back to article NHS diabetic gizmo will text for help if wearer is in danger

Scientists from Swansea University are collaborating with a consortium of Welsh technology companies to develop a blood glucose-monitoring sensor that can transmit readings to the mobile phones of NHS staff. The university's Centre for Nanohealth and its e-Health Industries Innovation Centre are working on a project to develop a …

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Stop

Repeat till fade.

I've seen this gravey train running for years and years now. 30 months from now there will be no announcement that the project will be wound up, ideally with another similar one. And on it goes again.

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I want one

I'm a diabetic myself and I nearly killed myself at the weekend. Got pissed and took the wrong kind of insulin by accident (triple the usual dose for that kind). Not pleasant. There's a good chance I wouldn't be writing this now if the Missus hadn't come downstairs to find me.

I'm all for a gadget that would save idiots like me from themselves.

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Anonymous Coward

A cure

What are you, type 2?

If so, give up refined carbs! Refined carbs are basically anything with sugar or white flour in it. Both are the cause of your condition. Just eat naturally, dairy, meat and vegetables and you will see your condition go away. It is that simple! Refined carbs are alien to our body and cause all sorts of problems, including hypertension, heart disease, and cancer, as well as diabetes.

For a healthier life you might also consider giving up the grain (bread, pasta, cereal etc).

There are plenty of sites on the internet that help you with your diet. Look at the primal diet for starters.

The same may also apply to type 1 but I have not looked into that side yet!

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Anonymous Coward

Diet

AFAIK diet can be used to control type 2 diabetes in many cases depending on the severity. Sometimes it's pills too. More severe and you're on the insulin injections.

Type 1 OTOH, is caused by a duff pancreas and no amount of careful attention to diet is going to fix that.

Type 1 and 2 are really quite different problems, but with similar symptoms. It's a bit like the difference between having a limp and missing a leg. Both will cause problems walking but only one is going to be fixed with a bit of physiotherapy.

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FAIL

Such a gadget already exists

It's called a "brain" and reputedly, it comes as standard on humans.

If your wife hadn't come downstairs then someone would still have written your post - as your well-deserved nomination for a Darwin Award. Did you not listen when the endocrinologist told you to drink alcohol only occasionally and always in moderation? NOTHING screws up your blood sugar levels like alcohol, while at the same time it impairs your ability to notice the symptoms.

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Headmaster

Not a cure

This certainly doesn't apply to Type 1.

All food gets converted into carbohydrates (glucose) in the body, but some foods take longer than others. Insulin is needed to metabolise the resulting glucose into energy that the body can use. Type 1 Diabetics don't produce any insulin, so blood sugar goes up to dangerous levels regardless of what's being eaten. Refined carbs will increase blood sugar quicker than proteins and fats, but it all has the same effect eventually. Injecting insulin is the only way to manage Type 1 diabetes. Low blood sugar is what happens when too much insulin is injected, as Mike Bell has pointed out rather vividly.

Type 1 diabetics on a basal bolus insulin regime (one or two slow-acting insulin doses per day, with fast-acting insulin injected at mealtimes) can benefit from fewer insulin injections if carbohydrates are avoided. The basal dose works over a 12 or 24 hour period, so covers low GI foods like vegetables and meats. For example, a fried breakfast (without hash browns or toast) needs little or no insulin because the basal dose can deal with the slower release of glucose.

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FAIL

@AC 11:23

If only curing major diseases were that trivially simple!

Now you have sorted out Type 2, I'd progress onto Type 1. Then it's a cure for cancer. You ought to be able to find a cure for death next, before you die.

Ah...

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Flame

@Jedit -- Bloody moralist!

How a bit of empathy for a change?

Life's not that simple, things often fuck up and go pear-shaped. And living with diabetes can be restrictive and debilitating. People's temperaments and moods change from day to day so their management of the problem varies.

I don't have diabetes and I'm damn glad I don't, but I've had to rescue someone from an insulin coma. Even with careful monitoring, I've seen how insulin and sugar levels can go awry.

Shit, I used to think I was a cranky irritable didactic bastard, seems others are worse.

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@Jedit

You're an idiot. Obviously stupid, and lacking the basic means to think things through before shooting your mouth off.

In other news, several insulin pumps, like the one mentioned in the article, are able to send alerts wirelessly (via Bluetooth or wifi) to their paired receivers. The Omnipod, for example. It is a miniscule modification to include a wifi transmitter and a little software to specify recipients of alert notices via email/SMS/whatever.

