Apple's Steve Jobs with Type 1 Diabetes?

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Permalink Reply by Jenny on January 5, 2009 at 5:06pm

Well, I don't actually wish this on anyone, but just think!! If His Jobsness had Type One, and wore a Pump CGMS, THINK of the software FINALLY coming out for Macs!!

Apple getting into the Biotech wagon with an implantable PUMP? That iPhone diabetes application many ppl want?

HECK YES!!

I hope Steve Jobs does NOT have type1 or ANY diabetes, but maybe this will get the diabetic Techno-Geeks in on this even more and we would see some sort of progress.

Jenny

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Permalink Reply by Manny Hernandez on January 5, 2009 at 5:16pm

Ssomething along those lines actually crossed my mind.

Whatever he has, I hope he can be treated properly. But if it is any form of diabetes that requires him to take insulin, I suspect we may see an iPump coming out of Apple some day! :)

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Permalink Reply by John Carlin on January 5, 2009 at 5:24pm

Pretty please, with a sugar-free popsicle on top, let's stop the speculation and not go back down the road of What If Apple Made a *Insert Critical Device Here* road. We took that trip around summer/fall '07 and I didn't like how it evolved. If the official letter has gone out from his Steveness as a hormone imbalance, I'm fine to accept that at face value.

Full Letter: http://www.apple.com/pr/library/2009/01/05sjletter.html

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Permalink Reply by Manny Hernandez on January 5, 2009 at 5:28pm

You are right: it was unnecessary for me to speculate the way I did it. I apologize, John...

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Permalink Reply by John Carlin on January 5, 2009 at 5:41pm

Absolutely no need to apologize! The media has sensationalized his health as if it were the successor to the iPod. It is very easy to get caught up in the momentum.

It's the gadget fantasy that I really don't like. Despite how much I loathe glucometer interfaces, navigating pump menus (MiniMed in my own experience) or the required steps to get readings onto a PC (oh wait, I use a Mac), I don't think an Apple-led development is really the answer either. I think the current industry knows the problem best, but needs to shake their razor blade sales mentality to really make devices for diabetics remarkably better.

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Permalink Reply by Manny Hernandez on January 5, 2009 at 5:47pm

Amen! You are right.

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Permalink Reply by Jason on January 5, 2009 at 6:33pm

I don't think it is a "razor blade sales" mentality that is the problem. With regards to the pump, sterility, infusion site issues, and the propensity of insulin to wear out infusion sets over a relatively short period of time seem to be the primary reasons we have to deal with the present sales model. The two former issues being particularly difficult to solve. Whenever you are introducing a foreign substance into the body (besides eating), especially through a break in the skin, there are going to be many parts that have to be replaced on a constant basis.

With regards to test strips, I don't know enough about the technology to form an opinion, but they seem to be more expensive than they should be, given their mass production and high worldwide demand. I think one major contributing factor is that the companies who produce them do not appear willing to standardize on a specific type of strip. While I understand this approach as it relates to the sales of razor blades, since different blades behave differently and give different results, diabetics are only looking for one thing: accurate blood glucose readings. It's a dichotomy, too. Either the strip delivers accurate results or it does not.

This is why I laugh when I see ads touting "no coding!", as if for so long we have all been terribly inconvenienced by looking at the side of a bottle once a week or so and pressing a button on our meters. Wow, this will really change my life! What will you do with the three minutes per year you're going to save on coding time? Do they really need to rub it in our faces that while there really is nowhere else to go with strips today that deliver a very accurate reading in just a few seconds, we're going to start paying a premium beyond the premium we already pay for laughable "improvements" that should have been made years ago with little or no fanfare?

But is the alternative to tell these companies they should work to make their product cheaper and reduce their profit margins by making a standardized strip? I know many people like to place different ethical restrictions on pharmaceutical companies but we need to realize that they are publicly traded companies with shareholders that do not lower their demands for profits merely because the company engages in selling health care products and services. And striving for and acquiring high profits is what allows these companies to research and bring to market the rather amazing devices we use today.

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Permalink Reply by John Carlin on January 5, 2009 at 6:48pm

Absolutely fair points in distinguishing between pump supplies and strips. With the pump, the sheer necessity of site rotation alone dictates a minimum supply requirement. And given the complexity of precise insulin delivery for a pump, I am far more inclined to exclude pump supplies from my "razor blade mentality" comments.

On the other hand, I'm not so generous with glucometers though. I feel that each meter is designed, from strip to data, for product lock-in. It's this belief that is the basis for my comments.

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Permalink Reply by Jason on January 5, 2009 at 7:01pm

Yes, they are designed that way. How do you solve the problem though?

What is a fair price to pay for test strips, and given the state of the market, why hasn't a single company been willing or able to design a meter with low-priced strips?

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Permalink Reply by MelissaBL on January 5, 2009 at 7:52pm

Great points, John and oneless.

Also consider that the batteries we need to power a pump for 24-hour consecutive operation take up space (even an omnipod's three little watch batteries). This dream of smaller, ipod-like flat pumps is currently unattainable I think (though even I was charmed by AdaptivePath's mock-up "Charmr" pump). Our devices suck batteries dry. And batteries account for a large portion of pump size. As we see improvements in battery technology, we will see improvements in pumping.

As for the glucometer and the strips, I totally agree with oneless that the "no code" marketing thing is ridiculous. The once a week I glance at the bottle wouldn't change my life. Coding has never been the difficult part about my diabetes. Watching strips increase in price by over 100% since I was a kid has, however. I remember when my mom would point out that strips were a quarter apiece or fifty cents. Now they're over a buck in most markets. But the no-code strips are not worth a rebrand or a big kick-off. They're not changing the meters to make it happen. They've just changed the chemical process by which they produce the strips.

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Permalink Reply by John Carlin on January 5, 2009 at 7:42pm

I think there are a couple high-level problems to solve. First, is the lock-in on everything beyond the strip. Personally, I think this is low hanging fruit in the era of cloud computing and APIs. If a company can embed wifi onto an SD card so you can upload digital pics to Flickr, Facebook and 20 other sites, it's beyond me to understand why we can't have the same tech for glucose readings. I think this is a good area to begin on competitive collaboration. I dream of an opportunity to drop in on a dev team to shout "MASH UP OR SHUT UP." :)

As for the price of strips or a standardized strip, this is beyond my expertise. But if some ground can be broken on collaboration, I think some momentum can be built towards that goal. Meters die. People change jobs. Employers change benefits providers. Users' preferences change. All of these are reasons to commoditize the supplies and data.

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Permalink Reply by Jenny on January 6, 2009 at 7:00am

There are a lot of patents for noninvasive test devices that do not require consumables. I have seen several come and go that worked.

My guess is that the big meter companies buy up the patents and keep them off the market. This is a standard business practice.

Pretty ugly, though.

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