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Technology and Diabetes

Josh DUK

Josh DUK

Online Community and Learning Manager
Staff member
Relationship to Diabetes
At risk of diabetes
Hi All,

How do you feel about technology used to manage your diabetes? What do you find it useful for? And is there something you would tell someone starting on a technology journey?


There are a lot of news stories that get posted on the forum about technology and diabetes and it would be good to hear your thoughts about what they mean to you. But also what the relationship between your diabetes and technology is. If you would like to share your story so that others can learn more about tech, we’d love to talk to you – reply to this post and we’ll be in touch.
 
The first thing that I would point out is that technology is a noun and can not be used as an adjective as you have done. That is because I am 74 years old and was taught, with the aid of a stick, that such thing are important.

Joking apart:

I have just been connected up, or Libre-ised, and if you would like a few words on this then I would be happy to provide them.
 
leonS said:
The first thing that I would point out is that technology is a noun and can not be used as an adjective as you have done. That is because I am 74 years old and was taught, with the aid of a stick, that such thing are important.
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My 93 year old dad told told me about one teacher he named clipper smith, as he regularly received a clip round the ear , also if he had told his parents his dad would have given him another one as he must have deserved the first one, boy how times have changed.

Joking apart:

I have just been connected up, or Libre-ised, and if you would like a few words on this then I would be happy to provide them.
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I love my Libre and would love to read your experience with it so far.
 
I use a libre, and manage to upload the results to my laptop, which is the summit of my technological ability. I find it’s changed the way I manage my diabetes, I’m more focussed on 'time in range' than what my actual pre-meal or waking readings are.
(@leonS, from one pedant to another, two nouns are quite often linked together, as in Stock Exchange, Horse box, Motor car, Insanity clause!)
 
The advances in technology over the last 20 years for diabetes has been rather fun to watch.

While Libre/Dexcom help with many things and certainly with Libre the Trends have been very useful and is a great way to learn about whats happening.

However the technology is still fragile and unpredictable and people who solely rely on it I think are heading from trouble in the long run, while it certainly reduces the need to finger prick it does not completely replace.

But other areas where tech has improved is the Pumps the way the can now be used and customised with various programs to cover things like lazing about, exercise, night time sleep etc has been something I have watched and found fascinating (I do not use a pump myself) and low linking in with extra kit to 'loop' making an almost artificial pancreas and with the big manufacturers getting interested, the future does indeed look promising.

Other things that people seem to forget is the improvements in insulin delivery with the pens and the smaller needles, they for me are the best thing to have changed over the years.

Anyway just a thought :)
 
Schrodinger said:
However the technology is still fragile and unpredictable and people who solely rely on it I think are heading from trouble in the long run, while it certainly reduces the need to finger prick it does not completely replace.
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I agree, I often point out to people who have replaced finger pricks with a Libre that the Libre is not completely reliable - most of us have had sensors fail completely and give all sorts of inaccurate readings, and if my blood sugar is rising or dropping rapidly the Libre is too far behind it to give an accurate reading, so I have to test if I think I might be hypo. And sometimes a sensor reads a consistent 2 or 3mmol/L lower or higher than a meter, which I wouldn't know if I weren't testing.
 
As I have no indication of a hypo I attempted to get technological support in the form of continuous glucose monitoring. The SDN offered Libre, and I pointed out that this was not, by definition CGM as it does not include alarms on low or high BG.

The first sensor was in place in the afternoon of 29-8-2019 and because I walked rather more than I had expected to I had low sugar that late afternoon. A check by finger prick showed that the Libre was reading very close to the BG reading.

The idea is that I should use the Libre for a short time and the result be reviewed by the SDN. I was confident that I could install the software, although it runs only on windows and I never use windows.

I have an old lap-top with windows 8, bought several years ago because most things only run on Micro$oft, and I had a need to run some of these things.

I failed to install the software, a careful reading of the specification shows that far more RAM is needed than I have available. The DSN will take the reader, rather than getting result by e-mail, and download them, and I shall be back to finger pricking.

I sat, the other day, doing nothing in particular, but doing it rather well, when I thought that it was time for coffee. Out of idle curiosity I scanned the Libre. The reading was 2.6 mmol/L. Rubbish thought I, but I had a spoonful of marmalade and then did a finger prick test, which confirmed that the result was indeed accurate.

Now here is a disadvantage of the Libre. The results lag, so that the next scan showed "LO" and I was given advice on how to panic. It was interesting to be able to get a series of readings as my BG went up (I would never have pricked my fingers so many times), but a worry as the readings did not go up as quickly as I believe the actual BG did, due to the lag.

