Sometimes it seems people with diabetes are from Mars and healthcare professionals speak from [their] Uranus, even those who should know better. There were a number of positive things about a recent article on Psychosocial Aspects of Diabetes Technology but throughout the short article, the authors allowed their biases to show.
“Gathering information about the reasons for discontinued use [of an artificial pancreas] are vital for all technology trials and will be key to helping create programmes that actually increase the chance that patients will be successful in their use of technology.”
Did we ask why drivers were unsuccessful in their use of the Edsel or how we could help PC users be successful in using “clippy”? NO! We don’t blame the users, we admit that there’s something sucky about the technology and work on fixing it or scrap it as a bad idea altogether.
That’s not how diabetes ‘care’ works though, it’s always the “patient” who is defective and needs fixing. Even with good intentions, that blame the patient mentality sneaks through.
Developing diabetes technology isn’t any more complicated than any other form of technology. Simply, the technology must solve more problems than it creates. It doesn’t have to be simpler or save time but it does have to make life better for people with diabetes.
This will be a bit Captain Obvious for my readers with diabetes but for those few without who are still wondering why we are so unsuccessful with technology, here are some examples:
Home blood glucose monitoring: This innovation (I remember the days of urine testing) is painful, time consuming (especially in the early days when tests took about 3-4 minutes) and costly. Yet it’s enthusiastically embraced by people with diabetes because it solved the huge problem of not knowing what your sugars are & enables you to feel so much better now as well as helping minimise or avoid later complications.
Inhaleable Insulin: Everyone thinks this is a huge breakthrough except the people actually having the injections. Everyone (well nearly everyone) with diabetes knows it’s not about the shots, so we’re not going to pay more and run the risk of lung problems to inhale insulin when we can inject. Inhaleable insulin isn’t solving a problem for us.
Dr Aaron Kowalski set the bar for D tech pretty high in a recent talk quoted in the article I link to above:
“…systems must offer patients a sense of night time security, prevent headaches that result from low blood sugars, decrease the burden of the daily regimen demands, improve sleep quality and quantity, and offer the possibility of “unimaginable joy” to all users.”
Wow! Give me some of that unimaginable joy please. The thing is though improvements in any sort of technology are incremental. The first insulin pumps were bigger than the backpacks worn by the Apollo astronauts, but gradually technology has improved such that my pump actually does give me night time security and ease the burden of diabetes. Useful technology that brings joy will only come about through clever engineering combined with listening to people who live with diabetes to make sure we’re solving the problems that matter, not trying to create solutions for problems that don’t exist.
What are your experiences with D technology? Has anything brought you either ‘unimaginable joy’ or irrepressible rage?
For more on this blame the patient is always wrong, see my previous blog in which pwd are criticised by an endo for not doing something that was shown in the same study to be of absolutely no benefit. Unbelievable!