When Gary Scheiner talks about the future of diabetes technology, we listen. He understands diabetes both as someone who has lived with type 1 for almost 30 years and as an internationally renowned Certified Diabetes Educator. His is author of six books, including the famed Think Like a Pancreas and recipient of the 2014 Diabetes Educator of the Year by the American Association of Diabetes Educators. He actively coaches people around the world at IntegratedDiabetes.com. He also recently joined our Scientific Advisory Board to help ensure we achieve our mission of helping people with diabetes thrive.
How important has diabetes technology been to improving outcomes?
Gary: To be honest, it should make more of a difference than it has. Patients continue to struggle to achieve and maintain reasonable A1c and stable glucose levels despite the advent of sophisticated pumps, meters, and downloading software & apps. There is often a disconnect between using technology and benefitting from technology. It takes a motivated and well-trained patient (and support system) to generate better outcomes. One possible exception: Continuous Glucose Monitors (CGM) seem to make a difference for almost everyone in terms of cutting down on the frequency & severity of hypoglycemia.
However, people with diabetes certainly have better quality of life through new technologies. The latest devices and software can make living with diabetes considerably more pleasant — less time consuming, less painful, more flexible, more engaging. This should be viewed an “improved outcome,” but it rarely is considered by the healthcare industry or 3rd party payers.
Gary: You’ve worn practically every diabetes technology device out there…In what areas are we still falling short?
One of the major areas where we fall short has to do with the speed with which insulin works. Our so-called “rapid-acting insulins” aren’t even close to matching the speed with which pancreatically-produced insulin works. They’re really just “rapider than regular”. This is the major cause of after-meal blood sugar spikes and hypoglycemia with exercise, and it is hindering progress in developing an artificial pancreas. Otherwise, my personal wish list includes a true all-in-one blood glucose meter (no loose parts to carry around), a CGM that integrates with a cell phone, and a full-feature patch pump that allows dosing right on the device (without requiring a remote control). I’d also like a way to make carb counting easier & more accurate. Perhaps a wand to wave over the food item, like Dr. McCoy used on Star Trek to diagnose and treat virtually every health malady.
Gary: How can smart meters help support diabetes educators and their patients?
The key to truly benefitting from BG meter data is to present the information in a clear and organized way. Overall summary data is nice, but we really need to look at and evaluate data by time of day. There needs to be a quick/simple way to categorize readings as pre-meal, post-meal or “other”, and then be able to chart the data according to mealtime. The meter needs to be universally downloadable and viewable remotely as well as in-person. We work with clients all over the globe, so we have to be able to see their data in an online format, or they have to be able to easily transmit the data or specific reports to us via e-mail.
Gary: What features should we be working on next?
Dario is the closest I’ve seen to a truly integrated system. I’d love to be able to test on the meter without having to first plug it into a phone, in case I don’t have my phone with me at the moment. A small display on the meter would be great. I’d also like the test strips to be more easily accessible. If it allows me to complete the entire BG checking process in under 10 seconds, I’ll be impressed.
Thank you, Gary!
Read more about the Dario Glucometer on the Dario website.