Is Libre a worthwhile use of technology? Yes, I think so, teething troubles apart, but I would much rather, be warned before a real low than be told long after it had ocurred.

I shall press for a proper BGM, but the Libre has given some useful incites into my technological [adjective] journey. [by the way the examples given of two nouns used together are example of compound nouns and are thus correct as are "baby powder" and "fish food". We would not say "milk coffee"]

More power to all pedants...
 
leonS said:
I was confident that I could install the software, although it runs only on windows and I never use windows.

I have an old lap-top with windows 8, bought several years ago because most things only run on Micro$oft, and I had a need to run some of these things.

I failed to install the software, a careful reading of the specification shows that far more RAM is needed than I have available. The DSN will take the reader, rather than getting result by e-mail, and download them, and I shall be back to finger pricking.
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There is a Mac version of the Libre software too, I have it running on my MacBook running Mojave (installed when on High Sierra I think). It gives an occasional warning when starting the program, but runs fine.
 
everydayupsanddowns said:
There is a Mac version of the Libre software too, I have it running on my MacBook running Mojave (installed when on High Sierra I think). It gives an occasional warning when starting the program, but runs fine.
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I had thought that the Mac version was being phased out, I might be wrong. My system is Linux, so what chance do I have? It is possible to run some Micro$oft programs under Linux, but Libre uses Visual C++ and Net Framework. These are not available under wine (the program that runs Windows programs under Linux).
 
leonS said:
My system is Linux, so what chance do I have?
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Some cheap Windows-running computer, or a suitable phone, I imagine. I can use the software on my Mac, but I find the phone software rather more convenient now: it uploads automatically to LibreView (which is what they want anyway), the phone's screen is bigger and the software seems at least as good as what's on the Reader. (Still need the reader for stick tests, and if I used the bolus calculator it would be necessary for that.)
 
I have a Linux machine too, @leonS - the Libre's still useable of course, but I can't download anything, and end up taking photos of my graphs in case I need them for future reference, which is far from ideal. My partner has Windows at work, but as he hasn't been able to get to work since the beginning of June we haven't been able to upgrade my Libre yet. It would be very helpful if Abbott could take note and make software which is useable by people who don't have or want Windows or Mac (or any kind of smartphone), but I can't see it happening somehow.
 
The worst part is that if Abbott were wiling to provide the required information, Linux programmers would almost certainly produce the software for free.

I eventually got the windows installation program to run. It proudly announced that it had installed the drivers. I expected to see an icon on the desktop or a new app in the list, or even have the program run when the libre was connected. But nothing.

If I were sure that I was to keep the Libre then I might be tempted to buy a cheap windows m/c. I don't want such junk, but it might be worthwhile. Phone or tablet is non-starter, eye sight is so poor that I need a 30 inch screen to see anything. I can see the big figures on the Libre and the smaller ones with a glass. The fact remains that Libre does not solve my problem - no hypo warnings. If I have to self fund it will certainly not be for this version of Libre.

The idea of pictures of the Libre makes me think that it might be possible to send pictures to the SDN and see if she can use those, rather than taking the reader for downloading.
 
leonS said:
Phone or tablet is non-starter, eye sight is so poor that I need a 30 inch screen to see anything. I can see the big figures on the Libre and the smaller ones with a glass.
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Actually you might well find a phone is about as usable as the Reader: the basic figure (with arrow) is about as big as on the Reader (I think), and the app can read it out (I just checked, and it said out loud (well, into my headphones) "six point four milimoles per litre, changing slowly"). (And, once I have the phone unlocked, that happens when I scan so I don't need to select the app.) The other graphs and things would presumably not be usable, but the data would be uploaded so you could view that in a suitably large web browser.

(I'm not saying it's an ideal solution for you. It's more a "well, if someone's giving you a phone for free, it's not silly to try it and see if it's worth it". But maybe the Libre 2 with alarms will offer more value.)
 
You may be right, Bruce, but let us not lose sight of the problem.

First I need the Libre's information in a form that I can send to the SDN so that she can make suggestions as to treatment. I am not too interested having them so for myself at this stage. If I can not do this I will lose the Libre for a time at least while the results are uploaded. When the DSN wants to review the results with me, by phone, I will not have access to them. I really needed a quick solution to this before the first sensor runs out.

