[Diabetes-talk] Dexcom SHARE - I can read the current BG reading on my iPhone using Voiceover

Sun Nov 9 01:27:20 UTC 2014

Hi Mike,

Thanks. I read a little more about the Dexcom Share product on the web, and
in fact, it did require FDA approval, so I had that wrong. However, the time
was relatively short, as FDA approvals go,  about a year-and-a-half. 

If you read the following post on the Diabetes Mine web site, it provides
some interesting background, and some hints about where Dexcom hopes to go
with their fifth generation (5G) CGM. Now is the time to approach Dexcom
about accessibility in their next generation products. 

http://www.diabetesmine.com/2014/10/newsflash-dexcom-share-gets-fda-clearanc
e.html

For me, getting the current reading on my CGM via my iPhone is a game
changer. I've had the Dexcom SHARE system in place now for four days, and I
still get a little charge of excitement every time I open the Dexcom follow
app and read my current blood sugar! Then I usually just leave the app open
for a few minutes until the number is updated, which happens automatically
every five minutes. 

Tom

-----Original Message-----
From: Mike Freeman [mailto:k7uij at panix.com] 
Sent: Thursday, November 06, 2014 2:33 PM
To: 'Tom and Eileen Rivera Ley'; 'Diabetes Talk for the Blind'
Subject: RE: [Diabetes-talk] Dexcom SHARE - I can read the current BG
reading on my iPhone using Voiceover

Tom:

This is a great post! I commend you for your out-of-the-box thinking and
imaginative/innovative thought in coming up with this solution to your CGMS
inaccessibility problem!

Actually, I suspect that FDA did do some sort of certification on the iOS
apps in that their policy adopted earlier this year said they were going to
do so when apps might be used to control medical devices. But perhaps
there's the loophole right there: one is still presumed to operate the CGMS
device primarily through its visual display and the iOS apps merely enable
the readings to be conveyed in other ways.

Mike

-----Original Message-----
From: Diabetes-talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of
Tom and Eileen Rivera Ley via Diabetes-talk
Sent: Tuesday, November 04, 2014 7:16 PM
To: diabetes-talk at nfbnet.org
Subject: [Diabetes-talk] Dexcom SHARE - I can read the current BG reading on
my iPhone using Voiceover

Hi everyone,

Dexcom is one of the companies that develops and sells continuous glucose
monitoring systems (CGM). For more information on their current CGM model,
the Dexcom G4 Platinum CGM, you can visit www.dexcom.com 

These devices are not accessible, no matter which company's CGM you
purchase. However, I have used one for several years now. I require sighted
assistance to set up the system, and sighted assistance a minimum of twice
per day to enter a current blood glucose reading from a blood glucose meter
for system calibration. Even though they are not accessible, I use a CGM
because the CGM can be configured to alert you when your blood glucose level
goes above or below values you set. 

For instance, the CGM gives me an audible alert and vibrates whenever my
blood glucose rises above 160. It also alerts me (with a different sounding
tone and different vibration pattern) when my blood glucose goes below 70,
and it gives a particularly urgent alert when it goes below 55. 

I find this very helpful. It wakes me up in the middle of the night when my
blood glucose gets low, and let's me know when I'm going out of range on the
high side so I can take corrective action if warranted. The CGM has even
more valuable information on the screen, such as the current blood glucose
reading, an indication using arrows if the blood glucose is steady, or
rising or falling, and how fast, along with a graph of your blood glucose
for the last 1, 3, 6, 12 or 24 hours. But none of this information is
accessible. 

Last Wednesday, Dexcom announced a new product that works with their G4
Platinum CGM called Dexcom SHARE. It was designed primarily to meet the
needs of parents who wanted access to the CGM readings of their children
when their children were at school or away from home. The Dexcom SHARE
system is made up of the Dexcom SHARE cradle (which costs $299), two free
iPhone apps, and the G4 Platinum CGM itself. The person using the CGM is
known as the sharer and the person remotely viewing the sharer's CGM reading
is known as the follower. 

Basically, the sharer, the person wearing the CGM,  downloads the Dexcom
Share app to their iPhone or iPod or iPad. They plug in the cradle and slide
the CGM receiver/display unit into the cradle. Then they pair the cradle via
Bluetooth with their iPhone using the Dexcom Share app. The cradle sends the
CGM data to the iPhone and the iPhone uploads the data to the Dexcom
servers. The sharer then uses the Dexcom Share app to invite up to five
people to follow their CGM readings. The Share app sends an email to the
followers you invite. 

If you are a follower, when you receive the invitation email, you download
the Dexcom Follow app onto your own iPhone or iPod or iPad and use the
information in the invitation email to connect to the Dexcom server to begin
to receive the CGM data from the Sharer. Note that the Dexcom Share app and
the Follow app are two different apps.

So, to summarize all of this fairly complicated sending and receiving of
data, the blood glucose readings come from the CGM, go into the cradle, are
sent to the sharer's iPhone, where they are uploaded to Dexcom servers, and
then sent from there down to the follower's iPhone where they can be viewed.

I immediately bought the system, because I wanted to see what would happen
if I put the share app and the follow app both on my iPhone. In essence, I
am "following" my own CGM readings with myself. And, it works. The apps
themselves are accessible using Voiceover. I setup the system using the
Share app, invited myself to follow, and installed the follow app on my
iPhone too. 

My CGM is in the cradle right now. If I want to know the current blood
glucose reading, I just open the Follow app on my iPhone and read it. And,
since the CGM provides a new reading every five minutes, if I check back  in
five minutes or so, I can see how much it rose or fell, if at all, which
gives me an good idea of the trend. It is not anywhere the same thing as
having an accessible CGM. But, it does give me much more information than I
could ever get before from my CGM. The Dexcom SHARE system was not designed
so blind people could get partial CGM information on their iPhones, but it
can be used for that. 

The other benefit of knowing the current reading on my CGM is that I think I
can now calibrate the CGM twice a day on my own - without sighted
assistance. The big problem with calibrating the system was that you had to
enter your current blood glucose into the system, and  the screen for
calibrating always puts the current CGM reading in as the starting point.
So, if the CGM current reading was 203, and my current actual blood glucose
is 215, I would have to adjust the reading using the arrow buttons on the
CGM from 203 up to 215. This is not a problem, as long as you know the
starting point. Now, with the Follow app, I do know the current reading and
I will be able to calibrate the system with a fairly high level of
confidence on my own I believe. 

Note that I don't think the Dexcom SHARE system required any FDA approval as
far as I know. So, it should be very easy to add additional functionality to
the follow app to provide even more information to a blind person. 

Also note that although in general, CGM devices are covered by many
insurance companies, although not all, the Dexcom SHARE system is not
covered by insurance. It costs $299, and you and the followers have to be
using an IOS devices; Android based devices are not currently supported. 

Tom

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