Piehl introduced the Confidant technology to 10 young patients for a six-week trial. They were given a free cell phone and asked to give it a try. Leinart was one of those patients.
Piehl says all the kids enjoyed the trial and offered valuable feedback to improve the process.
"It's easy. It's fun. It reminds them to check more often," Piehl said. "We know it makes them test more often and now we would like to discover if testing more frequently works in the overall improvement of keeping them within their blood sugar range."
During the WakeMed trials, Leinart found himself sticking to his normal disciplined routine of testing when he woke up, before every meal, mid-morning, after school, and at bedtime.
"I want to do well for myself and my doctors, so I don't need that whole big brother is watching thing to motivate me. But I've gone to the WakeMed Hospital summer camp and I know those little kids have high levels and they don't know to monitor it too well yet," he said. "Positive reinforcement is good. Doing it well no matter how you get it done is doing it right and a lot of kids are connected to their phones anyway, so I think it will help them."
Confidant makes the software themselves and has been conducting their trials with off-the-shelf cell phones that run on the AT&T wireless network. The programs are created for a Java environment that is present in most modern AT&T phones and the medical devices connect to the phones without wires due to the carrier's open serial Bluetooth framework.
The open standards are important to make sure the most phones will work with the most devices, because their business model is planning on a lot of volume, Marc O'Brien, Confidant's VP of Sales says.
"Chronic diseases are an epidemic in our country and we see this being a tool for not only diabetics, but people with asthma, high blood pressure, heart problems and people trying to lose weight. We are going to start rolling out our service wherever points of care are involved," he said. "The software is going to be a single download over the air and we are aiming for an all inclusive price of $1 a day."
As the company negotiates rates with insurance companies, clinics and hospitals they are also responding to early user feedback. The interface is being spiffed up and there is now a way to enter diet, exercise and medications into the phone so the doctors will have a more complete picture of the patient's overall health.
Piehl is working on a grant proposal to do a follow up study that will include 50 patients and is especially interested in incentive-based programs.
"I think it would be fantastic to see if children would respond any differently to a reward system where testing a certain amount of times a day would earn you a song download, or keeping your levels within range would allow you access to a certain game," he said.
Today, nearly two years to the day since he was first diagnosed, Leinart is one foot taller, has put on 40 pounds of muscle and is a 16-year-old wrestling champ at Sanderson High in Raleigh, N.C.
Having to measure his complex carbohydrates, simple sugars, and managing portion control made Glenn a self-taught nutritionist and he has taken up jogging for fun. Even if the life-saving supplies weigh him down he says he won't leave the house unless he's prepared.
"Even when I go for a run I have my insulin, blood glucose meter, some juice in case my levels get too low," he said. "And I don't go anywhere without my cell phone."