Continuing Connections

The topic of this last day of Diabetes Blog Week, Continuing Connections, reminds me of my last post of last year's week, the
Diabetes Thought For the Day.

The very first inspiration for Diabetes Blog Week was to help connect our blogging community, and that continues to be the most important reason it's held every year. So let's help foster and continue those connections as we wrap up another Dblog Week. Share a link to a new blog you've found or a new friend you've made. Or pick a random blog off of the Participant's List, check it out and share it with us. Let's take some time today to make new friends.

At the end of last years Diabetes Blog Week I implemented a simple web page that redirects the visitor to a random post of all the posts from all the participants of the week. I have been using the service myself, and found many new voices within the community. I'll be updating the contents with this year's entries soon, and welcome you all to try it out at sensotrend.com/ThoughtForTheDay/, whenever you feel like you could use some peer support or want to see diabetes through someone else's eyes.

Favorites

Today's Diabetes Blog Week topic is Favorites and Motivations.

If you have been blogging for a while, what is your favorite sentence or blogpost that you have ever written?  Is it diabetes related or just life related?  If you are a new blogger and don't have a favorite yet, tell us what motivated you to start sharing your story by writing a blog?

My own favorite is the one from very early on, the post on whether to Compete or Collaborate. The main message is still the way I see diabetes technology needs to be developed. There are so many people with diabetes, and so many different needs. We need a lot of different devices and apps, so that each of us can choose the tools that best suit our individual lifestyles. At the same time, we need cooperation and open interfaces, so that all those different apps can use the data from glucose meters, insulin pumps, and continuous glucose monitors, enabling the best possible combination for their users. All of this is nowadays further emphasized by the #WeAreNotWaiting movement.

What about your favorites then? The most read post of this blog is The Exciting State of Diabetes Technology in 2014.

Changes

Today's Diabetes Blog Week topic is Changes.

Today let's talk about changes, in one of two ways. Either tell us what you'd most like to see change about diabetes, in any way. This can be management tools, devices, medications, people's perceptions, your own feelings – anything at all that you feel could use changing. OR reflect back on some changes you or your loved one has seen or been through since being diagnosed with diabetes. Were they expected or did they surprise you?

My first thought was, of course, to write about the tools and devices, and all of #WeAreNotWaiting that's currently happening. And all the development that has happened in one year after I wrote about The Exciting State of Diabetes Technology in 2014. But then again, that would have been too easy for me.

Today, I'll rather write about my relationship with, or attitude towards my diabetes. There have been some noticeable changes.

As I wrote in one of the earliest posts in this blog, I first saw diabetes as a friend, telling me to take better care of myself. Later on, our once happily intense relationship cooled down a bit, as I concentrated more on other things in life.

Right now me and my diabetes are closer than ever. I'm the founder of a startup creating self-care tools for people with diabetes, and I think about diabetes very intensely, literally each and every day. You might say diabetes and the best possible treatment for it has become my life's purpose.

I think it's very important for all of us to understand that the relationship between people with diabetes and their condition is changing continuously. That is yet another reason why we need to have a wide array of tools and methods for our treatment.

We have different priorities and different challenges at each point of our lives. No one solution fits all.

Clean It Out

This is by far the most difficult topic of Diabetes Blog Week for me this year.

Yesterday we kept stuff in, so today let's clear stuff out. What is in your diabetic closet that needs to be cleaned out? This can be an actual physical belonging, or it can be something you're mentally or emotionally hanging on to. Why are you keeping it and why do you need to get rid of it?

To get some inspiration, I read through the entries already posted for this topic. Surprisingly many of those are about all the supplies us people with type 1 diabetes need to store and use. Actual physical things in an actual physical closet.

My supplies take up space too. I put some effort into keeping them organized, and rarely have problems with the sheer volume of the supplies. What gets to me, however, is the way they are packaged. One thing in particular, are the user instructions. I get my tests strips in a package of 10 containers; one container of 50 strips lasts for around a week. Why does each one of them come with its own user instructions? And my infusion sets too, for each pack of 10 I get 2 different booklets.

All these instructions I just throw away immediately. It's just so much waste, over years and years of use. Couldn't they rather make some beginners set that's available when you first get your pack of certain type of supplies? And then all the subsequent packages would contain just the essentials.

Yes, I am aware of some of the regulation that's in place for patient safety. But in this particular case, with consumables I use day in, day out, for many years, I don't really see the benefit of having to immediately discard so many user instructions.

