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Diabetes Data, Everywhere

A Continuous Glucose Monitor, the Cloud = Life Saving, Life Changing Diabetes Care... for everyone.

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This project was created on 07/15/2014 and last updated a day ago.

Description
A Dexcom G4 continuos glucose monitor and its protocols were decoded to allow for real time upload of critical Blood Glucose data (of my 4 year old son), and viewing by Mom, Dad, his school nurse.

A pebble watch to give a glanceable peek and helpful alerts, allowing us to live our lives and take back some of the "normal" that type 1 and its rigorous management steals from the individual and their loved ones.

Making the uploader and pebble app open source & collaborating with others has grown the tools into a viral sensation and is widely used by many, many more people than I would have ever imagined.

The intense interest and growth speaks to the challenges of type 1 diabetes, a constantly life threatening and challenging disease... Some estimate about 600 individual tasks PER DAY are required to manage type 1 diabetes. These freely available tools, even with the challenges of a DIY project, have been embraced by many for the simple fact: it makes life better.
Details

An important aspect of this project is the profound impact it can have on the lives of those that are not waiting, and already use it:

http://sixuntilme.com/wp/2014/07/14/waiting-cgm-cloud-part-2/

The Facebook Group:

https://www.facebook.com/groups/cgminthecloud

Super high-level of our current system... all working!! Goal is to make this all turnkey, much easier to setup & customize.

ONE of literally hundreds of unique testimonials of the impact this project, and making it open source, has had:

The growth of the community (CGM in the Cloud & Nightscout):

http://www.zeemaps.com/view?group=1071312&x=-119.599236&y=33.298578&z=15

Other Open Source Projects used to make this possible:

https://github.com/mik3y/usb-serial-for-android

Components
  • 1 × Android Device USB Host (OTG) capable, OS verison 4.x+
  • 1 × OTG Cable
  • 1 × Micro B Male to USB A Male [cable]
  • 1 × Dexcom G4 Continuos Glucose Monitor Receiver
  • 1 × Web Server Data & Service (API)
  • 1 × Pebble Watch (Optionall)
  • 1 × iOS Device (Optional)
  • 1 × Scientific Angler Fly Box
  • 1 × 1.5" Drill Bit & Drill
  • 1 × Velcro (low profile)

Project logs
  • Prospect

    7 days ago • 0 comments

    A summary of where we are, and where we're headed.

    As I plan out my final video for the semi-final portion of the hackaday prize, I find it difficult to focus on one particular aspect of the build for very long, as there are many exciting aspects, and my mind simply races with the possibilities, the prospects of this project.

    We made our rig smaller:

    And with a sweet case design, we can make it better still.

    We've also found many new ways to present the data....

    Evan was running low after a busy night, I was drowsy and not paying attention to the iPad on our entertainment center, nor was I cognizant of the buzzing pebble on my wrist... but this got my attention:

    Once the CGM data has been liberated, the sky is the limit. We can use off the shelf "internet of things" devices, or augment everyday items ourselves.

    We can tap into common device features, such as the new iOS "widgets," to offer yet another quick view of realtime data (we can do the same for Android!):

    The online community that has taken these tools as their own and evolved them, is now nearing 7,000 people. A formidable group, with potential resources to rival some of the big players in this field. So... we begin chatting with the FDA and finding more ways to trial and research our wild ideas, while continuing to drive the conversation about where Open Source and regulated devices or systems converge. 

    We are at a unique and critical moment, where we can help evolve a process to promote, not stifle, the innovations most desperately needed by those with type 1 or other chronic conditions. 

    The true prospect is the great change possible across the medical & healthcare industry, where patient data has been liberated and innovators, particularly those on the front lines, have an unencumbered path to victory. 

  • Packaging

    8 days ago • 0 comments

    Type 1 diabetes is burdensome. When designing tools to help manage it... don't add to the burden, okay?

    Seems simple enough, but most of the tools a diabetic is given are not designed with this in mind. They're intended to keep a person alive, which is certainly a good thing, but the actual usability is often lacking.

    The truly awesome Scott Hanselman nails it:

    http://hnsl.mn/iamdiabetic

    http://www.hanselman.com/blog/TheSadStateOfDiabetesTechnologyIn2012.aspx

    So, when building an ambulatory system, which by definition, is to be taken with the patient, it needs to benefit beyond the burden.

