You heard me. We need a pedometer in an insulin pump. And we needed it yesterday. Heck, maybe last week.
Exercise doesn’t get the credit it deserves in diabetes management. There are plenty of reasons for that, but for now, let’s focus on this pump-plus-pedometer idea. After 46 years with diabetes, I can say with confidence that without regular activity, I probably wouldn’t be complication-free. Exercise has been my not-so-secret weapon — my glucose sidekick, my heart’s best friend, and occasionally my excuse for an extra cookie.
Sure, I’m biased. But I’m also a clinical exercise physiologist and a diabetes educator, so yes, I think I’ve earned the right to talk about this with a little authority.
Exercise and diabetes are deeply connected. It’s why physical activity is one of the ADCES7 self-care behaviors, and it’s one of the most effective “medications” for improving blood glucose control, cardiovascular health, and overall well-being. The American College of Sports Medicine and the American Medical Association launched the Exercise is Medicine campaign in 2007 because, frankly, exercise does many of the things your prescriptions do, without the sticker shock and with fewer side effects (unless you count the occasional sore muscle).
For cardiovascular exercise, which you can easily track with a pedometer, is recommended for at least 150 minutes per week of moderate-to-vigorous activity spread across most days. Who recommends it? Well, there’s the American Diabetes Association, ACSM, the Centers for Disease Control, the World Health Organization, pretty much everyone. And here’s where pedometers come in. They promote goal-setting, feedback, and accountability. They also deliver that dopamine hit when your step count rises. Studies show pedometer users are more active than those who don’t track steps. Plus, it’s proof that your midnight kitchen shimmy counted as exercise.
Not to brag (okay, maybe to brag a little), but I had this idea years ago while working at Animas Corporation. My concept: the EZ PD, a simple pedometer built into a pump, just to give users feedback on daily activity. It wasn’t meant to affect insulin delivery — we were in the prehistoric era of pumps. I just wanted activity accountability in the same device I wear 24/7. The idea was accepted, but after the company was sold to Johnson & Johnson, it was shelved. And here we are, 20 years later. Nothing. Zip. Nada. I thought someone else would have “run” with the idea (pun very much intended), but apparently, like some of my jokes, it landed flat.
Sure, pedometers exist on watches, phones, and countless gadgets. But integration? That’s where we’re lagging. I remember when CGM sensors first came out; if you wanted to compare sensor and pump data, you had to print each separately, cut them, and then MacGyver them together with tape. Convenient, right? (Yes, sarcasm.) Now, imagine pairing step counts with CGM data. Suddenly, you could see how your walks, jogs, or dance breaks affect your blood sugar. Cue Louis Armstrong: What a Wonderful World.
This isn’t just a pipe dream. xDrip⁺, which was the software choice for Dexcom users on Android, is now more considered a data hub that can send and receive data from other sources like fitness trackers. Prior to switching to iOS, that’s what I used (and it was amazing). Nightscout has some workarounds to show fitness data too, but the need for workarounds proves it’s not integrated into the pump.
A quick history detour: yesterday’s pedometers were clunky mechanical gadgets that clicked with every step; they were loud, imprecise, and oddly satisfying. You clipped them on, took two steps, and heard a click-click-click that annoyed everyone within a five-foot radius. Today’s pedometers are sleek, smart, and suspiciously judgmental. They track steps, calories, sleep, GPS routes, and even midnight trips to the fridge. They sync with apps, show trends, and nudge you when you’ve been sitting too long.
Now imagine a pump with a built-in accelerometer. It tracks movement, links it to glucose trends, and shows exactly how your afternoon walk, morning yoga, or mad dash for coffee affects your blood sugar. Pair that with modern AI-enabled insulin delivery, and you’ve got something game-changing. A pump that “knows” you’re active could auto-adjust basal rates and flag patterns.
Adding a motion sensor shouldn’t be hard; lots of devices already have them. The real challenges are regulatory approval, battery life, and data reliability. But the payoff would be huge: a pump that personalizes insulin delivery, contextualizes glucose trends, and helps users recognize patterns they’d never noticed. Extra steps could turn into mini victories, something people with diabetes desperately need.
If we can make a disposable pump, we can put an accelerometer inside. The first company to do it will be a hero. I’d buy it, recommend it, and probably start a fan club. Exercise matters. Tracking matters. Integrating the two into diabetes technology? That just makes sense. Pedometers encourage activity, CGMs track trends, and a pump that combines both could finally give exercise the credit it deserves.
So hear me loud and clear: put a pedometer in a pump. And if any pump company is reading this, consider this my official application for CSA — Chief Step Advisor. Qualifications? Well, I’m pretty good at walking, full of ideas, and can deliver sarcastic motivational messages at no extra cost. And yes, I get to name the feature. How about Gluc-o-Motion? No, how about StepSulin, The Metabolic Motivator? Pancre-ometer? Pumpzilla?