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Virtual Diabetes Management

The amount of diabetes-related software has exploded in the past few years, fueled in part by the proliferation of applications for mobile phones. Nearly every insulin pump and blood glucose meter now comes with computer software that can organize data from the device, and there are lots of offerings from independent companies that work with several different glucose meters. At the same time, the rise of smartphones — mobile phones with extensive software capabilities — has opened up a new market for on-the-go diabetes management programs.

Some software programs now offer extensive features, while others remain fairly basic. There are programs for graphing blood glucose trends, programs that let you share blood glucose readings with your health-care provider, virtual logbooks, meal-planning aids, restaurant locators, educational guides, and more. This article describes a range of programs for different devices and platforms, varying in their purposes and capabilities. For prices and contact information, see the table “Software, Hardware, Where?”.

Online data management
There are many Web-based programs that allow the user to directly upload data from a blood glucose meter using a cable connecting it to a computer. These programs provide different views of blood glucose data, such as logbook, report, and graph formats. Some of them have account settings that can be adjusted so that a health-care provider can log in and see the user’s information. This way, the provider can offer recommendations by e-mail or prepare ahead for the next office visit. Some of these Web-based programs also offer educational materials and useful tips.

Telcare is a blood glucose meter that wirelessly transmits blood glucose readings in real time to the password-protected MyTelcare.com portal or to the MyTelcare iPhone app. Both the Web site and the app offer a number of different graphs and charts that are constantly updated; you can also add notes to each reading and set goals and blood glucose ranges through the online portal. You can also give health-care providers access to the portal, allowing them to give feedback on your readings.

DiabetEASE is a free program that lets users upload blood glucose readings directly from a meter and then graph trends in easy-to-read formats. Trends can by viewed by the day, week, or month, or based on events such as exercise or meals.

Cornerstones4Care from Novo Nordisk lets users set and track goals in the areas of blood pressure, physical activity, weight, and frequency of blood glucose monitoring. It also offers educational materials, meal-planning guides, and many other features.

MyCareConnect is an online system designed to share information between children with diabetes and their parents, teachers, school nurses, and health-care team. Blood glucose readings can be entered by the child, teacher, or school nurse either on the Web site or by text message. Whenever new data is entered — either a blood glucose reading, an insulin or carbohydrate dose, or a note — all designated parties receive a copy by text message or e-mail. The system can be set up so that some people, such as parents, get notified for every data entry and other people, such as the school nurse or members of the child’s health-care team, are alerted only if an out-of-range level is reported.

Computer-based management
The following software programs will work on most home computers running Windows and on Macs when indicated. Most programs can be downloaded from the manufacturer’s Web site, and many are also available on CD upon request.

Lifescan offers the OneTouch diabetes management software to work with its OneTouch blood glucose meters. Any OneTouch meter with a data port and cable can have its stored blood glucose readings transferred to the OneTouch software using the OneTouch USB Interface Cable. The program has extensive reporting and graphing options designed to help the user spot trends and patterns in blood glucose levels. Reports generated by the program can be printed, faxed, or e-mailed.

ezManager Max from Animas accepts data from the full range of Animas insulin pumps and from Lifescan blood glucose meters. Pump and meter data are used to generate reports and logs that can be viewed on-screen, printed, or e-mailed to your health-care provider. One useful feature of this program is the ability to create a graph that compares blood glucose readings with insulin use and carbohydrate consumption. Note that this feature only works if you store insulin and carbohydrate data in your insulin pump or if you manually enter this information into the software. ezManager Max is compatible with both Windows and Mac platforms.

The CoPilot Health Management System from Abbott Diabetes Care is a Windows-based program that works with Abbott’s line of glucose meters. The software offers graphical trend analysis, detailed reports, and the ability to share data with your health-care team — features similar to those of previously mentioned applications.

AgaMatrix, the maker of Wavesense blood glucose meters, offers data management software called Zero-Click. As the name implies, its main distinguishing feature is that it loads data and creates charts automatically when you plug your meter into the computer.

Mobile management
Most diabetes-related applications, or apps, for smartphones are made for the iPhone (and, therefore, also often work on the iPad and iPod touch). But many apps exist for other devices and platforms, as well. So depending on what kind of phone you have, browse the iTunes App Store, Android Market, Amazon Appstore, or Blackberry App World to see what is available.

WaveSense Diabetes Manager is an iPhone app from AgaMatrix (the maker of WaveSense meters) that lets you track blood glucose levels, insulin doses, and carbohydrate intake by manually typing in that data. The program color-codes each blood glucose reading so that you can easily see when you are low (red), high (yellow), or in the desired range (white). Data can be viewed in logbook or graphical format. One attractive feature of this app is streaming video from dLife TV, with segments covering diabetes education, cooking, blood glucose control, and much more. According to the AgaMatrix Web site, the company is also working to make it possible to import data to the program using a special cable that connects its blood glucose meters to the iPhone. You can sign up to receive notice of that product’s release.

