With commentary by Minisha Sood, MD, director of inpatient diabetes, Lenox Hill Hospital, New York, and Aaron Kowalski, PhD, chief mission officer, JDRF.
Even when those with diabetes are careful about eating right, exercising, getting enough sleep and monitoring their blood sugar, the unexpected can happen. Despite all that attention, as anyone with the condition knows, blood sugar can go haywire, potentially triggering a medical emergency.
Now, Medtronic, maker of insulin pumps and continuous glucose monitoring systems, has teamed up with IBM and its supercomputer, Watson, to develop an app usable on smart phones that can predict a potential problem hours before it's reality.
"In the Medtronic app being developed, we plan to have Watson synthesize information from Medtronic insulin pumps and continuous glucose monitoring devices—detailed information like the rate of insulin delivered, the constantly fluctuating glucose level and carbohydrate intake information,'' says Pamela Reese, a spokesperson for Medtronic. "The app may also integrate information sources like wearable activity trackers, digital scales, geo-location data, calendar details and even the weather, to develop more valuable and personalized insights."
In a pilot study, IBM and Medtronic ''applied cognitive analytics to 600 anonymous patient cases using data from Medtronic insulin pumps and glucose monitors," Reese says. The technology was successful, she says, in predicting low blood sugar (hypoglycemia) up to three hours before it occurred. That is early enough, she says, to head off a potentially dangerous health event due to abnormal blood glucose levels.
The app was unveiled in January at the Computer Electronics Show (CES) in Las Vegas.
"Medtronic plans to bring the app to market upon meeting regulatory requirements," Reese says. The target date for launching is summer of 2016. "Medical devices like insulin pumps and glucose sensors generate continuous streams of valuable data every day," Reese says. "For the first time, we believe we can combine that data with additional information to ease the burden of daily diabetes management decisions."
When the development was announced at CES, Medtronic's Annette Bruls was quoted as saying, "What we are doing here is providing predictions, insights and in the future actionable recommendations to patients."
Deborah DiSanzo, general manager of IBM Watson Health, was quoted as describing the app as a kind of personal medical assistant for those with diabetes.
No information was immediately available from Medtronic about pricing. "More details on pricing and the app features will be provided at launch," says Francesca DeMartino, a Medtronic spokesperson. "Our aim will be to make this app available on both iPhone and Android platforms," she says. But one may launch earlier, she says.
She describes the app as a kind of personal assistant ''to provide relevant, real-time insights and coaching to help people with diabetes improve their ability to understand the impact of daily activities on their diabetes."
The move to this new technology has been described as a transition from a focus on medical devices only to healthcare solutions. Among other devices with a similar healthcare solution focus are the DexcomG4 Platinum System with Share. It uses Bluetooth wireless communication to allow remote viewing of blood glucose levels, trends and data sharing between the person with diabetes and others with Apple's iPhone or iPods.
Medtronic's MiniMed Connect provides the ability to view insulin pump and continuous glucose monitoring data on the go, but DeMartino says the new app will go beyond those capabilities.
Experts in diabetes management laud the development. "Having a smart app which compiles a patient's glucose, exercise, sleep, dietary patterns and recognizes possible interventions based on that data is a very exciting idea," says Minisha Sood, MD, director of inpatient diabetes at Lenox Hill Hospital in New York City.
Putting it in perspective, she says: ''It will potentially add to the burden of information those with diabetes already receive [from various sources], but could prove invaluable, maybe even life-saving, for many."
Those who use the app, when available, will need to learn to use it correctly, of course, she says. "A smart diabetes alert app, however, is only going to be as good as the person using it," she says. If they enter incomplete information, advice may be misleading. And of course it won't substitute for good medical information from a patient's doctor, she says.
More research is needed to show the effect of the app on glucose levels, and other outcomes, she says.
Aaron Kowalski, PhD, chief mission officer for the JDRF, also welcomed the new development. "Recent advances are making life a lot easier for people like me who have to constantly monitor their blood glucose levels," he says. "The technology is really changing the landscape."
The payoff, he hopes, is better glucose management, less work and worry, and the ability to start the day ''in a good place, instead of playing catch up.''