We often demand a lot more. Better devices, more accurate test strips, sensors for CGMs, etc. When someone asks me what I could do without and where would it be possible to save some cost, I say the user instructions for the everyday consumables.

Nurses Day

Today is the second day of Diabetes Blog Week, with the topic Keep It To Yourself:

Many of us share lots of aspects of our diabetes lives online for the world to see.  What are some of the aspects of diabetes that you choose to keep private from the internet?  Or from your family and friends?  Why is it important to keep it to yourself?  (This is not an attempt to get you out of your comfort zone.  There is no need to elaborate or tell personal stories related to these aspects.  Simply let us know what kinds of stories we will never hear you tell, and why you won't tell them.)

Since this is also the International Nurses Day, I'd like to express my gratitude to all the diabetes nurses and certified diabetes educators (CDE's) who have helped and continue to help me achieve the best possible treatment, and at the same time encourage me to lead a life that's not all about treating my chronic condition. You have all been so amazing!

So, I wish nobody will ever hear me brag that I've achieved any good treatment results just by myself. The support from my loved ones, from my nurses and doctors, and from the technology I have access to are the key ingredients that I couldn't cope without.

I Can

It's Diabetes Blog Week again!

This year, the topic for the first day was the empowering I Can.

Lets kick things off this year by looking at the positive side of our lives with diabetes. What have you or your loved one accomplished, despite having diabetes, that you weren't sure you could? Or what have you done that you've been particularly proud of? Or what good thing has diabetes brought into your life?

The first thing for me, obviously, is all that I have accomplished with Sensotrend this far. Both myself and my wife have worked for our startup company full time for over a year already. I feel incredibly empowered, being able to create tools that can help me gain better understanding of how my body works, and better treatment outcomes.

I've written before about the change that using a Continuous Glucose Monitor brought to my life as a diabetic and to my attitude towards treating myself.

For the first time, I was able to see how my blood glucose really behaved. No more shotgun charts. The resulting chart was rather a roller coaster, showing the glucose go up and down, sometimes fast, some times slower. Very far from the ideal curve, but providing so much more insight than the isolated dots of the meter.

I had been told I can control my blood glucose by simply calculating all the carbs I eat and taking little less insulin when I'm exercising. But for me, it was not so simple, and I could never really explain all the variations in the values of my isolated blood glucose measurements. The CGM curve showed me how the values changed, and prompted me to find out what was causing the different ups and downs.

That's what changed my attitude completely. I had already given up, found good control of my blood glucose values to be beyond my capabilities. Getting more insights from the CGM curve was the ground breaking change I needed, to get the sense that there is a way to learn what exactly affects my blood glucose levels and how, so I can start to keep it better under control.

Diabetes Thought For the Day

The topic of the last day of Diabetes Blog Week is My Favorite Things, meaning what has moved me the most during the week.

This was the first time ever I attended the Diabetes Blog Week. One important thing for me was that the week pushed me to write and get my thoughts out. Too many times in the past I've drafted something but never quite finished with the writing. It really helps to have a schedule. I didn't manage to post on Saturday, but don't feel too bad about it.

What's a lot more important is that the through the Diabetes Blog Week I found dozens of new interesting diabetes blogs, and gained an incredible amount of new diabetes wisdom. However, during the week I only managed to read a few percentages of the total blog posts listed. I really want to create a habit of reading more of these blog posts.

What's key when creating a habit, provided motivation is there already? We need to make it simpler to take that action. So, to make it as easy as possible to read new blog posts, I decided to create a simple web page that takes me to a new blog each time I visit it. It would not be that complicated to navigate to the Diabetes Blog Week pages, select a topic, and a new blog from there. However, I didn't believe I'd be able to make that sequence of actions into habit, and wanted to make it even simpler.

Originally, I considered a service that would take me through the blog posts one by one, in the order they were entered in Diabetes Blog Week, topic by topic. Then I thought it could be more fun if there be some randomness in the process. So instead, the service I created now randomly selects one of the posts entered so far. I've bookmarked that page, and just now made it my home page, so whenever I'm going online, I'll always have new diabetes reading available. You can do that too. The address is:

sensotrend.com/ThoughtForTheDay

It only took an hour to set this up. Honestly, writing this blog post took more effort. Here again, I think the main point was to keep it simple. In the future, I might include filters to search posts about certain tags or topics. I also may add posts from previous blog weeks, or add a user interface for bloggers to add their content to the service manually. Or anything any of you may think of, that would add value to the service. But first, let's see if this raises any interest.

