Alicia: UnLeashed! February 2018 monthly article

We’re living in a technical world, and I am a technical girl!

Madonna is the material girl to any of us old enough to remember the 80’s. This song typified the material culture of the time. Well in the 21st century materialism has been replaced by technical connectivity! We’re living in a technical world, and who is more connected to technology than insulin pump and CGM users?!  We are bionic!

Tiny computers read our blood sugars, tiny computers dose our insulin, tiny computers can even regulate our basal levels! So WHY do the companies that make our products expect us to have giant hulking desktop computers running outdate software in order to interface with our diabetes tech?!

What are the best insulin pump and CGM management apps?

The company currently leading the way in user tech interface is Dexcom.
The clarity app and bluetooth capabilities of the Dexcom G5 allows access to real-time information across Windows, Mac, and Android devices with no need for a USB port. (Though medicare users still have to use the receiver and USB uploads as Medicare has not approved the Clarity mobile app) This means that desktops, mobile devices and smart phones give users easy access to their data! No flash players, no java plug-ins, just an app! Some third party data management designers have been slow to incorporate Dexcom G5 data, particularly when coming from a paired device such as the Tandem X2 pump. The only hitch here seems to be that Dexcom developers report being unable to keep apace of the rapid updates of Apple iOS updates.

Compare this to Medtronic’s Carelink software.
First, we hope you have a desktop computer, because these devices are not bluetooth compatible, so you have to plug them in. Now you have to download a Java plug-in; a notoriously poorly functioning plug in. Here in our PCP based office I have had to do multiple downloads just to get this to work. Oh, and while you are on your desktop from the last decade, I hope you remember where your Internet Explorer icon is, because newer browsers can’t run the Java plug-in needed for uploads. Now that you’ve gone back in time you can upload your state of the art pump to a website that has not changed one single bit in appearance of interface, since I started by first Medtronic pump back in 2007. Reports then export to an Adobe PDF. That’s right another download and another plug-in to view your data.

For Mac users, best of luck. When I started with Medtronic their software was not even Mac compatible. I kept my slowly dying hulk of an antique desktop PC for the singular purpose of uploading my pump and sensor data. Years have passed (far too many) and the overwhelming popularity of Mac platform devices have forced Medtronic to broaden their compatibility…. sort of.  The developers of the Carelink site do not even bother developing updates for Safari! The best answer I can get from tech support as to why, is because Safari and Mac software updates too frequently for their development team to keep apace. REALLY?! The developers of the devices that are keeping most Americans alive in hospitals can’t manage to keep up with the pace of updates? And remember, the Java updates don’t work with other Mac compatible browsers like Chrome or Firefox updates either. Mac users are left with two options, either restore back to older software versions, or give up being able to upload their data. This is entirely unacceptable, and the highly proprietary nature of Medtronic devices means that users do not have the option of using a third party data uploading platform (such as glooko, diasend etc)

Tandem
But don’t feel too bad Medtronic, other device companies are not far ahead. Tandem’s pump does have bluetooth receiving technology and pairs with the Dexcom CGM, but you still need a USB to upload your data, so no smartphones or iPads there. In fact you also can’t use your Mac based mobile devices to view your uploaded data as viewing requires a flash player plug in. Mac desktop users won’t meet any other added tech issues. And PC users shouldn’t be over burdened. And Tandem devices work well with other platforms. Tandem uses an upload driver that must be downloaded.

Omnipod
Omnipod may have taken the wisest approach, leaving the data management to the developers who do it best, directing users toward third party developer Glooko.  The PDM (Oersonal Diabetes Manager) that is used to program the pods still needs to be plugged in and has no bluetooth capabilities. We are waiting to see what features the new DASH PDM will offer.

The Freestyle Libre
The Freestyle Libre is a device built on being easy to use, so would expect the data to be easy to upload, view and use. The simplest option is to download the software to your computer.  There are not further plug ins needed to generate reports. Again, no bluetooth capability here so you will need a USB port, so no mobile uploading. The online uploading function also requires downloading a driver which is both PC and Mac compatible.

So what’s the future?

We are quickly moving to a world without desktop devices in homes. The continued dependence on these devices is frustrating at best. This limitation is reducing the user’s ability to maintain their best diabetes management at worst.  Surely with our banking and commerce on mobile devices and being transferred via bluetooth technology medical technologies developers can better use this technology to give users access to the data that is so central to their management.