes (thanks for the correction from Mr. Sven below). It's a treatment for extremely low blood sugars where food or liquids can't be given. So it's really only used when there's an emergency.
The picture shows a glucagon kit from Eli Lilly. You may notice that the vial on the left contains a white powder. This must be combined with the liquid in the syringe just prior to use. Reconstituted glucagon has a shelf life of up to 48 hours when refrigerated.
So here's how it works. Your loved one is lying on the floor unconscious. You get the glucagon kit (you did put it in a well-known place, didn't you?). Before you can inject the glucagon into them, you need to follow about a half-dozen steps written on the enclosed leaflet. It's really difficult. One paper says the process "requires a manually dexterous operator who is composed, confident and competent in the whole procedure."
Let's look at the GlucaPen approach. Here's a picture of the GlucaPen prototype.
It will be a single unit, slightly longer and larger than an EpiPen. So you easily carry it with you, or pack it for a trip. And there are two simple steps before using it. These are displayed clearly on the side of the pen.
GlucaPen is looking for your opinions, they have a survey that includes a short video of the prototype being used. There's one survey to complete if you're an adult patient with diabetes, and a different one if you are a caregiver for someone with diabetes.
The GlucaPen folks have been developing this for about three years now and hope to have it on the market before too long. I think it's a great example of innovative design to make living with diabetes a bit easier. I'd love to hear any stories you have about using glucagon and whether something like this might make it easier.
Update: The GlucaPen has been entered in the DiabetesMine design contest, so there's now an animated video showing how it works. You can watch this below.
Amy Tenderich of DiabetesMine has just announced the start of the 2009 DiabetesMine Design Challenge. This year the grand prize is $10,000. So you can improve the state of diabetes design and win some serious prize money.
The competition is open from tomorrow March 2, 2009, to end of day (PST) on May 1st, 2009. Each entry is judged on three criteria: Relevance; Clinical Efficacy; Aesthetics. You can submit a video or a paper describing your idea. Full details are on the entry page for the competition.
I know we've got got lots of devices that are efficacious (FDA criteria), but with lousy design. This presents a great opportunity to make life easier for everyone with diabetes.
So think about anything diabetes related that's driving you nuts. Have you some way to fix the problem? Or maybe a completely new idea to make it easier to live with diabetes. I can't wait to see what folks come up with.
Medtronic clearly sees a lot of revenue potential in future devices. According to Reuters, they are planning to spend 35% more this year on their next generation of diabetes devices. According to the article they want to make these
simpler to use and more effective in managing the disease
I do hope they also consider other design aspects like the fun factor and how they look. Ease of use is definitely important, but I'd also like a device package that doesn't necessarily look like another mobile phone. I'd also like to move away from the Henry Ford-like approach to diabetes devices. "You can have that in any color as long as it's black or blue".
As a long-time Minimed pump user, I moved to a Cozmo last year because I just didn't see any innovation in what Minimed were doing. The design of the sensor for their CGMS is just plain ugly and way too large.
Do you want proof? See klil's picture from the Diabetes 365 project. How did they manage to make something this big? Have they checked out what Dexcom managed to do?
Despite my cynicism, I think this commitment from Minimed is a good thing. They're the big dog of diabetes devices and if their additional spending produces innovative designs, it's a sure thing that competitors and start-up companies will take up the challenge.
While I'm talking about device design, I hope you've had a chance to see Amy's post about the recent DiabetesMine design contest.
Last year Amy wrote an open letter to Steve Jobs. The design company Adaptive Path took up the challenge and created a design concept for a new device called Charmr.
Recently Medgadget (co-host of the competition) reported on some diabetes device design work by Sascha Morawetz.
This year the challenge has two prizes. $1,000 for 18 and over and the same for those under 18. The competition is open until May 26th. Read Amy's blog for full details.
Designers, ask someone you know with diabetes about the devices they use several times a day. The 'design' is close to awful. Some of the newer devices are an improvement, but very small. Look at the market reaction to the UltraMini blood glucose meter, and that's just because it's got a cute shape and is available in colors.
I do hope this year produces some designs that will make it into real devices. I can't wait to watch the entries on YouTube.