Many thanks everyone for the amazing week! And a special thank you to Karen for organizing it all!

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http://www.bittersweetdiabetes.com/2014/05/diabetes-blog-week.html

Diabetes Life Hacks

Today's Diabetes Blog Week topic is Life Hacks, everything about the tips and tricks that help people with diabetes in the day-to-day management of their condition. We restrict the advice to non-medical ones.

In Finland, the Quantified Self and Biohacking movements are working closely together. Biohacking includes all the modifications you can make to your habits and behavior, nutrition and exercise, mental models and ways of thinking. Quantified Self, with the mantra "Knowledge Through Numbers" helps validate the results, taking a more scientific approach. With many kinds of measurements you can see whether a change you made really had an impact or are you just telling yourself it had.

I have some simple metrics I follow. For instance, I create a mental note whenever I floss. When I realize it's been a week since the last time, I know I'm also not paying enough attention to the treatment of my diabetes, and it's time to let go of some of the pressuring factors and concentrate more on diabetes. Diabetes treatment must always have that priority. Otherwise I'll just get into a state where I'm no good doing anything else.

My biggest challenge with diabetes has been with understanding the effects different types of exercise have on my glucose levels. I've started to understand some of the biological mechanisms, but still need to track myself in order to apply that knowledge to my own treatment. For almost a year now, I've carried a pedometer in my pocket. Actually several ones nowadays. I've got two applications in my phone, Moves and Wellmo. Both of them track my every step, just by running on the background, without requiring any interaction or manual logging. That's great, and I've learned that it really makes a difference if I take 200 or 20 000 steps per day.

The best hack with increasing my step count was to install a tracker also to my wife's phone. The week that followed was the first time ever I recorded 10 000 steps every single day.

Moves works great as a diary too. Sometimes when analyzing the data from my continuous glucose monitoring sessions I have hard time remembering what was it that I did a week ago that may have caused a certain change in my glucose levels. In addition to my steps, Moves keeps a log of where I've been, and a glimpse on a certain day always helps me remember what I was doing. Moves is also quite clever in automatically separating between walking, running, and cycling. Again, fully automatically, just running on the background.

Wellmo is a more comprehensive wellness solution. It allows me to track changes in my weight, my blood pressure, alcohol consumption, and a lot of other metrics. If I'd be a true gadget freek, I'd get the weight scale and blood pressure meter from Withings, so they'd be transfered to Wellmo's service automatically. As I only track my weight once a week and blood pressure even less often, it's not a big thing for me to enter those measurements manually. And Wellmo does a good job in reminding to enter those values. I also manually enter all exercise and sport I do.

All this logging is very different from tracking blood glucose results. I never manage to enter my glucose values to a logbook, as there's often so much other things going on at the same time: I need to measure, think of what that measurement means, is it higher or lower than I expected and if so, what could  have caused that, guess the carbohydrates in the meal and the glycemic index, taking into account a couple of previous times I've had a similar meal and remembering how well I estimated then, enter the carb estimate to the bolus calculator, think about other affecting factors (stress, exercise I've done and perhaps will do after the meal), check the amount of insulin the bolus calculator proposes and estimate it's sanity, etc. Taking out a logbook and entering the values there as well, does not really fit into the scenario, with my limited capacity.

So that's what I'm currently hacking together with Sensotrend. Getting the data from where it already exists. Blood glucose values and carb estimates from my meter, insulin values from my insulin pump, basic activity from pedometer apps, exercise from apps designed to track exercise, and so on. To make tracking all  that information so much easier.

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Again, this is a part of a series of posts part of the Diabetes Blog Week.

The Exciting State of Diabetes Technology in 2014

My post of yesterday dealt with the #DBlogWeek theme of What Brings Me Down. Today, let's take a look at what brings me back up and running again.

One of my early posts got a comment linking to Scott Hanselman's blog post The Sad State Of Diabetes Technology In 2012. Both that post and the discussion in the comments thread express the frustration all people with diabetes sometimes share. We'd just like a break from constantly monitoring ourselves, guesstimating carbohydrates, injecting insulin, etc. And we know many of the problems we're experiencing can be solved with technology. And we're frustrated when we don't have that technology, only a promise of it.

