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Ch-ch-changes

A quick update on the progress of the app:

It’s actually coming along quite nicely in many respects, I’ve got it up and running on iOS, Android and Windows Phone, which is great, and it runs pretty smoothly across all 3 and collects all the information. I’ve yet to implement any way of viewing the information you’ve entered, or altering it once you’ve put it in, but I’m working on that!

As far as changes go, where originally I’d planned to have between 1 and 3 buttons to drag horizontally, now there will be one button to drag vertically. This change is simply to make A) each question more consistent with the last and B) increase the ‘drag’ distance to maximise the fidelity of choice.

I’ve also settled on a monetisation method for the app, which will make it completely free for all users. I’ve worked with a company before called Kiip who offer real world rewards for virtual achievements, and I’ve decided to implement their SDK to reward people for things like 5 good sugar readings in a row, or averaging below 8mmol over a given time span. I’m confident enough in what they do as a company to give users the free and no strings attached option of turning these rewards off, and I’ll be working with them to make sure the rewards supplied are appropriate. Hopefully it will help fund further development to realise all my visions for it!

Cheers

Ian

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What’s happening?

Ok, things haven’t been too great for me of late…

Back when I originally started this project, I’d been given some good news regarding my right eye, which meant I didn’t require more injections in it for a while. This gave me a bit of an impetus to get something important to me done while I had a relatively clean bill of health and I could dedicate some more time to working. I decided on an ambitious schedule (with an equally ambitious funding goal) with a diabetes management app that would serve all purposes. I felt confident that I could deliver on my expectations of what a proper app would be.

Then my vision went. Badly.

My macula in my right eye swelled up fast, and my sight deteriorated within the space of about 4 days. I could barely read a computer screen, let alone debug code. I went to the emergency eye department, but it took a while to get anything done. Nearly two months passed without any improvement before I finally got the Lucentis injection I needed to reduce the swelling. It worked, and my vision has restored to the point where I can actually be productive again, if I pay close attention to what I’m typing.

There are drugs available that can stop my eyesight deteriorating, hopefully ending my need for the injections. A combination therapy of two types of anti-cholesterol drugs that’s been shown to help protect the macula. I’m on one of these drugs, atorvastatin, but not the other yet. The reason for this is that my liver can’t deal with the added load. I’ve developed a fatty liver and no amount of healthy eating, exercise or lack of alcohol seems to be bringing it under control. This is leading to a decrease in liver functionality that’s making me pretty tired a lot of the time, and adding in the scond drug would make this problem worse, so the doctors ar holding off on it.

All in all, it’s pretty stressful, and pretty scary. It’s certainly hit my mood and keeping my spirits up (and by extension, my sugars under control) has been tough. I am, however, getting there.

As I’m getting more able to do things again, I’m trying to get the app back on track, but I’m scaling back it’s ambitions, at least initially. My plan now is to get a functional DAFNE diary working and launched, before heading back to adding the proactive functionality, analysis tools, and life quantifying questions afterwards. This streamlining will bring the app launch forward, and conversely, set the funding campaign back. I’ll work towards a usable, basic DAFNE diary to completion first, then fund from there for the additional features.

I’m also going to try and update this blog at least once a week. It’s pretty therapeutic, even if nobody reads it!

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DKA

If you’re diabetic, and you aren’t scared of that little TLA, then you need to do some research. I didn’t mention DKA in my post about side effects that you want to avoid because, quite frankly, it doesn’t happen to me. OK, it did. Once…

It happened when my partner was pregnant with our first child. Heavily pregnant. I picked up a slight sickness bug that didn’t do me any favours. My sugars went crazy, as they always do when I’m ill, and I couldn’t get them down. Nor could I eat anything. And fluids were out too. If you’re in that sort of state and you have diabetes there’s not much by way of options. You need fluids in you, so you have to be re-hydrated. Off to A&E I went.