I use this term for a product that you may already like that then surprises you with a feature that you didn't even know existed. Like a car that turns off the interior lights before the battery runs dead, even if you'd left them on by accident.
I had one of those experiences today with my Cozmo. Yesterday my pump had started to complain that the battery was almost empty. And today I was running on voltage fumes.
I knew that I had to replace it, but I kept forgetting to. That is, until I was putting in a combination lunch and correction bolus. While the pump was delivering the bolus I decided to test what would happen if I removed the battery, essentially mimicking loss of power.
After replacing the battery I was pleasantly surprised to see a Bolus Interrupted message on my Cozmo. This is the kind of attention to detail that I've seen in other parts of the Cozmo pump. Those firmware engineers (the folks who write the code that runs the pump) really thought about this - good for you folks!
Dexcom delights
Another customer delight for me, this time from those great Dexcom folks. Today I got the new Dexcom CGM model to try out for a week or so (one sensor life). I'm going to replace my 16-day old sensor this evening and tomorrow I plan to try and use both receivers against the same sensor and see what happens. I'll use the OneTouch meter with the older receiver and my AgaMatrix WaveSense meter to calibrate the newer receiver.
What I'm hoping is that the newer receiver will show my readings to be higher that on the older receiver. If I'm right then it may prove my theory for my A1C being higher than expected.
The trial model also came with the slightly newer version of the Dexcom software. They've re-introduced the modal day view, which is very useful when you want to see recurring patterns in a number of days.
I'll blog about the new receiver and software after I've had a chance to play with it for a few days.
Update: I've posted a video on YouTube showing how to calibrate the Dexcom open choice. I still need to talk about the software.
Note: I currently own shares in Dexcom, I try not to let this ownership influence what I say about the company or its products.
I saw my endo today and I was given a sample SymlinPen 60. I've blogged previously about my experiences with Symlin. So in this post I'll just talk about the pen itself.
When I got home I snapped some pictures before using it.
As you can see the pen itself is a little longer and thicker than a large ballpoint. It's an awkward fit in my shirt pocket, only about a half-inch of the clip is actually holding it in place. I'll definitely keep it in my diabetes kit.
I had planned to use the pen at lunchtime. When I opened the box and took the cap off I found...no pen needle in place. That's right, the sample cannot be used immediately. It's like a Christmas toy that has no batteries and all the stores are closed.
Luckily I had some 10-year old pen needles left from when I used an insulin pen, and once I got home I grabbed one of these. It fit perfectly.
The pen has a dial at one end that lets you choose to dispense Symlin in doses of 15, 30, 45, or 60 micrograms (mcg). For comparison, 10 units of insulin is equal to 60 mcg of Symlin. Many people with type 1 diabetes will use 45mcg or less per meal. If you have type 2 diabetes and are taking insulin then the Symlin 120 pen is probably more useful, it will deliver either 60 or 120 mcg.
To start with I attached the pen needle, dialed up a 15 mcg dose, pulled back the end to prime the pen and dispensed the dose into the air. This was to fill the needle. I repeated this several times until I saw a stream of Symlin.
Then I dialed up my regular dose of 60 mcg and was able to inject it using the wonderfully small pen needle. If you put the needle cover back on, you can replace the pen cap with the needle still in place.
There's an interesting design feature, where you can stand the pen on end. I'm not sure what the benefit of this is, or whether it's just a side-effect of having a built-in plunger. There are markings on the barrel of the plunger that help you determine whether it's pulled back far enough. This is especially useful when the cartridge is almost empty and there may not be enough Symlin left for the dose you want.
Note that once you've pulled back the plunger the only way to undo this is to dispense the dose. If you dial up too small a dose you can choose a larger number and pull the plunger further back. If you've dialed up too much, you need to just dispense the Symlin into the air.
As you push the plunger there are soft clicking noises. I didn't count these, but there seems to be one click for a 15 mcg dose and three or four (I didn't count carefully enough) for a 60 mcg dose.
Once you've started to use the pen, you can store it at room temperature up to 86 degrees F (30 degrees C). Unopened pens must be stored in a fridge.
Overall I think this is going to be a lot easier than carrying around a vial and syringe. I wish the pens themselves weren't disposable, but that seems to be the way these things are made nowadays. I think I'd give the pen design a score of 7 out of 10.
