当码农的悲惨_2012年糖尿病技术的悲惨境况

当码农的悲惨

I've been diabetic for almost two decades. It's tiring, let me tell you. Here's a video of my routine when I change my insulin pump and continuous meter. I'm not looking for pity, sadness or suggestions for herbs and spices that might help me out. I'd just like a day off. Just a single day out of the last 7000 or the next, I'd like to have a single piece of pie and not chase my blood sugar for hours.

我已经患有糖尿病近二十年了。 很累，让我告诉你。 这是我更换胰岛素泵和连续仪表时的常规视频。 我不是在寻找可怜，悲伤或对草药和香料有帮助的建议。 我只想休息一天。 在最近的7000天或下一天中，只有一天，我只想吃一块馅饼，而不是连续几个小时追逐我的血糖。

Every time I visit the doctor (I do every 3 months) and every time I talk to someone in industry (I do a few times a year) I'm told that there will be a breakthrough "in the next 5 years." I've been hearing that line - "it's coming soon" - for twenty.

每次拜访医生(我每3个月做一次)和每次与行业人士交谈(我每年做几次)，都被告知“未来5年内将取得突破”。 我一直在听那条线-“它很快就要来了”-已经二十了。

I used to wait a minute for a finger stick test result. Now I wait 5 seconds but we still have blood sugar strips with +-20% accuracy. That means I can check my sugar via finger stick twice and get a number I'd take action on along with one I wouldn't. Blood sugar strip accuracy is appalling and a dirty little secret in the diabetes community.

我过去通常要等一分钟才能得到指棒测试结果。 现在，我等待5秒钟，但我们仍然有血糖条的准确度为+ -20％。 这意味着我可以通过指尖检查两次糖，然后得到一个我会采取行动的数字和一个我不会采取的行动。 血糖试纸的准确性令人震惊，在糖尿病界是一个肮脏的小秘密。

I started with insulin that would reach its peak strength after about 4 hours. Today it takes about an hour. Awesome, but that's not fast enough when a meal can take me to the stratosphere in minutes.

我开始使用胰岛素，它会在约4小时后达到峰值强度。 今天大约需要一个小时。 太棒了，但是当一顿饭可以在几分钟内将我带到平流层时，这还不够快。

We are hurting here and we can't all wait another five years. Diabetes is the leading cause of blindness, leading cause of kidney failure and leading cause of amputation.

我们在这里受伤，我们不能再等五年。 糖尿病是导致失明的主要原因，导致肾功能衰竭的原因和导致截肢的原因。

I wrote the first Glucose Management system for the PalmPilot in 1998 called GlucoPilot and provided on the go in-depth analysis for the first time. The first thing that struck me was that the PalmPilot and the Blood Sugar Meter were the same size. Why did I need two devices with batteries, screens, buttons and a CPU? Why so many devices?

我在1998年为PalmPilot编写了第一个葡萄糖管理系统，称为GlucoPilot，并首次提供了进行中的深入分析。 让我震惊的第一件事是PalmPilot和血糖仪的尺寸相同。 为什么我需要两个带有电池，屏幕，按钮和CPU的设备？ 为什么有那么多设备？

In 2001 I went on a trip across the country with my wife, an insulin pump and 8 PDAs (personal digital assistants, the "iPhones" of the time) and tried to manage my diabetes using all the latest wireless technology. Here's what I had to say 11 years ago:

2001年，我与妻子，胰岛素泵和8台PDA (当时的个人数字助理，当时的“ iPhone”)一起去了全国，并尝试使用所有最新的无线技术来管理我的糖尿病。 这是11年前我不得不说的：

With Bluetooth coming, why couldn't my [PalmPilot] monitor my newly implanted smart-pump? GlucoPilot could generate charts and graphics from information transmitted wirelessly from the pump. For that matter, the pump, implanted in my abdomen, could constantly transmit information to Bluetooth-enabled devices that surround me. The pump might use my cell phone to call in its data into a central server when I'm not using the phone. If I wander near my home computer, the pump or Visor might take the opportunity to upload its data. During a visit to the doctor, Bluetooth's 30-meter range could provide the doctor with my minute-by-minute medical history as I sat in the waiting room.