In A&E, at Rotherham General Hospital, I was seen relatively quickly and sent to the Acute Assessment Ward. By this time, if I sipped, I could keep my fluids down. My Mrs went to her parents to sleep as it was getting late and I was under the assumption that I would be in for a day or so. I still hadn’t been hooked up to a drip, so I was definitely dehydrated, and felt pretty awful.

I didn’t even get to see a doctor. The story I was given was that I’d kept a cup of water down, so I had to go home. They didn’t even test my blood sugars. I was alone, I had no money on me, no wallet, no house keys, and too weak to put up an argument. It was 1 am. There were no buses and I had no way of getting home. Eventually, after wandering aimlessly for a while, I saw a taxi, and got to my in-laws, (why I didn’t stay there is a tale for a different time, and only has minor links to my diabetes) got some money to pay for said taxi from my partner, and then walked home, collapsed on the bed and woke up at 6 in the morning to start throwing up the bile in my stomach.

From here on out the story gets better. I made an appointment at the doctors, who spent no more than a minute with me. She sent me straight to hospital as I was severely in need of fluid. There was a small incident in the doctors toilet that required the discreet disposal of my shorts and then my mum drove me to the Royal Hallamshire Hospital, where I was flushed with fluid, monitored closely and actually checked for things. My blood was acidic, but soon came into normal range. When I got there I thought I was going to die, when I left only 14 hours later, I felt human again. But just barely.

I never got round to complaining about Rotherham, they’d given me spectacularly bad treatment and genuinely could have killed me. A thoroughly horrible experience, and fortunately not one that has been repeated.

Cheers,

Ian

*I wrote this after reading this post from a member of the #DOC about her recent DKA. Remember kids, diabetes is for life, not just for Christmas.

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The Indiegogo Campaign

Here’s a quick update on when things are happening:

Our Indiegogo campaign will start soon, a preview of it is available here. I’m hoping it can raise a bit of cash. Realistically, we need it to raise about £15000 to cover the development costs to get it out before the end of the year. If we don’t manage that, we’ll still develop the app to completion, but we might have to increase costs and trim a few features (API inclusions will be early casualties, each one takes time and money, so we’ll focus on just a select few), and feature parity across platforms may be affected too. We will still release across platforms though, we feel that iOS isn’t the be all and end all that other apps seem to.

If we do hit our funding goals, we’ll make sure that every feature is included and polished, and that each platform has as close to parity feature-wise as possible. If we exceed our goals by more than a few percentage points, we’ll be able to make the app completely free to download. We may operate a custom and secure cross platform cloud storage feature if there is demand for it, but more than likely we’ll rely on the proprietary storage for each individual platform.

A note on the iPad/Tablet version of the app – so far, we’ve only shown features from a smaller screen experience. but be assured that we will release a version for screens with more real estate. Depending on funding, we will release this very close to the release of the small screen version.

Cheers,

Ian

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The Complications Diabetics Want to Avoid

This post is a personal one. It’s about the complications that diabetes causes. Or more specifically, about the complications it has caused for me, and what I hope I can help other people avoid through the use of the Active Diabetes app.

So, a few months ago I suffered a ‘neurological event’. Basically, I got up after a mild hypo and went completely numb down one side. My face, arm, leg and torso on my right hand side was completely dead to any feeling. Strangely, I could still move everything, and pretty quickly the numbness was replaced with an intense tingling. It took about a week to recover from the tingling sensation, and 3 or 4 weeks before I stopped slurring my speech and getting tongue-tied, and a slight bit longer before I stopped forgetting simple words. An MRI showed no permanent brain damage, and there was disagreement between doctors as to whether it was caused by a TIA or something directly related to my diabetes.

For diabetics, the risk of clots is high. We die younger. There’s little point in me having a pension as I won’t make it to 70. Right now I’ll be happy to make 50.

