On Friday, June 9, just before the big ADA conference kicked off in San Diego, we hosted our 8th biannual DiabetesMine D-Data ExChange.
The aim of this forum is to convene key players in the Diabetes Technology World for a chance to update, interact and have the critical discussions that help drive progress. We’re very happy and proud to be able to facilitate these gatherings.
See the event agenda and guide here, and photo album here.
Thanks to Wes Nordgren of the Nightscout Foundation, the event was live-streamed again, and is viewable here.
For those who still like to read, here’s my own assessment of the day’s program, and what it means for our community.
The Backdrop
Seriously, where once people rolled their eyes at this concept… the AP is now making mainstream headlines and has become nearly synonymous with progress in diabetes care.
We have many of the people in attendance at our #DData17 gathering to thank for that!
Meanwhile, in the current political environment, there’s an unprecedented level of uncertainly about the American Healthcare system. No one knows how reform is really going to play out… So against that backdrop, we believe the #WEARENOTWAITING movement of pushing ahead with bottom-up innovation is more important than ever.
#WEARENOTWAITING Community Updates
I kicked off the program by doing my best to provide an update on what’s new from the Nightscout Foundation and #OpenAPS community. This wasn’t easy, because when I reached out to leaders Wes Nordgren and Dana Lewis, I was overwhelmed at all that’s happening. But I was able to cover some exciting milestones.
This DIY “CGM in the Cloud” group is now active in 33 countries, with over 40,000 users (!)
2016 was an incredible year for them. Among other things they:
- Had a presence at the ADA & AADE annual meetings, Children with Diabetes, the Connected Health Conference, and various D-Data Conferences and TCOYD events
- Granted their first scholarships to a couple of incredible students with T1D
- Sponsored almost $10K in developer support through direct resource grants and through the first Nightscout Foundation Hackathon
- Held their second Hackathon the day following our #DData17 event
This Foundation has a lot more happening and planned – including some important access and advocacy initiatives, so be sure to check out their site.
There are now approximately 330 people around the world using various types of DIY closed loop implementations. Collectively, this amounts to over a million collective real-world “loop hours,” they tell us.
The closed loop rigs are getting even smaller – like the size of two chapsticks – and easier to set up — down to 1-2 hours from several days.
There’s continued work to develop next-generation algorithms, like oref that enables tiny micro boluses to further improve post-meal outcomes, and handle unannounced meals in automated systems.
This community has also just launched a tool calledAutotune, that makes it possible for both loopers and non-loopers to better fine-tune basal rates, insulin sensitivity factor and carb ratios. This is pretty HUGE since there are currently no commercial tools that help people fine-tune their pump settings in this way.
Kudos to Dana Lewis, the force behind the OpenAPS system for recently being named one of “The Most Creative People of 2017” by Fast Company magazine.
Her standout quote (to me): “Patients are changing the innovation pipeline.”
This has become the new reality… and in large part, our program for the June 9 event aimed to explore the ripple effects of that: How is industry reacting to patient-led innovation? How are they EMBRACING it?
Industry Focus
For that reason, heard more from industry players today than we usually do at these #DDATA events.
Btw, we appreciate recent diaTribe article by Jim Hirsch, that notes: “Corporate America is not our enemy but our partner” and that working with them rather than against them is in the best interests of the patient community.
He goes on to quote Jeffrey Brewer, CEO of Bigfoot Biomedical, saying: “It’s all about getting something done for patients… Scientists make discoveries, companies make products. A cure will eventually come from a company. If you don’t understand that, you don’t understand our society.”
Exploring Innovation Paradigms
As our opening speaker, we were VERY privileged to have a celebrated expert on just that: the opportunities for grassroots “free innovators” to influence and collaborate with established industry players.
Eric von Hippel is the T Wilson Professor of Innovation Management at the MIT Sloan School of Management and Professor of Engineering Systems at MIT. He’s a big academic brain with a wonderful down-to-earth speaking style who actually did an innovation case study on the Nightscout community for his newest book “Free Innovation” (free for download from MIT Press).
The book explores the two paradigms of Free Innovation vs. Producer Innovation – and how they are both competitive and complementary. Insights include:
- How innovation is shifting away from product and service producers to product and service users in the Internet Age
- The connected shift away from intellectual property that’s protected, to free and shared
- How the open sharing of “design recipes” is changing the game
- How Formal “go-to-market” strategies are becoming obsolete in the this Internet era
Very insightful stuff, and our mixed audience of product producers and DIY patients was eating it up!
Under the Hood
This flowed directly into talks meant to illustrate industry-patient collaboration in action, with a look “under the hood” of three leading organizations:
- Nate Heintzman, Dexcom’s director of data partnerships, gave a brief update on what’s happening the company’s new open developer platform developer.dexcom.com first announced at our Fall 2016 D-Data ExChange. He used a David Letterman-style “Top 10 Things You Need to Know” list to shed light on this WIP (work in progress) project.