随着蓝牙的到来，为什么我的[PalmPilot]无法监视我新植入的智能泵？ GlucoPilot可以从泵无线传输的信息中生成图表和图形。 为此，植入我腹部的泵可以不断地向周围的支持蓝牙的设备传输信息。 当我不使用手机时，泵可能会使用我的手机将其数据呼叫到中央服务器。 如果我在家用计算机附近徘徊，则水泵或遮阳板可能会借此机会上传其数据。 在看医生的过程中，当我坐在候诊室时，蓝牙的30米范围可以为医生提供我的每分钟病史。

Back in 1998 when I was writing and marketing GlucoPilot I was using a custom cable that connected directly from my PalmPilot to the glucose meter and downloaded my historical glucose data. Fast forward to 2012 and what new technologicals innovation do we have?

早在1998年，当我编写和营销GlucoPilot时，我就使用一条定制电缆，该电缆直接从PalmPilot连接到血糖仪，并下载了我的历史血糖数据。 快进到2012年，我们拥有哪些新技术创新？

Yes, that's a custom cable to plug-in to my PDA. Yes, I'm a frustrated diabetic. This a 15 year old solution with no backing standards, no standard interchange format, no central cloud to store the data in. It's vendor lock-in on both sides.

是的，那是一条定制电缆，可以插入我的PDA 。 是的，我是一个沮丧的糖尿病患者。 这是一个有15年历史的解决方案，没有支持标准，没有标准的交换格式，没有用于存储数据的中央云。供应商双方都处于锁定状态。

Kudos to the Glooko guys for fighting the good fight and shame on the blood sugar meter manufacturers for making their job hard.

格洛科(Glooko)伙计们为打好血糖仪制造商的良好战斗而感到羞耻，他们因工作辛苦而感到羞耻。

Fifteen years ago we talked about data standards and interoperability. I was even on a standards board for a while to try and pressure the industry to standardize on data interchange formats. I have personally written multiple blood sugar meter data importers from the very simple (CSV) to the very complex (binary packed and purposely obscured to prevent 3rd party data dumps) and I can tell you that the blood sugar meter manufacturers are not interested in making it easy to move our data around. This is a billion dollar industry.

十五年前，我们谈论了数据标准和互操作性。 我什至在标准委员会上工作了一段时间，试图向业界施加压力以使数据交换格式标准化。 我已经亲自写了多个血糖仪数据导入器，从非常简单的(CSV)到非常复杂的(二进制包装，故意将其模糊化以防止第三方数据转储)，我可以告诉您血糖仪制造商对轻松移动我们的数据。 这是一个十亿美元的产业。

Today I read an article about the iBGStar (a forgettable name) glucose meter that plugs directly into an iPhone 30 pin port. The article came up on Hacker News and one of the designers said this in a comment:

今天，我读了一篇有关iBGStar (一个易忘的名称)血糖仪的文章，该血糖仪直接插入iPhone 30针端口。 这篇文章发表在Hacker News上，其中一位设计师在评论中这样说：

I'm one of the designers of the iBGStar and we considered Bluetooth. We actually have another FDA cleared product that uses Bluetooth, but cost, battery life, and a bunch of technical issues led us to favor the 30 pin.

我是iBGStar的设计师之一，我们考虑过蓝牙。 实际上，我们还有另一款使用蓝牙的FDA许可产品，但是成本，电池寿命和一系列技术问题使我们倾向于使用30针。

This is hugely disappointing especially since Bluetooth 4.0 is said to offer battery life as long as 10 years on some products. Given all the new iPhones have Bluetooth 4.0 just waiting for devices to connect to, you'd think this is a perfect opportunity for a Bluetooth 4.0 glucose meter.

