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I use a Dexcom Continuous Blood Glucose Monitor that pairs with this pump (I don't use the pump). And honestly, this is not surprising. The software quality in

I use a Dexcom Continuous Blood Glucose Monitor that pairs with this pump (I don't use the pump). And honestly, this is not surprising. The software quality in this space seems really low. I don't understand why some single-developer Mastodon client app can absolutely reliably get notifications to my watch but Dexcom can't. Even on the phone, the app cannot get alerts right at all, sometimes stacking them over an hour or more, but getting the current value for the alert, so you can get like five in a row (ALERT YOUR BLOOD SUGAR IS IN RANGE). It's kinda terrifying to be honest.

bdcravens 2y ago
My alerts have pretty much always been on time (Dexcom 6 and iPhone 14 Pro Max)
- thejohnconway 2y ago
  Don't move to the 7. The software has regressed tremendously. It's clearly some sort of cross-platform abomination.
  - bdcravens 2y ago
    I know that paired pumps have been slow to move to the 7 (only the Tandem has AFAIK; I'm currently on the Omnipod) and I can understand why from what you're describing.
  - gmaster1440 2y ago
    Software aside, how do the accuracy/precision of the readings on the g7 compare to the g6? Not having to replace/order a transmitter every 3 months, and a 30-minute warmup, seem like significant improvements over the g6.
    - thejohnconway 2y ago
      Regarding accuracy, I don't know, because I never compare it to anything. Seems pretty similar based on how I feel vs readings when I'm low. The hardware experience is indeed better. Bundling the transmitter with the patch and the 30 minute warmup are great, and part of the reason why I haven't got the energy to switch back.
      - bdcravens 2y ago
        I do a manual test strip test from time to time.
  - HumblyTossed 2y ago
    There you go. They optimized developer productivity over everything else.
    - jnsie 2y ago
      This is a bit of a wild jump. OP hasn't even explained their grievance with the software.
      - thejohnconway 2y ago
        No, I think that is exactly what happened. They wanted to merge their Android and iOS teams. I described one major bug (the alert stacking). It seems pretty obviously they are using a cross-platform framework, the buttons and the way alerts are displayed is non-standard. Given that I've never seen a native app struggle so much with it's notifications, I'm going to go out on a limb and say that not dealing with bog-standard native APIs because they are running through a framework might be the problem. Honestly, I kinda think Apple has some responsibility here too. They should reject these apps, or help the companies figure out what is going wrong.
        HumblyTossed 2y ago
        > They should reject these apps, or help the companies figure out what is going wrong. This is what the 15/30% Apple tax is supposed to be for. I simply don't understand why they drop the ball so much when they're making a mint from developers (and consumers!).
        jnsie 2y ago
        As a matter of interest, are your issues on iOS or Android? No real reason for asking beyond curiosity...
        chuckadams 2y ago
        > Honestly, I kinda think Apple has some responsibility here too. They should reject these apps, or help the companies figure out what is going wrong. So it's on Apple to basically become a shadow FDA and maintain their own panel of experts to second-guess the whole FDA review process?
  - jnsie 2y ago
    I moved to the 7 and have no issues with the (iOS) software whatsoever. What issues are you having? If I had one issue with the 7 it's that it appears much more impacted by bluetooth interference than the 6. I suspect that this is a hardware, not software issue.
    - thejohnconway 2y ago