    Our very first pass at combining the CGM and an Android phone:

    We put this in a pouch, and it worked well... until we discovered the G4's biggest weakness: the USB port. Apparently, even normal force and use can snap these bad-boys off of the PCB. So, in this configuration, it took about 2 weeks to snap it off...

    I went to amazon and searched for "small plastic cases" and after hitting a few variations on those terms, I found this:

    It's a "Fly Box" and comes it several sizes, and living in the Finger Lakes region, the waterproof 'feature' would come in handy.

    We ended up using two cases, one to maintain the waterproof-ness, and another for day to day use that allowed access to the control pad on the CGM:

    And this worked well for kindergarten, when combined with a "fanny pack" that holds other essential supplies, it made it easy for Evan to keep with him. He rarely wears it, but it is a nice option to have. 

    For 1st grade, we wanted to shrink it down further - custom PCBs & 3D printed cases came to mind, but for our hack, these fly cases work well and don't cost very much (~$20).

    The trick then is to find a SMALL Android phone with OTG capabilities. They're rare, and the trend in phone design is headed in the wrong direction... as far as this project is concerned. So, we dip back in time and try out an Xperia Ray  (c. 2011). The G4 & Xperia Ray are very similar in size, so I put them in the smallest fly box (~3x5)... it works great, and is much smaller than "last years" model.

    Now, the Ray is a less than ideal selection for other reasons: 

    it must be "rooted" to work

    The battery is small (~13 hours before needing recharge)

    It's old

    So, when I first began helping people get their own ambulatory system setup, I recommended the Moto-G.

    Not too big, inexpensive off contract, and a quality product. It has proven so popular that others have come up with this:

    Beautiful! And a testament to the benefit of making all of this open & crowd sourced. Brilliant people contribute their skills to project and share it with thousands that may benefit.

    Here's a rough sketch of a universal cradle design. Primary purpose is to remove the wear and tear and undue force on the G4 receiver's USB port.

    With a few cables to choose from, we can connect to most phones. I think bottom ports are most common on phones, but there are a few with side mounts (Xperias come to mind) that I'd like to handle, too.

  • UI Refinement

    15 days ago • 0 comments

    We made significant updates to our system this past summer -  a streamlined web app interface, a more portable and reliable "rig" were our highest priorities. 

    Here I'll discuss a few of the changes we made to our web views...

    Current chart & care-portal:

    Grabbing all the data is only useful if it is actionable. Making a useable chart view or watchface is not always as simple as it seems. What works for me, may not work for my wife, the school nurse or others.

    Our initial view was simply blood glucose and trend,

    We added a chart as others began to participate and collaborate (Lane D. Ross N. of Nightscout fame), and we added a "care-portal" to pull in even more diabetes data in real (or close to it!) time.

    Our initial care-portal, used for Kindergarten:

    The squares on the chart are treatments: insulin dose, food, blood glucose check, or even notes or questions. Once someone enters it, it is added to the chart, and a tooltip will be displayed when clicked or tapped. I made sure the site was responsive, as we like to log or view data from whatever device is handy.

    Recent updates followed this responsive design, while also allowing for a faster logging experience and use of CSS media queries allows us to customize for devices, even for orientation.

    Here's a look at the menu on an vertically oriented smartphone:

    In landscape mode, we display a larger chart for better retrospective analysis and scrubbing:

    A larger tablet screen gives us the best of both worlds - a large number and arrow for the current blood glucose data, and a big chart for a quick look or deeper dive into the data:

    One enhancement currently in progress is a "time of day" customization of the menu, more specifically the treatment logging. 

    As person with diabetes or parent of a child with diabetes can tell you - overnight can be a challenge. Without a continuous glucose monitor, many of us set alarms to make finger check measurements  to ensure blood glucose is in a safe range. Now, with a CGM, it alerts us to possible highs and lows, and, bleary eyed, we make corrections. We either give insulin for a high or glucose for a low - and logging this data accurately in a sleepy stupor can be tricky. What if one parent corrects right after the other, not knowing a correction was already made? 

    Laura suggested a "fat finger" interface, and I am current;y working to make that interface come and go by time of day:

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