Remember how years ago, Ford was working with Medtronic on technology that would weave diabetes data into vehicles?
Well, that concept came and went with both companies eventually abandoning the idea and moving on to other things. But with Bluetooth tech and connected smartphones and devices becoming ubiquitous, we've reached a point where #WeAreNotWaiting for that capability to find its way to us behind the wheel.
A number of people in the energized do-it-yourself diabetes tech world -- specifically the active CGM in the Cloud community on Facebook -- are sharing that they've successfully connected their Nightscout / xDrip systems to their vehicles, and are able to view their diabetes data on dashboard screens while driving.
This is super-exciting, but also brings up the inevitable safety concerns of distractions to drivers.
Automobiles are very much on my mind this week, as here in Metro Detroit the dynamic Woodward Dream Cruise starts Saturday, with car lovers convening from all over the state and country to show off and view classic cars. So it seems like a perfect time to reflect on how modern vehicles are giving people with diabetes (PWDs) and their loves ones more options to view data while on the road, a far cry from where we were just a few short years ago.
BG Data in Cars - Then and Now
First, a flashback: Medtronic had this in their sights back at the 2008 ADA Scientific Sessions, when 'Mine editor Amy Tenderich got a glimpse of how the pump-CGM company had built a CGM system into a dark blue Lincoln sedan, using a large color GPS screen configured to pick up real-time glucose data.
Back then, the screen display was clearly incredibly distracting -- i.e., a major road hazard! That partnership evolved with Ford Motor Company over the years into 2011, with a Welldoc Messenger car system, and was still on the radar after that with Ford showing off the concept at local JDRF events here in Metro Detroit (you know, 'Motor City') and how the Ford family was touched by type 1 diabetes.
Fast forward to 2017, and we heard in January that the Medtronic partnership with Ford had been scrapped -- most likely due in large part due to how far consumer technology and Bluetooth capabilities have come in the past several years, making it easy for a variety of players to develop similar solutions.
In fact, several automakers are now building this capability into their vehicles, using the interfaces Apple CarPlay and Android Auto that are specifically designed to allow drivers to hear and respond to texts using voice commands, and to safely use other smartphone features and apps on a car screen. This is already available from a number of car-makers including Audi, BMW, Buick, Chrysler, General Motors, Fiat, Ford, Honda, Nisan, Subaru, and Tesla.
Of course, that opens the door for the tech-savvy folk in the Diabetes (#WeAreNotWaiting) Community to start tinkering with their own ways to get real-time diabetes data behind the wheel.
#WeAreNotWaiting Behind the Wheel
In Colorado, type 1 PWD and D-Mom Laurie Schwartz (diagnosed herself a few years ago at age 49) has her CGM with real-time diabetes data connected to her Tesla to keep tabs on her own BGs, as well as data from her 14-year-old son Adam who was diagnosed at age 5.
They both use the Dexcom G4 and xDrip data-sharing app, and they have a dozen or so setups in each room of their house to track their data trends while at home, so they don't lose signals and don't have to carry special devices around to connect to the cloud.
Laurie says when she's not driving her Tesla but is in a different vehicle, her iPhone is mounted on the dashboard, displaying the CGM monitor for two, and there's typically not a situation where she isn't driving without a display locked on. She sent along a photo with her own Nightscout data on the right side and her son's display on the left:
"The utilization of instant info on displays is instrumental to our goal of tight control," she says. "Glance-able devices and the ability to collectively assist each T1 family member through a team approach has been crucial for safety. I can see an issue, and hands-free call a suggestion, and then see the correction on the display."
Some folks are even buying cars with this specific feature in mind. For example, another well-known #WeAreNotWaiting DIY enthusiast is Melissa Lee, a longtime type 1 advocate and blogger who uses CGM in the Cloud tools and a do-it-yourself closed loop. Her husband Kevin is a programming genius who helped build Nightscout over the years, and now they both work for Bigfoot Biomedical developing a next-gen automated insulin delivery system. Unrelated to the job, Melissa says they actually recently bought a 2017 Honda CR-V specifically for this purpose of being able to beam diabetes data to the vehicle's display.
Right now, they're viewing a Nightscout screen via the dashboard's web browser and you can see the top blue line is the Loop dosing line, displaying the temp basal rate and some other Loop info inputted into NS app. But it doesn't work while the car's in motion, as a built-in vehicle safety mechanism. Kevin plans to fully hack the Android operating system on the car, so it's a work in progress for them.
Even my own mom (a veteran type 1 herself who has all the modern gadgets and is using a do-it-yourself looping system) has an interest in this, using Apple CarPlay to connect her D-data directly to her 2017 Ford Escape. She hasn't set it up yet, but says it's easier to view when driving than having to glance at a smartphone or Apple Watch, especially since the watch doesn't always keep up with real-time BG data.
Getting Serious About Safety
Safety issues are top-of mind-these days, with many states enacting and enhancing laws cracking down on distracted driving and hands-free tech, even to a point where only "limited finger movement" is allowed when touching a mobile app during driving, as specified in Washington state's new law.
Distracted driving is no joke, and more studies and groups -- including the National Safety Council -- are urging people to be mindful of the serious risks, in that even hands-free tech can still be dangerous and lead to distracted driving.
Apple is supposedly soon going to lock down their tech so that iPhones can't connect to text messages or Bluetooth while a vehicle is in motion, and Nissan has proposed adding a so-called Faraday cage to its cars, a box built in to the car that would block radio transmissions of any kind from reaching the phone.
And an interesting sidenote is that more states are exploring driver's license restrictions for PWDs -- especially those with a history of hypoglycemia that might impair driving. This could present an interesting dynamic on whether Auto D-Tech could actually benefit those who face these issues or present "Big Brother" concerns about auto insurers monitoring D-Data... yikes! On the other hand, just think about the future possibilities if these data-connected vehicle displays get smart enough to recognize hypos when a car starts up, and possibly prevent people from driving -- much like some cars have an ignition lock that triggers if a driver's breath test detects a certain amount of alcohol.
You never know.
From those we've talked to using D-tech to view blood sugar data while behind the wheel, they are aware of the potential dangers but emphasize it's not really any different than taking a quick look at the radio display or GPS screen on the dashboard, and that having their D-data right in front of them is certainly safer than having to turn your eyes away to view a separate device.
"Safety is improved with glance-able displays. No delay of looking at a watch, device or phone -- it's just right there," Laurie says. "Any new device or display option that seamlessly assists allowing the focus of diabetes management to be performed improves safety. I would say that for our family, having a mounted display in the vehicle is required for the diabetic driver or caregiver."
Fascinating to see how far we've come in just the past few years, and we fully expect to see more PWDs live-streaming their diabetes data to vehicles as we drive into the future.