In his previous article, Type 1 campaigner and self-proclaimed data
geek Nick Cahm shared with us his key elements for successfully
managing diabetes: Motivation, Education, Technology and Support.
Here, he shares his own experience with diagnosis and his hopes for
the diabetes technology of the future.
This article reflects the experience, views and opinions of Nick
Cahm, and should not be interpreted as being a representation of a
wider group of people with diabetes.
Insulin can easily be taken for granted. It is worth remembering that
insulin was first used to treat diabetes only almost 99 years ago. Its
use was crude and whilst it undoubtedly enabled the management of a
previously life-limiting condition, it couldn’t be considered as
controlling the condition1. Fast-forward to my diagnosis in
2007. I received an hour’s training and was handed a log book, two
insulin pens and a blood glucose meter. Tools to manage my
newly-diagnosed condition, but I had scant knowledge of what to do
with them. I had no knowledge of whether there was a choice between
any of these tools or whether they were the most appropriate for my
circumstances.
I was fortunate, I had been using the internet since the early 1990s
and knew the power (and pitfalls) of finding information online. I had
scientific training and knew the finding out as much as I could was
the key. Not everyone is that fortunate. I managed to keep my logbook
up for a few weeks…but that soon fell by the wayside! I had much of
the education I needed, I had support from peers and I had some of the
technology that I needed. Looking back at that time, I did OK, but I
didn’t do brilliantly. Two key elements caused me to transition from
having mediocre control to exceeding my expectations considerably.
- Continuous Glucose Monitoring
- Attending an education
course
Of course, it is not one size fits all. For me personally, glucose
monitoring was key to understanding how to manage diabetes of any
type. Blood glucose meters are wonderful pieces of technology, but
they require commitment, knowledge and motivation to use effectively
and for me proved to be inconvenient in many circumstances. The launch
of the first flash glucose monitor in 2016 made a huge difference to
me2, however, it wasn’t until I was able to get live levels
transmitted wherever I needed them without intervention, that my
control had a step-change improvement. Looking back it wasn’t because
I didn’t have the ability to use the device effectively, but the
visibility of my glucose levels motivated me to work harder at
managing my control.
Looking to the future
On the horizon, there is a new innovation that is greatly exciting
me. For many reasons, I use injections rather than a pump for my
insulin delivery – this works best for me. The first insulin pen was
sold in 1983 and become widely accepted over the next few
years3. The technology in this area has not had a
step-change improvement since this time. The introduction of smart
pens may address this. Having the insulin dose alongside real-time
blood glucose data will make my diabetes management easier as
well as enabling better conversations with the clinicians I interact
with4. It will be both motivating and educational, helping
me to have in-depth knowledge of another part of my diabetes.
Diabetes technology will continue to develop and improve. With more
options becoming readily available aiming to cater to the varying
needs of people with diabetes, I am looking forward to the innovations
ahead to see how these technological advances can bring about more
effective management of the condition.
