diabetes

26 Articles

Why Is Continuous Glucose Monitoring So Hard?

December 3, 2018 by 99 Comments

Everyone starts their day with a routine, and like most people these days, mine starts by checking my phone. But where most people look for the weather update, local traffic, or even check Twitter or Facebook, I use my phone to peer an inch inside my daughter’s abdomen. There, a tiny electrochemical sensor continuously samples the fluid between her cells, measuring the concentration of glucose so that we can control the amount of insulin she’s receiving through her insulin pump.

Type 1 diabetes is a nasty disease, usually sprung on the victim early in life and making every day a series of medical procedures – calculating the correct amount of insulin to use for each morsel of food consumed, dealing with the inevitable high and low blood glucose readings, and pinprick after pinprick to test the blood. Continuous glucose monitoring (CGM) has been a godsend to us and millions of diabetic families, as it gives us the freedom to let our kids be kids and go on sleepovers and have one more slice of pizza without turning it into a major project. Plus, good control of blood glucose means less chance of the dire consequences of diabetes later in life, like blindness, heart disease, and amputations. And I have to say I think it’s pretty neat that I have telemetry on my child; we like to call her our “cyborg kid.”

But for all the benefits of CGM, it’s not without its downsides. It’s wickedly expensive in terms of consumables and electronics, it requires an invasive procedure to place sensors, and even in this age of tiny electronics, it’s still comparatively bulky. It seems like we should be a lot further along with the technology than we are, but as it turns out, CGM is actually pretty hard to do, and there are some pretty solid reasons why the technology seems stuck.

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Homebrew Pancreas Gets 30 Minutes Of Fame

August 9, 2018 by 25 Comments

It is pretty unusual to be reading Bloomberg Businessweek and see an article with the main picture featuring a purple PCB (the picture above, in fact). But that’s just what we saw this morning. The story is about an open source modification to an insulin pump known as the RileyLink. This takes advantage of older Medtronic brand insulin pumps and allows you to control the BLE device from a smartphone remotely and use more sophisticated software to control blood sugar levels.

Of course, the FDA isn’t involved. If they were, the electronics would cost $7,000 instead of $250 — although, in fairness, that $250 doesn’t cover the cost of the used pump. Why it has to be a used pump is a rather interesting story. The only reason the RileyLink is possible is due to a security flaw and an active hacker community.

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Ask Hackaday: Preserving Electronic Devices

December 20, 2017 by 62 Comments

Conventional wisdom holds that we no longer make things to last for the long haul, and that we live in a disposable world. It’s understandable — after all, most of us have a cell phone in our pocket that’s no more than a year or two old, and it’s often cheaper to buy a new printer than replace the ink cartridges. But most of that disposability is driven by market forces, like new software that makes a device obsolete long before it breaks down, or the razor and blades model that makes you pay through the nose for ink. It turns out that most electronic devices are actually pretty well engineered, and as long as they’re not abused can still be operating decades down the road.

But what happens when you want to put an electromechanical device away and preserve it for a rainy day? What can you do to make sure the device will operate again a few years down the road? Are there steps one can take beyond the typical “keep it in a cool, dry place” advice? In short, how do you preserve electronic devices?

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Hackaday Prize Entry: Ebers – Diabetes Care, Step By Step

September 29, 2017 by 1 Comment

Diabetes is a disease that, among other things, has significant effects on the feet due to a combination of neuropathy, vascular issues, and other factors. You may have seen special diabetes socks with features like non-elasticated cuffs for better circulation and a lack of seams to prevent the formation of blisters. Taking care of  your feet is essential in diabetes to prevent injury and infection. Ebers is a project that seeks to help in just this area.

Ebers monitors plantar pressure, temperature, and humidity in the sole of the shoe. It then feeds this data back to a smartphone for analysis over Bluetooth. The brain of the project is an Arduino Pro Mini which is tasked with interfacing with the various sensors.

The project relies on 3D printed insoles which fit inside the shoe of the wearer. This is a particularly useful application of 3D printing, as it means the insole can be customised to fit the individual, rather than relying on a smaller selection of pre-sized forms. This has the additional benefit of allowing the insole to be designed to minimise pressure on the foot in the first place, further reducing the likelihood of injury and infection. The pressure sensing is actually built into the insole itself, and can measure pressure at several different areas of the foot.

