1. Current Diabetes-Monitoring Systems Mara Hemminger University of Maryland Department of Information Studies HCIL Conference, 2004

2. Overview What is diabetes? What meters are currently available? What record-keeping systems are currently available? What research initiatives exist? What are some user-interface issues?

3. What Is Diabetes? Body cannot process sugar properly. –Insulin controls the amount of sugar in blood. –Diabetics’ pancreas cannot produce / properly process insulin. Types –Type 1 Body produces little/no insulin (insulin injections needed) Typically hits people under age of 30 –Type 2 Body produces insufficient amounts of / improperly processes insulin (no insulin injections needed) Typically hits adults over age of 40 –Gestational (during pregnancy)

4. What Is Diabetes? Can cause: –Blindness –Heart attack –Poor circulation –Gangrene –Kidney disfunction –Death. No cure, but monitoring can prevent long-term problems

5. What Meters Are Currently Available? Types: –Blood glucose monitors * Blood-pricking Minimally-invasive Non-invasive –Urine glucose monitors –A1c monitors Features: –Testing location –Testing speed –Blood amount required –Storage of readings –High/low values –Size –Cost of meter –Cost of strips

6. Blood-Prick Meters: Hand Logs (Accutech) Drop blood onto meter Wait 2 minutes Read results on thermometer-like display Compare reading with chart of average readings

7. Blood-Prick Meters: PC-Based (LifeScan) Meter Arm or finger prick Digital display of reading Record-keeping system Glucose Measurements before and after meals Colors indicate levels above/below target Medications Meals (carbohydrates) Bar/pie charts, graphs By date By time-of-day By target levels

8. Blood-Prick Meters: PDA-Based (Therasense FreeStyle) Meter –Multiple testing sites –Digital display of reading Recording-keeping system –Glucose levels –Medications –Meals –Exercise

9. Minimally Invasive Meters (MiniMed CGMS) Insert sensor under abdominal skin for 72 hours Sensor reads interstitial fluid glucose level Patient can enter meals, exercise, meds in monitor Physician reads sensor results User must calibrate sensor via a finger prick 4x/day

10. Non-Invasive Meters (Cygnus GlucoWatch) Auto-Sensor fits on back of watch Monitors glucose (u/i method); no blood-pricks User can enter meals, exercise info User can set high/low alert Biographer stores 8,500 readings Data can be downloaded to PC as graphs, charts, stats

11. What Record-Keeping Systems Are Currently Available? Types –Hand logs –Spreadsheets –Internet logs (hand) –PC-based (here) * –PDA-based Here: (WinGlucoFacts) –Daily/weekly/mo stats –Bar chart, dot graphs

12. What Research Initiatives Exist? (MIT/Frost & Smith) Web-based tool Patients photograph daily habits Glucose readings stored and color-coded (red=high, blue=low) Glucose readings mapped to photos Goal: highlight bad habits

13. What Research Initiatives Exist? (University of Pittsburgh/Schultz & Ballerstadt) Sensor implanted below skin Sensor fluorescence reflects blood sugar level Photometer sits atop skin Photometer measures intensity of fluorescence Reminiscent of CGMS, but measurement method is known here

14. What Are Some User-Interface Issues? Meters –Eliminate blood-prick strips –Show test countdown –Show more than one reading at a time Record-Keeping Systems –Show personal high, low and average –Track several factors (glucose, ketones, A1c, insulin) –Provide analysis (only a few do) –Multi-task: Measure, log, analyze, and inject insulin -- all in one fell swoop!