No single insulin pump has everything I like, but there are bits and pieces in each device that I'd love to be able to combine into a dream device of my own. I'm sure many of you PWDs out there can relate.
A few of us in the DOC (Diabetes Online Community) had some fun on Twitter recently tossing ideas around, and that prompted me to compile a kind of "holiday wish list" based on the idea of "Build-A-Pump." Think of it as being able to personalize your medical device using selected Legos or puzzle pieces.
Hey, this isn't as far-fetched as it seems! The idea already exists with a concept called PhoneBloks, a mix-n-match type of phone that would be customizable for each person, that made news earlier this year. Motorola is already working on making this a reality. Love it!
And heck, if the experts can do it with a smartphone, why not with an insulin pump? OK yes, there are big obstacles in the medical realm in the form of Regulatory authorities, and potential health/safety impacts, but we PWDs can still dream... and just maybe some of what we dream up could be realizable in the near future.
So all that said, if I could create an ideal D-Device out of puzzle pieces of my own choosing, here's what I'd like it to include:
Tandem Body and Style: I'd go with the sleek Tandem t:slim's body and touchscreen, without a doubt. This is how a medical device should look in 2013, and the size and design are exactly what I'd want. I like the little grey 'T' (Tandem shoutout) to the right of the screen that serves as a practical way to take you to the homescreen from anywhere -- unlike other pumps that make you scroll through multiple menus just to find the homescreen choices. My only change would be to make sure the pump face is easily viewable in sunlight, which the current t:slim is not.
Integrated Dexcom G4: Of course, I want my CGM (continuous glucose monitor) to connect with my pump, the way current Medtronic systems are designed, and how the Animas Vibe and t:slim will ultimately be connected once this combo is approved and becomes available (hopefully in the next several months!). But I'd want my CGM to have a similar look to the current G4 receiver, except displayed on the t:slim face. The sensor should be modeled after Dexcom's too -- or even smaller. Smaller's always better. Not to mention the dream of a single infusion site...
Interactive CGM Graphs: I like how I'm able to scroll back through the results stored on the Medtronic CGM to any point in time and see what my actual blood sugar numbers were, instead of how Dexcom just gives you a line graph for past timeframes but no specific numbers. So, I'd build that Medtronic feature into the t:slim + G4 screen.
Low Glucose Threshold Suspend: Medtronic has it, and I want it. But I want the Dex G4 accuracy and sensor, not the Minimed one, so I'd mix these features into my customized device.
State-of-the-Art Wireless: Since Tandem has Bluetooth already inside the pump but it's not turned on, I would flip the switch so my dream pump would allow for seamless data streaming to any smartphone or tablet device. Naturally this should be the latest & greatest, i.e. Low-Energy Bluetooth, which has the advantages of low power requirements, small size and low cost, and compatibility with the biggest variety of mobile phones, tablets and computers.
Glucose-At-A-Glance: In an ideal world, CGM would be accurate enough that we would no longer need fingerstick meters. But assuming we still do, I'd like to also have access right from my pump to at least some of my glucose meter data -- a pump-displayed logbook, basically. Bluetooth technology ought to enable this easily. In fact, my new system should be able to access and display data from whatever meter or app I might choose to use alongside it!
Simplified Button Pressing: Entering commands needs to be safe, but as low-hassle as possible! With the t:slim, you have to click multiple confirmations every time you want to do anything -- from giving yourself a bolus to changing settings. I get that it may be an FDA safety requirement because of concerns over the touchscreen getting activated accidentally, but there has to be a viable compromise that's less annoying. (The t:slim requires no less than 14 button-presses to bolus - oy!). My dream pump would maybe have a one-click "confirmation button" on the side that would help reduce the steps and make entering commands more practical. Or maybe it could be voice activated, using futuristic technology that would know the unique tone of my voice.
Insulin Cartridge: Again choosing from existing technology, I would pick the Asante Snap variety of pre-filled glass cartridges that carry 300 units of insulin. Of course the cartridges should be available with any fast-acting insulin variety I choose, and not limited to Humalog as they are now. (Like the visionary PicoSulin pump entered in our Design Challenge back in 2009!)
Reverse Corrections: When I'm below my ideal blood sugar range and indicate that I want to take a meal bolus, I want my pump to recognize the situation and automatically reduce the bolus delivered. If I'm low, I may not be thinking too clearly, so why shouldn't my pump be able to do the opposite function of what it currently does in calculating corrections for highs? Simply put, the pump should be able to calculate lopping off some suggested meal bolus insulin based on an undesirably low starting BG.
No-Brainer Bolus Calculating: Some pumps currently require the user to re-enter the amount of insulin desired after the system has calculated the suggested dose based on a BG reading and carb-count entered. Why? The pump should be able to retain its own information and act on it without forcing the user to manually re-enter that data. My future dream pump is going to make my life easier, right?! So heck, why don't I just wish for a built-in optical carb scanner too, that can assess fresh food as well as reading nutrition labels. Now we are talking real life improvement!
In all seriousness, wouldn't it be great to be able to personalize our devices with selected features? At the very least, like when you buy a car and you can choose from a variety of features and specs. But we'd need to steer clear of the "have-nots" problem, where the richest patients get the super-devices while the rest of us have to settle for basic models. *sigh*
Anyway, it's been fun imagining some possibilities...
Now it's your turn, Dear Readers: What would you choose to include if you could Build A Pump with interchangeable parts?