What is most remarkable about this article are two things: (1) That the GOVERNMENT believes that a good way to spend your money is to develop a medical device that has already been developed for the most part by PRIVATE industry and (2) that they would allocate so much of your money (not my money ... I'm in the USA) to the task. I mean, almost everything about this device already exists in products available on the market right now. Does it really cost that much money to be able to include the NHS in the list of alert recipients? And why does the NHS need this info? Are they going to call an ambulance, or something?

This sounds a lot like yet another way to spend your money. After all, if they admit they don't need it, then they won't get any more of it, will they?

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@Stupidscript

2 things:

1 - I've just re-read the article and I can't find any mention of a specific pump. Did I miss something?

2 - All insulin pumps that I am aware of (including the Omnipod you mention) don't read blood glucose levels: the patient has to manually check their blood using a finger pricker or similar then adjust the pump accordingly. The device highlighted in the article is a blood glucose reader, not a pump.

To address your points:

(1) The GOVERNMENT is giving a grant to an academic institution who will, if successful, develop this as a PRIVATE company. Is that capitalist enough? Private company gets free money from government!

(2) I'm completely happy for MY money to be spent on something which will help thousands of my fellow diabetics and, thanks to the GOVERNMENT, we won't have to pay extra for.

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Rubbish

Diabetes doesn't "just go away." There are more than enough ignoramuses peddling "cures" out there already. And your recommendations would kill the average Type 1 diabetic in a week or two.

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Lack of sympathy is not lack of empathy

I have also seen insulin levels go awry, in my case first hand, because I've been a Type 1 diabetic for 13 years. And yes, sometimes I would like to have a couple of drinks or a Snickers bar, so I do empathise with the poster in that regard. But I don't actually go out and *have* those drinks or that chocolate, because to properly control my condition I have to practice self-control. As a result, in 13 years I've had only one major incident - an attack of diabetic ketoacidosis in December 2009 triggered by the flu - and no long term damage.

I have no sympathy for people who ignore their doctor's advice and jeopardise their own health, nor should I be expected to. Apparently this makes me an idiot - but as I'm an idiot who has no impairment to his sight and no nerve damage, and plans to stay that way until a cure is found, I consider myself ahead of the game.

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I really want one of these

But will they release an app so you can monitor your levels yourself? I'm not fussed about alerting medical professionals really but being able to fire up an app that told me what my glucose levels were (and even better the direction of travel!) would be really useful!

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Happy

A wonderful idea.

Having had to help someone who had fallen into a diabetic coma, I can only agree with Mike Bell's comments.

It's a tragedy there isn't more of this kind of surveillance than the traditional kind that we're all too familiar with.

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Arthur C Clark again

Reminds me of one of Arthur C Clark's ideas

One of his characters wore a heart monitor that would make announcements like "I think you should take it easy", "you should lie down and rest", "I have radioed for assistance, an ambulance will be here soon" and "if anyone can hear this please assist"

I thought it was a pretty cool idea for the 1970s

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Joke

The world of the future

Made in Wales.

Seriously *continuous* monitoring is tricky. Either you break the skin (infection, ulcers etc) or find some clever way to look at the glucose level through it.

Of course people have been talking about active monitoring/implantable pumps to do this since the 1970's.

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Coat

Alternative text message?

Gimme sum suga baby!

Sorry, I really shouldn't pretend to be in touch with youth culture!

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Anonymous Coward

KISS

Why do these projects start with a complex solution as the starting point.

For most Diabetics - something that goes Beep when sugar levels drop below a trigger level would improve life 10 fold.

Then when that is working develop the rest.

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Spot On

Something like that would be HUGE. But I can't really think of any health system that is really looking for good solutions - they want the big money solutions.

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Alert

How does your gizmo know when to beep?

Surely it would have to know your exact blood sugar level: I think that might be the complex part!

Once that problem is cracked I imagine that adding a display and wireless communication are trivially easy.

I wish the university team every success with this.

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Big Brother

We're all fixated on point in time levels...

But as Matt_V says, direction is much more important.

I'm going to bed, I need my long acting insulin, and my blood sugar is 7.8 mmol/l. If that is on its way up, I don't need to eat anything. If that's on its way down, boy do I.

My current option is retest 10 mins later. Okay, not difficult but not ideal.