Second, as you point out, the Libre does not solve the main problem of no awareness of hypos. You say the 'phone tells you information when you scan, but the Libre reader does that too so I fail to see how it is better. The only solution as far as I can see is an updated Libre or another alarm producing CGM device.

Some finger-prick manufacturers are producing speaking meters. I pointed out to six makers (by e-mail) that the problem is not so much reading the result as bringing a very small sensitive area of the end of a strip to a very small spot of blood - only one replied to tell me that this problem was far too difficult to solve!
 
leonS said:
but the Libre reader does that too so I fail to see how it is better.
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It's different rather than better. (You'd be using just a phone rather than using a Windows (or Mac) computer.) I find it more convenient, but I'm fine using a smartphone. (And none of this helps if the Libre's not accurate enough to be useful.)

As I noted, I'm not suggesting using a smartphone is a sensible idea: I just think it's not quite as stupid as it might seem.
 
I have recently changed from Libre to Dexcom on advice from my specialist nurse.
Whilst the technology is advanced I regret to say that I have found the sensor reliability to be very poor. Apart from those that fail early in life several have failed to work beyond 7 days when the manufacturer claims 10 days life.
To protect against reliability issues one must carry a traditional meter and test strips especially if you are travelling. Had to go back to my GP to get some test strips recently. He would not give me the strips I used for my Freestyle meter and insisted on giving me a new One Touch meter and strips. This apparently reduces NHS costs BUT I have had many strips that have failed to work. They need a lot more blood than my previous strips and bearing this in mind the failure rate in my case makes them a false economy.
My old Freestyle strips were far more reliable than those I am now being given and my Libre sensors were ultra reliable.
So I have significant reservations about the technology and its cost to both self funding and NHS patients.
These advances are only satisfactory if they are reliable, and sadly my recent experience has not been good. Yes my faulty sensors are replaced free of charge but I am fed up with calling the manufacturer and requesting replacements.
 
I use household tools to manage my diabetes ..an A5 size diary serves as my ✻diabetes logbook✻ ..bathroom scales to monitor my weight ..I nevertheless buy-in 30mL urine bottles for my Diabetic Reviews.

Diet, exercise, and Metformin are the cornerstones of my regimen ..personal biotechnology simply isn't marketed towards folk like me.

I can see the appeal of shiny gadgets and gizmos ..but they aren't fit-for-purpose for me ..and they ain't cheap, either.
 
Hi @Josh DUK , here are some bits about the tech I use. Hope that they help.

I have seen the improvement in my management as I switched first to a pump and then added in the Libre.

With the pump:
- I am able to create profiles with different basal rates, with variations of 0.01 each hour has enabled me to get one that matches my needs, rather than a best fit in MDI
- I can give a much more accurate Bolus measured to the nearest 0.1 units, rather than rounding off to 1/2 units.
- I have more flexibility as I am able to turn down my basal rate (using Temporary Basal Rates) at any time during the day, which will take effect within the hour. This enabled me to be more confident with the exercise that I do.
- it is easy to change my basal insulin with more accuracy during illness. This helps to avoid prolonged highs and ketones.
I had a drop of 10 on my HBA1c with this switch.

With the Libre:
- I can see the impact of different foods which has helped me to alter my diet and portion sizes to reduce spikes
- I have used the graphs to help me find appropriate timings for my pre-meal bolus
- Using the arrows alongside the glucose levels I generally head off hypos, so have far fewer than before.
With effective use of the Libre I reduced my HBA1c again.

I would not want to be without the equipment I use as I know that they have contributed to the improvement in my health and well-being
 
The two main things I think are important for technology in relation to my diabetes are information and insulin delivery.

Vitally the information includes not just BG levels but also education and training on diabetes management, and is supported by a peer network (like here) to help trouble-shoot issues and assist through the challenges to mental health of living with a long term condition.

There have been a variety of different tools that have helped me during my pancreas impersonation career, different insulins, pens rather than syringes, BM sticks, bg meters, then smart BG meters that help calculate doses, insulin pump, and continuous sensors.

Each person will have their own ideal toolkit, and what works for one won’t necessarily work for someone else. So it’s good that we have choices, and can select from a range of options to put together our own individual selection.
 
I find the technology to be great and very helpful is aiding people to control there diabetes BUT what would happen if it all failed are became unavailable?

Some of us managed using Clinitest which had an accuracy of ooo 4 hours if you were lucky but more 6 hours LOL LOL LOL LOL LOL

As I note I would miss my tech if it was removed but its not the end of the world ;)
 
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