      For the first few months, the watch would be 20 minutes behind, maybe 60% of the time. About 20% of the time it wouldn't have any readings at all and tell me to check my phone. I almost gave up on the watch (now it pairs directly with the watch it's more reliable). As I described, I got stacked alerts, sometimes as many as ten arriving in rapid succession with inconsistent readings (Alert: 10.5, Alert: 7.3, Alert: 12.2... etc). Sometimes the reading would actually change while I was looking at the alert. Alerts are particularly unreliable when the phone is in some sort of sleep? I'm not sure, but if the phone is inactive for a while alerts get really flakey. Dexcom clearly knows about the problems, they continually update the app, and keep say "we're still testing it!" I've used it on two phones, same problems. I'm never used an app with such basic problems in its functionality. So the idea that the FDA or Apple are keeping software quality up in this space seems laughable to me.
userbinator 2y ago
I don't understand why some single-developer Mastodon client app can absolutely reliably get notifications to my watch but Dexcom can't. The same reason why software developed by individuals or small teams can be very high quality, while "enterprise" software is universally horrible; the former work in more self-structured and effective ways, but the latter usually involves tons of bureaucracy. This tends to introduction a selection bias to the types of developers who work in those environments.
- djbusby 2y ago
  Why blame the devs when management is who make the environment? Or is your point that only lower quality devs have jobs at those places?
  - londons_explore 2y ago
    smart devs who like to iterate fast and build awesome software will leave rapidly when bogged down with paperwork and compulsory training courses. And you end up left with only mediocre devs who just want to take the salary and be home by 5pm because they care far more about their family/hobbies/life more than the quality of the app they're building at work.
    - jdgoesmarching 2y ago
      Yeah imagine those weirdos who care more about their family and lives over the app they build at work. If your company relies on no-lifers to be successful, you’re running a bad company. This is a management issue.
    - framapotari 2y ago
      > And you end up left with only mediocre devs who just want to take the salary and be home by 5pm because they care far more about their family/hobbies/life more than the quality of the app they're building at work. I think it's amazing that in your mind this is a negative thing.
UomoNeroNero 2y ago
I was here to say exactly the same thing but about another insulin pump system. A few months ago, an update to Roche's DiabetLoop (DBLG1) created a thousand problems with emails recommending temporary tricks, subsequent updates, etc. It’s unclear how such a serious issue didn’t surface during QA testing for a system that is, ultimately, fully under the control of the manufacturer (hardware/software). I see a lot of effort to ensure the ecosystem is increasingly closed, touting the need for security of devices that can be fatal, but, in reality, there's little attention given. (And I say this because bugs and issues that everyone reports are always present, they're known, and they’re not being addressed.)
delfinom 2y ago
It's because one app is made by an engineering enthusiast. The other app is made by a company whose primary field isn't software, the executives are most likely wholely inexperienced with software development and/or sometimes nepo hires who then proceed to hire yesman middle managers or even outsource app development.
greggsy 2y ago
I’d argue that the regulation for ‘alternative control enabled’ (ACE) pumps [1] is too vague. These devices should be ‘designed to reliably and securely communicate with external devices’. These incidents were caused by the app crashing, resulting in the connection re-establishing itself frequently enough to drain the batteries [2]. How reliable should it be? Shouldn’t it include some stability measures? Manufacturers should have to submit their devices and software for certification of the technology before itself. Bluetooth and coding standards are mature enough at this point, and it’s time customers start demanding this from their products. [1] https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPCD/classification.cfm?ID=QFG https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPCD/cla... [2] https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRES/res.cfm?id=206914 https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRES/res...