这尤其令人失望，特别是因为据说蓝牙4.0在某些产品上的电池寿命长达10年。 鉴于所有新iPhone都具有等待设备连接的蓝牙4.0，您会认为这是蓝牙4.0血糖仪的绝佳机会。

I appreciate the attempts and the word that is being done in the space, I truly do, but as an end user when I see products like this that are trying to push the envelope but fail with fundamental usability issues, I'm saddened. Most diabetics check their blood sugar 10 times a day or more. I can't keep this glucose meter attached to my phone. It'll fall off, get bent, mess up the 30 pin connector. It's simply not reasonable for a day to day use coming in and out of pockets.

我确实很欣赏在太空中所做的尝试和成功，但是作为最终用户，当我看到像这样的产品试图突破极限但由于基本的可用性问题而失败时，我感到很难过。 大多数糖尿病患者每天要检查血糖10次以上。 我无法将此血糖仪保持在手机上。 它会掉下来，弯曲，弄乱30针连接器。 口袋里进出的日常使用根本不合理。

A more reasonable mode of usage would mirror the FitBit. It's tiny, clips to my belt and automatically notices when I pass by my computer then uploads its data wirelessly. That's how wireless is supposed to work. And the battery lasts at least a week.

更合理的使用方式将反映FitBit 。 它很小，可以夹在皮带上，并在我经过计算机时自动发出通知，然后以无线方式上传其数据。 这就是无线应该工作的方式。 电池可持续使用至少一周。

Twenty years and no significant moves. We are still wiring our devices together, translating from one format to another, all the while being hamstrung by the FDA and their processes. When we do start to get something working well, it's attacked and we're told that our insulin pumps can be hacked from a mile away and we can be killed in our sleep. This will no doubt slow progress and make the FDA even more paranoid when approving new technology.

二十年了，没有重大变化。 我们仍将我们的设备连接在一起，从一种格式转换为另一种格式，同时一直受到FDA及其过程的阻碍。 当我们确实开始使某种东西运转良好时，它就会受到攻击，并且被告知可以从一英里外的地方入侵我们的胰岛素泵，并且我们可以在睡眠中被杀死。 无疑，这将减缓进展，并使FDA在批准新技术时更加偏执。

I've just this week switched from a Medtronic Continuous Glucose Meter to a DexCom, which is another company. This new CGM gives me more accurate data with less lag time. However, I still have the same insulin pump. This means my meter and pump aren't integrated so I carry another device on my person. This is because while the Animas Vibe, a pump that integrates both the DexCom meter and an insulin pump as well as other features like being waterproof, is available EVERYWHERE but the US. It's in the FDA process. Maybe ready in 6 months? 18? Who knows. When it shows up, the technology will be years old while the iPhone is on generation 6. We've got 3D TVs to watch crappy movies on by my insulin pump's firmware hasn't changed in nearly a decade.

我刚刚在本周从Medtronic连续血糖仪转到了另一家公司DexCom。 这项新的CGM以更少的延迟时间为我提供了更准确的数据。 但是，我仍然有相同的胰岛素泵。 这意味着我的仪表和泵没有集成在一起，因此我在自己的身上携带了另一台设备。 这是因为虽然Animas Vibe泵既集成了DexCom流量计和胰岛素泵，又具有防水等其他功能，但在美国以外的任何地方都可以买到。 在FDA程序中。 也许在6个月内准备好了？ 18岁？ 谁知道。 当它出现时，该技术将在iPhone进入第6代时就已经存在多年了。我们的胰岛素泵固件在过去的10年中都没有改变过3D电视来观看糟糕的电影。

The article about the iBGStar is poorly researched and galling.  I appreciate what Hacker News commenter lloyd said with emphasis mine, calling out this inane line from the article.

