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Australasian Diabetes Congress

Christmas Day, For a Person With Diabetes

October 4, 2018 by Frank 4 Comments

Imagine one massive room, that you could wander around at your leisure. A room that had all of the latest and greatest diabetes tools and technologies on show. A place big enough that you were free to go and chat with any of the exhibitors that you wish to approach, without having sales reps from competing companies clamouring all over you. An opportunity for you to actually hold a blood glucose meter in your hand, have a play with an insulin pump, and ask all of the questions that have been sitting on your mind for the last few months.

There might even be a few coffee bars with complimentary chocolates on the counter to help get you through such a massive day. Ideally, there might even be a few freebies such as a new blood glucose meter, a mug or a sample of glucose tablets to take home. But above all, you have the opportunity to really learn and get excited about all of the options available on the market to support you in the self management of your diabetes.

This is actually a reality for healthcare professionals, researchers and people working in the diabetes industry. I’ve been lucky enough to experience what I can only describe as Christmas Day for a person with diabetes through my attendance at the Australasian Diabetes Congress over the past two years.

Several weeks ago over a coffee with one of the players in the diabetes space, I was asked what I would like to see more of from their brand. My answer was simple. More direct to consumer initiatives like the ones that I’ve been lucky enough to be involved in as a diabetes blogger.

One good example of such initiative is Abbott’s FreeStyle Libre group set up sessions. To my knowledge, people with diabetes are invited to attend a group session with both a diabetes educator and an Abbott representative. They are provided with a complimentary FreeStyle Libre reader and sensor, and learn how to use the product during the session (depending on the place of setup, CDEs may charge for the session).

Both Diabetes Victoria and Diabetes NSW have held large diabetes expos in the past. While I don’t know a lot about the nature of these events, I believe that these are weekend events held in Convention Centres with a combination of exhibitors and information sessions.

Another personal highlight for me was the technology night designed by my fellow Young Adult Diabetes Committee members in Perth last year. The evening brought together representatives from Abbott FreeStyle, Roche, Cellnovo, AMSL and Medtronic Diabetes. There were also a selection of the Committee’s favourite diabetes accessories on sale.

Most importantly, the evening was designed by people with diabetes, for people with diabetes. There were Committee members speaking about their own personal experiences with such technology, as well as healthcare professionals explaining how the technology works. Seeing people in attendance who were only hearing about such technologies for the first time really highlighted the importance of holding events like these.

I get that there are regulations around the direct ‘marketing’ of pharmaceuticals to consumers. I have been told that the pharmaceutical players in this space are free to support any events that are initiated by third parties, but there are restrictions on events initiated in house. In fairness, I don’t want to see events where diabetes sales representatives are smothering innocent consumers who may be unable to see through the heavy spin.

However, the reality is that not enough consumers know about all of the available options on the market to manage their diabetes. Would it not be in the best interests of pharmaceuticals to be able to reach the actual users of their products in the same way that they can reach healthcare professionals?

There was a time before this blog existed where I didn’t really know a lot about diabetes and the options available. It took me five years until I moved on from the blood glucose meter that I was given on diagnosis, having learned about something more modern and better suited to my needs. There was a time where I never would have dreamed that I would be a candidate for an insulin pump, because I thought they were only for kids or people who were really struggling to manage their diabetes.

As I follow Tweets from the European EASD conference happening in Berlin this week, I am reminded of just how lightening fast these advancements in the treatment of diabetes are happening these days.

It doesn’t necessarily mean that newer or more ‘tech-ier’ will be better, but people with diabetes have a right to know and make an informed decision that best suits their needs. I try to share as much of what I learn here on my blog, not because I am in the pockets of big pharma, but because getting that information out there is a mission which I truly believe in.

I distinctly remember emphasising the importance of healthcare professionals relaying word of these new technologies back to people with diabetes throughout this year’s Congress. Equally, I know that there are many person centred healthcare professionals who will do just that.

People with diabetes have a right to know about all of the options out there.

We need more opportunities like these.

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Posted in: Diabetes and Healthcare Professionals, Diabetes Gear, Diabetes Tech Tagged: 18ADC, Australasian Diabetes Congress, Co Design, Diabetes Technology, HCPs, Healthcare Professionals, Technology, Tools

Cellnovo on Show at the Diabetes Congress

September 7, 2018 by Frank 1 Comment

I had the pleasure of reconnecting with the Cellnovo team at the Australasian Diabetes Congress last month.

The Cellnovo insulin pump launched 12 months ago, with the availability of consumables on the NDSS eventually delayed by a month. The system consists of a small rechargeable pump that sticks to a velcro patch on the body, a very short line and an infusion set that sits within close proximity to the pump. The system is controlled wirelessly via a mobile handset. You can read more of my observations from last year’s launch here.

