Michael Maniscalco is co-founder of Ihiji, a leading provider of network monitoring and remote management services for the smart home. He kindly agreed to share his family's experience with a toddler diagnosed with Type 1 diabetes (T1D), also known as juvenile diabetes. Some 30,000 people are diagnosed with the potentially fatal disease each year. Yet, as Maniscalco has learned, there is no simple way to integrate glucose meters (for blood sugar monitoring) with home automation — for the simplest of IoT tasks like flashing the lights when glucose reaches dangerous levels. Join us as Maniscalco explores the state of technology for monitoring and protecting individuals with T1D.

WITH ALL OF THE WRITING I'VE DONE LATELY, this piece is harder for me because it touches on a very personal topic. I find myself at an interesting intersection of family, technology, and healthcare needs, which I am quickly finding has some unique challenges and opportunities. My personal and family life collided with my technology world when one of our children was diagnosed with Type 1 Diabetes (T1D) in August of 2016, when he was only 18-months old.

For those of you who aren’t familiar with T1D, it is an autoimmune disease for which there is no known cause or cure and affects about 1.2 million Americans. If untreated, it can lead to death, and even with daily management there are some very scary long-term complications that can arise because of the disease. 

The bad news is that we, as parents, now act as our son’s pancreas and that results in stress, sleeplessness, and anxiety! The good news is that there is significant research happening around T1D and the technology is constantly improving. Some of that technology happens to be in an area that I have a good deal of experience and knowledge of — remote monitoring.

In our one-week hospital crash course upon diagnosis, we learned how to keep our son healthy on a combination of carbohydrate counting, insulin treatment, and constant blood sugar monitoring. It was all intimidating, tedious and archaic.

Counting carbs, calculating insulin doses, manual insulin injections, then a finger-prick blood-sugar reading on a regular interval throughout the day. Logs were manual; devices were dated. It was honestly depressing

During the last day or two of this immersion, we began to learn about some more modern technology to address the disease. This included insulin pumps for more precise and convenient delivery, as well as something called Constant Glucose Monitoring or CGM.

Being a techie and concerned father, I immediately dove into these two technologies and expedited delivery to get them into our hands as quickly as possible. When everything showed up at our doorstep, the reality quickly set in that this technology, as modern as it seemed compared to the archaic techniques we were taught in the hospital, still had a lot of shortcomings.

I’ll spare you more details, but after a lot of fumbling and experimenting we were up and running on an insulin pump, combined with a CGM, and our lives were immediately improved. I spent the next few weeks trying to understand why the technology wasn’t better than it was, found some interesting projects, and hacked together a few DIY improvements to help us manage his disease.

So why am I writing this article in CE Pro? Well, some of the DIY projects are smart-home related. For instance, I was able to have my lights turn on at night if the CGM detected low blood sugar. Low blood sugar can lead to seizures, loss of consciousness, and death so coordinating the lights to the CGM ensures I don’t miss an audible alert on my phone indicating my son needs to get his blood sugar back into range.

There are also applications for voice user interfaces. This raised an obvious question – Is there an opportunity for CE Pros around the treatment of disease with technology?

I have been participating on the CEDIA Technology Council and IT Task Force for many years, and security is a growing topic of conversation. There are many people who believe that healthcare IoT best practices around security are likely to drive residential IoT security policies.

I took this even more seriously when I read a report that a Johnson & Johnson Animas diabetes pump had been hacked through the use of an unsecured communications protocol over Bluetooth.

The interest in security is high for home technology professionals, consumer electronics manufacturers and consumers, so the more we can learn from other industries, the better.

So I set out on a diabetes immersion weekend at the Annual American Diabetes Association Scientific Sessions in San Diego (home of CEDIA 2017). My goal was to learn and investigate whether there were opportunities for CE Pros to apply smart home technology to disease management and also determine what security topics were being discussed that could impact IoT and smart home.

The short answer: I came back with more than I expected. Stay tuned for the follow-up piece!

Next up from Maniscalco: How difficult it is today to integrate medical monitors with home automation: “It takes open source software, unsupported APIs and a little bit of creativity.” 

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