- Dr. Trang Ly, now Medical Director at Insulet, gave a quite comprehensive talk on the company’s Lightning Labs project — a collaborative methodology for including patients in the development of their upcoming Horizon closed-loop system (integrated with Dexcom CGM). Fascinating to see how they’re working side-by-side to iterate and improve on the UI. They even brought in a half-dozen @OpenAPS users to provide feedback. Props!
- Stayce Beck of FDA was tasked with giving an update on how the regulatory agency is continuing to “Tackle the mHealth Challenge.” Instead she turned her talk into a call for Interoperability Standards – asking for help from the industry and D-community to make this happen, so the FDA can more easily handle reviewing the various devices that will need to function side-by-side in new closed-loop systems. Given that we’ve been shouting about the need for Interoperability for years, it was mind-blowing to hear FDA issue this important call to action!
The “Yin & Yang” of Diabetes Care
Our two featured discussion panels for the day tackled what we think of as the Yin & Yang of D-tools:
- Artificial Pancreas technology, that’s obviously in the spotlight now as the first early system(s) come to market
- But also recognition that somewhere in the neighborhood of 95% of PWDs (people with diabetes) will not be candidates for an AP for various reasons. So what’s the promise for of technology for them?
AP Commercialization Forum
For this forum, we invited the four organizations closest to taking a closed-loop/ AP system to market — led by Medtronic, with its now-approved 670G hybrid closed-loop system – to address how they are including patients in their development process.
The panel was moderated by the venerable Adam Brown of Close Concerns and diaTribe, who also offered up several signed copies of his new book for an on-site giveaway.
You can watch the proceedings of this panel here. What stood out to me was the fact that when the panelists were challenged on addressing certain patient concerns, or adding specific features to their systems, not one of them said, “No, we can’t do that.”
The can-do attitude and openness to input was highly encouraging!
“Other 95%” Diabetes Tech Panel
As exciting as AP systems are, of course they will not be for everyone. In fact, the lion’s share of PWDs will never use these systems – either because they are not on insulin, can’t get access, or simply don’t want to be hooked up to such a contraption.
So we’ve long felt that it’s important to better address the promise of diabetes tech tools for “the other 95% of people with diabetes”: How will sensors, apps and data platforms figure into their lives and help them achieve better outcomes?
For this panel, we included four orgs offering different types of tools useful for type 2 PWDs and beyond:
- Abbott Diabetes Care – creating a new paradigm for CGM with the FreeStyle Libre (making its way slowly to the U.S.)
- Companion Medical – developing new smart insulin pen technology
- Omada Health – arguably the most successful tech-based lifestyle/coaching platform ever
- Ascensia Diabetes Care (formerly Bayer) – as an example of a traditional fingerstick company now embracing data tools
This panel was moderated by Manny Hernandez, ueber patient advocate who now works with Livongo Health.
The conversation was interesting in that it focused so much on patient behavior: what are people doing with these tools now, and how might they continue to use them to solve real-life problems?
Dr. Carolyn Jasik, Medical Director of Omada, who has some serious experience in behavior change research, explained how their system is able to onboard PWDs in all different stages of the disease – from newly diagnosed to burnt out – and provide customized content that’s proven quite effective. They call their program “digital therapeutics” that begins with self-tracking to get to know your own body and behaviors. Read all about it here.
#DData Demos + New Simulation Tool!
We ended the day with a series of five demo presentations from hot new players.
Pops! Diabetes Care – creating new a fingerstick meter and data solution that’s essentially a smartphone accessory. Founder Lonny Stormo, a T1D himself, knocked it out of the park with his presentation, btw.
GlucoMe – a new digital diabetes management platform with three a number of components including an insulin pen tacker.
Insulia (from Voluntis) – the first prescription-only medical app that provides insulin dose recommendations based on BG values and other diabetes-related data.
DiabNext – a fascinating Artificial Intelligence platform for diabetes, with three distinct components. It won a CES Innovation Award in January, and you can read all about it from us here and here.
GlucoDyn by Perceptus – from the DIY community, Ken Stack (parent of a T1D teen) abd Gustavo Munoz (T1D out of Mexico) introduced Glucodyn, a platform that lets users model expected outcomes on different inputs including carbs, insulin and the interaction thereof.
And perhaps even more exciting was their unveiling of a new tool announcement of a new tool that should be hugely beneficial to the open development community: GlucoSym, a new tool for simulating patient data that aims to help develop faster, safer and more accessible software for the community. This announcement was met with many a mouth-lipped “WOW…”
A huge THANK YOU to everyone involved in the #DData17 event in San Diego – not least to our program sponsors who make these gatherings possible (without any interference in the event content, I might add – they just let us do our thing!)
Are you working hands-on with diabetes technology and burning to get involved in the DiabetesMine D-Data ExChange? Ping us on Twitter for Fall dates and details.