There were rumours circulating earlier this year around the system being unable to withstand the heat of the Australian summer. I was told that this issue was nothing more than a temperature sensor in the pump that alerted users when insulin was at risk of spoiling, such as during hot days at the beach (Tandem’s t:slim pump also contains an insulin thermometer). I believe that the system may have since been upgraded to address the uber-sensitivity of the alarms.

Last year Aaron Crook was the sole sales rep, travelling all over Australia where the demand took him. There are now several new additions to the team. I was pleased to meet a dedicated sales rep for Western Australia, who reminded me that we had met previously when she had worked for Roche (and shown me how to use the eject button on the AccuCheck Guide!)

Cellnovo will soon be rolling out a new handset to all of their customers. The upgrade features a larger screen than its predecessor, and is also much slimmer and sleeker to hold in my hands. I am told the primary reason for this upgrade is enhanced performance. The team are also in disagreement on its new colour scheme, which gets a thumbs up from me.

The upgrade has come at the expense of the test strip port that was built into the handset. For the Cellnovo customer who may not be too keen on attachment, the prospect of now having to carry a blood glucose meter may be a big deal.

For the time being, users will need to manually enter their blood glucose readings into the handset to use the bolus calculator. However I was told that the handset will soon be compatible with a variety of wireless blood glucose meters, meaning that readings will wirelessly transmit to the handset via Bluetooth.

I really like the idea of having a separate handset to control the pump. With the emerging integration of diabetes management into smartphone apps, phone performance and battery drain has definitely been very noticeable for me in recent months. It’s also good to know that I could leave my phone on my desk if I wish to.

Cellnovo may not sit in the ranks of Medtronic or Tandem, but they are clearly focussed on filling a gap in the insulin pumping market. There are many people who don’t wish to take up insulin pump therapy for the sake of attachment and pump lines and weight and complexity.

I feel that Cellnovo is the option that may get many to reconsider their feelings toward insulin pump therapy.

Disclosures: Diabetes Australia covered my travel, accommodation and registration costs to attend the Australasian Diabetes Congress. These are my own views, and not those of Diabetes Australia. My time, including the annual leave I took from work to attend, was my own.

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Posted in: Diabetes Advocacy, Diabetes and Travel, Diabetes Tech, Insulin Pumps Tagged: 18ADC, Australasian Diabetes Congress, Cellnovo, DAPeoplesVoice, Insulin Pump

Treating Lows.

September 3, 2018 by Frank 3 Comments

The very first thing that I used to treat my hypos were jellybeans. You know, the ones that came in little packets at the Chemist, and had the glucose syrup mixed into the recipe.

Those packets weren’t particularly easy to walk around with, especially once opened. The jellybeans often got squashed at the bottom of my bag, or went hard fairly quickly once opened.

During hypos, it was easy to lose count of how many I’d pulled out of the packet and popped into my mouth. It was difficult to translate a serving size into individual carb counts per jellybean. Having to ‘chew’ through six of them during a hypo often felt like a lot of work. Not to mention all of the little bits of jelly that got stick in-between my teeth afterwards!

They weren’t particularly cheap, and I absolutely hated having to throw all of the black ones that were left at the bottom of the packet into the rubbish bin! On occasion I would pick up a 1kg bulk bag, but I always felt like I was being judged for the number of hypos I was having from the Pharmacist behind the counter.

It wasn’t until I joined the Young Adult Diabetes Committee last year that I entered the world of glucose tabs, which are one of the perks of being involved (just quietly, they’re the only reason I come along to meetings…) I absolutely loved how portable they were to carry around, with the ability to carry 40 grams of fast acting glucose in one very tiny container. One tablet was four grams of carb. Easy enough to count during a hypo. No sticky bits left in my teeth afterwards!

Anyhow, these TRUEplus soft glucose tablets were on show at the Diabetes Congress last month, where I picked up a few free samples. There are two new flavours, choc marshmallow and kiwi strawberry. I sure as hell envied all of the healthcare professionals in the exhibition hall who were able to taste them for fun!

I consumed a few of the chocolate tabs during a hypo the other night, and I guess they tasted a bit like Cocoa powder or Nesquik. Meanwhile, the Kiwi Strawberry tabs kind of smell like our cupboard under the stove where the olive oil and salt is kept. They were also far less chalky than the Dex 4 tablets that I’m currently consuming.

One tube of eight glucose tabs retails for $4.95. I was told that these will launch in December, available online, through some Pharmacies and at Diabetes WA.

