Recently I started using the mobile app Moves. It uses the sensors in your iPhone to measure your activity in the same way that devices like FitBit do, but without the need to buy and carry an additional advice. So far, I have been really impressed with the app. It can distinguish between walking, running and cycling. It also displays the information in a nice, simple way.
Most surprising however has been comparing its results with RunKeeper, which I activate when I run. Moves on the other hand is running in the background all the time. The two apps obviously use the same GPS data from the same phone, yet consistently reach different results about the length of my runs. My base run these days is a 5 miler near my home. Moves has been consistently pegging it at 4.9 or 5 miles, while RunKeeper usually pegs it anywhere between 5.25 and 6.5. It’s an interesting case for understanding who is to blame for these discrepancies, the software or the hardware.
- 5 mile run results with Moves
RunKeeper results from the same run
Another marathon down(my third)! And a new personal record! My time of 3:47 at the Philadelphia Marathon was a two minute improvement.
This race is an important point in my 2012 Quantified Self project. In order to best learn from the day, I carried a total of 8 devices with me: an insulin pump, 2 continuous glucose monitors (CGM) (a Dexcom 7 and my newly arrived Dexcom Gen4), a standard blood glucose monitor, a Garmin heart race monitor chest strap and GPS watch, an iPhone, Nike FuelBand and FitBit. I’ll talk more about these later.
As for my diabetes, managing my blood sugars on the day of the race turned out to be more of a challenge than I was hoping for. During my two previous marathons, I saw my blood sugars spike in the hours before the race, both from being anxious and from how i managed my meal dosages. I was determined to prevent that from happening again this year. I had a normal breakfast (an english muffin with almond butter and a banana) very early in the morning at 5am in order to get to the start line on time. I took a dose of insulin that I would normally take assuming I wasn’t about to exercise. I then had another half of an english muffin at 6am. I took a smaller dose for this, hoping that my blood sugars would start going up a bit closer to the 7am start time (they had been at about 145). I also began a temp basal rate at 6am, setting it to 20% my normal rate for 3 1/2 hours.
Waiting for the start along with Ann, my friend and running companion. We ran the Paris Marathon together back in 2010.
Last week, I participated in a terrific event out in the Bay Area, the DiabetesMine Innovation Summit. Amy Tenderich, the leading patient advocate, and her team organized a truly inspiring day of presentations and discussions.
This past weekend, I finished a 20 mile run. This marks the peak of my training for the Philadelphia Marathon! I’m glad that the distances will be tapering down between now and race day on Nov. 18.
The run itself went well. After a sluggish 19-miler two weeks before, I was glad to bounce back with more energy and a better pace. Most importantly, I am glad to have no injuries at this point in the training. I have gone into both my previous marathons injured, so staying healthy remains a key goal for me.
My blood sugar remained relatively under control for this run. With longer distances lately, I have noticed that often my blood sugar will be ok the first two hours of running. But my reduced basal rate, combined with drinking Gatorade along the way will cause it to spike in the third hour. This last run, I skipped the Gatorade and instead had a second gel instead. I use the Hammer Nutrition brand because they use more natural ingredients than other brands. At about 22g of carbs, once an hour works pretty well to both give me an energy boost but not knock my blood sugars too high (compared to 34g of carbs in a bottle of Gatorade). I also have been eating a banana about a half hour before starting a run. It’s tricky to get the timing right since you don’t want to get going with too much food in your stomach. Nonetheless, low blood sugars during a run causes me more anxiety than high blood sugars. General nervousness will probably be another factor on race day, causing blood sugars to spike. But I’ll be on the lookout for that this time.
I’m excited to be taking part in an Insulindependence event the night before the race in Philly. IN, as they refer to themselves, is great in connecting athletic patients with diabetes. The Philadelphia Marathon is one of their regional events, so hopefully I will get a chance to chat with several other T1Ds. IN excels because it is made up of so many dedicated, driven and proactive patients looking to stay healthy. Looking forward to it!
I have grown increasingly frustrated with the MapMyRun iPhone app. For the first half of this year, I used RunKeeper to track my exercise. I switched to MapMyRun on July 1. I wanted to give each app half a year and do a comparison later. But given how disappointing the results have been recently, I am switching back to RunKeeper.
The main problem I am having is such an oddly simple one. MapMyRun is often calculating inaccurate total times for my exercise. A few examples are below. Today, it notes a start time of 7:58 and a completion time of 8:40. Duration according to the app? 24 minutes. My previous run on Saturday has a start time of 7:10 and a completion time of 8:27. Duration according to the app? 32 minutes. Looking back through the results, I see this error creeping up again and again and again. My phone is on my arm during runs with the screen locked, so there is no way that the pause button is getting hit.
I see no point in continuing to use this app when I was perfectly happy with RunKeeper. Neither app is perfect, especially since so much of the functionality relies on the phone’s hardware and GPS connection strength. Regardless, I see no reason why MapMyRun cannot calculate a length of time between when I hit “Start” and “End.”
In other exercise-related self-tracking news, I have been having problems with my new Nike Fuelband. After the glowing review in my last post, things have gone sour with the device. It stopped working completely 2 weeks ago (only 3 weeks after I started using it). It simply stopped syncing with my computer. It kept insisting that I update the driver, but the driver update failed every time.
To their credit, Nike’s customer service was very responsive. They quickly replied to my e-mails. They then forwarded me on to phone support to get a replacement device, which showed up about a week later.