- Spivak 2y ago
  Reliability to the degree that medical devices need to be when you're sharecropping on someone else's shifting-sand platform is a game I'm glad I'm not paid to play. It in no way excuses the bad behavior, they chose to go this route and committed to the work it would take, but the results of the such certification would be outdated by the time you finish it. I think a "sacrificial device" is the right way to make reliable the unreliable parts. Big battery for running the pump, small battery for the smart device connection. If something happens and you drain the auxiliary device it's annoying but not life critical. Your phone and pump can both alert you indicator light/notification that the auxiliary device died.
hammyhavoc 2y ago
I use a Freestyle Libre and think the software is junk too. Lot of proprietary lock-in and trying to push you towards certain vendors in this space. Should all be about people and not profit. These aren't difficult problems to solve. Nightscout is great, as is xDrip+, but pairing your device with xDrip+ gets you locked out of the vendor app and invalidates your warranty, which is a big deal as sensor quality is hit-and-miss and may come out of your arm before the 15 day window is up, so you won't get a free replacement if that happens. I would love to figure out DIYing CGMs, but the enzyme-dipped probe is the challenging part. Also, I don't think smartphones should play an active role in this space. As a means of reading data and perhaps modifying routines on a dedicated device? Maybe. But these things should all function independently of phones. My phone does an update or runs out of juice? I stop getting CGM data until I unlock with PIN and use the NFC to reconnect. Happened to me last night in my sleep, so missed going hypo in my sleep. Complete junk in this space, IMO. It's very annoying.
- thejohnconway 2y ago
  Any device can run out of juice, I'd rather worry about one than two.
bsder 2y ago
> The software quality in this space seems really low. Why is this surprising? No one is willing to spend any money on it. A developer can make $400K+ at a FAANG and work remotely. Or they can work on-site for a quarter that salary in a medical enterprise company. FAANGs may suck at hiring good developers, but good developers are excellent at leaving shitty companies. Want better experiences on this stuff? Start paying embedded developers non-crap amounts of money.
- thejohnconway 2y ago
  People working in their spare time make better apps than these. I don't think you need great developers, just ones that follow specs and use native development tools would probably do. In any case, I was responding to the notion that the FDA was quality-controlling these things. They aren't doing a very good job.
  - bsder 2y ago
    > People working in their spare time make better apps than these. So? If you want better software, pay for it. This infects all embedded development--not just medical. Everybody refuses to pay people what they are worth and then wonders why all their software sucks. > In any case, I was responding to the notion that the FDA was quality-controlling these things. They aren't doing a very good job. The FDA doesn't exist to ensure something is "good". It exists to ensure that something "does what it says" and "doesn't actively do harm". That's all. If you want something to be "good", you will somehow have to ensure that there is pressure or money to incentivize such behavior.
- olliej 2y ago
  What faang allows remote work? What faang has average devs making 400k? (Also it remains weird to me that Netflix is considered a tech company) The reality is companies like this often use minimum cost contract companies to develop the software rather than actually employing developers directly. They seeing software engineers (or any non managerial position) as purely an expense not the source of value in their products so you only get penny pinching on development and QA.