I’ve tried and tested a lot of hypo treatments over the years, and if there’s one recurring theme, its that I get sick of them pretty quickly. And I often have to will myself not to treat them with something more appealing like chocolate.

So, hooray for more choices for people with diabetes!

Disclosure: Diabetes Australia covered my registration, travel and accommodation costs to attend the Australasian Diabetes Congress. These are my own views, and not those of Diabetes Australia. My time, including the annual leave I took from work to attend the Congress, was my own.

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Posted in: Diabetes Advocacy, Hypos Tagged: 18ADC, Australasian Diabetes Congress, DAPeoplesVoice, Glucose Tablets, Glucose Tabs, Hypos, TRUEplus

Championing the Consumer Voice

August 27, 2018 by Frank 3 Comments

I walked away from the Australasian Diabetes Congress feeling that consumers had an even bigger impact than last year.

This was my second year attending the joint Annual Scientific Meeting of the Australian Diabetes Society (ADS) and the Australian Diabetes Educators Association (ADEA). Diabetes Australia pioneered a fantastic initiative called the ‘People’s Voice,’ which brought the voices of a few bloggers and consumer advocates to the Congress.

I don’t, for a minute, ever pretend to be representing anyone other than myself at events like these. I fully accept the privilege I have, knowing that I do not even come close to representing all people out there with diabetes. I’m super proud of all of the people with diabetes in attendance who drove this narrative home to the delegates, speakers and pharmaceuticals in attendance. In particular those with gestational diabetes, those with type 2 diabetes and those who are not as engaged as we are.

On Wednesday afternoon, I was lucky enough to contribute to a session which presented case studies on ‘co designing’ diabetes services with the involvement of people with diabetes. I spoke about my involvement with Perth Diabetes Care through the Young Adult Diabetes Committee. For more of a taste of what we do, you can find our Facebook page here. Melinda Seed at Twice Diabetes also spoke about her involvement with Reality Check and the resources that she helped to develop for people with diabetes.

As I said last year, I was so humbled to be in the presence of so many people that simply wanted to learn from us. The idea of this session was to plant ‘seeds’ in the minds of delegates, and we really did delve deep into some of the issues that were prohibiting the engagement of people with diabetes. I spoke about how big of a step it was for me to come along to a gathering of people with diabetes for the first time, and also sharing how much of a ‘slow burn’ some of our work in this space can truly be.

I have personally found the Diabetes Educators to be the most supportive, open minded and willing to learn from us. They are truly the people who approached me the most during the course of the week, and hopefully they will only bring more healthcare professionals and researchers along for the ride with us. I really do apologise for our narrative that, at times, can come across as assuming that all healthcare professionals are not person centred. We really are just passionate about person centred care!

The consumer voice was also championed on Friday morning during a technology symposium. As Professor Anthony Russell presented a narrative about the administration of insulin in a hospital setting, the dialogue that followed on Twitter was more interesting.

One of the biggest issues that I have heard from other people with diabetes is the forced relinquishment of self management in a hospital setting. People with diabetes are forced to relinquish their insulin. People have had to fight for the right to hold onto their insulin pumps or CGMs. Highly capable people with diabetes are often treated as incapable of self managing a condition that they spend relentless hours managing on their own.

I really hope to see a resource developed around the rights of people with diabetes to self manage in a hospital setting. If there are two organisations that I would like to see tackle this issue, it would have to be the Australian Centre for Behavioural Research in Diabetes (ACBRD) and Diabetes Australia.

People with diabetes also slayed the Twitter conversation. In a short two years, it really does make you wonder what they ever did without us? Ashley Ng ran a Twitter masterclass with the support of ADEA, encouraging healthcare professionals to get online. Just look at these amazing stats!

I am super proud of everything that the people with diabetes in attendance achieved throughout the week. I truly feel that the consumer voice was championed, and that we have proven our worth.

This is EXACTLY why we need to be at events like these.

Disclosure: Diabetes Australia covered my registration, travel and accommodation costs to attend the Australasian Diabetes Congress. My opinions and my time, including the annual leave I took from work to attend, are my own.

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Posted in: Diabetes Advocacy, Diabetes and Healthcare Professionals, Diabetes and the Online Community, Diabetes and Travel, Peer Support Tagged: 18ADC, Australasian Diabetes Congress, Co Design, Consumer Voice, DAPeoplesVoice, Diabetes Australia, HCPs, Healthcare Professionals, Hospitals, Insulin, Peer Support

Day 3 at the Australasian Diabetes Congress

August 24, 2018 by Frank 4 Comments

Day 3 at the Australasian Diabetes Congress kicked off today with breakfast at the Adelaide Central Markets. I was absolutely flattered that Renza sacrificed participating in the 6.45am Novo Nordisk Fun Run to join myself, Ashley and Bionic Wookiee David for the best brekky in Adelaide! 

