Through my work with several diabetes centers, I know that the rates of new onset type 1 diabetes cases has skyrocketed lately. In fact at one center in Texas they have seen a consistent influx of new cases double the rate of normal starting about 9 months ago. Other centers are talking about this too although nobody seems to have a very good handle on this in the US. The new cases of diabetes aren’t normally reported (and not required by law) so there is only informal data and the centers are slow to check around and to let other centers know of their own experiences.

Now a couple of reports just came out at the ADA Scientific Sessions that nails down that there is in fact an increase on an order of magnitude. The reports come from Finland, the world’s highest rate of type 1 diabetes at 41 cases per 100,000. This is double the rate since 25 years ago.  They are projecting another doubling to a rate of 80 per 100,000 in the next two years.

The second report comes out of Canada and it backs up this notion of doubling that is slowly raising awareness:

A second report by researcher Jeffrey A. Johnson of the University of Alberta, Canada, echoed that. Dr. Johnson and colleagues found the prevalence of diabetes under age 20 increased by nearly 50% in the last decade, from about 19 per 10,000 in 1995 to 28 per 10,000 in 2006. The rise was most dramatic in younger children, leaping 93% in the 1-4 year-old age group; 51% for 5-9 years, 42% for 10-14 years and 30% for 15-19 years during that period.  The data do not differentiate between type 1 and type 2 diabetes, he said, but “the incidence is rapidly increasing and it is likely to be due to an increased incidence of type 1 diabetes.”

So what does this have to do with Arizona traffic… or any traffic scenario in any large city? You can only send so many cars across the given traffic grid in so much time… Unless you expand the grid or somehow make the grid smarter - more efficient. In Chandler, Arizona, a suburb of Phoenix, they experienced tremendous growth and still are. The city planners should be congratulated since they approved an extensive rework of their traffic management systems and installed a series of “smart cameras” at each intersection and implemented complex analytics in a centralized management system to automatically change the timing of lights at each intersection, automatically alert the traffic manager of accidents or malfunctions, etc… in order to maximize the throughput of traffic and improve safety for the city’s drivers and pedestrians.

Of course the other or more obvious thing to do is build more roads.  That’s what the construction lobby would propose. And of course they did build roads. Only problem is that new roads don’t remove the bottlenecks (intersections). You may have actually intensified the problem though since now more cars can arrive at the same intersection at the same time.

This is exactly what is happening to people with type 1 diabetes compounded by the simultaneous rise in type 2 diabetes in kids who are seen by these same physicians and diabetes educators.

There is a shortage of qualified physicians, especially those with pediatric credentials needed to deal with the vast majority of these new onset cases.  Some people say add more pediatric endos.  Suggest that solution to a pediatric endo and you’ll either get a laugh or a smack across the chops. Let’s just say that while we do need more it’s not something that will happen soon enough at a rate to keep pace with the onset of type 1.  In other words, just “building more roads” won’t solve the problem.

I guess we had better look at information technology akin to those smart cameras to increase the efficiency and reach of the qualified people we already have then.  That includes pediatric endocrinologists, pediatricians, diabetes educators, pharmacists, social workers, family psychologists and family members to name a few. Would it be possible to borrow from the concepts deployed in Chandler’s smart traffic system? Can we increase the effectiveness and efficiencies for the rare but skilled pediatric endocrinologists and their support staff? Can we increase the flow of knowledge to the newly diagnosed so that they can be better prepared to manage their own diabetes most of the time? Would it be possible to head off a dangerous episode of DKA before it forces the patient to visit the emergency room?

Yes we can and it’s called ADMS™ - Automated Diabetes Management System. Truth is that ADMS started its deployment even before the City of Chandler had completed their traffic system. I actually met with the man leading the project back in 2003 as part of our research behind development of ADMS. Our smart cameras include the GlucoMON®, HomeCheck™ and a few other devices. The intelligent analysis is taken care of inside of GlucoDYNAMIX™. And rather than send all of the exception reports to a traffic manager, we spent additional time figuring out how to get only the useful information, at the right time to the right person - automatically - ADMS is the traffic manager.