bdcravens 2y ago

My alerts have pretty much always been on time (Dexcom 6 and iPhone 14 Pro Max)

thejohnconway 2y ago
Don't move to the 7. The software has regressed tremendously. It's clearly some sort of cross-platform abomination.
- bdcravens 2y ago
  I know that paired pumps have been slow to move to the 7 (only the Tandem has AFAIK; I'm currently on the Omnipod) and I can understand why from what you're describing.
- gmaster1440 2y ago
  Software aside, how do the accuracy/precision of the readings on the g7 compare to the g6? Not having to replace/order a transmitter every 3 months, and a 30-minute warmup, seem like significant improvements over the g6.
  - thejohnconway 2y ago
    Regarding accuracy, I don't know, because I never compare it to anything. Seems pretty similar based on how I feel vs readings when I'm low. The hardware experience is indeed better. Bundling the transmitter with the patch and the 30 minute warmup are great, and part of the reason why I haven't got the energy to switch back.
    - bdcravens 2y ago
      I do a manual test strip test from time to time.
- HumblyTossed 2y ago
  There you go. They optimized developer productivity over everything else.
  - jnsie 2y ago
    This is a bit of a wild jump. OP hasn't even explained their grievance with the software.
    - thejohnconway 2y ago
      No, I think that is exactly what happened. They wanted to merge their Android and iOS teams. I described one major bug (the alert stacking). It seems pretty obviously they are using a cross-platform framework, the buttons and the way alerts are displayed is non-standard. Given that I've never seen a native app struggle so much with it's notifications, I'm going to go out on a limb and say that not dealing with bog-standard native APIs because they are running through a framework might be the problem. Honestly, I kinda think Apple has some responsibility here too. They should reject these apps, or help the companies figure out what is going wrong.
      - HumblyTossed 2y ago
        > They should reject these apps, or help the companies figure out what is going wrong. This is what the 15/30% Apple tax is supposed to be for. I simply don't understand why they drop the ball so much when they're making a mint from developers (and consumers!).
      - jnsie 2y ago
        As a matter of interest, are your issues on iOS or Android? No real reason for asking beyond curiosity...
      - chuckadams 2y ago
        > Honestly, I kinda think Apple has some responsibility here too. They should reject these apps, or help the companies figure out what is going wrong. So it's on Apple to basically become a shadow FDA and maintain their own panel of experts to second-guess the whole FDA review process?
- jnsie 2y ago
  I moved to the 7 and have no issues with the (iOS) software whatsoever. What issues are you having? If I had one issue with the 7 it's that it appears much more impacted by bluetooth interference than the 6. I suspect that this is a hardware, not software issue.
  - thejohnconway 2y ago
    For the first few months, the watch would be 20 minutes behind, maybe 60% of the time. About 20% of the time it wouldn't have any readings at all and tell me to check my phone. I almost gave up on the watch (now it pairs directly with the watch it's more reliable). As I described, I got stacked alerts, sometimes as many as ten arriving in rapid succession with inconsistent readings (Alert: 10.5, Alert: 7.3, Alert: 12.2... etc). Sometimes the reading would actually change while I was looking at the alert. Alerts are particularly unreliable when the phone is in some sort of sleep? I'm not sure, but if the phone is inactive for a while alerts get really flakey. Dexcom clearly knows about the problems, they continually update the app, and keep say "we're still testing it!" I've used it on two phones, same problems. I'm never used an app with such basic problems in its functionality. So the idea that the FDA or Apple are keeping software quality up in this space seems laughable to me.

userbinator 2y ago

I don't understand why some single-developer Mastodon client app can absolutely reliably get notifications to my watch but Dexcom can't. The same reason why software developed by individuals or small teams can be very high quality, while "enterprise" software is universally horrible; the former work in more self-structured and effective ways, but the latter usually involves tons of bureaucracy. This tends to introduction a selection bias to the types of developers who work in those environments.

djbusby 2y ago
Why blame the devs when management is who make the environment? Or is your point that only lower quality devs have jobs at those places?
- londons_explore 2y ago
  smart devs who like to iterate fast and build awesome software will leave rapidly when bogged down with paperwork and compulsory training courses. And you end up left with only mediocre devs who just want to take the salary and be home by 5pm because they care far more about their family/hobbies/life more than the quality of the app they're building at work.
  - jdgoesmarching 2y ago
    Yeah imagine those weirdos who care more about their family and lives over the app they build at work. If your company relies on no-lifers to be successful, you’re running a bad company. This is a management issue.
  - framapotari 2y ago
    > And you end up left with only mediocre devs who just want to take the salary and be home by 5pm because they care far more about their family/hobbies/life more than the quality of the app they're building at work. I think it's amazing that in your mind this is a negative thing.

UomoNeroNero 2y ago

I was here to say exactly the same thing but about another insulin pump system. A few months ago, an update to Roche's DiabetLoop (DBLG1) created a thousand problems with emails recommending temporary tricks, subsequent updates, etc. It’s unclear how such a serious issue didn’t surface during QA testing for a system that is, ultimately, fully under the control of the manufacturer (hardware/software). I see a lot of effort to ensure the ecosystem is increasingly closed, touting the need for security of devices that can be fatal, but, in reality, there's little attention given. (And I say this because bugs and issues that everyone reports are always present, they're known, and they’re not being addressed.)

