The Design of Diabetes


Yesterday I had the chance to participate in a focus group for a computer program for a CGM. I love focus groups like this — you get a glimpse of upcoming diabetes products, you have a chance to provide feedback to improve it, and at the end of the hour, they hand you an envelope with $100. It’s a pretty great way to spend a morning.

But yesterday’s session left me disappointed. It was for a computer program meant to work with a continuous glucometer — you download information from your meter and then use the program to look for patterns, keep track of trends, etc. I can’t say much about the specifics of the program (they tend not to like that, the companies developing the products) but I will say that an odd thing happened as I was speaking with the interviewer: I got a chance to speak directly with one of the people  who was working on the program.

The room had a one-way mirror (i.e. I saw a mirror but people in the other room saw me) and after I’d spent several minutes trying to clarify a particular aspect of the product that I found confusing, there was a knock on the door and a man entered, stepping in to answer my question. I thought we were going to have a pleasant back-and-forth, me explaining what I didn’t understand and giving him feedback from a diabetic’s point of view,  him clarifying the reasoning behind this particular aspect of the program. But instead, he aggressively repeated exactly what the woman conducting the interview had told me — and when I again explained why I didn’t understand it, loudly exhaled and just said the same thing.

Now. I understand that, despite my best intentions, I can occasionally come off as rude. Case in point: a romantic dinner with my husband-to-be in which we shared with one another our life dreams (you know, that conversation. Maybe date five?). I was asking what I thought were astute and attentive follow-up questions, but Peter — lovely, sensitive Peter — stopped what he was saying and said “What the hell is your problem?” (A phrase, I might add, that has never been repeated in the course of our five-year relationship.) Apparently what I thought was a sensitive follow-up question came across as me grilling him about loopholes in his list of life aspirations. Whoops.

Anyway, perhaps I was doing some of the same things to Mr. Programmer Guy. It is true that at some point before he came in, I’d referred to the screenshot as looking like “something from Microsoft, circa 1993.”  But dude — I wasn’t on a date. I was being paid to give feedback on a product they’re presumably going to try to sell to people like me, and I was pointing out things that did not make sense. I do  not think I was being the asshole.

But regardless, the guy kept repeating, in condescending tones, the same explanation he had given previously (okay, fine, the question was about how to look at situations where one particular event caused a hypo- or hyper-glycemic episode, and my question was about how the software was able to pick out what the specific cause was, given that multiple factors can work together to cause your blood sugar to rise or drop). And as he continued speaking, the dynamic in my mind shifted from “Cool, this guy is working to help improve the lives of people with diabetes” to “He clearly has no idea what it’s like to live with this disease.”

I hate that. I want to be excited by the idea that there are companies out there trying to build on patients’ suggestions and create well designed, intuitive tools to help improve our lives. But after being talked down to by this guy, I felt pretty certain that he and his team are not actually going to change anything based on my suggestions. The way I see it, that’s not just frustrating; it’s a real waste.

Which is why I’m happy to announce that Amy over at DiabetesMine just launched the 2010 DiabetesMine Design Challenge — a chance for everyone from patients, and parents to caregivers, students, entrepreneurs, developers, and engineers to come up with innovative diabetes devices or web applications. Got an idea? Check out the video below.


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Dr. Margaret A. Morris
13 years ago

I would love to, actually– so if you hear of any in the San Diego area, let me know :) And actually, I’ve been doing some research on software-based approaches to predictive and reactive insulin management; are you allowed to share the name of the company and/or software that you were testing? Do you know of any others out there?
Thanks for the great post!

13 years ago

QuickBooks from the 90s — that is EXACTLY WHAT IT LOOKED LIKE. Thanks, Karmel. I feel like you should participate in these focus groups — you’d bring a useful perspective. 

Dr. Margaret A. Morris
13 years ago

“something from Microsoft, circa 1993” — Sigh, I know exactly what you’re talking about, and it’s so very unfortunate. I understand that medical software and hardware must be vetted by the FDA, and is slowed by regulation, but really, now– there must be some way that we can speed up product development and release cycles so that medical devices and services are at least in the same ballpark as consumer devices and services. There is so much that can be done in terms of heuristics and smarter applications, but I’ll even let that go for now if the software at… Read more »

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