As for our smart cameras, we use those too inside of our Diabetes Housecall program. Imagine what it must be like to leave your car in the garage, no waiting room, no waiting. Just log on with your web cam and have a 30 minute one on one 3 times per year plus at least 1 visit per year face to face (vs the typical 5 minute drive by). Your diagnostics are already in front of your endo including your blood sugar profile, your A1c and any other data needed for the visit. This program is the first of its kind and growing rapidly in Texas and Iowa and soon in a few other states as well.

So much like the people of Chandler, Arizona, people with diabetes who want a safer and more efficient system now rely on Diabetech®’s ADMS technology and programs like Diabetes HouseCall™ that wouldn’t be possible without it.

It’s always nicer when someone else is talking about the virtues of your product.  Being compared to the simplicity of Google’s gmail and online applications was especially sweet.  Thanks David!

“The Simple GlucoMON”

“It works in a similar way to Google’s Gmail and Google Docs that I completely rely on nowadays. GlucoMON® even does Google one better. To use it you don’t need an Internet connection. Or even a computer. Or a phone line. And soon you won’t even need electricity for it.”

“… especially attractive to parents who have children with diabetes in school.”

“I have seen and used lots of different log sheets and in fact link some of them on my website. But none of them hold a candle to the GlucoMON’s report, which is not only automatic but also logs blood glucose results in hourly time-slots, highlights highs and lows, and makes trend analysis simple.”

— David Mendosa, a writer on the web

Read David’s complete review of the GlucoMON-RT commercial offer at Healthcentral.com

Thanks to an initiative sponsored by Microsoft which opened for submission on Feb 25 described as a way to jump-start the online health ecosystem, we have accelerated our plans to complete the integration between Diabetech’s real-time Automated Diabetes Management System and Microsoft’s HealthVault platform. The timing couldn’t be better as it coincides with the commercial availability of several Diabetech programs and the launch of our new global GSM/GPRS wireless & mobile device platform.

“Hold on there! What about and their $10M competition for Android applications (Google’s open mobile phone platform)?”

(In the event that clicking on the image tells you the clip is defunct, try this link: http://www.youtube.com/swf/l.swf?video_id=1FJHYqE0RDg)

I can think of just a few apps we could build on Android that function as an extension to ADMS in the field of diabetes care and beyond.

Of course, Google beat Microsoft to the punch when they announced this back on Feb 18! I fully expect Diabetech to be in the mix with Android based apps as well but those are perhaps a little further out for us than today’s announcement.

We’ve always believed that it’s important for patient’s to have choice and control over their own health data. Likewise, it’s critical that providers have an environment that standardizes the way in which they deal with patient data. That’s where this likely combination comes in. By combining the flexibility of patient data collection with established protocols and an easy to use portal by the endocrinologists, diabetes educators and other providers needing or contributing to the overall patient record, everyone wins.

Not only will we see the various technologies coming together, we are also bringing a committed and geographically dispersed team of diabetes specialists with us given that we’ve already earned the incumbent position as their diabetes health care extender. This ensures that the technology will actually get used. Unlike the days of the bubble when nobody seemed to care about what happened after you built something, this time we already have a head start with an active subscription-based consumer driven patient community, regional health centers, endocrinologists and CDEs actively working more efficiently with their patients through our ADMS and even the prospect of insurance reimbursement for our Diabetes HouseCall program looming on the horizon led by the likes of Aetna and Cigna.

Over the next couple of months, Diabetech will be developing its contribution to at least two consortiums targeting new models of diabetes care delivery. The first is obvious given our pioneering and leading position concerning children and their families with type 1 diabetes as well as the schools and churches who also play a role in keeping these kids safe. In addition, Diabetech’s technology and programs will be proposed as a better way to care for kids and their mothers even before they are born as in the case of gestational diabetes. Through more effective screening programs and active management via remote patient monitoring, complications are likely reduced thanks to a proactive model including advanced patient-centric self-care tools and remote provider interventions.

Stay tuned for announcements including the diabetes specialists signing on to this initiative and an eventual announcement regarding Diabetech’s strategic partners on these proposals. For more details on the Microsoft HealthVault Be Well Fund initiative, head on over to Microsoft and get familiar with their offer.