Designing for Diabetics

Inspired by consumer gadgetry, medical-device makers are creating slick tools for insulin injections and readings

Tom Baldwin, a 43-year-old flight attendant, regularly wears two sleek gadgets strapped to his belt: an iPhone on one side and his Medtronic (MDT) MiniMed insulin pump on the other. Baldwin, diagnosed with diabetes more than 20 years ago, says passengers and co-workers rarely question why he's got two devices attached to his body. The pump is compact, with a large screen that displays his body's glucose levels in real time and a friendly user interface that features several control buttons with arrows on them. The device, says Baldwin, "looks like a pager."

"I used to be self-conscious about taking insulin shots or using my [earlier] insulin pumps," Baldwin says, referring to the cumbersome syringes and bulkier equipment he had to use. "But no one has ever asked me why I'm wearing this pump. The only people who notice are other diabetics on the flight, who can recognize that there's a tube sticking out of the pump—and they ask me where I got it, how it works."

A new study presented at the annual meeting of the European Association for the Study of Diabetes in Amsterdam Sept. 20, suggests that the design of a diabetes therapy device might affect a patient's experience with the disease. The Italian study examined quality of life among patients with type 1 diabetes. After surveying 1,341 patients, researchers found that diabetics using insulin pumps such as Baldwin's MiniMed experienced 70% less therapy-related dissatisfaction than patients using multiple injection therapy to manage their glucose levels. In other words, the user-friendly design of insulin pumps—which don't require needles and are therefore less complicated to use—can offer a more comfortable diabetes therapy experience.

Double-Digit Growth

The audience for diabetes-management tools is large—and growing. The Centers for Disease Control & Prevention estimates that there are 20.8 million American diabetics, about 7% of the U.S. population. According to the International Diabetes Federation's latest statistics, nearly 194 million adults around the world are diabetic; by 2025, according to estimates, this figure will reach 333 million. Palo Alto (Calif.) research and consulting firm Frost & Sullivan estimates that the U.S. market for traditional diabetes monitoring (blood testing equipment and strips that diabetics use to measure their glucose levels) tallied $3.53 billion last year, up 12% from 2005.

"In the last several years, we've seen low double-digit growth," says Mona Patel, director of Frost & Sullivan's medical research department. "Yes, there will be a saturation factor, but the number of diabetics keeps increasing—even among children." So, Patel says, the market for pediatric devices will grow, too.


Medical-device manufacturers and industrial designers alike are increasingly using popular consumer electronics, from MP3 players to cell phones, as inspiration for easy-to-use and unobtrusive diabetes-management tools. The goal is to provide diabetics with equipment that fits as seamlessly into their lives as, say, an iPod, complete with an intuitive interface and a "cool" design factor that encourages patients to monitor their health and self-treat the disease. Just as Apple (AAPL) has used elegant design to competitive advantage, medical-device makers are hoping that trendy-looking diabetes devices will attract new customers and retain existing ones.

Dr. Alan Marcus, director of medical affairs at Medtronic, maker of Tom Baldwin's MiniMed pump, says that the company's research and development division is paying close attention to advances in consumer electronics design, from both a technological and user interface design standpoint. "It's our primary focus," he says. "We're actively moving in that direction."

In August, a specially equipped LG Electronics phone incorporating a glucose meter for diabetics received FDA approval. The GlucoPhone, created by Korean medical-device maker HealthPia, allows diabetics—after they prick a finger and take a blood sample—to insert a blood-test strip into the phone where a meter reads the results. Proprietary software allows the diabetic to send the blood data to a caregiver immediately.

And Bedford (Mass.) medical-device maker Insulet (PODD) has released OmniPod, designed in collaboration with design-strategy firm Continuum; it's on the market in selected areas of the U.S. The insulin management system consists of an infusion pump that attaches to the body via a thin tube and also synchs with a monitor that wirelessly communicates with the pump (the first of its kind). The device, a nominee for a prize at the INDEX: awards this year, won a Medical Design Excellence award, given by trade journal Medical Device & Diagnostic Industry, last year.