I personally, at least on a good day, find it much better to appreciate every small step that is taking us in the better direction. I know we're not there yet, and it will take us decades to get to where diabetes no longer produces a slightest burden, but all the progress I'm seeing genuinely aims at making life with diabetes easier and improving the treatment results.

In my previous posts, I've presented some of the Finnish diabetes startup companies. Today, let's take a global view.

Connectivity

One of the main issues presented in Scott's post was interoperability between devices, and open, standardized interfaces. While a lot of work is still needed on this front, a lot of progress has already been made. Companies like Diasend integrate with nearly all glucose meters out there, and are able to get the data out of them to their service, so that people with diabetes can remotely communicate their measurements with healthcare professionals, and the healthcare professionals only need to learn one user interface to inspect those results. Mendor have done a lot of the same work integrating glucometers to their Balance software. And Sinovo similarly for their SiDiary, also enabling people to feed their results to Microsoft's HealthVault platform, a Personal Health Record system where those measurements can be linked to all other relevant data, like nutrition and exercise, obtained from other apps and devices.

The above solutions mainly rely on people with diabetes using the readers shipped with their glucose meters, to upload the results. That process involves fetching the device, connecting it to a computer, starting the upload program and using it. While not a huge task, still something that people won't make a part of their daily routine.

There are a few attempts to make this process simpler. Biomedtrics, Diabeto, and Glooko all provide solutions not involving the computer in the process. Modz have a SIM card in their meter, sending each measurement to the cloud fully automagically. This week, I'm getting a Fora meter that communicates measurement results to my smartphone, and the phone then transmits the results to a cloud service, again with no manual interaction required from me. I really like the way things are evolving.

Towards the Bionic Pancreas

I'm also thrilled to read the experiences people are reporting from the Bionic Pancreas experiments. People with type 1 diabetes finally getting that break, not having to worry about glucose levels, carbs, and injections, just living their lives.

There's so much going on on this front, including the whole We Are Not Waiting movement, starting again from getting the measurement data out of continuous glucose monitoring devices in real time (see Hacking Type 1), but already involving development of advanced algorithms and Do It Yourself Pancreas Systems.
Just today, Femma announced they're about to start testing their own algorithms for an artificial pancreas system.

Photo from http://www.hackingtype1.com/2014/03/08/awareness/

A lot of all this is of course just pipe dreams. I realize this, and I'm still encouraged by each new attempt. They all tell me I'm not alone, people share the same frustrations and are active in trying to solve them the best they can.

I'm also excited of each small concrete step forward, like finally getting a meter that transmits it's results to a cloud service automatically.

Small steps, but important ones!

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This is my post for the Diabetes Blog Week, under topic Mantras and More, what gets us through a tough day.

Easy Answers

Throughout my life, I've been underweight. I've come to notice that most of dietary advice just implicitly assumes that all people always just want to lose weight. I'm sure this has triggered in me an allergy towards easy answers suitable for everyone.

I've learned this with diabetes as well. When we're taught the basics of the condition and the treatment, it's of course good to stick to the basics. But oversimplifying diabetes can lead to frustration and a burnout. It did for me.

You're told you can calculate your carb ratio and insulin sensitivity by just measuring your blood glucose just before and two hours after your meal, and that's relatively simple. And you do that, even eating a same pre-packaged meal each time, that even has the nutrition values printed on the packaging -  and you still keep getting different results each time. It just makes you feel discouraged, stupid, and disappointed.

The same with diabetes and physical exercise. As a general rule of thumb, physical exercise enhances the effects of insulin and lowers blood glucose. I notice this quite clearly when running, for instance. But with football it's a totally different game. My glucose tends to rise quite dramatically, and I need more insulin during games, not less. Part of that is due to type of exercise, also running sprints and intervals is different from running a long distance with an even pace. Another part is the competitive nature of the sport, and the adrenalin that produces. Just knowing physical exercise generally lowers blood glucose is not what I need as a diabetic. I really need to understand more of the complexity of the matter.

Lately, as a startup entrepreneur, I've done my fair share of public speaking. It has interesting effects on blood glucose as well. The adrenaline just pumps my glucose levels up. I've seen many people in diabetes online communities testifying similar results.

