Gamesmanship

Gamesmanship

According to Wikipedia – Gamesmanship is the use of dubious methods to win or gain a serious advantage in a game or sport. And nowhere is gamesmanship more prevalent than in the area of way cool whiz bang. Yes the toys in the toy chest continue to fascinate the folks in our wacky world no matter how many times we have to tell these people it’s not about the toys rather getting patients to play with the toys. Still we are continually amused to lengths some of these companies will go to when trying to out cool their competition.

Our friends at Livongo are a great example of this. Read through any of their press releases or listen to any of their presentations or earnings calls and they are filled with lots of way cool whiz bang buzzwords. In the land of way cool whiz-bang artificial intelligence, something that used to way cool and whiz bang has been replaced with AI+AI. Which according to Livongo is the engine that drives their platform while “providing new insights to deliver personalized information empowering our members to effectively manage their diabetes and many aspects of their health.”

Now I don’t know about everyone else but that sure sounds way cool to me. But in the land of way cool whiz bang Livongo now has a serious competitor as take a look at this from a OneDrop release;

“One Drop leads the paradigm shift in health management from reactive to prospective, unveiling new AI-powered predictions for blood glucose, A1C, blood pressure, and weight up to six months in advance”

The release goes onto state;

“To date, One Drop has collected more than 11 billion health data points from nearly 3 million One Drop app users in 195 countries. The app collects health data through manual input, automatic upload from connected devices, HealthKit, GoogleFit, and direct integrations with Dexcom, Fitbit, Apple Watch, Companion Medical, and other strategic partners. One Drop recently acquired the assets and intellectual property of Sano Intelligence, Inc. and announced plans to develop a multisensorial patch that will generate thousands of new data points per user per day.

This pooled population data powers the machine learning models behind One Drop’s Predictive Insights. Currently, users can receive eight-hour glucose forecasts, along with real-time advice for exercise, diet, and lifestyle adjustments.

“The real power of our predictive models is how individualized they are,” said One Drop VP of Data Science, Dan Goldner. “We don’t bother looking for broad patterns of factors that might help in distinct groups. Instead, we jump straight to predicting the factors most likely to help you. We update that prediction every day and use that insight to steer your personal One Drop experience.”

Treatment goals for diabetes and related conditions, including hypertension and prediabetes, are defined as reductions in average blood glucose concentration, blood pressure, and weight. Accurately predicting these metrics can enable the delivery of timely treatment and lifestyle recommendations, leading to improved outcomes.”

Now seriously doesn’t all that sound so damn cool and impressive. Let’s not look at this from a practical standpoint rather a buzz standpoint. This sounds so damn cool. Listen we have seen, heard and read tons of way cool whiz bang but OneDrop has set a new standard with this release and have raised the way cool whiz bang bar to new, higher level. Frankly we can’t wait to see how Livongo responds.

Yet here in the mundane boring real world us plebeians who struggle each day to put together a coherent sentence began to wonder how this way cool whiz bang helps us manage our diabetes from one boring day to the next. Knowing nothing about AI or AI+AI or now Predictive Insights it’s a wonder we can manage our diabetes without all this way cool whiz bang. Yet somehow, someway even with our below average IQ and inability to use even a simple smartphone correctly we manage. How is this possible? Frankly we have no idea.

Even though we can sometimes be dumber than a doorstop allow us to speculate as to how we do manage. How it is possible that we can manage our diabetes effectively without all this way cool whiz bang. Now let us say upfront that we do use some very cool diabetes technology. As Momma Kliff used to say we may be dumb, but we aren’t stupid either. Hence the reason we have embraced CGM over BGM. Some of us have gone a step further and use an insulin pump but even before becoming a pump patient we did pretty well using an old fashioned non-connected insulin pen and injected our insulin.

Now we know this will sound crazy to all the folks who have fallen in love with way cool whiz bang we also did something they seem to think is impossible with all this way cool whiz bang. We took ownership of the fact we had diabetes in the first place. We took the time to get educated about this disease we are going to have for the rest of our lives. Additionally we did something else that’s akin to heresy in the world of way cool whiz bang, we used common sense. Yes we know this a foreign concept to many in diabetes toy land, but it does exist.

Knowing that managing our weight was an important aspect of managing our diabetes using common sense we knew it’s not a good idea to eat deep dish pizza every night no matter how great Chicago deep dish pizza is. And not to digress but it’s a real bummer that ADA did not make it to the home of the best deep-dish pizza in the world. Whether its Lou Malnati’s or Gino’s East there is no question Chicago is tops when it comes to deep dish pizza.

Common sense also told us that it was a good idea to get out and exercise, that we should shouldn’t be couch potatoes all the time. Hence the reason here in Chicago many of us are doing a major happy dance now that the Mayor is reopening our beautiful lakefront. Besides some truly stunning views of this great city the lakefront has one of the greatest bike paths we’ve ever had the pleasure to ride. It may not be the same as riding Coronado Island or the coast in San Diego but it’s a nice ride nonetheless.

Limited as our intelligence can be we also understood how to use the data provided by the toys we played with. Even before CGM we knew what the numbers meant that came from old-fashioned BGM. The same goes for our pump settings which for many use became a daily science experiment until through trial and error we figured it out. Back in the day before all this way cool whiz bang trial and error combined with the WAG method was how we figured things out. Crazy for sure but we did figure it out.

We also survived without someone collecting all of our data, analyzing it and then telling us what to do. We became our own data analytics computer. Nor did we worry much about what might or might not happen 6 months from now. Quite honestly we were and are happy just to make it through another day. We’ve accepted the fact that we will occasionally go low or have periods when we just can’t get our numbers where we want them to be. Most importantly try as we might we have also accepted that there are just some things we cannot control which directly impact our levels, just any diabetic who’s under a major amount of stress.

Let’s be very clear here we are not against all this way cool whiz bang as there is niche portion of the patient population which will embrace it. However having lived with diabetes all these years we also see all this way cool whiz bang, all the data analytics and predictive insights as over complicating a simple peanut butter and jelly sandwich. The way we see it about 10% of the patient population gets diabetes management, another 20% doesn’t and will never get, the remaining 70% understand they need to do something, but they want to live WITH and NOT FOR their diabetes.

Year after year we look at all this way cool whiz bang and remember that nearly two thirds of all patients are not achieving good control. That with the billions spent, the billions made this problem still exists. The way cool whiz bang gang could care less about this as their job is to enrich their stakeholders and nothing enriches stakeholders more than a great story. Again we aren’t against people making money we’re all for it this is what capitalism is all about. However it would be nice if one day we were talking about how all this whiz bang way cool was actually changing that sobering statistic that patients were actually achieving better outcomes and that these better outcomes were being sustained.

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