Health & Fitness

Smartphone app ‘revolutionizes’ how to manage diabetes

Igor and Olga Quintero program the monitoring system for their daughter Ivanna Quintero, 11, who has diabetes.
Igor and Olga Quintero program the monitoring system for their daughter Ivanna Quintero, 11, who has diabetes. FOR THE MIAMI HERALD

During a recent class at Joe DiMaggio Children’s Hospital in Hollywood, where parents learned how a new smartphone application could help monitor their child’s blood glucose levels, Ivanna Quintero said being 11 and focusing on class work and monitoring her Type 1 diabetes leaves little room for error.

“Sometimes you don’t know when you’re dropping low at school,” said Ivanna, who wears a small pump inserted into her hip that administers small dosages of insulin, the hormone needed to regulate blood sugar, throughout the day. She said her glucose levels were too high or low at least two to three times a week.

So when Ivanna’s parents, Igor and Olga Quintero, learned about Dexcom, a company based in San Diego that manufactures an FDA-approved device that continuously monitors glucose, their biggest concern was the product’s effectiveness. They were surprised to learn that Dexcom’s sensor connects with a small transmitter through Bluetooth — about the size of an mp3 player — to an iPhone app that checks glucose levels every five minutes.

There are about 1.25 million Americans living with Type 1 diabetes today, including 200,000 kids and teens. They either take injections of insulin throughout the day or, like Ivanna, continuously with a pump. Most measure blood-glucose levels four to eight times a day with a blood sample obtained by pricking a finger.

Marina Chaparro, an expert in diabetes and pediatric care, and a spokesperson for the Academy of Nutrition, said a key feature in the app is that both parents — or up to five people who downloads the app’s “share” function — can monitor their child’s blood glucose fluctuations throughout the day.

“This is revolutionary in the world of diabetes,” said Chaparro, who uses the device to monitor her Type 1 diabetes. “Sometimes my husband will call me and say, ‘Did you know that your levels are dropping?’ 

Dexcom developers suggest that users calibrate the device at least twice a day using a blood sample. Dexcom’s sensor is 91 percent accurate — or within a 20 milligrams per deciliter — on the first day of use and jumps to 97 percent accuracy after the first week, company officials say.

Chaparro said there are about 5,000 apps to help manage diabetes, but few that actually help monitor blood sugar levels with a sensor. During Wednesday’s class, she encouraged parents to use the device not only to monitor levels but also to collect data.

Dr. Sandy Steiner, in Joe DiMaggio’s pediatric endocrinology department, said she has worked with parents like Andre and Kemilyn Daley, visiting the class with their 13 year-old son, who can’t explain the spikes in their son’s glucose level.

“We’re still trying to figure out a pattern,” Andre Daley said. He said he hopes the new device will change that problem.

Most living with diabetes check their glucose levels four to six times a day, usually before meals and snacks, before and after exercise and before bed. But the readings, Steiner said, are taken when glucose levels are expected to be normal — between 80 and 120 milligrams per deciliter.

“But if you’re able to monitor throughout the day, you can understand what causes the fluctuations in-between meals,” Steiner said, adding the information should help users make better choices when eating or deciding whether an insulin shot is needed.

Of all the products that help manage diabetes, Dr. Janine Sanchez, a pediatric endocrinologist at UHealth-University of Miami Health System, said Dexcom is the most popular.

“We’re starting to see a lot more stable sugar levels because people are learning from the reports,” Sanchez said. “I’m at the point where a lot of my patients are wanting one.”

Most private insurance companies will cover the cost — $80 for the sensor and $1,000 for the transmitter. (The sensor is inserted into the skin near the abdomen region and must be replaced every seven days.)

But families who receive healthcare through Medicaid or an HMO, Sanchez said, are having issues accessing products like the Dexcom sensor.

“Some insurance companies feel that you can get the same information by a finger prick,” Sanchez said. “And a lot of kids don’t have private insurance.”