But clots aren’t the only issue. Either through the fluctuations in sugar levels, or higher sugars in general, or a combination of both, the small blood vessels in your body get damaged. This causes neuropathy, which can lead to losing feeling in your extremities, after years of random but painful nerve spasms. Yeah, they’re fun. The nerves in my stomach don’t function properly either. That means food isn’t moved through properly, and I don’t know when I’m full properly. If I don’t pay attention to the amount I eat I can eat too much before I realise. Then I’m sick. Also fun. It also causes retinopathy, where your eyes leak blood onto your retina. this pushes the retina away from the nerves and causes blindness. I have injections in my eyes once every four weeks to stop the fluid buildup. The scarring across my retina requires removal by surgery. That’s fun too.

Then there’s the kidney damage. The likelihood of kidney failure in diabetics is high. Currently my kidneys constantly leak protein, but haven’t yet reached the stage of needing any additional treatment for that, but it’s coming. Heart disease is coming too. I’m already on a statin. Only a low dose but early thirties is pretty young for that. And the erectile dysfunction. That’s coming too.

On top of that, there’s the damage done to your immune system. A none diabetic might get a cold and feel rough for a few days. For me it takes a week to fight off. Thrush type infections are common. There’s an increased risk of picking up infections. Flu can be a literal killer. Wounds don’t heal.

These symptoms don’t work in isolation either. They combine together to make life harder. Neuropathy may cause your feet to go numb, so you don’t feel it when you injure yourself. Your immune response is compromised, so your injury doesn’t heal. Suddenly, a small cut on the foot is an ulcer. Infected and pus-ridden, the only solution is amputation. Bye bye feet. Fortunately, again, I’m not that far down the road.

On top of all this, there’s the simple day to day issues caused by walking the tightrope of sugar control. If you’ve ever felt shaky when you’re hungry, that’s what being hypo feels like. Only that’s what it feels like if your sugars are about 4mmol. at 3mmol you sweat, shake, find concentrating difficult and become… irritable. At 2, you’re lucky to be conscious. and are likely to be convulsing on the floor. High blood sugars make you tired, thirsty, and pretty rough.

The only way to stop all this is to keep control of your sugars. To test, to monitor and to analyse. It’s time consuming and easy to forget. Hopefully our app can make this process easier, and help at least delay some of these issues for it’s users.

Cheers,

Ian

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How is it so Fast?

Let’s take a look at how designing an app for touchscreen devices from the ground up can completely revolutionize the way sugars can be inputted into a diabetes management app.

The first principal was that you had to be able to enter your glucose readings in a single tap. Obviously, that’s impossible for detailed control, but for a rough guide to how your sugars are doing, we simply went for three buttons: Low (hypoglycemic), normal, and high (hyperglycemic). Simply by tapping one of these buttons, you can move on to something else incredibly quickly.

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But that isn’t enough. We didn’t just want a rough estimate of control, we want full control over your readings in as few steps as possible. All other apps require you to tap a box, bring up the onscreen keyboard, tap out your result and then confirm your reading. It’s a bit… old fashioned. We went a different direction. No onscreen keyboard and as streamlined as possible so that if you’re on the go, you can just get it done.

After days of trialing different approaches, we found that the best results came from one of the simplest solutions: Sliding. All you need to do to enter an accurate reading is drag the appropriate button to the right until you get to your reading. You can do it with your thumb in under a second, and you’re away!

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The gains from entering data in this way are massive, by our reckoning it’s 5 times faster than any other diabetes management app out there, and it has the gentlest of learning curves. All the input streams in the app are designed to be as simple to use as this. If you’re interested in the app, please visit our indiegogo campaign and contribute!

Cheers,

Ian

 

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Announcing the Active Diabetes App

The Active Diabetes app aims to revolutionize diabetes management on smartphones. It will be made available for iPhone, iPad, Android and Windows Phone 8. It has a ton of new features that previously haven’t been seen in diabetes management apps, it speeds up data entry massively through it’s intelligently designed interface and it collects data proactively to improve your control!

We’re currently running a campaign on Indiegogo to help fund the development. For more information on the app, take a look at the app details page!