Nightscout
Adrien Ben Bryan Dan Don Jason Jason
John Lane Peter Rajat Ross Scott, Toby
and many many more
what
Nightscout
cloud
Watch Web browser “app”
CGM Remote monitoring for people wearing CGM:
CGM + USB Cable + Android + Databas...
what
how
John Costik: type 1 dad / tweeter / hacker /
system engineer / awesome guy
How
1. Social software development
– Community support
– Blogs, emails, tweets, stackoverflow, Github
– Open means OPEN
1....
1. Basic functionality: 20 lines of
node.js “Frankencode”
2. Added trend arrow, sensor time,
current time
3. Added direction and sparkline
(primitive trend)
4. Added primitive graph with d3.js
Frankencode
5. Changed graph to hypo-maximizing
scale, added auto-dimming
6. Added prediction half an hour into
the future
7. Added prediction if signal is temporarily lost,
added audible alarms based on future predicted
danger, added multiuser ...
8. Added buttons, added remote access (port
forwarding on home router), cleaned up graph
9. If one watcher acknowledges alarm then BG turns
purple and alarms are suppressed for xx min
10. Added “other watcher(s)” for shared
situational awareness / coordination
11. It only gets colorful / noisy if action
is required
12. Added retrospective review
(panning)
13. Added meal / bolus display
14. Added retrospective prediction
http://nightscout.github.io/
what
how
why
Thanks Nightscout, low treated before dexter alarmed
Nights
Love having this by my bed. So much
easier having it always available to
see especially at night.
Nights
Nights
“After multiple nights of persistent growth hormone highs, we have finally dosed
aggressively enough to break the h...
Glanceable
Glanceable
“The new "must see TV" in our house!”
Glanceable
Glanceable
“Went to the gym, Starbucks, Costco and watched an NBA game in
my den all while making sure things were going g...
Glanceable
“What is this you ask?? Oh it's a
pebble watch, and a constant
reading of my DAUGHTER'S
BLOOD SUGAR!!!
At the m...
Date night is even better because
of the CGM in the Cloud...
Glanceable
“This morning my dad wanted to take Jojo
to his workshop to build a dog bed for his
DAD, Dexter.
Now, grandpa isn't the mo...
“Evan's at piano a few miles away. My
watch buzzes and this is what I see on
my phone.
We were able to text his piano
teac...
At the grocery store with my hubby and am
able to see that our daughter is trending down
(she was at home in bed with my m...
Dropped Adam off at Drama Camp
at CGM 90 but now is the time to
text him to have a half tab as he is
in a slow drop...
He ...
With inexperienced people
“At church this morning and Jojo is off in
his class, but mama still can keep an eye
on him now!...
Being active
My intervention from a distance was
without a doubt lifesaving for us.
This single instance is noteworthy but...
Being active
“It's 100 degrees outside. Luke is out with his
brothers and all the neighborhood kids in the
front yard play...
Being active
“Running a 6 mile loop around the lake
with my dogs. Stella is the blur on the
bike ahead if me.
We used to s...
School
“I'm going to say it again, I am so
grateful. Luke is at preschool I'm 23 miles
away at work. I see him start to dr...
“This is making living with T1D better.
Today my 5 year old won't come home from
preschool crazy high because I am able to...
School
“Witness a diabetes paradigm shift here. This BG data sharing technology allows a
parent to be instantly aware of b...
Value
1. Not just for Nights
– Teachable moments
– Shared learning / troubleshooting
– More flexibility
– Before / during ...
Thank you
I went to my son's pediatric endo office
this morning. Two doctors were in the
office, and I went up to them and said
"Che...
Nightscout / CGM in the Cloud Presentation at the June 2014 DiabetesMine D-Data ExChange
Nightscout / CGM in the Cloud Presentation at the June 2014 DiabetesMine D-Data ExChange
Nightscout / CGM in the Cloud Presentation at the June 2014 DiabetesMine D-Data ExChange
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Nightscout / CGM in the Cloud Presentation at the June 2014 DiabetesMine D-Data ExChange

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D-Dad Jason Calbrese presents the amazing, grassroots solution developed by a group of tech-savvy diabetes dads: they've hacked a way to stream data from the Dexcom G4 CGM to show up on pretty much any device, anywhere, in real time.