Self-tracking in real time: here's what live video interviews do to me. #MedX pic.twitter.com/EO91e303Ik
— Kim / Diabetes (@txtngmypancreas) January 29, 2014

So there is a plethora of things affecting our blood glucose levels. Thinking you can easily calculate the effects of a meal with two measurements ignores these other factors. At the very least, you need to know to take many measurements, and estimate the averages. Much better would be to understand as much as possible of the other factors, and take those into account when estimating the effects of one variable.

Sticking to the simple answers has not been helpful for me. I would greatly appreciate healthcare system in general moving from that old broadcast model (one message for all) to more personalized information and advice. I've seen that change take place in media, and believe that with the current availability of wellness trackers and medical devices, the technology makes this transition possible also in healthcare.

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This is my third post for the Diabetes Blog Week. The theme for today is What Brings Me Down. For me, that has been the easy, over-simplified answers.

Finnish Diabetes Startups, Combined

There are two important diabetes device manufacturers in Finland. Mendor's Discreet glucose meter offers everything you need to measure your blood glucose in a single package. It makes measuring blood glucose really fast, and also discreet. Modz have a glucose meter that sends the measurement results directly to the cloud service and routes it to a cell phone in another location if requested, so parents of children with diabetes can monitor the treatment of their children, for instance. It's also highly motivational, and they have their Moodz characters - and also Angry Birds themes!

You can get the Modz meter with the Angry Birds look!

Of course, both of the device manufacturers also develop their own software solutions to analyze the measurement results. But there are limits to how many things a startup company can really focus on.

There are other companies concentrating on software and services. Both MyHealthWay and Quattrofolia are warming up the WellMate concept developed in Nokia in early 1990's. Both are building their offerings as turn-key standalone solutions, and targeting other chronic illnesses as well. Quattrofolia are being bold enough to even start their own clinic.

Then there is the brand new Femma5. They don't even have a website up yet, but they have a grand vision for algorithms for artificial pancreas systems.

Working Together

What does this all mean for Sensotrend? I personally really appreciate the work Mendor has put into product development, and also for integrating other blood glucose meters into their Balance software. We've worked together with them to get the data flowing between Balance and Taltioni, and like to continue cooperating even further. Currently their Balance software only analyzes blood glucose measurements. We're trying to help them see that that information does not really include everything you need to know to manage your treatment parameters. Factors like nutrition, exercise, and insulin dosages need to be factored in.

Modz complements Sensotrend's offering beautifully. We get a lot of wishes for our solution to be real time, allowing parents to check on their kids while they are away. Most currently available glucose meters don't offer that kind of automatic real-time sharing of measurement results, and Modz certainly fulfills a real need there. With them, we're discussing combining our efforts in service development. We seem to share a common vision.

I like the way MyHealthWay manages the communication between people with diabetes and their healthcare professionals. And their mobile apps look quite nice, I'd like to use them as part of Sensotrend's service, for manual data entry when that is needed. They haven't yet warmed to my proposals of cooperation. They also don't see the value of automated data import, rather feel it is important that people with diabetes interact with their app as often as possible, claiming it empowers the patient. I myself tend to disagree with that sentiment. For me, data entry needs to be as automated and easy as possible. I want to be empowered by data just being there for me to analyze it when I want to, not having to manually copy each entry from a device to another.

I edited the above based on Jarl's comment "Our roadmaps cover the automatic input part as well but the point here is to start off with the manual input to activate the user and become empowered in his/her care process and see beyond the figures and data in order to see the big picture." Please see the full comment in comments section.

Quattrofolia have interesting studies and knowledge around HbA1c values, how those can be calculated from measurement results and how that benefits people with diabetes. For me, some of that thinking seems kind of twisted. I mainly appreciate HbA1c as an easy and cheap metric available when there are no reliable glucose measurements. But when there are measurements available, they offer much more information, and HbA1c should just be used as a verification method to spot possible systematic errors. What I really like about Quattrofolia, though, are their plans for the evolution of their service, into a kind of a Diabetes University, providing high quality guidance for people with diabetes.

Finally, I hope the data gathered with Sensotrend's own solution will ultimately help Femma5 in their development work. At some point, they need to know how different kinds of exercise affect different people, and in general how differently we all react to all the factors affecting blood glucose values.

Just combining the products and services of all these Finnish diabetes startups into a single offering would be a big step towards that often discussed Dream Device. If we can agree to work together to get the basics in place, we'll get to take the next steps much sooner!

