What would you expect the sessions at the Advanced Technologies & Therapeutics for Diabetes (ATTD) conference to focus on?.....
I know, a silly question.
However, there is a not so silly question that is often asked in the Diabetes Online Community (DOC) and also at the recent #ATTDDSMS (see post below) event.
“What does diabetes technology mean to you?”
It’s easy to just consider insulin pumps and the latest glucose monitoring sensors along with smart phones and smart watches as diabetes tech. After all they are very techy and pretty much all you will read about or hear talked about in the online community.
DIY APS (Artificial Pancreas Systems) are a popular topic, with some impressive results and lovely pictures of in-range blood glucose (BG) graphs. We now see sessions on DIY APS at conferences, which is a huge step forward from a few years ago when these sessions would have not been allowed in any way.
Commercial APS systems are here with more promised to be on the way, and this time I think we can be confident this will actually happen.
The performance cars of diabetes technology will soon be available!
There is one issue though. Not all people that manage their diabetes with insulin will have access to these performance devices. Not all have access to CGM or Flash monitoring systems. Even fewer have access to insulin pumps. The vast majority (around 90%) do not (or in some cases, choose not to, which is entirely their right) have access to these technologies.
So, what does diabetes technology mean to them?
BG meters are technology of course, but so are insulin pens. In fact, I personally consider pen needles as technology too. Any PWD that has used a quality pen needle and then been moved to a “cost effective” one may agree with me. I started out on my journey with diabetes by using syringes to inject. Insulin pens and needles were a big technology jump for me, and a positive one.
Having said all of the above, and rambled on a bit as always, I was encouraged to see in the raft of high tech stands in the exhibition at this year’s ATTD, one that stood out to be different. I spent more time at this stand talking to the team and getting a demonstration of this new technology.
What was it?....
A new “Smart Pen” from Novo Nordisk that records and holds the data on the last 800 injections it delivered. Time, date and dosage. The data can be uploaded via NFC (near field communication, which is the same technology that Flash monitoring currently uses. This enables PWDs to upload data via their smartphone or if they do not have one then their clinic can upload it for them via a bespoke NFC reader. There is no proprietary software or diabetes management app, and instead the company have partnered with existing companies. This enables PWDs to upload all of their data from different devices to the same management software.
Why am I so pleased to see this? After all, I’m the Grumpy Pumper, not the Merry MDI’er.
Because I do my best to remember my privilege and that I am very lucky. Where possible, I think the diabetes community has a responsibility to advocate for all.
There were sessions that discussed managing diabetes with MDI (multiple daily injections) and covered topics like injection techniques, but they were few and seem to be getting less year on year. Some were focussed on type 2 diabetes managed with insulin which is also good to see.
However, I left the conference feeling both encouraged and saddened. Encouraged by what I did see on show for those in the majority but saddened that I had to search to find it.
I am not saying that we should take our foot off of the accelerator of change. Certainly not. I am fully supportive of the advances from the community, industry and science. I do fear though that this acceleration increases the technology gap for the majority of PWDs can make them feel isolated from the online community, and worse, could serve to demotivate them in their diabetes management. Those of us who are advocates in the diabetes community must remember the importance of advocating for all, no matter what technology we are using personally.
Maybe it’s time to look at the technology advances and challenge ourselves to see how we can use them to help make diabetes technology decision making easier for the many people that manage their diabetes with blood glucose meters and MDI?