To improve the score Amylin would need to include a pen needle with their samples and reduce the size enough for this to fit in a normal shirt pocket. I think this will be a useful addition to my diabetes kit.
Update: As I've used the pen I've paid more attention to how it works.
When you press the 'plunger' to deliver there is one click for every 15 mcg. One each click 15 mcg is actually delivered, so it's a chunky delivery. Because of the pH of Symlin (4.0 which makes it acidic), that first click stings a little. After it stops clicking the plunger still has a way to go, but the last part doesn't deliver anything.
Also, when you dial up a quantity and start to pull back the plunger it clicks, again one click for every 15 mcg. If you pull slowly you can count the clicks. This is probably helpful for anyone who has vision problems. Nice design feature Amylin!
If you've got diabetes you already know that one of the big challenges is loss of feeling in your feet. This is caused by peripheral neuropathy and it often leads to foot damage because you can't feel the pain of an injury to your feet.
So those of us with diabetes are taught early and often to protect our feet. "Don't walk barefoot" is a standard mantra.
Today I was doing my random walk through the internet and I came across a product called Vibram FiveFingers. I've not bought a pair and I have no connection to the company.
These things look very interesting to me. And the thought of having a barefoot experience of sorts is intriguing. I really like the look of these, someone has clearly put some thought into the design (diabetes product makers take note).
I'm blessed with wide feet, but according to the FiveFinger FAQ (I had to use this alliteration it was too tempting) the material accommodates wide feet. So that removes one obstacle for me.
Have you ever heard of, or bought a pair of these? I'm tempted, but at $70 and more for a pair I'd love to know before I invest in them.
I couldn't resist this. Apparently B&O has a division called Medicom. They've designed a new inhaled insulin delivery device called the Insulair
This is clearly meant to steal the huge market share of the Exubera insulin bong. Personally I think the issues with the Exubera was the silly marketing name. Why not just come out and call it the exuberant bong. I can see the name designers say "We can use the slogan - Get a hit from your insulin!". Hah
B&O is well known for their product design, I can't help thinking this one might actually stand a chance. Though from a Google search it's not clear whether this is just a design concept like the Charmr or a real product that's not yet available.
Amy Tenderich posted an open letter in April that expressed her frustration with current diabetes devices.
This has been a recurrent theme on diabetes blogs for some time. In the book Universal Principles of Design, there's a Hierarchy of Needs that follows Maslow's hierarchy for self-actualization. This principle argues that a design can't be Creative before it empowers people to be Proficient. And it can't enable Proficiency until the design is Usable. Usability builds on Reliability and Reliability on Functionality.
The trouble is that the diabetes devices have been stuck at the Reliable and Functional levels of the hierarchy for way too long.
Amy's challenge was to get past what we use today and start providing us with devices that are 'insanely great', like this types of things we expect from Apple.
The (insanely) great news is that the design firm Adaptive Path have taken up this challenge. They've created a concept device called the Charmr, and they've blogged extensively about their design process for the Charmr. There's even a Charmr video on YouTube.
My hope is that diabetes device makers take this challenge seriously. And that they also remember that all devices are part of a larger system.
This system includes: those of us with diabetes; our various devices; the data collected by the devices (insulin intake, blood glucose readings, health information, etc.); and our healthcare team(s).
Remember the iPod? It's successful because it combines the iPod hardware with software that allows us to add music from a variety of sources.
Our diabetes devices will only really be successful when they combine beauty (creativity) and all the other important design attributes with the ability to get the data off the devices and easily share it with other devices and systems. In other words when the accompanying software is an integral part of the system, instead of an afterthought.
The Diabetes Technology Blog is focused on using technology to life better with diabetes. I review: blood glucose monitors; continuous glucose monitor; blood sugar meters; diabetes software and living with diabetes.
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 36 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 Plus CGM to track my blood glucose levels.
I'm blessed by God, and every day brings the possibility of a cure.
The Solo Remote has a color screen. It downloads settings to the pump base so that it will operate to some degree without the remote. The pump base has buttons (highlighted in orange in the picture) that allow bolusing without the remote. I assume this is like other pumps where you set a predetermined bolus amount and press a certain number of times to get a bolus of a certain size.
