Initial Prototype Video Comments (Part 2 of 2)

Three more comments about the initial prototype videos were made. I’ll summarize them below.

The third reviewer mentioned the possibility of using urine strips. The problem (I believe) with this approach is that glucose is normally not found in urine. Glucose transporters in the kidneys reabsorb almost all of the glucose filtered, so unless there is a lot of glucose in the filtrate such that not all of it can be reabsorbed, glucose will not appear in urine tests. Diabetics who have high blood glucose levels will have kidneys that excrete excess glucose, which can then be detected in urine. However, we want to be able to measure glucose concentrations at all levels. Also, I’m not sure how representative glucose concentration in urine is of glucose concentration in the blood.

The reviewer also challenged the idea of using a cell phone, making the point that not everyone has a cell phone. A question that I have in response is whether it would be simpler to provide a cell phone to the user, given that they are rather cheap, and also the point that the patient could benefit from a having a cell phone.

The reviewer also questioned the need for having software to read the results, or to send the measurement off to a doctor. I would respond that the software will be able to more accurately compare the reading to the standardized gradient, and that if the glucose concentration appears to be out of normal, the doctor can be notified (and the doctor can then read the data accumulated over time).

Lastly, this reviewer questioned the use of cell phones as a diagnostic tool. The reviewer proposed having a health worker come to the patient instead and read his/her glucose level. The health worker would then use the cell phone to transmit data. I would respond that the power of this technology comes from using what patients may already have (cell phone) and combining it with a need (reading blood glucose levels). Ideally, patients would want to read their glucose levels multiple times a day, so having a health worker visit them routinely might not be possible. Also, it might not be a bad idea to let the data collection and storage happen instantaneously after the measurements are made (so that the information does not become lost on random paper sheets). Of course, we could be wrong about our assumption that cell phones are widely available/accessible.

The fourth reviewer liked that fact that we had a multi-layered solution, which gives us flexibility in implementing this project is such a short time. The reviewer also liked the fact that we were creating a new platform for reading colorimetric assays that would eventually be open source.
The reviewer makes the neat point that we took an old technology and combined it with newer technology to create a product that can solve current problems. The reviewer also agreed with the idea of having a controlled light system and the CCD camera (since the test strip would be placed against the glass plate, and thus no outside light would reach the interior of the box). The reviewer suggested that we could build this with a cell phone light for the time being.

In addition, the reviewer suggests that we should better work out the details of the reader, and reduce the number of steps to use the reader down to 2 or 3. The reviewer also asks that we make a budget to make sure that the device will remain affordable. Surprising, this reviewer sounds a lot like our course instructor (=P).

The fifth (and last) reviewer made the great suggestion of collecting more information: How much do we currently know about the needs of diabetic patients? What challenges do they currently face? How are they meeting those challenges? We know that diabetics in developing countries certainly are not getting their blood glucose levels checked several times a day, if at all. What risks does this pose for the patient?

We should investigate the living conditions of diabetics, what access to medical care they have, what are conventional diabetes management procedures in the region.

Commenting on our video, the reviewer said that we could have used the doctor-patient scenario in the video to better explain diabetes, since the audience might not know about the basics of diabetes and why testing is important. This is a great idea. The reviewer also suggested that we make an elevator pitch (which will come shortly!)

Thanks to all of the reviewers! We certainly got some good ideas on directions that we should pursue.