I don’t hear anyone talking about how frequently their CGM goes dark on them throughout the day and really getting to the bottom as to why. I’m no engineer, but I do work for a leading application development company who specializes in creating software applications faster and smarter, and it seems obvious to me that regular changes or updates in our operating systems and mobile applications are the main variable at play. Example: each time Apple updates the iOS on your phone, Dexcom,as well as all other companies, need to catch up and make tweaks of their own in the code to ensure compatibility. So the blue tooth connection could be just fine (phone right next to you) but the sensor still isn’t working. My hypothesis is that it’s not the Dexcom sensor at all. It’s the application that we cannot see that is faulty. I just think that software hasn’t caught up to the technology yet. That’s what my company does, helps create software faster and more exact than the traditional manual effort. So.it would be great if Dexcom and others like them realize the need for low code and no code app development platforms to keep up with the times and realize how they can positively impact our individual type 1 diabetic lives.
HI @Jgallagher Jason, welcome to TypeOneNation. I read your hypothesis, thank you for writing it, and wanted to provide some feedback because it made me think.
For Dex, as well as CGM in general. Each sensor consists of a chemically treated filament that is inserted below the skin and should (at least in theory) be in close contact with the interstitial fluid, which is not blood and not fat (as you can guess I am not a doctor)
Then there is a CGM transmitter. This device has a (rechargeable) battery and a controller. It powers the filament, it powers the circuit and controller that converts a very weak signal from the filament into the conditioner with an output of IG (intersatitial glucose). The Transmitter has at least 1 antenna and a modulator, typically using Bluetooth (some use near-field comms NFC), to connect to an outside receiver. It’s clipped to the part of the sensor sticking out of your skin. Everything smart that is going on in the CGM, happens in the transmitter.
phones and medical devices: a phone is a phone and a medical device is a medical device. exactly as you describe, a phone has wifi, cellular data, cellular digital, bluetooth, GPS, and some have NFC antennae, as well as a handful of light, sound, position and accelerometer sensors. it’s a computer, a phone, a communications hub of a kind. even if you were just using it as a CGM receiver, you have the bluetooth or NFC antenna, a operating system, and an application requiring resources, and some computing power to receive the IG, demodulate it, and then convert the IG to a blood glucose.
it raises the hair in my neck to think about depending ONLY on a phone for this function, especially if you have the G6 and are using the displayed data to inject insulin. in my industry (pharmaceuticals) that would require the lockdown of the operating system, the hardware resources such as the bluetooth antenna, and the validation that the data displayed is accurate, timely, and with proof of integrity and security. I can’t speak for any of the available “reader apps” out there but just like you said, in order to validate the data and integrity, every single app or OS update would require extensive testing and verification, and it just can’t, in my opinion, be happening that way.
If you also consider that the bluetooth is a dedicated service, then who wins if you are in your car and your phone has a choice to connect to the CGM transmitter or vehicle onboard hands free? your phone cannot be hands free and talk to the CGM transmitter bluetooth at the same time,. The answer is whoever connects first wins. if the phone drops the CGM transmitter signal for any reason, it’ll connect to the fist and sometimes loudest bluetooth signal it can see, that might be wireless speakers or the CGM or your car or whatever you have in there as “paired” connections.
a dedicated CGM receiver, at the very least, does not get “ad-hock” OS updates. It also isn’t surfing, sensing, running facebook, or transmitting google traffic data while you need it to be a CGM receiver, since it can only do 1 thing… that also means you have potentially tighter data collection and privacy control as well. It may be a pain in the neck, but a dedicated receiver is the closest you will get to no code since the OS and CGM demodulator and display, in the receiver, are either burned on the chip or NVram. The way phones are going, I doubt if you will ever be able to control the environment the way it needs to be controlled. Software doesn’t have to catch up - current and future software and hardware are diverging from what it needs to be for this function.
blah blah blah sorry for the rant. if you made it this far - I am also not a fan of “updateable” pumps. allowing operating basis code updates to a pump such as the Tslim is just as scary if not more to me.
ok I am done