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Nightscout / CGM in the Cloud Presentation at the June 2014 DiabetesMine D-Data ExChange

  1. 1. Nightscout Adrien Ben Bryan Dan Don Jason Jason John Lane Peter Rajat Ross Scott, Toby and many many more
  2. 2. what
  3. 3. Nightscout cloud Watch Web browser “app” CGM Remote monitoring for people wearing CGM: CGM + USB Cable + Android + Database + Cloud Server + App running on Glanceable Display = Safety and Peace of Mind
  4. 4. what how
  5. 5. John Costik: type 1 dad / tweeter / hacker / system engineer / awesome guy
  6. 6. How 1. Social software development – Community support – Blogs, emails, tweets, stackoverflow, Github – Open means OPEN 1. #Wearenotwaiting
  7. 7. 1. Basic functionality: 20 lines of node.js “Frankencode”
  8. 8. 2. Added trend arrow, sensor time, current time
  9. 9. 3. Added direction and sparkline (primitive trend)
  10. 10. 4. Added primitive graph with d3.js Frankencode
  11. 11. 5. Changed graph to hypo-maximizing scale, added auto-dimming
  12. 12. 6. Added prediction half an hour into the future
  13. 13. 7. Added prediction if signal is temporarily lost, added audible alarms based on future predicted danger, added multiuser alarm acknowledgement, added alarm snooze / shelving, made minor changes to screen layout
  14. 14. 8. Added buttons, added remote access (port forwarding on home router), cleaned up graph
  15. 15. 9. If one watcher acknowledges alarm then BG turns purple and alarms are suppressed for xx min
  16. 16. 10. Added “other watcher(s)” for shared situational awareness / coordination
  17. 17. 11. It only gets colorful / noisy if action is required
  18. 18. 12. Added retrospective review (panning)
  19. 19. 13. Added meal / bolus display
  20. 20. 14. Added retrospective prediction
  21. 21. http://nightscout.github.io/
  22. 22. what how why
  23. 23. Thanks Nightscout, low treated before dexter alarmed Nights
  24. 24. Love having this by my bed. So much easier having it always available to see especially at night. Nights
  25. 25. Nights “After multiple nights of persistent growth hormone highs, we have finally dosed aggressively enough to break the high before morning. Having the cloud just made stacking the necessary insulin in the middle of the night much easier to monitor. Puberty with Type 1 is going to be quite the challenge. I think this technology is going to make a big difference for us.”
  26. 26. Glanceable
  27. 27. Glanceable
  28. 28. “The new "must see TV" in our house!” Glanceable
  29. 29. Glanceable “Went to the gym, Starbucks, Costco and watched an NBA game in my den all while making sure things were going great in the blood sugar world. No More Screaming "NUMBER!!!" from upstairs (or...TMI...The bathroom...lol).”
  30. 30. Glanceable “What is this you ask?? Oh it's a pebble watch, and a constant reading of my DAUGHTER'S BLOOD SUGAR!!! At the moment Tay's around 107. She is out shopping with Ki. This is the best Mother's day present!!!”
