I know everyone wants their diabetes devices to talk to the cloud, but I don't think that smoke signals are the best way to go about it. And I'm pretty sure that using smoke signals would be faster than using the new Bee "Diabetes Smart Tracker" from the company Vigilant in Switzerland.
Really, I would have expected the country that brought us the Swiss Army Knife to have done better by us.
Never heard of Vigilant? They're not so much a medical device company as a company that connects things. Vigilant also makes a floating Wi-Fi swimming pool thermometer and UV sensor, a smart phone-controlled home air filter, and a children's toothbrush that interacts with an app that tracks where in the mouth the brush has been, pointing out any teeth overlooked during the brushing process. For those of us in the diabetes universe, their Bee product is supposed to be "the world's first Bluetooth-enabled smart insulin tracker" that uses wireless tech to beam shareable injection and blood sugar data to an app residing on a smartphone or a tablet.
Unveiled first at a local American Diabetes Association Expo in Denver, CO, in February and then displayed at ADA's Scientific Sessions in June, Bee hit the market in the U.S., China and Mexico this past Spring and goes for $69.99. There's also a multilingual European Bee+ in Switzerland.
The main offering includes adapters to click the Bee right onto an insulin pen, where it's touted to function as a tracker-cap. But in the U.S., so far only the "Pocket Version" ($59.99) minus the pen cap options is available, while FDA reviews the various adapters.
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Now wait: an insulin pen cap that keeps track of your injections and even your diabetes data? You may be thinking it sounds a lot like the ever-popular Timesulin pen cap that is now just entering the U.S. market, or even the NovoPen Echo that came out early in the year.
To me, it's hard to compare the three. Timesulin only gives you a countdown on an injection from when you took the last one. Echo gives both the volume and the time of the most recent dose, which more times than not is all you need. But Echo can't store or download data, so it's good in the moment but no good for Monday Morning quarterbacking on insulin doses.
In theory, the Bee would let you combine your BG and Dosing data in one place. I say in theory because it's a lot of work and I doubt most people will bother with it. This goes for syringe-and-vial users, too, as they're encouraged to use the Bee Pocket Version for tracking.
The Vigilant folks have pretty smooth marketing materials that state: "Bee helps patients by creating a log book of insulin injection and blood sugar level data which they may share with their loved ones and healthcare providers." And that's true, to an extent. Provided those same patients have a Zippo lighter, some kindling, and an Indian Blanket on hand (smoke signals, remember?)
First off, Bee is BIG. It looks more like a bottle of Dex4 glucose fluid than a pen cap. It's 2.75 inches long and one inch across at the widest point. Attached to my Echo pen, it feels like I just bought a turkey drumstick at the county fair. If it weren't so lightweight, it might make a formidable martial arts weapon.
The Bee comes with eight adapters that allow it to fit on every insulin pen you can think of. (Note: I got a review version, since these adapters are still pending FDA approval.) These grey plastic tubes slip over the front half of the pen and serve as the new cap, and the Bee device screws onto the adapter, making any insulin pen three to four inches longer. Supported pens include the Novo FlexPens, FlexTouches, all the NovoPen models, the KwikPens, HumaPens, SoloStars, and several other pens not seen in the USA. But beyond this admirably wide adaptability, I found the Bee to be poorly thought out, poorly designed, and poorly manufactured -- IMHO.
Unlike the Timesulin insulin pen cap and timer — which at least is activated by pulling the cap off the pen — the Bee and the pen don't interact in any way whatsoever. The Bee is a manual device that is completely independent of the pen. It just perches on your pen like an oversized parasite. According to Vigilant, the Bee will store up to 200 records and, when linked, transmits them to its app via Bluetooth.
Problems from the Onset
The images in the one-sheet manual (I received a first draft, they tell me) and the device itself looked so different that at first I thought maybe I'd been sent the wrong thing. The instructions kept referring me to a Bluetooth light that was nowhere to be found on this drumstick. And it went downhill from there. I had to email Lara Loveman, the VP of US Operations, to figure out how to mate the Bee's Bluetooth to my iPad Mini.