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This is my second entry to the Diabetes Blog Week. The selected theme for today was poetry, but with everything going on with our Startup Sauna program, end user interviews, and closing the financing round I wasn't able to connect with the poet within, and decided  to play the wildcard 'Diabetes Dream Device' instead, and continue with yesterday's theme.

Stronger Together

Many things have changed since we started building our service, but our vision of doing this in cooperation with other companies is still strong.

Last week, a bunch of Finnish startups met with Microsoft's Healthvault representatives. The discussion was about creating a combined service offering for diabetes, involving services from each of the companies. There are many great health and wellness startups in Finland. Platforms like Healthvault and Taltioni are one possible glue that may join their areas of expertise into a great combined offering for healthcare.

Sensotrend's solution for diabetes treatment depends on data from other services. Of course, we need the data from blood glucose meters and continuous glucose monitors. We have integrated our solution with the devices from Medtronics, Accu-Chek, and Dexcom, but that integration always comes with a cost. Mendor have already integrated their Balance software with dozens of glucose meters from different vendors. We're working with them to get that data flowing between Balance and Taltioni.

Just the glucose readings are not enough for us. We want to visualize the measurements together with all the factors affecting them. Insulin doses, nutrition, physical exercise, stress, weight changes, etc... Modz, another device manufacturer shares our sentiment, and we're discussing how we could work together in creating such services and visualizations.

Of course, we also need data from many other sources. There are plenty of activity and wellness trackers available, and quite a few Finnish companies (Beddit, Fjuul, Moves, Myontec, Omegawave, Polar, PulseOn, RecoApp, Runteq, Sensorfit, Sports Tracker, Suunto, Vigofere,  Wellmo, ...). We want our end users to be able to select the tools and apps that best suit their individual lifestyles and needs.

W2E helps us by bringing all that data to platforms like Taltioni and Healthvault. They build the integrations to many trackers, and standardize the data to a common format.

In addition to tracking physical activity, sleep, and stress, we're still missing a key ingredient, nutrition. We can get the carbohydrate estimates from the bolus calculator integrated in insulin pumps and glucose meters. People with diabetes have a high motivation to enter their estimates to these tools, as the bolus calculator makes it easier to estimate the correct dose of insulin. But not all people with diabetes have an insulin pump system with a smart bolus calculator. For them, we need to offer other tools to enter that data.

For many people, it makes sense to track more parameters than just the amount of carbohydrates. Glycemic index indicates how fast the carbohydrates are absorbed from the meal after eating, an important metric. You should always take this into account when analyzing post meal measurements. You may also need to inject your insulin dose differently if the glycemic index of your meal is low, meaning not all of the carbohydrates are released into blood stream immediately after eating. In addition to carbohydrates, it is also important for people with diabetes to understand their overall energy consumption and to track other macronutrients: fat, protein, and alcohol.

As with exercise, we'd like to see several meal logging apps being available for people with diabetes using our service. Some apps may concentrate just on storing pictures of meals, some can help searching for nutrition information from databases, and some may educate users about different meal choices. We're in discussions with MealLogger and SeeHowYouEat, and there are still many we need to get in touch with.

The business models

Many times the discussions with app providers and device manufacturers lead to ownership of the data and of the customer relationship. We're quite happy with the solution where the full set of data only resides in the original service provider's database. There probably is no suitable slot for every piece of information in Taltioni or Healthvault anyway. For a sports tracking application, we may just store the sport, duration, and maximum or average heart rates to Taltioni. However, with that information we also want to store a link to the origin of that data, so the end users may check the full range of heart rate variations, the running course, speed, and other information in case they need more detail.

Even in this case, the personal health record platforms still have a critical role in managing trust relationships between services. It is absolutely best for the end user if they can administer all their data sharing in one place. On Taltioni or Healthvault, they can indicate which services are allowed to read which pieces of their information, and revoke that permission at any time they feel like it. It gets too messy and complicated to manage all this in different services, case by case.

Finally, we're happy to share a fair piece of income with all parties. We plan to pay the platform fee to the personal health record platforms, and another for companies that integrate and aggregate data from multiple sources so we only ever need to care for one integration, the one to the central system. We're hoping that will be an incentive for all players to participate in the ecosystem.

Because there's no way we can do all of that ourselves. And there's no way any other company can.

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This post is my first entry to the Diabetes Blog Week. Today's theme is Change the World.