  31. 31. Date night is even better because of the CGM in the Cloud... Glanceable
  32. 32. “This morning my dad wanted to take Jojo to his workshop to build a dog bed for his DAD, Dexter. Now, grandpa isn't the most well informed on the t1 front, he is afraid to do something wrong so this is his first outing with J in a year and a half. Thanks to cgm in the cloud I am able to let my dad know how to handle things, when I see he is still dropping, one more quick action to make it right again. Yay!!” With inexperienced people
  33. 33. “Evan's at piano a few miles away. My watch buzzes and this is what I see on my phone. We were able to text his piano teacher to have him drink some juice. Such great technology!” With inexperienced people
  34. 34. At the grocery store with my hubby and am able to see that our daughter is trending down (she was at home in bed with my mom). Was able to get home and catch low blood sugar before it got out of hand!!! Thank you to everyone who has worked so hard to get this set up and help us not so tech Savy parents through this setup. We are so glad God made you!!! you are such a blessing to all of us tired and and weary parents!!! With inexperienced people
  35. 35. Dropped Adam off at Drama Camp at CGM 90 but now is the time to text him to have a half tab as he is in a slow drop... He is very comfortable and functional between 60-80, so with the cloud I will be able to micromanage from a distance to my comfort level. With inexperienced people
  36. 36. With inexperienced people “At church this morning and Jojo is off in his class, but mama still can keep an eye on him now! The teachers were almost as happy as I was”
  37. 37. Being active My intervention from a distance was without a doubt lifesaving for us. This single instance is noteworthy but after 3 weeks, we have multiple situations that have occurred where the presence of this technology has improved not only the timing of our management strategies but also our peace of mind and most importantly the quality of our relationship interactions with our son.” “I picture him mid lap when the unfamiliar extreme hypo symptoms hit him and with 70 - 100 kids in the pool, what would have been the lag time for the pool staff realization that he was in trouble?
  38. 38. Being active “It's 100 degrees outside. Luke is out with his brothers and all the neighborhood kids in the front yard playing on the slip'n slide. Activity like that usually causes him to drop so I normally have to stay out there and watch him. Not anymore Luke's kit is on the porch near him and I am in the air conditioned house watching Lord of the Rings with my husband and I know Luke's fine. Love love love this and how it brings some normalcy back to our lives and I don't have to hover over Luke as he plays so he can just be a kid.”
  39. 39. Being active “Running a 6 mile loop around the lake with my dogs. Stella is the blur on the bike ahead if me. We used to stop every 15 minutes to test. Not anymore”
  40. 40. School “I'm going to say it again, I am so grateful. Luke is at preschool I'm 23 miles away at work. I see him start to drop quickly so I text the preschool assistant director and you can see what happens and how 1/2 juice box landed him at a perfect 113. He never had to stop playing and he never went low and I'm a happy mom right about now! If they had waited till snack he would have been low for sure. So glad I don't have to just sit around anymore and just hope he will be ok when I am away from him!!”
  41. 41. “This is making living with T1D better. Today my 5 year old won't come home from preschool crazy high because I am able to work with the preschool staff and prevent that. Our preschool is amazing- they have gone over and beyond caring for Luke - but they still get worried sometimes which is completely understandable. They love the cloud too because they know I am helping watch over him! Less stress on everyone! It's been a month now with this technology and I can't imagine going back to not having this. Thank goodness for #‎wearenotwaiting” School
  42. 42. School “Witness a diabetes paradigm shift here. This BG data sharing technology allows a parent to be instantly aware of blood sugar trends in the child (or any other person willing to share these data) from any distance. In this case, it allowed prompt intervention by the parent directly to the school medical staff to avert an impending low. Note that this is NOT a commercially sold device but one of several prototypes discussed on a sister FB page. This kind of "instant surveillance at a distance" will alter the dynamic of how schools interact with parents regarding the health of their children. It could be a spirometer or other health monitoring system that sends instant reports too. No real limits. Of course the quality of the data being collected is another variable. You are simply seeing data being moved around. What's done with it and how it is critically reviewed is even more critical. These technologies will require changes to the way schools are prepared for frequent calls (at times) from parents and ultimately will redefine the role of the doctor’s office as well. Get ready for a very interesting ride!”
  43. 43. Value 1. Not just for Nights – Teachable moments – Shared learning / troubleshooting – More flexibility – Before / during / after school 1. Discoveries – New alarm techniques – Humane alarms – Shared situational awareness challenges – Blurs line between real time and retrospective use cases – Huge unmet need
  44. 44. Thank you
  45. 45. I went to my son's pediatric endo office this morning. Two doctors were in the office, and I went up to them and said "Check out my new watch". They said "That's nice". And I said "No, that's my son's blood sugar." ... Silence ... then bug eyes ... then "THAT. IS. SO. COOL." They took pictures and I left them my drawing of the high level setup, with the facebook page information. Other parents were asking about it too, and I sat there for at least twenty minutes talking about it and answering questions. This project is so infectious and incredible. I had to share.

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