This transcript has been edited for clarity.
Today, I'm going to talk about the perils of using a smartphone to control diabetes devices. Don't get me wrong, I think smartphones controlling devices is a wonderful thing. My patients prefer it, they love the simplicity of it, they don't have to carry a second device with them, and it makes it easy to look at glucose levels because people always have their devices at hand.
The US Food and Drug Administration (FDA) recently issued an alert to patients because they found there were smartphone device alert settings that were erased. This happened especially following phone hardware or software changes so the phone no longer alerted for critical situations, like too high a glucose level or too low a glucose level, or all the other kinds of important alarms and alerts that patients should get from their smartphone.
They suggest patients check their alarms and alerts periodically, just to be sure they're working, because you don't want to depend on something to alert you if it's not going to alert.
I recently became aware of the concerns of using smartphones when I had a patient who ended up in jail. One of the first things they do when they put you in jail is take away your smartphone. This particular individual was on an Omnipod 5 system, so without the smartphone, they couldn't use their pump, they couldn't look at their glucose levels, and they were really lost.
The entire situation was very disconcerting, but when you have type 1 diabetes, to not be able to manage it or even know what your glucose levels were really contributed to the trauma of this situation.
I also have patients not in such a difficult situation, such as people who work in highly secured environments or who are working in jobs like judges, where looking at a smartphone isn't really allowed or considered part of what their daily routine is. I know there are people where smartphones aren't the answer, and having a separate kind of controller is actually preferred.
This made me think even more about what happens when you travel with a device that's just running off your smartphone. What happens if you lose your smartphone, it breaks, or it is stolen? How then do you run your diabetes devices?
If you're in the US, that's not such a problem. If you're abroad, it can be more of a problem because of the phenomena of geofencing. I can't explain this in great detail, and I am sure there are those of you out there who are much savvier with these systems than I am. I do know that a US phone doesn't run the apps that you can get, say, in Germany, for controlling a Dexcom or an insulin pump system. They're specific to the country. I think the apps are specific to a country and possibly the phones are.
I know you can do things like change SIM cards or VPNs or do things to make things look like they're in the US. This could be problematic, especially if you're not a computer science whiz — like I'm not.
This really highlights the need for people to be prepared to manage their diabetes without technology. If it's, say, a longer trip, people might want to bring a backup smartphone so they always have something to fall back on. We need to think about it because it's a change in how people manage their diabetes. It's a change to use devices that only rely on a smartphone.
As always, when one has diabetes, it's good to think through all possibilities and then to prepare for them.
This has been Dr Anne Peters for Medscape. Thank you.
COMMENTARY
Are Smartphone Alerts Reliable for Diabetes Management?
DISCLOSURES
| March 07, 2025This transcript has been edited for clarity.
Today, I'm going to talk about the perils of using a smartphone to control diabetes devices. Don't get me wrong, I think smartphones controlling devices is a wonderful thing. My patients prefer it, they love the simplicity of it, they don't have to carry a second device with them, and it makes it easy to look at glucose levels because people always have their devices at hand.
The US Food and Drug Administration (FDA) recently issued an alert to patients because they found there were smartphone device alert settings that were erased. This happened especially following phone hardware or software changes so the phone no longer alerted for critical situations, like too high a glucose level or too low a glucose level, or all the other kinds of important alarms and alerts that patients should get from their smartphone.
They suggest patients check their alarms and alerts periodically, just to be sure they're working, because you don't want to depend on something to alert you if it's not going to alert.
I recently became aware of the concerns of using smartphones when I had a patient who ended up in jail. One of the first things they do when they put you in jail is take away your smartphone. This particular individual was on an Omnipod 5 system, so without the smartphone, they couldn't use their pump, they couldn't look at their glucose levels, and they were really lost.
The entire situation was very disconcerting, but when you have type 1 diabetes, to not be able to manage it or even know what your glucose levels were really contributed to the trauma of this situation.
I also have patients not in such a difficult situation, such as people who work in highly secured environments or who are working in jobs like judges, where looking at a smartphone isn't really allowed or considered part of what their daily routine is. I know there are people where smartphones aren't the answer, and having a separate kind of controller is actually preferred.
This made me think even more about what happens when you travel with a device that's just running off your smartphone. What happens if you lose your smartphone, it breaks, or it is stolen? How then do you run your diabetes devices?
If you're in the US, that's not such a problem. If you're abroad, it can be more of a problem because of the phenomena of geofencing. I can't explain this in great detail, and I am sure there are those of you out there who are much savvier with these systems than I am. I do know that a US phone doesn't run the apps that you can get, say, in Germany, for controlling a Dexcom or an insulin pump system. They're specific to the country. I think the apps are specific to a country and possibly the phones are.
I know you can do things like change SIM cards or VPNs or do things to make things look like they're in the US. This could be problematic, especially if you're not a computer science whiz — like I'm not.
This really highlights the need for people to be prepared to manage their diabetes without technology. If it's, say, a longer trip, people might want to bring a backup smartphone so they always have something to fall back on. We need to think about it because it's a change in how people manage their diabetes. It's a change to use devices that only rely on a smartphone.
As always, when one has diabetes, it's good to think through all possibilities and then to prepare for them.
This has been Dr Anne Peters for Medscape. Thank you.
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
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