delfinom 2y ago

It's because one app is made by an engineering enthusiast. The other app is made by a company whose primary field isn't software, the executives are most likely wholely inexperienced with software development and/or sometimes nepo hires who then proceed to hire yesman middle managers or even outsource app development.

greggsy 2y ago

I’d argue that the regulation for ‘alternative control enabled’ (ACE) pumps [1] is too vague. These devices should be ‘designed to reliably and securely communicate with external devices’. These incidents were caused by the app crashing, resulting in the connection re-establishing itself frequently enough to drain the batteries [2]. How reliable should it be? Shouldn’t it include some stability measures? Manufacturers should have to submit their devices and software for certification of the technology before itself. Bluetooth and coding standards are mature enough at this point, and it’s time customers start demanding this from their products. [1] https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPCD/classification.cfm?ID=QFG https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPCD/cla... [2] https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRES/res.cfm?id=206914 https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRES/res...

Spivak 2y ago
Reliability to the degree that medical devices need to be when you're sharecropping on someone else's shifting-sand platform is a game I'm glad I'm not paid to play. It in no way excuses the bad behavior, they chose to go this route and committed to the work it would take, but the results of the such certification would be outdated by the time you finish it. I think a "sacrificial device" is the right way to make reliable the unreliable parts. Big battery for running the pump, small battery for the smart device connection. If something happens and you drain the auxiliary device it's annoying but not life critical. Your phone and pump can both alert you indicator light/notification that the auxiliary device died.

hammyhavoc 2y ago

I use a Freestyle Libre and think the software is junk too. Lot of proprietary lock-in and trying to push you towards certain vendors in this space. Should all be about people and not profit. These aren't difficult problems to solve. Nightscout is great, as is xDrip+, but pairing your device with xDrip+ gets you locked out of the vendor app and invalidates your warranty, which is a big deal as sensor quality is hit-and-miss and may come out of your arm before the 15 day window is up, so you won't get a free replacement if that happens. I would love to figure out DIYing CGMs, but the enzyme-dipped probe is the challenging part. Also, I don't think smartphones should play an active role in this space. As a means of reading data and perhaps modifying routines on a dedicated device? Maybe. But these things should all function independently of phones. My phone does an update or runs out of juice? I stop getting CGM data until I unlock with PIN and use the NFC to reconnect. Happened to me last night in my sleep, so missed going hypo in my sleep. Complete junk in this space, IMO. It's very annoying.

thejohnconway 2y ago
Any device can run out of juice, I'd rather worry about one than two.

bsder 2y ago

> The software quality in this space seems really low. Why is this surprising? No one is willing to spend any money on it. A developer can make $400K+ at a FAANG and work remotely. Or they can work on-site for a quarter that salary in a medical enterprise company. FAANGs may suck at hiring good developers, but good developers are excellent at leaving shitty companies. Want better experiences on this stuff? Start paying embedded developers non-crap amounts of money.

thejohnconway 2y ago
People working in their spare time make better apps than these. I don't think you need great developers, just ones that follow specs and use native development tools would probably do. In any case, I was responding to the notion that the FDA was quality-controlling these things. They aren't doing a very good job.
- bsder 2y ago
  > People working in their spare time make better apps than these. So? If you want better software, pay for it. This infects all embedded development--not just medical. Everybody refuses to pay people what they are worth and then wonders why all their software sucks. > In any case, I was responding to the notion that the FDA was quality-controlling these things. They aren't doing a very good job. The FDA doesn't exist to ensure something is "good". It exists to ensure that something "does what it says" and "doesn't actively do harm". That's all. If you want something to be "good", you will somehow have to ensure that there is pressure or money to incentivize such behavior.
olliej 2y ago
What faang allows remote work? What faang has average devs making 400k? (Also it remains weird to me that Netflix is considered a tech company) The reality is companies like this often use minimum cost contract companies to develop the software rather than actually employing developers directly. They seeing software engineers (or any non managerial position) as purely an expense not the source of value in their products so you only get penny pinching on development and QA.