Day 1 at the Australasian Diabetes Congress

I’m in Sydney today for the Australasian Diabetes Congress, which is the annual scientific meeting of the Australian Diabetes Educators Association and the Australian Diabetes Society. I’m here with the support of Diabetes Australia as part of their ‘people’s voice’ team of consumer reporters.

Most exciting news of the day: there’s a new tubeless patch pump for Australia! Roche have launched their new Solo insulin pump today. It comprises of a remote handset, a pump base that needs replacing every four months, a reservoir and cannula. The reusable components will be funded by private health insurance like other insulin pumps, and the disposable components are expected to be listed on the NDSS in November.

I did have a brief hands on with the pump this morning, and it looked really encouraging. It looks much smaller than the late Cellnovo. Unlike the Omnipod, the pump can easily be unclipped from the site as needed, meaning that you can see what’s going on underneath your infusion site. I also liked that you don’t need to throw away the whole ‘pod’ should the site fail. More on that in another blog!

The opening plenary was a little disappointing, focussing on diabetes in China. As the opening session ‘psyching’ delegates up for the Congress, I feel it could have benefitted from a more engaging speaker and broader topic. But hey, that’s only my two cents.

After morning tea, I dipped into a presentation on the PREVIEW study, which looked at lifestyle interventions for the prevention of type 2 diabetes. Participants shed most of their weight during the first eight week phase of this study, through a very low energy diet of meal replacements. During the second phase of the study, eligible participants received support to implement diet, exercise and behaviour change. Participants were randomised to two diets and exercise plans. Diets comprised of low to moderate protein and low to moderate glycemic index, while exercise was HIIT training.

The study followed participants for three years, with the support becoming more remote from the 12-36 month mark. Of the 945 people who completed the lifestyle intervention study, only 4% of people developed type 2 diabetes after 3 years and weight loss maintenance was excellent. I’m not an expert, but I think the key to weight maintenance is balancing kilojoule consumption with energy expenditure, and it’s inevitable that a structured plan will produce the results. For some of these research participants, the meal replacements were the most nutritional thing they’d eaten in some time!

After lunch I headed to an ADEA symposium. The most interesting presentation was a case study at Blacktown Hospital in one of Western Sydney’s ‘diabetes hotspots,’ which was placing a strain on hospital resources and wasting patients’ valuable time. A review of the diabetes clinic saw many implementations to optimise time prior to appointments. This included the implementation of a central point for clinic referrals that were coming in from many different places, tended to by the appointment of an enrolled nurse. The clinic also made reminder phone calls prior to appointments, chased pathology results and had a nurse download data from patient’s glucose meters. This is definitely what person centred care looks like!

It was fantastic to finally meet CDE/Nurse/Midwife Belinda Moore after lots of back and forth online through #OzDOC over the past few years. It was also great to catch up with former Roche-turned-B-Braun diabetes division manager Nicky who makes a noticeable effort to keep up with some of us #OzDOC folk.

The final session of my day was the ADS Clinical Young Investigators session. The most interesting session here looked at reducing glycemic variability among people with type 1 diabetes, which I think is often overlooked after a day of research presentations so heavily focussed on hba1c.

In this study, research participants were given education in conjunction with bolus calculations to reduce glycemic variability. In both insulin pumpers and Multiple Daily Injections, breakfast was the most challenging time of the day in terms of glycemic variability. Which, as a person with diabetes, makes total sense when combined with dawn phenomenon. I know that my insulin needs change while I’m sleeping depending on where my blood glucose levels are sitting, how well I have been eating and sleeping, and even how early the sun is rising in the morning!

Research presented suggested that insulin pumpers may have a better quality of life. Insulin pumpers in this study ate breakfast an hour later than those on MDI, and tended to eat more. I know for myself alone, a pump (combined with learning more about my diabetes) has definitely helped me to find more freedom to eat to match my feelings of hunger. The sleeping in…well, it still needs to be planned to an extent.

Disclosure: Diabetes Australia covered my travel, registration and three nights accommodation in Sydney to attend the Australasian Diabetes Congress as part of their ‘People’s Voice’ initiative. I gave up my own time to attend, and am sharing my own thoughts as always.

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