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

Sun Nov 9 21:29:27 UTC 2014

Sounds like we have a DAN Seminar presentation in the making!

Mike Freeman

-----Original Message-----
From: Diabetes-talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of
Joy Stigile via Diabetes-talk
Sent: Saturday, November 08, 2014 6:41 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

Hi Tom,

That is so fantastic!  I can not wait till I can operate my own CGM, too.

Joy

----- Original Message -----
From: "Tom and Eileen Rivera Ley via Diabetes-talk" 
<diabetes-talk at nfbnet.org>
To: "'Mike Freeman'" <k7uij at panix.com>; "'Diabetes Talk for the Blind'" 
<diabetes-talk at nfbnet.org>
Sent: Saturday, November 08, 2014 5:27 PM
Subject: Re: [Diabetes-talk] Dexcom SHARE - I can read the current BG
reading on my iPhone using Voiceover

> 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-cl
> earanc
> 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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