Medtronic Plus
SUMMARY
The insulin pump therapy is an insulin delivery system designed for juvenile diabetics around the world. It performs the function via a cannula inserted in the body of the patient, connected to a tube with the insulin reservoir at its other end. The reservoir is situated within the insulin pump so that the technical mechanism of the pump allows for doses to go through the tube and into the cannula and within the blood stream to be absorbed and breaks down the necessary glucose to maintain a steady level of blood sugars.
Another cannula corresponding to the pump machine has been created to sense the blood sugar from within the skin and approximate its value by sending the signal to the insulin pump. It can be considered an attachment to the bigger initial development of the pump. Unfortunately the sensor mechanism needs constant correspondence to the pinprick traditional method of identifying blood sugar levels, a minimum of thrice a day. These two advancements have made diabetes management significantly easier.
Both technologies however lack an exact way of determining the amount of insulin to be given at specific times. The pump has a ‘bolus wizard,’ that tries to determine the insulin dose; according to the patients insulin to carb and insulin to blood sugar sensitivity. But these ratios have to be calculated by the doctor and patient based on other calculations. The interaction of the wizard and the patient is highly inefficient and more or less inaccurate.
Personally, as a user of the insulin pump therapy I find many shortcomings in the pump that were tried to have been resolved or easened by the IPhone/ Ipad application available on iTunes. The application seemed to be a great data base for video tutorials on the insulin pump settings, a good way to document current setting of the pump, set up reminders for blood sugar checks or pump supply orders etc, but proved again not so effective in communicating recommended doses according to the specific, individual patient.
DESIGN PROBLEM
Therefore the design problem lies here; to recreate an application for all types of devices, that serves the patient as a tool to calculate insulin doses according to the patients specific cases; food, activities, sleep etc. It aims at sensing the signals of the blood glucose and taking into consideration the 24- hour insulin specifications as well as momentary ratios used and with the above amalgamation to be able to approximate setting changes (change hourly rate/ suspend delivery completely) or to increase the dose (increase hourly rate/ momentarily up the dosage.) the plan includes the for me to introduce the Bluetooth connection in all three devices so they can interact with each other and develop the most apt response to the patient/ user.
The above diagram (1.1), represents the interaction (in red) that will be introduced for user, pump, sugar machine and phone to the existing manual connections (in black.) and diagram 1.0 shows the conditions before the introduction, where the arrows indicate the humans physical inputs and connections from one element of the system to another.
NEED
TECHNOLOGY
How it works?
Weight, height and other basics will need to be input manually, but other things like intensity of work out/ heart rate the app will be able to predict (based on choice of exercise picked and time set.) to calculate the heart rate the user will have to place his/ her finger on the rear view camera and the phone calculates the pulse rate.
Therefore after a certain exercise performed even once the device will have the hear rate stored for future interpolation or extrapolation.
in this diagram. the patient records the activity, time, sugar levels before and after. The app records insulin rates and doses before as well as food intake. This then serves as a library for common activities specific to the individual patient.
The above diagram, is an example of a result of using the app for an activity. it causes a feedback loop eventually. the app tell the patient whether he or she should increase/ decrease the current insulin rate and to what extent, if needed then food intake; based on prior recording, heart rate; according time and intensity.
Other corrections to the app would include; For example, you can enter your “Standard Basal Rates” and enter the corresponding times for these basal rates. Same with “Insulin Sensitivity,” “Blood Glucose Targets.” Suggestions and ways of calculating these will be already embedded in the app so by filling this out initially the user would not be bothered with constant need to update unless such changes occur demanding the revision of any entries.
DESIGN
Overall, the idea is for the app to be a personalized doctor to the patient that knows the sugar levels and insulin delivery system on an hourly basis in order for informed determinations and interaction but ultimately it is the patient’s final click of a button that decides the delivery/ suspension of the insulin pump. The following drawing shoes an example of what the app would like like and how it would function with the user interface.
On picking any activity of the four screens the following pages turn up. The forth page left with question marks are tools to customize the ‘activity.’
In this case, the user has chosen kickboxing.
He/ she fills in the food intake and then the app diagnoses what the sugar was by Bluetooth connection with the testing machine/ sensor and similarly identifies previous and on going insulin data.
This information, with heart rate predictions and carb: insulin, sugar level: insulin ratio is considered and combined to result in ‘1 unit dosage,’ pre work out!
Additionally, the application can serve as a log book. It automatically records whatever information it receives and generates. this information could be used for research and development, the data generated could form patterns and diagnose trends for the patients use and analysis him/herself. Further this will help reduce the time of clinic visits as it can be directly transferred into EMRs; electronic medical records, and referred to throughout the life of the patient. If and when cures are made the it can be used to compare the patients need and urgency of it.
on a much broader base, the data collected could be uploaded to an online database for all patients and data/ patterns/trends can be discovered in relation to demography- age, income, gender etc as well as geography that is where the patient resides. It can also go into more details and discover what times of the day or what seasonal changes affect the blood glucose of the patients in all or specific places. This actually might turn out to be the most helpful element of this project in terms of facilitating further research and development in the field of diabetes whether its for technology, material or just education.
FEASIBILITY
Since the design solution has turned out to be an application that can be downloaded on any device, such as smart phones, laptops, ipads etc. and synced with standard glucose meters and the most common insulin pump it should be highly feasible. For the patient, it incurs the larger initial investment of purchasing the insulin pump, as mostly all patients have a glucose meter but are still using the injection and insulin cartridge for insulin delivery. The App itself would be free but its connections will be expensive or inexpensive based on the patients disposable income and access to the products and the constant supplies required.
CRITICISM
The application very much depends on the patient’s interaction with it. Where possible the app synchs with the products and recommends actions in its relation. But in the case of food intake and activities where the knowledge is required prior the decision to do either the application is dependent on the patient. So if the patient is not interested in updating and or using the advice then it shall prove to be ineffective. It also lacks the efficiency to deliver the insulin without interrupting the life of the patient. This is both a good thing and a bad thing, in the case where the patient may not fill in the details and decide to give more or less insulin based on the real time events that the application lacks knowledge of the prediction of the app will be ignored. But it is a bad thing every other time when the patient does not perform anything unusual and by trend, if it goes high, obviously insulin is needed hence just delivering it before the patient actually confirms the high sugar the app has sent.
SOURCES
"2 Ways to Get Started." Insulin Pump Therapy. https://www.medtronicdiabetes.com/treatment-and-products/insulin-pump-therapy (accessed October 4, 2014).
"myMedtronic Connect." App Store. https://itunes.apple.com/app/mymedtronic-connect/id449940322?mt=8 (accessed October 4, 2014).
