Diabetes Management System Project

Diabetes ManagementUsing future technologies to create a system to help individuals manage a chronic condition.Noam Zomerfeld

RogerRoger is a 66 year old man that has been living with type 2 diabetes for the past 20 years.

He is retired and loves cooking. Roger and his husband also eat out 1-3 times a a week. Roger’s eating habits vary a lot and he does not keep to a strict diet.

Roger’s husband takes an active role in keeping Roger on track with his diabetes management.

Current System – High Blood GlucoseFeedback Loop DiagramNoam Zomerfeld

InjectsInforms

Which low

ersm

easu

red

by a

raise

Blood glucose meter Roger Insulin

Blood GlucoseLevel

Carbohydrates,Sugars, Starches

lower

Insulin, diet,physical activity

Acceptable blood glucose level:

80-120 mg/dL

Currentreading

Planned meal

Insulin Dosage

+ =

Goal: Keep blood glucose levels stable

Frequency:

4 times a day

Goal: Keep blood glucose levels stable

Current System – High & Low Blood GlucoseFeedback Loop DiagramNoam Zomerfeld

Consumes

Which low

ers

Which raisesm

easu

red

by

raise

RogerInsulin

FoodFeeling loopy

Blood GlucoseLevel

Carbohydrates,Sugars, Starches

lower

Insulin, diet,physical activity

Acceptable blood glucose level:

80-120 mg/dL

Currentreading

Planned meal

Insulin Dosage

+ =

InjectsInformsBG meter

Frequency:

4 times a day

Frequency:

Constant

IssuesRoger finds testing his blood to be painful and complex.

Choosing the required Insulin level is both predictive and reactive. It’s based on the most recent reading and on an estimate of the future intake of carbohydrates, sugars and starches.

Roger only tests his blood 4 times a day, those are the only solid indications he has for his BGL and his opportunities to balance it.

Care Giving NetworkNoam Zomerfeld

Visits

Kaiser - Medical Relationships

Marriage

Friend circles

Roger Husband

Yearly retina scan

Optometrist

Meet every 2-3 years or as needed

Initially providedtraining on a more frequent basis

Personal Care Manager(Diabetes specialist)

Calls several times a day to check up

Reminds, veri�es insulin and keeps schedule

Takes blood sample when Roger’s is too low

Moderates diet

•

•

•

•

Call and check up occasionally

Remind about insulin on social events

Respond to emergencies

•

•

•

2 full blood work labs a year

Primary Care Physician Friends

Roger’s family and friends play an important role in keeping him healthy.

Diabetes ManagementRange and outcomes

80

120

blood glucose level(BGL)

requires immediate intervention

requires monitoring and long term change of habits and behavior

shaky, sweaty

cranky

confused, loopy, sleepy

passed out

death

Too low

Too high

acce

ptab

le ra

nge

mg/dL

Long term effects

fatigue, kidney damage,heart disease, poor circulation,retinal damage, death

thirst, nausea,frequent urination

Short term effects

Being on different sides of the BGL range has different outcomes for Roger:

Having high blood glucose levels leads to serious complications over time.

Having low blood glucose levels creates immediate consequences and dangers.

Can we offload Roger’s Insulin adjusting tasks?

Diabetes ManagementEcosystemNoam Zomerfeld

Shows numberLight and buzz

Weekly Insulin delivery / pickup. Or – optional weekly maintenance by trained professional in-store.

Shows numberno light

Instantly adjusts insulin level - mini injections

just under normal

When high

Low / slightly low but for a while now

...(other, personalized

mid-states)

Very low

Blood glucose level Number value High / low / normal TrendTime in current status Number valueLocation Coordinates

Insulin usage Quantity Timestamps for injectionsLow events Timestamps Response timeBlood glucose level Line graph

Messages partner / husband / wife

Calls ambulance

Ring Sensor Insulin pump

husband

Walgreens / CVS

CareManager

(doctor / nurse)

self

hospital

Low events:requires immediate intervention

When Normal: High Events:requires monitoring and long term

change of habits and behavior

Twice a year review of data, adjustment of Insulin and / or of Roger’s diet




When high



Roger wears a ring on his finger that constantly measures his blood glucose levels (CGM).

It displays the current BGL level. No light / color.

When his BGL goes over his range, it sends a signal to his pump to deliver a mini dose of Insulin and stabilize his BGL.

In fact – when this system is operational, Roger no longer has to worry about high BGL events.




just under normal


Ring Sensor

When Roger’s BGL drops below his range (80 mg/dL), the ring vibrates and turns the display red – notifying Roger he needs to consume food or glucose tablets to resolve it.




just under normal




Ring Sensor

husband

self

If Roger’s BGL remains low for a period of time, the system notifies Roger’s husband via text message / phone call to check up on Roger and to make sure that the situation is taken care of.




just under normal

Very low


Calls ambulance

Ring Sensor

self

hospital

If Roger’s BGL is so low he might be in immediate danger or unconscious, the system alerts emergency services and provides them with Roger’s condition and his location.

(Note: other triggers and settings between the ones described in this document can be set-up in the system.)



Instantly adjusts Insulin level - mini injections


Insulin pump

CareManager

(doctor / nurse)

Roger meets up with his doctor or care manager twice a year to review his Insulin usage and check up on other health issues that might arise, especially now that his diet is unrestricted by his diabetes.



Insulin pump

Walgreens / CVS

Roger gets his Insulin capsules delivered to him or he can pick them up at a pharmacy. For other patients that are less self-reliant or just dislike the procedure – an option exists to get all maintenance done at the local pharmacy by trained professionals on staff, a quick 30 minutes procedure.

Other regular maintenance of sensor and pump is also performed at the pharmacy, as needed.

New System Conceptual ModelConceptual ModelNoam Zomerfeld

hasPerson Blood Glucose Level (BGL)

Exact level

Status

Trend

Time in current status

Number value

High / Normal / Low

Rising / Falling

Time Value

Viewed / Shared / Automatically updated

Viewed / Replaced

Sent

Set up

Set up

Seen / felt / heard

Seen

Automatically updated / Sent with alerts

Full name

Number value

Content

Number value

Latitude

Longitude

If <condition>then <action>

On / Off

Color (red / neutral)

Examples:

If 75 < BGL < 80 for the last 10 minutesthen notify husband.

If BGL < 70 and trend is fallingthen notify husband.

Text Message Example:

Roger’s blood sugar level has been below 80 for the past 10 minutes.

Please follow up with him.”

Quantity (percentage)

Timestamp

Dosage

Sensor

Pump

Insulin

History

Communication Triggers

Local Alert

Ambient alert

Family Contact

Name

Phone Number

Family Alert

Emergency Service

Location

Phone Number

Coordinates

Objects Properties User Actions

Shared / Viewed

has a

is a

are

are

can be either

can be either

has a

has a

has

is a

is a

includes

is a

can be either

Set up

can be

“






just under normal

When high


...(other, personalized

mid-states)

Very low




Calls ambulance


husband

Walgreens / CVS

CareManager

(doctor / nurse)

self

hospital

Low events:requires immediate intervention

When Normal: High Events:requires monitoring and long term

change of habits and behavior


Diabetes Management System Project

Design