Introducing the insulin?

But large medical-device makers aren't the only companies paying attention to the market. Adaptive Path, a San Francisco user-experience design strategy consultancy best known for its Web-design work for companies including Intel (INTC), Crayola, and Wells Fargo (WFC), recently created a concept for a diabetes device called Charmr, which looks like a necklace charm. The concept was inspired by an open letter written by diabetic Amy Tenderich (author of the site Diabetes Mine) to Apple Chief Executive Steve Jobs.

"Most of these [diabetes] devices are clunky, make weird alarm sounds, are more or less hard to use, and burn quickly through batteries," wrote Tenderich. "In other words: their design doesn't hold a candle to the iPod." She called for Jobs to sponsor medical-device design contests, to enlist Apple design head Jonathan Ive to remake the contest winners into feasible products, and to fund an Apple medical design school. To date, Tenderich says Jobs has not responded to her letter.

Worthy Concept

After reading Tenderich's post, a group from Adaptive Path decided to respond; they applied their experience at designing user interfaces to creating a concept for a diabetes-management tool that might have the consumer appeal of an iPod. Their goal was not only to challenge themselves as designers but also to work on a humanitarian product to which they could apply their knowledge of user-centric interface design. "The language of the Web and the digital are moving into the physical," says Dan Saffer, an interaction designer at Adaptive Path who worked on the Charmr project. Saffer and his colleagues wanted to see if they could apply Web-style navigation elements and intuitive graphics to a medical device.

So this past summer the team spent nine weeks designing a two-part device consisting of a wearable pump and a controller that can be plugged into a flash drive to upload a diabetic's health data and transmit it to a caregiver. While Charmr exists only as computer renderings and in a faux-promotional video that's circulating on the Web, the idea, Saffer says, was to prompt other designers, consumer-electronics companies, and medical-device manufacturers to develop more user-friendly diabetes-tool designs.

But what's the value of a design concept if there's no contract to produce it? "It's kind of like a concept car or a couture dress—things that are experimental. Sure, it may not get made, but parts of the project can inspire others and eventually find their way to the mass market," says Shaffer. And there has been some early interest in Charmr. "We've been approached by diabetics who want to buy it, and we're talking with VCs in the medical-device world," says Saffer. "But we haven't been approached yet by Johnson & Johnson (JNJ). That would be nice."

Accuracy, After All, Trumps Design

Other companies see the value in developing innovative concepts. At this year's prestigious INDEX: awards (BusinessWeek, 9/10/07) in Copenhagen, Denmark, several nominees in the "body" category were diabetes-care concepts with consumer-electronics appeal.

Take, for instance, the prototype for a slick, minimalist insulin injection tool called the C-Cap, designed by Medicom, a division of Bang & Olufsen, the Danish manufacturer better known for high-end, gracefully designed audio and video equipment. C-Cap is shaped like a pen (an increasingly common metaphor in self-injection devices) and flashes a short green light every 24 hours to remind a diabetic to inject insulin; a long green flash signals the injection has registered. A red light flashes if the pen isn't used within an hour, sending a clear reminder.

Analysts agree that the design-centric approach to medical devices makes sense in terms of attracting patients and doctors. Of course, it's not just a product's surface appeal that determines which next-generation pumps and monitors will remain popular or boost a company's bottom line.

"Gadgetry that's consumer-like, with a cool factor, might be more appealing," says Frost & Sullivan's Patel. "But the one key feature is the accuracy of the device. This is important for doctors and patients: They need accurate results. I would say, in terms of looking for the most potentially successful devices, we should ask: 'Has the device been designed to minimize [blood glucose] sampling error?'"

Those devices that pass the test will prove that the beauty of an iPod-like pump or monitor for diabetics can be much more than skin deep.

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