Glucose Buddy from Sky Health is an iPhone application that allows you to enter glucose numbers, carbohydrates, insulin dosages, and activities. All log entries can be edited with detailed notes and also graphed for visual representations. All data is synced with the user’s account on www.glucosebuddy.com using the Quick Sync button in the application. You can also use your iPhone to access the Glucose Buddy Forum, where you can read and post articles, post questions, comments, and other information.

iRecordit from Communiteq Systems is an app for the Blackberry line of phones. It lets users manually enter data such as blood glucose levels, cholesterol readings, blood pressure, weight, meal composition, physical activity, and doses of insulin and other drugs. Users can view stored information in a variety of formats and easily share it with anyone by e-mail. The program includes a searchable database of more than 7,000 foods with their nutrition information, and users can configure and save typical foods and meals. This means that whenever you eat a meal you’ve saved in the program, you can just refer to it by name instead of entering all of the foods individually. iRecordit can also wirelessly receive data from the Bluetooth-enabled MyGlucoHealth glucose meter.

Coheso offers a proprietary handheld computer called the Track3 to help with diabetes management. It allows users to record blood glucose levels, food intake, physical activity, and drug doses. Also included is a nutrition database of more than 50,000 foods, including the offerings of 250 restaurants and 500 food brands.

Rewards programs
Some health insurance companies offer Internet-based rewards programs as an incentive to be more health-conscious. One program, for example, offers enrollees a list of activities associated with a healthier lifestyle, such as exercise, weight loss, and tobacco cessation. Each activity is worth a certain number of points, and once you collect enough, you can redeem them for a gift certificate to stores such as Amazon, Best Buy, or Blockbuster.

A similar program is HealthPrize, by HealthPrize Technologies. This Web-based software lets users record when they take prescribed drugs to track compliance; it is offered by many employers and health insurance companies as a way to motivate individuals to take prescribed drugs as directed. There is also a HealthPrize iPhone app that syncs with the online software. Users receive points for taking medicines regularly and, as in many insurers’ awards programs, can spend these points at an online shopping mall.

Meal-planning help
Many software programs exist to help people with diabetes track the nutrient content of meals. GoMeals from Sanofi-aventis allows users to search for thousands of foods and menus from popular grocery stores and restaurants, giving the calorie count as well as information on fat, protein, and carbohydrate for each. The program uses the CalorieKing nutrition database, which contains more than 25,000 common foods and menu items from more than 200 restaurants, as well as a restaurant locator. GoMeals is available for the iPhone and for Android.

CalorieKing Nutrition and Exercise Manager is designed to help users achieve weight loss by keeping track of calories consumed in meals and burned through exercise. It follows the same concept as the online CalorieKing program, which requires a membership account; Nutrition and Exercise Manager, by contrast, is a stand-alone computer program. It supports up to five users per computer, and the included food database is updated automatically. The personal profiling feature lets you know how many calories you need each day to reach or maintain your desired body weight. Versions are available for Mac, Windows, and Palm OS devices.

Carb Master, an iPhone app, helps keep track of your daily intake of carbohydrate as well as fat, protein, and calories. There is a diabetes feature that lets you keep track of blood glucose levels, insulin doses, and exercise. This information can be viewed in chart form and compared with target levels that you set.

Exercise help
DailyCoach, a product of Quantia-Care, is a free app that provides daily tips and suggestions for getting more physical activity. It was developed by certified diabetes educator Gary Scheiner, a frequent contributor to Diabetes Self-Management magazine, and is available on a number of platforms. Each tip is delivered via voice, text, and images, and most tips take about a minute to listen to.

Diabetes education for children
There are lots of software programs that offer diabetes education, both for home computer and for the iPhone. Savvy Knowledge Systems has created Type 1 Diabetes in Children: A Passport to Knowledge. This Windows-based program both entertains and educates children using animated videos and interactive content, helping them understand how diabetes works. It also deals with how to control diabetes and its complications.

An educational app for the iPhone is Carb Counting with Lenny from Medtronic. This app has a guide showing nutritious food choices with common serving sizes and corresponding carbohydrate values. Children can learn to count carbohydrates through interactive games with Lenny the Lion, who is a global ambassador for children’s diabetes education.

The Didget blood glucose meter from Bayer HealthCare falls more in the category of motivation than education, but it may help children keep up with their diabetes management. This meter plugs into a Nintendo DS or Nintendo DS Lite system and lets users play games whenever they check their blood glucose. It includes the Knock ‘Em Down video game and Mini Game Arcade for use with the Nintendo gaming systems.

Getting started
The number of software applications to help manage diabetes has grown enormously in recent years and continues to grow. More apps for the iPhone, in particular, are appearing every day. While many of these apps simply duplicate the functions of ones that already exist, some have adopted useful features such as compatibility with blood glucose meters and automatic syncing with Web-based software. This typically allows for more data storage and more extensive graphing and reporting capabilities than a phone app would have on its own.

How do you figure out which products are right for you? A good place to start is to try out the software supplied by your meter or pump manufacturer for a couple of weeks. If it does what you need it to do, great! If not, then figure out which features you want or need and start looking at other programs. Do you want it to run on your home computer, your smartphone, or the Internet? How much money are you willing to spend on equipment and software? Whatever your situation, chances are there is a program that is right for you.



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