1. © 2004, John Walsh, PA, CDE Intelligent Devices A Smart Pen demonstrates possibilities for intelligent diabetes devices by John Walsh, P.A., C.D.E. Smart Pen Online Slides

2. © 2004, John Walsh, PA, CDE Sample Feedback From An Intelligent Device You are having too many lows/highs at lunch Over 2 weeks, 6 readings have been below 50 mg/dl In the last x days, your BG pattern is better/worse Your readings suggest you need more/less insulin Discuss changing your basal rate (carb factor or correction factor) with your doctor right away You often have lows-to-highs. Are you eating excess carbs for your lows? Your current BG and BOB indicate you now need x.x units (or x grams of carb)

3. © 2004, John Walsh, PA, CDE The Intelligent Pen 300 personal carb selections with accurate carb counts Carb factor (1:1 TO 1: 100) Correction factor (1:4 to 1: 400) 5 sec microdraw BG meter 0.1 unit precision motor Non-volatile memory 3,000 events Bluetooth data transfer

4. © 2004, John Walsh, PA, CDE SmartPen – Lab Results Fast lab results without calling. Messaging also allows physician to make recommendations.

5. © 2004, John Walsh, PA, CDE Smart Pen – Reminders Useful reminders

6. © 2004, John Walsh, PA, CDE SmartPen – Reminders And Appointments Reminders for when lab tests should be done and allows convenient appointment changes.

7. © 2004, John Walsh, PA, CDE SmartPen – Carb Database Carb database for accurate carb counts.

8. © 2004, John Walsh, PA, CDE SmartPen – Estimate Of Miscalculated Carb Count A high glucose can be analyzed to determine the magnitude of the error

9. © 2004, John Walsh, PA, CDE SmartPen – Carb Suggestions Suggestions to limit intake based on weight, calorie, or carb goals, or for specific amounts of carb needed for a given situation

10. © 2004, John Walsh, PA, CDE SmartPen – Carbs Needed For Exercise Recommended carb intake (or insulin reduction) to balance activity.

11. © 2004, John Walsh, PA, CDE SmartPen – Low High Pattern Alert Insulin dose suggestions and an alert about past overtreatment of lows.

12. © 2004, John Walsh, PA, CDE Smart Pen – Low High Pattern Alert An intelligent device can provide a persons precise carb requirement when the blood glucose is tested.

13. © 2004, John Walsh, PA, CDE SmartPen – Dose Changes Or Reminders Dose recommendations and reminders

14. © 2004, John Walsh, PA, CDE SmartPen – Dose Changes New dose recommendations based on lab data, relative amount of correction boluses, and frequency of hypoglycemia

15. © 2004, John Walsh, PA, CDE SmartPen – More Dose Changes New insulin dose suggestions generated from current BG data and reduction of steroid dose.

16. © 2004, John Walsh, PA, CDE SmartPen – Pattern Recognition Insulin dose suggestions and an alert about past overtreatment of lows.

17. © 2004, John Walsh, PA, CDE Smart Pen – Pattern Alert Pattern alerts and advice

18. © 2004, John Walsh, PA, CDE Summary Intelligent devices are being evaluated and designed to improve BG control in diabetes with less effort. Intelligent devices solve a critical problem: that the current treatment interval of 3 to 4 months between doctors visits is too long Intelligent devices can deliver useful control advice at any time of day Devices provide short treatment intervals and thereby shorten the time to goal