Life Health & Wellbeing

Tuesday 17 July 2018

Tech that's a good friend to people with diabetes

While an estimated 225,840 people in Ireland have the condition, only a handful are using the latest advances

New technology in the field of diabetes is doing away with the need for finger pricking
New technology in the field of diabetes is doing away with the need for finger pricking
One of Conor Heelan's rules is that he never uses diabetes as an excuse

Kathy Donaghy

Apps that help monitor glucose levels in the blood, new devices including an artificial pancreas and even training dogs to detect changes in a person's blood sugar levels, are among new developments to help people living with diabetes.

According to Diabetes Ireland, many technologies are in their infancy but the organisation says there is no doubt that tech is a good friend to have in the daily management of diabetes.

An estimated 14,000-16,000 people in this country have type 1 diabetes. This tends to occur in childhood or early adult life and always requires treatment with insulin injections. It's caused by the body's own immune system destroying the insulin-making cells - called beta-cells of the pancreas.

Type 2 diabetes usually develops slowly in adulthood. It's progressive and can sometimes be treated with diet and exercise but more often, type 2 diabetes may require antidiabetic medicine and/or insulin injections. It's estimated that around 854,165 people over 40 in this country are at risk of developing or have type 2 diabetes today while some 370 million people worldwide have the condition.

According to Dr Anna Clarke, head of research and health promotions with Diabetes Ireland, the latest technologies will have the biggest impact on young people with type 1 diabetes who are monitoring blood sugar levels up to six times a day.

"Technology is becoming available but there will always be an onus on the person to interpret the results and act appropriately. It will help, but it will also impose greater responsibility on the person, and in some cases it may increase feelings of frustration," she says.

Clarke explains that parents of children with type 1 diabetes have to pin prick their child's finger many times a day to monitor their child's blood sugar levels. She says the technology for Continuous Blood Glucose Monitoring (CBGM), where a plastic cannula is inserted under the skin, would do away with the need for finger pricking.

While an estimated 2,750 people under 20 in Ireland live with type 1 diabetes, Clarke says it's a small minority who are using the CBGM technology.

One device coming on stream but not yet available in this country is the FreeStyle Libre Flash Glucose Monitoring System. The system works via a small sensor inserted into the skin which continuously stores glucose readings day and night, that can be read on a hand-held reader in a user-friendly way.

One of the most exciting developments is the invention of the artificial or 'bionic' pancreas which made its debut this year. The product monitors blood sugar levels and provides the correct amount of insulin when required through patches on the skin. It could be available in Europe by 2018.

While diabetes research has made enormous strides in the past decade, a cure remains elusive. Much of the research has centred on 'maintenance' technologies.

With a health condition like diabetes, where the individual is responsible for round-the-clock self-monitoring, there are many benefits to come from care that is both increasingly automated and personalised for the individual.

Many people with diabetes use phone apps to help manage glucose levels. Glucose Buddy, available on iPhone and android, is a comprehensive, easy-to-use logging app which collates your daily data inputs and sends back the results via PDF to the user or healthcare team.

Another, Carbs and Cals, informs people of the carbohydrate content of foods, which helps people with diabetes monitor their glucose levels. ShugaTrak, aimed at parents worried about their children while they are away at school, reads glucose levels inputted under the skin to give the most accurate readings and sends them via text or email back to the parent.

Pioneering research in England involves training dogs to sniff out when a person with diabetes needs to take their medication. A major challenge for people with type 1 diabetes is hypoglycaemia or 'hypos'. This is where blood glucose levels drop causing shakiness, disorientation and tiredness but also creating a risk of seizures and falling unconscious. Night-time can be a particular worry as hypos may occur while sleeping.

Researchers at Addenbrooke's Hospital in Cambridge became aware of people claiming their dog alerted them to when they came close to having a hypoglycaemic event. They found that a compound in the breath rose markedly when a person's blood sugars fell below a certain point. This compound is detectable by specially trained dogs.

Dr Mark Evans, a physician at Addenbrooke's, says they are hoping that the breakthrough might lead to the development of a breathalyser where people could simply use a breath test to detect when their blood sugar was falling too low.

Other developments include an inhalable and ultra-fast insulin called Alfrezza. Taken before or during meals, Alfrezza does not require needles. The insulin comes in powder form and is designed for adults with type 1 or type 2 diabetes. It's not a standalone insulin treatment, however, and is meant to primarily control post-meal glucose spikes.

Ultimately technology that is focusing on improving lives rather than corporate bottom lines is what will allow people with diabetes to put their concerns associated with the condition behind them.

In the ongoing battle against diabetes, it isn't just technology that will provide all the answers but it is a valuable tool in managing this condition and preventing long-term complications.

‘If you manage diabetes well, you’re no different to anyone else’

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One of Conor Heelan's rules is that he never uses diabetes as an excuse

Conor Heelan was 19-years-old when he was diagnosed with type 1 diabetes. Now aged 46 and working as a lecturer in printing and digital media at DIT, as well as being an extreme sports fanatic, Heelan says he never wanted to use his condition as an excuse for not doing things in his life.

A globetrotting adrenaline junkie with over 3,000 skydives under his belt, Heelan says he’s learned to stay on top of his condition. He checks his blood sugar levels by doing a finger prick test five or six times a day and injects insulin accordingly, and says the more you test, the better you can control things.

Heelan, from Malahide in Co Dublin, says he’s an advocate of keeping a tight control of things. “It’s a personal disease — a doctor can’t say ‘do this and you will turn up with results like this’. Everything affects your blood sugar levels from what you eat, to exercise, to how much pressure you’re under. You have to be proactive to keep on top of it,” he says.

“All the advances in technology can make that process of keeping on top of things easier. But if you hand all that technology to a patient who’s not interested, it won’t make a difference,” says Heelan.

“When I was diagnosed, I was old enough to take it in my stride. I wanted to be the best I could be. When I got my diagnosis, I gave myself a couple of rules: I was never going to use it as an excuse to get out of activities, and I was going to manage it in such a way that I could excel at whatever I did. It is a disease that can be managed — if you manage diabetes well, you are no different from the person beside you,” he says.

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