Yesterday, I discussed how I'd like diabetes healthcare providers and the healthcare industry to better use existing tests and technologies, and how I believe our current crop of devices and programs might be developed in the near-term future. Today I'm going to discuss items that will take a bit longer to develop and get through FDA approval, or which may take technological and medical breakthroughs to bring to fruition.

Longer-Term Future

As I've mentioned in a previous post, I -- and many others -- could really use medications, diagnostic equipment, and supplies that will remain stable and usable in extreme temperatures. Let's face it, there's very little as frustrating as losing the use of an entire vial of insulin or test strips, or an entire bottle of pills, because it accidentally got locked in the car on a hot August afternoon while you did your grocery shopping -- or getting constant battery and temperature errors when you're trying to test in the middle of a cold morning on the ski slopes. Of course, that's not even beginning to touch on the issues of multiple-day blackouts during heat waves and severe tropical storms, improper transportation environments, and delivering these items to the remote areas and extreme environments that constitute most of the world's indigenous populations and emerging nations.

I'd like to see more accurate CGMs that don't have a lag to blood-based measurements and which don't need calibration. Perhaps our nanoelectrical technicians can even come up with an ingestible glucometer that sits somewhere in your gut and transmits readings to a hand-held receiver. I'd also like to see a multiple-lead CGM-type system for use in research situations, so our medical researchers can track how the body uses and metabolizes glucose -- both amongst people with different types of diabetes and people without diabetes. This could possibly be funded by the elite sports industry, since testing athletes this way may help them optimize their nutritional intake before, during, and after their performances.

I'd also like to see glucometers and CGMs that are at least as accurate as today's devices, but which use noninvasive technology -- and in the process, fewer and less-expensive consumables.

Finally, I'd like to see medications and devices that better manage glucose and insulin metabolism than those we have available right now. Perhaps we may look at something that does for insulin release what an artificial pacemaker does for people with various heart malfunctions. This might be one of the paths of research that would lead to true artificial islets, since there is more to the issue than insulin delivery programmed to food intake and circadian rhythm.

Summary

You'll find I haven't said anything about more accurate glucometers, less expensive consumables, smaller (or larger) devices, or integrated devices. I feel device size will develop on its own, as we already have a large range of device and display sizes, backlight options, and strip loading options. We have a few devices which have port lights for testing in the dark, and it would be nice for more manufacturers to incorporate this feature in their devices -- but perhaps not a deal-breaker. As technology becomes more accurate, the real price of consumables rises to meet the needs of the technology -- so I don't foresee a ten-cent test-strip on a five-times-more-accurate glucometer any time in the foreseeable future. The one integrated device I've tested -- a wrist blood-pressure cuff with integrated glucometer -- was so inaccurate at reading my blood pressure, and had such a primitive set of software, that I'd rather deal with the Batman Utility Belt (or the Backpack or Handbag O' Doom) and devices I trust, than a single device that can become a single point of failure for multiple medical needs.

This post is part 2 of 2 for my July entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2011/july-dsma-blog-carnival/