Overall, it’s a project with huge potential health benefits for those with diabetes. We look forward to seeing where this project goes in future, and how it can bring improvements to the quality of life for people the world over.

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Getting Data Off Proprietary Glucometers Gets A Little Easier

June 23, 2017 by 22 Comments

Glucometers (which measure glucose levels in blood) are medical devices familiar to diabetics, and notorious for being proprietary. Gentoo Linux developer [Flameeyes] has some good news about his open source tool to read and export data from a growing variety of glucometers. For [Flameeyes], the process started four years ago when he needed to send his glucometer readings to his doctor and ended up writing his own tool. Previously it was for Linux only, but now has Windows support.

Glucometers use a variety of different data interfaces, and even similar glucometers from the same manufacturer can use different protocols. Getting the data is one thing, but more is needed. [Flameeyes] admits that the tool is still crude in many ways, lacking useful features such as HTML output. Visualization and analysis are missing as well. If you’re interested in seeing if you can help, head over to the GitHub repository for glucomerutils. Also needed are details on protocols used by different devices; [Flameeyes] has only been able to reverse-engineer the protocols of meters he owns.

Speaking of glucometers, there is a project for a Universal Glucometer which aims to be able to use test strips from any manufacturer without needing to purchase a different meter.

Thanks for the tip, [Stuart]!

Hackaday Prize Entry: Reverse Engineering Blood Glucose Monitors

July 10, 2016 by 26 Comments

Blood glucose monitors are pretty ubiquitous today. For most people with diabetes, these cheap and reliable sensors are their primary means of managing their blood sugar. But what is the enterprising diabetic hacker to do if he wakes up and realizes, with horror, that a primary aspect of his daily routine doesn’t involve an Arduino?

Rather than succumb to an Arduino-less reality, he can hopefully use the shield [M. Bindhammer] is working on to take his glucose measurement into his own hands.

[Bindhammer]’s initial work is based around the popular one-touch brand of strips. These are the cheapest, use very little blood, and the included needle is not as bad as it could be. His first challenge was just getting the connector for the strips. Naturally he could cannibalize a monitor from the pharmacy, but for someone making a shield that needs a supply line, this isn’t the best option. Surprisingly, the connectors used aren’t patented, so the companies are instead just more rigorous about who they sell them to. After a bit of work, he managed to find a source.

The next challenge is reverse engineering the actual algorithm used by the commercial sensor. It’s challenging. A simple mixture of water and glucose, for example, made the sensor throw an error. He’ll get it eventually, though, making this a great entry for the Hackaday Prize.

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Hacking Diabetes Meters, Towards An Artificial Pancreas

October 29, 2015 by 51 Comments

We’ve covered a number of diabetes-related hacks in the past, but this project sets its goals especially high. [Tim] has diabetes and needs to monitor his blood glucose levels and administer insulin accordingly. As a first step, he and a community of other diabetics have been working on Android apps to log the data when combined with a self-made Bluetooth re-transmitter.

But [Tim] is taking his project farther than previous projects we’ve seen and aiming at eventually driving an insulin pump directly from the app. (Although he’s not there yet, and user input is still required.) To that end, he’s looking into the protocols that control the dosage pumps.

We just read about [Tim] in this article in the Guardian which covers the diabetic-hacker movement from a medical perspective — the author currently runs a healthcare innovation institute and is a former British health minister, so he’s not a noob. One passage made us pause a little bit. [Tim] speaks the usual praises of tech democratization through open source and laments “If you try to commercialize [your products], you run up against all sorts of regulatory barriers.” To which the author responds, “This should ring alarm bells. Regulatory barriers are there for a reason.”

We love health hacking, and we’re sure that if we had a medical condition that could be helped by constant monitoring, that we’d absolutely want at least local smart-phone logging of the relevant data. But how far is too far? We just ran an article on the Therac-25 case study in which subtle software race conditions ended up directly killing people. We’d maybe hesitate a bit before we automated the insulin pump, but perhaps we’re just chicken.

The solution suggested by [Lord Ara Darzi] in the Guardian piece is to form collaborations between patients motivated by the DIY spirit, and the engineers (software and hardware) who would bring their expertise, and presumably a modicum of additional safety margin, to the table. We like that a lot. Why don’t we see more of that?