I'm looking forward to a solution to non-penetrative testing as that's ultimately what will drive advances in Diabetes monitoring and management, however I suspect that this isn't going to achieve it.

Equally, I'm not that sure I'd want the NHS having the ability to constantly receive data on my current blood sugar. They are frequently poor at using data properly anyway, and this will just confuse them more. Additionally, more data, more opportunity for an insurance company, for example, to demand constant info on your diabetes control prior to any kind of insurance policy...

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Do another blood test 10 minutes later

Yup and then get told off for doing too many checks / using too many test strips when you try and order more....

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WTF?

@Matt_V...

I used to get told similar to that until I moved to an area where they are a bit more enlightened.

Ask your GP how much extra it will cost the practise to deal with the complications that may arise from your inability to keep fine control of your diabetes!

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Too many strips?

If you are type 1 and your GP tells you off for using too many strips, then report them to your local PALS (Patient Advice and Liaison Service). The strips are cheap compared to a visit to casualty in an ambulance.

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Alert

Location Data?

Will the people monitoring the device get location data as well? Or just a warning that sends everyone into a nationwide panic looking for the sick person? Most fatal blood sugar issues happen because there was no one around to help when it happened.

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DVLA - losing license

The problem is, the new EU law that has come in where if a diabetic has 2 or more cases of having low blood sugar (hypoglycemic) within a year, then they lose their driving license. So, if the doctors are receiving these texts then they have to by law report them to the DVLA.

The only way anyone would use one of these is if they are unable to tell themselves if they have low blood sugar - to use it as a life saving device only.

However, I wouldn't mind a device which can report and save my blood glucose levels throughout the day, but only ever report them to me (my mobile).

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Re: DVLA - losing license

@Chris 100

This is not the case. You have to report if you have unrecognised hypoglycemic episodes or more than one hypo per year which requires intervention of another person. If you don't recognise when you are getting hypo, you shouldn't be driving anyway. If you do recognise the symptoms when driving you MUST stop and take some glucose and test until your Blood Glucose is back above 4mmol/l

The details of the DVLA recommendations come be found here (and the recommendations have little to do with the EU):

http://www.diabetes.org.uk/Guide-to-diabetes/Living_with_diabetes/Driving/Informing_the_DVLA/

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Big Brother

Oh dear...

One of the problems seems to be that Doctors are trying to keep blood sugar levels as low as possible. I'm been told that doing so can reduce the detectable warning symptoms, as your body gets used to the low level, but this aggressive control of blood sugar will reduce other side effects

And if you have hypoglucemia without warning symptoms, the DVLA will take away your driving licence. Scylla and Charybidis, gentlemen, and sjall be the one trapped between them. I am the one on the spot, who can take the immediate action, not some NHS Worker, based at a hospital some 15 miles away. The tech might make a big difference. This application seems less than helpful.

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I already have a GCMS....

But all in favour of more research and improved sensors. The current crop of sensors all require implanting under then skin so if they could develop a non-invasive one I would be happy. Not too concerned about the txt messaging. That part doesn't/shouldn't be built into the sensor anyway, the sensor just needs to communicate with its controller, if you want to message, get the controller to do it.

I'll be even happier if the price comes down. The CGMS makes a significant difference in glucose management but now that I am self funding rather than on the NHS the cost is too high for me to use it all the time so I typically use it for 2 weeks every three months to make sure I have everything trending ok.

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Alert

Seem to recall reading somewhere about

A variant of pulse oximetry that measured blood glucose by sensing the slight change in differential absorption of red blood cells as glucose varies.

Seems that by compensating for the (large) change caused by blood oxygen concentration it is possible to calculate glucose level by measuring it with conventional stick sensors, at a range of blood oxygen levels.

Sounds doable, I think the problem here is that the changes involved are very small and significantly affected by skin density which changes by location etc.

Perhaps using something like an optical shunt (my idea) implanted through the skin in much the same way as the OOKP device used for repairing the eye.

-Andre (B.Sc hons Med Elect)

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IT Angle

Wrong answer, right problem

Texting or alerting an NHS professional is a silly way of solving this problem. The first thing to do is alert the diabetic that his or her blood sugar is dropping. They will normally have time to deal with the problem themselves. If they are asleep the alarm would be via an alarm or phone call. Only if the glucose level kept dropping do emergency services need to be warned. For those who live on their own the best emergency service is probably their next door neighbour.

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