Class convened at 9am with a symposium on diabetes technology that, quite frankly, could have gone on for hours. Diabetes Australia CEO Greg Johnson was first up onto the stage to share an update on diabetes technology, much of which I had already heard at Abbott’s DX2Sydney event back in May. 

Diabetes Australia advocated for CGM funding for high risk and high need groups, with no age limits. Advocacy had also focussed on co-payments, as has been the case with insulin pump consumables and test strips. The federal government’s announcement of fully subsidised CGM was a complete surprise and will make advocacy more complicated going forward. 

Over 9,000 people have taken up CGM since the federal government’s full subsidy launched in April 2017. I also felt slightly patriotic as Professor Johnson highlighted that our NDSS should be the universal access pathway for diabetes technologies. 

There is also a product tender of syringes, test strips and urine ketone strips currently listed on the NDSS. It is expected that lower volume items will be removed to reduce costs, with an expected implementation date of December 1. 

We are also still waiting on an outcome on the subsidy (not reimbursement!) of Flash Glucose Monitoring. A public health consultation commenced in July 2017. Despite many healthcare professionals spreading Chinese whispers that the FreeStyle Libre will be subsidised soon, a final decision rests with the department of health. This really is anyone’s guess! 

Jane Speight of the Australian Centre for Behavioural Research in Diabetes took to the stage next to present some of the research into the psychosocial issues around Diabetes technology. My takeaways were that the tech is only as beneficial as the commitment from the person using it. The studies also prove that technology won’t be for everyone. It all comes down to individual choice.

Sue Wyatt rounded out our session, pursuing the topic of how well we have closed the loop. Although not made clear, the research presented referred to clinical trials in Medtronic’s 670G hybrid closed loop system only. 

Closed loop systems automatically adjust basal insulin based on CGM readings in order to regulate blood glucose levels. The system had a blood glucose target of 6.6mmol, with a target of 8.3mmol set during exercise. This is disappointing, and I know for a fact that these targets wouldn’t be suitable for many people with diabetes. 

However, I completely get that this blood glucose target may help to get a hybrid closed loop system as such approved for use sooner. I also expect there’s a commercial motivation for this as well, with the ability to sell an upgraded or enhanced hybrid system down the line. 

The major benefit of Medtronic’s 670G was seen in overnight blood glucose levels. Interestingly, we were told that this 6 month study was only in its infancy. It leaves a lot to be said about the timing of approval for Medtronic’s 670G system (the 670G pump has been approved, the 670G compatible CGM sensors are yet to receive approval).

Congratulations to Amy Rush of the Telethon Type 1 Diabetes Family Centre, who was awarded Credentialed Diabetes Educator of the year. Go, WA! 

I was also delighted to hear that SA based CDE Jayne Lehman was also awarded an honorary life membership to the Australian Diabetes Educators Association (ADEA). Well done, Jayne! 

The day rounded out with a debate on whether diabetes technology was helpful or harmful. This was a complete letdown, given that people with diabetes were on the affirmative side and people without diabetes were on the negative side. Without technology, we’d all be living in caves!

I would like to extend a massive thank you to Diabetes Australia for inviting me to be part of the ‘Peoples Voice’ team once again this year. While they covered my travel, accommodation and registration costs to attend the Congress, they did not pay for my opinions or my time. While I certainly don’t claim to represent anyone other than myself, I hope that I have been able to bring a consumer voice to the Congress. 

My gratitude also extends to joint Congress hosts – the Australian Diabetes Educators Association (ADEA) and the Australian Diabetes Society (ADS) – for their support of Diabetes Australia’s ‘People’s Voice’ initiative. 

Finally, a massive thank you to my amazing tribe of people with diabetes that made my week so special. I feel so privileged to spend time in your company call you all friends.

It’s been an insanely busy week with long days and late nights attending product launches, networking and blogging. I haven’t even began to scratch the surface of the exciting developments that have come out of this week.

I’m homeward bound as we speak and look forward to sleeping in my own bed tonight, having a coffee machine at my disposal tomorrow morning, and spending my weekend recouperating.

Stay tuned.

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Posted in: Diabetes Advocacy, Diabetes and the Online Community, Peer Support Tagged: 18ADC, Australasian Diabetes Congress, Consumer Voice, DAPeoplesVoice, Diabetes Australia, Peer Support, Technology
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