有关iBGStar的文章研究不力，令人振奋。 我很欣赏《黑客新闻》评论员劳埃德(Lloyd)强调的话，并在文章中提到了这句无聊的话。

"Could this be the beginning of mobile diabetes monitoring?"

“这可能是移动糖尿病监测的开始吗？”

As so many people above have stated, no, you moron. We've been monitoring blood sugar on the go for the past 30 years.

正如以上许多人所说，不，你这个笨蛋。 在过去的30年中，我们一直在监控血糖。

I've got Type 1 diabetes...and my current meter is smaller than the one shown here. I can plug it into my Mac via USB to download and visualize the data (& can control my insulin pump via bluetooth using the meter).

我患有1型糖尿病...并且我的当前仪表比这里显示的仪表小。 我可以通过USB将其插入Mac以下载和显示数据(并且可以使用仪表通过蓝牙控制胰岛素泵)。

The only benefit with this particular iPhone-compatible meter would be enhanced, immediate visualization of results. Which might be easier to get, and might not, given the inconvenience of having to remove an iPhone case and plug in the meter. (Not to mention other issues - what if my iPhone's batteries are dead? Will it still work?)

这种与iPhone兼容的特殊仪表的唯一好处是可以立即显示结果，从而得到增强。 鉴于必须卸下iPhone外壳并插入仪表的不便之处，这可能更容易获得，而可能不会。 (更不用说其他问题了-如果我的iPhone电池没电了怎么办？它还能继续工作吗？)

Unfortunately, this product reminds me of 5 years ago, when someone would announce a new toaster, and the tech crowd wouldn't be impressed...unless it was a Bluetooth toaster. We're so focused on it being the hot new thing (it's compatible with iOS! Oooh!!) that we ignore the fact that there's nothing revolutionary being presented here.

不幸的是，这款产品让我想起了5年前的那一年，当时有人宣布推出一款新的烤面包机，而技术人群也不会对此印象深刻……除非它是蓝牙烤面包机。 我们非常关注它是炙手可热的新事物(它与iOS兼容！噢！！)，以至于我们忽略了这里没有革命性的事实。

The way I see it, this doesn't really change anything in terms of treatment. If it's a more accurate meter, great - sell based on that. Not on the bogus "we're taking blood glucose monitoring mobile" claims.

以我的看法，这在治疗方面并没有真正改变任何东西。 如果它是更精确的仪表，那就太好了-以此为基础进行销售。 并非虚假的“我们正在使用血糖监测手机”的说法。

You may feel like technology is amazing and it's moving so very fast and it surely is. But as a diabetic who relies on technology to stay alive as along as I possibly can, it feels like nothing has changed in 20 years. Maybe something will happen in just 5 more.

您可能会觉得技术是惊人的，它的发展是如此之快，而且确实如此。 但是作为一名糖尿病患者，我尽可能地依靠技术来维持生命，所以感觉20年没有改变。 也许还会再发生5次。

Sponsor: I want to thank the folks at DevExpress for sponsoring this week's feed. Check out their DXperience tools, they are amazing. You can create web-based iPad apps with ASP.NET and Web Forms. I was personally genuinely impressed. Introducing DXperience 12.1 by DevExpress - The technology landscape is changing and new platforms are emerging. New tools by DevExpress deliver next-generation user experiences on the desktop, on the Web or across a broad array of Touch-enabled mobile devices.

赞助商：我要感谢DevExpress的人们赞助了本周的提要。 查看他们的DXperience工具，它们很棒。 您可以使用ASP.NET和Web窗体创建基于Web的iPad应用。 我个人真的很感动。 由DevExpress的引入DXperience 12.1 -技术前景正在发生变化，新的平台不断涌现。 DevExpress的新工具可在台式机，Web或支持触摸功能的移动设备上提供下一代用户体验。

翻译自: https://www.hanselman.com/blog/the-sad-state-of-diabetes-technology-in-2012

当码农的悲惨