Before I attended ADS-ADEA’s Annual Scientific Meeting I did a little survey of what people with diabetes were most interested in hearing about at conferences. As the survey was largely completed by my friends in the D world, it is unsurprising that they were almost entirely type 1s and most had had diabetes for at least 20 years. The topics of most interest were new technology, research with only a few more saying stuff that was relevant to life with D now as opposed to the cure and psychosocial issues. Many people also said the main benefit to them of attending D conferences was the opportunity to socialise with other people with diabetes.
So here’s my best effort at rounding up the categories of most interest from ADS-ADEA 2017:
The two big tech items at the conference were the Freestyle Libre and the Cellnovo pump. As most of you will know the Libre has been available in Australia for about 18 months. I reviewed it just after launch, A Day With Flash Monitoring. A number of Diabetes Educators were sporting the Libre as Abbott organised a session in which DEs were given a trial of the product. So worth asking your DE if you have one about the product and see if you can get a trial, if you haven’t done so already.
I went to an NDSS update session delivered by staff from the Department of Ageing. It was declared that an announcement on the subsidisation of the Libre was due shortly. As an aside, the NDSS process excludes consumers as stakeholders. The presenter talked about consulting stakeholders but there was no voice for those of us with diabetes at all. Diabetes Australia Scientific and Medical Committee (most definitely the Drs and science side of DA, not consumers) are consulted as are JDRF apparently but there is no consumer consultation. I asked about this and was told “We know what the consumers think from the letters [of complaint] we receive…”. I suggested this was reactive not consultative and my feedback was acknowledged as something to take on board. Hmmm, the pharmaceutical benefits advisory board has a consumer rep, why are people with diabetes ignored?
Cellnovo launched a new pump and the announcement was made that the consumables are available on the NDSS. The Cellnovo is a patch pump (like the Omnipod only smaller). Some people are super excited about a pump that doesn’t require tubing, I’m not all that enamoured of the idea of having a box stuck to your arm. This seems to be a preference thing. This pump doesn’t have a syringe driver, there is some other technology involving a diode and paraffin wax melting. It can be temporarily detached which is a plus. It will only hold 150 units of insulin and I believe this has an expiration time of 72 hours, so think you need to refill/use a new cartridge every 72 hours whether you have used 150 units or not.
The handset is pretty schmick, full colour, touch screen and all your data can be uploaded to the cloud via the Cellnovo platform and can be available to your healthcare professional. Frank has done a more in-depth review of the product, check it out here.
There wasn’t a lot here as far as I could tell that would make a difference to one’s everyday life with diabetes.
There were two sessions on the development of type 1 diabetes. More is being understood about the processes involved in beta cell destruction and the antibodies that appear during the process. In some people thought the same antibodies don’t progress the person to diabetes and in others they do. Suffice to say that it’s great more is being understood and I can see how this research may one day lead to prevention of type 1 diabetes, which is necessary before a cure can take place as otherwise the cure would be undone by the autoimmune process. This isn’t anywhere near being 5 years away, so for me it was vaguely interesting in a sciencey way but not particularly relevant.
One of the ADS plenary speakers, Andrew Hattersley spoke about sub-types of type 1 and 2 diabetes. This again has potential for new treatment options. For those diagnosed under the age of 12 months, and thought to be type 1, they are highly likely to have a subset of diabetes that can be treated without insulin. Woohoo for them, sadly I was just over 12 months when diagnosed and I have the antibodies proving I’m type 1 🙂
Bolusing for fat and protein was an interesting and potentially useful session at Roche Educators Day (RED2017).
The upshot of this talk by Carmel Smart from the John Hunter hospital was that protein does increase blood sugar levels even when eaten without carbohydrates. Fat will not impact upon blood sugar unless eaten with carbohydrates. In attempts to reduce post meal spikes, patients at her clinic were given bolus ratios and square wave boluses etc. There were some reductions in spikes but also an increase in hypoglycaemia, which seems problematic to me. I have posted up some pictures of Carmel’s slides here, note these (like everything on this website are not medical advice), merely info on things they tried. if you’re interested in reducing blood sugar “excursions” [I always think it sounds like they’re going to the zoo] then speak to your HCP about considering bolus calcs for protein and or fat when eaten with carbs.
It was heartening to see that these issues were being talked about a lot at the conference. What was less heartening was that we don’t seem to have moved past the awareness stage. I did enjoy Professor Lori Laffel from the Joslin Centre’s speech on expectations and the burden of disease. I think all the people with diabetes were nodding and a bit like “we’ve been saying this for years” but it has impact on the doctors and DEs when it comes from an authority like Professor Laffel.
Other big issues in the psychosocial area were eating disorders, peer support and patient-centred care, I plan a post in the next few days on these issues.
A Quick Note on Peer Support in Particular, more later.
Renza has blogged just recently about the discussions around peer support at the conference, check it out. https://diabetogenic.wordpress.com
The camaraderie of my peers for me personally was not only fun and emotionally nurturing but also, with each other we learnt so much more by sharing and discussing things rather than just hearing and forgetting. I think this is the key-we learn in community, not just by a “better” imparting their knowledge and this goes for learning to live with diabetes in general. I am grateful to Diabetes Australia for giving us the opportunity to attend, be heard and to share the results of this conference with our D communities. May there be more opportunities supported by DA, our state bodies, pharma and the professional bodies for the people with ‘skin in the game’ to be included in these meetings.Tweet