As a result of this change, I lost about 3 days of data and have a gap in my recorded data. I tried to syncing the new device to the official Nike mobile app over Bluetooth, but this failed just as it had for the first device. And today, I am even having problems signing in to Nikeplus.com. Clearly some technical issues to be worked out there with both the hardware and the software. But I’m willing to give them another chance. I still think the product is a good one (assuming these bugs get worked out soon).
Last week, I was able to get my hands on a Nike+ Fuelband to try out for a few weeks. I have to say, it is quite impressive. The hardware, the software, the whole experience is very well done.
I reached my 2,000 fuel points goal after doing a morning run. The light start with a single red dot in the morning and are added as you approach your goal, a blinking green dot (on the left).
It being July, we am glad to now be halfway through 2012 and halfway through gathering data for my Databetes 2012 thesis project. Since Jan. 1, I have been recording every type of data related to my diabetes. That includes blood sugar readings, insulin dosages, A1c readings, exercise, meals, drinks and more.
Data aggregation is still a tedious task for patients with diabetes. Device manufacturers still design proprietary systems that do not play nice with their competitors. In the end, patients suffer because they cannot get all their readings in one place. This makes it difficult to design improved analysis software to spot trends and offer proactive notifications.
Beyond the essential medical readings, I also believe that it would be helpful to have additional information to give medical data more real-life context. This would make it easier for patients to manage all this information, understand how they are doing and make more intelligent decisions.
Instead of getting held up by the current challenges with aggregation, I have decided to move past it and focus on other pieces to the puzzle. I am convinced that if patients had a complete set of data, they could improve their health. But few people have spent much time on what a future patient data system will look like or how it will work. That is the focus of this project. I do not expect others to adopt the same approach to aggregating their data because it is quite time-consuming. But I do believe a better solution will result in more patients becoming interested in making optimal use of their data to improve their health.
As we continue development of Databetes, we are using my medical data as the first test case for this new type of solution.
My January readings line the walls.
We are also studying existing products on the market, both in the diabetes sector and other data-intensive services.
Screenshots of iPhone applications relevant to the diabetes space.
We look forward to showing you our progress in the coming months!
This weekend, I got to spend time with two separate support groups for patients with diabetes. On Saturday, I attended my first “Dawn Phenomenon” session. This is a Saturday workout session run by Rachelle Glantz, a New York City team leader for Insulindependence.org. Insulindependence, or In as they call themselves, is a group for patients who make exercise a part of their treatment. The group has four separate sub-groups called A1Sea (for surfing, diving and kayaking), Glucomotive (for running and walking), Testing Limits (outdoor adventure) and Triabetes (triathlon). Rachelle is the head of the Triabetes group for this area.
I have been learning more about In over the last few weeks and plan on joining soon (a yearly membership requires a minimal fee). I am really impressed with them as a grass-roots organization that connects very driven patients with a healthy and supportive community. The people involved seem to be really impressive athletes, regardless of the fact that they have diabetes. Most importantly, they all seem to “own” their diabetes. They are tackling their condition head-on and refuse to have it affect their other goals in life.
On Sunday, I attended the New York Type 1 Diabetes Meetup group’s June event. This was my fifth time at a Meetup. We normally grab dinner together, although this time we met in Prospect Park for lunch. The group usually draws 5 to 15 patients. Many are like me and have had diabetes for 20 or 30 years. Others are newly diagnosed and still learning about the condition. The conversations are always interesting for a variety of reasons. First, it highlights how uniquely diabetes affects different people. While one patient may have a particular outcome in one situation, another patient may have a completely different outcome when encountering the exact same situation. For example, we recently talked about how drinking alcohol affects diabetes. For me, the large amount of carbs in beer and liquor do not affect me. My blood sugar level does not rise or fall in the hours during or after I drink. Yet another patient sees the opposite, with the carbs having the same effect on their body as sandwich. He takes a dose of insulin to compensate for the carbs while I don’t take any.
The best thing about the Meetup is that everyone is supportive of each other’s situation. Even this casual discussion of daily challenges does feel good. Having lived with diabetes for 26 years now, I do not feel isolated by it. My control is also very good right now. But still, I always learn something about diabetes and leave thinking about whether some of the treatment decisions other patients make might be right for me too. I strongly encourage other patients to take part in these types of activities regardless of your situation. There is always something valuable and unique about gaining knowledge from other patients rather than your doctor. I know I didn’t have this type of support when I was newly diagnosed and most needed it. It’s nice to think that other patients can benefit from the wisdom we have accumulated over the years.
Last week, there were two events focused on health and technology. I attended the demo day for the new healthcare start-up incubator Blueprint Health. Additionally, last Friday was the day that the semi-finalists for the Data Design Diabetes contest were announced. It’s exciting that there is so much activity in this sector. It’s also interesting how differently these two organizations are approaching the challenges in the US healthcare system.
An impressive turnout at the Blueprint Health demo day in New York.
I have needed to change several of my basal rates in the last few weeks. This is mainly a result of my changing exercise patterns. During much of January, I was running 3-4 times a week. This month I have been averaging 2-3 runs a week. Despite the lower number of runs, the total distances I am covering each week is staying constant because of my long weekend runs. Lately, those have been over half-marathon distances.
As far as my body is concerned, I guess that means that the number of runs is the more important factor. I have needed to change my basal rates for both daytime and overnight. These rates had all dropped about 30-35% at the start of January when I was really active. The recent rebound has seen them go back up about 10-15%.
It will be nice when winter ends and I can hopefully be a little more active.