Friday, April 9, 2010

Remote Monitoring/Programming and Diabetes Management

Diabetes management is a personal area of concern for me.  No, I'm not diabetic.  However, my late mother-in-law was.  She had Type II diabetes; however, she was not overweight.  She died of a sudden cardiac arrest that was a direct result of her diabetes.  Although she did a great deal to manage her diabetes, her insulin would swing widely.  Those wide swings damaged her heart muscles leading to a cardiac arrest.  I can't help but believe if remote monitoring had been available to her, that she should would be alive today.

In the past my primary topical area has been cardiac rhythm management.  I plan to broaden my focus. Diabetes management using remote monitoring and even remote programming will be a topical area of increasing focus in this blog.  In later weeks I plan to branch out into COPD.

For those of you who have domain expertise in diabetes management and COPD, I would appreciate your comments.  You can make your comments in the comment area of this blog or email them to me.  Whatever way you feel the most comfortable.

To get things started, I have three links that I would like share.  The first link is a blog article titled, "Finding patterns in diabetes treatment may be key for telemedicine."  The article is a brief discussion about a presentation by Dr. David Klonoff of Mills-Peninsula Health Center and UC San Francisco.  His focus was on Type I diabetics, however, I believe what he discussed has significant implications for Type II diabetics as well.  Dr. Klonoff's interest is technology "...for automatic measurement of blood glucose, automatic dose calculation, and automatic insulin delivery."  From the article ...
For this ideal scenario to develop, five technologies need to be solved, and Klonoff sees printed electronics being used in every one:
  • Self-monitoring of blood glucose
  • Continuous (and ultimately non-invasive) monitoring of blood glucose
  • Alternate routes for delivering insulin rather than needles, such as micro-needles. (Klonoff referred to work being done at UC Berkeley; I saw some demonstrated at the University College Cork/Ireland (PDF poster here) although using traditional semiconductors, not printed electronics.)
  • Artificial pancreas
  • Telemedicine
 In the quotation above, there are several links.  The one of greatest interest to me and to this forum, is the "non-invasive" link.  This will link you to an article titled, "The Search for Noninvasive Glucose Technology That Works: Where It Stands Now".

The article is a discussion of a need for a means for non-invasive monitoring of glucose levels.  The capability of having a non-invasive means of monitoring glucose levels would go a long ways towards supporting automatic, remote monitoring of glucose levels.  This could be an extension of the body area networks work (BANs).  So if anyone has any ideas in this area, apparently this is a wide open area for invention.

Finally, I want to provide a link to a brief report by the Whittier Institute of Diabetes.  The report is undated, but a brief review of the document's properties indicated that it was created in 2004.  It's not as recent as I would like, however, I believe that it's findings are relevant.  In summary, it showed that even relatively crude means for monitoring diabetes could lead to some positive outcomes at relatively low cost. 


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