It turns out that, unlike most Bluetooth devices, you don't link to the device through the settings control panel. Instead, you turn on your Bluetooth, then inside the Bee app you select Menu, then Device Info, then "Plus." This opens another window that gives you a three-step process that opens a scanning window that is supposed to read the QR code label on the back of the Bee.
Like many other things in Bee-land, this did not work, and I had to enter the 13 character-and-digit ID number manually.
Next, I was prompted to choose my pen type. Although Vigilant was thoughtful enough to include an adapter for my pen, they did not bother to include my pen in their app's menus. They've made adapters for five different Novo pens, but the app only recognizes the FlexPen and the Novopen 4. The app also isn't set up for American insulins, presenting me only with the options of Novolin, NovoRadpid, and Novomix 30.
Of course that really doesn't matter, as it doesn't affect how the app works, but don't ask if you can't give us the options we use! Having no other choice, I selected a pen I don't use holding an insulin not available in my country, and then I set the device for mg/dL by holding the "on" button down for six seconds.
Finally, I was ready to road test the KungFu Drumstick.
The Bee is supposed to turn on by depressing the button on the top. I pressed. Nothing happened. I pressed twice. Then three times in a row, rapidly. No dice. I pressed and held, but I held the button down too long and switched the damn thing back to mmol/L again.
Problems in Play
By using enough colorful language and stabbing at the button like a maniac, I was usually able to get the Bee to wake up, but even after messing with it for several days, I've not established a reliable pattern as to how to get it to turn on when I want it to.
But once you (eventually) wake it from its slumber, a bright blue LED number screen will read 0-0-0. If you rotate the dial away from you (it's an exclusively right-handed device) it changes to a 1, and if you keep rotating it will run all the way to 60. This is how you log your insulin doses. That's when another shortcoming of the Bee was revealed to me. While Vigilant was kind enough to give me an adapter for my half-unit dosing pen, there's no way to log half units on the device. I can only log full units with the Bee and its app.
If, from 0-0-0, you rotate the dial towards you, the display changes to 600 and a small blue dot appears in the corner. The dot tells you that you are now logging blood sugar. The problem? You have to scroll a loooooooong way to get to a normal BG number. In fact, one complete 360-degree rotation of the large command dial only lowers you from 600 to 453. Getting to any sort of typical blood sugar number requires three complete rotations of the dial.
To make matters worse, if you are logging both a blood sugar and an insulin dose at the same time, like you would need to do in the real world, even more scrolling is required. You have to scroll up to your insulin dose, hit the button, then scroll back down to the blood sugar. Entering one or the other does not reset the counter to the baseline of the three zeros.
Speaking of rotation, the app doesn't rotate with the iPad. It's locked into vertical display only. And the app's shortcomings don't stop there. Once I finally got a couple of readings in, I discovered that the app had decided it was January 1st and I could find no way to correct the date. Well, at least the year was right. (Several days later the app got its act together and magically changed to the correct date).
Other than serving as an electronic logbook, what does the app do? Well, it's set up to share readings to Twitter and Facebook, as well as Sina (a Chinese online community) and WeChat, a social messaging service popular in China that's just beginning to make inroads in the U.S.
I tired to take a look at the app's graphs, but that required a Vigilant account and I already knew that entering data was so tedious with their system that I wouldn't Bee able to keep up with it long enough to have anything to look at.
As noted, right now only the Pocket Version of the Bee is available in the USA. As a strictly data-tracking device, this version turned out to be exempt the from FDA 510k rules, and we're told that Vigilant hopes the "Pen Version" including adapters that I played with will be determined to be exempt as well.
But either way, Bee is not for me. It's waaaaay too bulky, the device is finicky, and the data entry is tedious in the extreme. To me, this is too high a price to pay — both in dollars and in time — to track data on a smart device. Of course we are all different, and you might find Bee suits your lifestyle, but I suspect most PWDs could enter data manually into any number of smart diabetes apps much faster than they could by scrolling the Bee in circles.
Overall, I think the theoretical benefit of having an interface between your data and the cloud that's attached to either a an insulin pen or glucose meter is a good idea. But in the case of the Bee, this is a good idea that needs some serious refinement. The potential benefits are currently overshadowed by the bulky size and slow method of entering the data.
Personally, I'll stick to sending my data to my doc using a fire and my trusty Pendleton blanket.
It would be faster.