The 7th -10th February 2012 saw the arrival of the international event known as the Advanced Technologies and Treatments for Diabetes (ATTD) conference, which I was lucky enough to be able to attend as a representative of INPUT and funding from Dexcom to assist INPUT in the work they do. The ATTD is a worldwide conference where research outcomes at the very forefront of technological advance are presented. Being only 5 years old it is still in its fledgling years, but growing noticeably each year. Although I was not at last year’s event, I am informed that there were around 1000 attendees. This year, there were 1600 and I’m sure there are many more who would have attended given half a chance. It is aimed at diabetic professionals (or professional diabetics, in my case) mainly being consultants, nurses and diabetes educators, although the odd advocacy service pop up here and there too!
Being an insulin pump user, a diabetes advocate and a bit of an inquisitive old lass, it is always of great interest to me to see where this diabetes technology beast is heading. We hear terms like ‘Artificial Pancreas’ and ‘non-invasive glucose monitoring’ thrown about on an almost daily basis now and yet many people in the diabetic community feel these are creatures of myth and seem to hold a ‘that’ll be the day’ attitude towards them. So to be involved in a conference where this research is being presented was an honour and frankly, somewhat of an eye-opening occasion for me. .
Clearly it would be impossible to go through each of the presentations, symposiums and workshops in detail. Not in the least because my less than scientific mind would never be able to recall all the details for you. But perhaps giving you an idea of the things that caught my eye would be of use.
One of the stands in the exhibition which I kept circling in a slightly cautious way, was that of C8 Medisensors. In case you haven't heard of them (I hadn't), they are bringing to market a non-invasive glucose monitor that uses Raman Spectroscopy technology which for those of you who don't speak 'medical journal', is effectively a light that shines through the skin and identifies how many glucose particles there are in the interstitial fluid. Phew, mouthful ay. Well, according to early tests they are showing promising results, although the last test only involved 6 people. I would need to see a significant higher amount before I would be convinced it would rival the likes of Dexcom 7+ and Medtronic Enlite. Now we all remember the success of previous non-invasive systems such as the Glucowatch, the remnants of which remains burned on the skin cells of countless diabetics who had the misfortune of using it. But this was impressive. In its current form it is a bit on the 'chunky' side, and is held around the midriff with a tight neoprene band. But for those parents out there who hate the feeling of piercing their children's skin with countless needles they have to face, I think this could be a contender. If, and only IF, they come good in clinical trials. Watch this space.
For quite some time I have been aware that in order to avoid post meal spikes I need to bolus 30 minutes before each meal, otherwise those spikes just creep in a couple of hours later. But we also know that each diabetic is different and we are told all the time to find our own way. So I was very interested in a lecture about bolus times in children using insulin pump therapy. In the results being demonstrated to the audience, the message was that 15 minutes was the optimum pre-meal bolus time to avoid those spikes. In addition to this the study, called “Fine Tuning of Insulin Pump Therapy in children with type 1 diabetes: The importance of bolus timing and type” demonstrated that making the most of dual wave boluses and separating correction boluses and meal boluses, would make all the difference. They found that with mediterranean food for example, boluses were split 70% straight away and 30% over 4 hours, while Pizza was 30% straight away and 70% over 6 hours. They also highlighted that the results of their study showed that when blousing for a meal, any correction bolus being included with the meal bolus, should be separated by 15 minutes, and that this would bring glucose down to normal via the fastest route. Fascinating stuff for me, someone who has always struggled to get my head about a dual waver
One of the key lectures for us to attend included INPUT’s very own Lesley Jordan taking to the stage. Lesley has been involved in a pioneering project to trial the Accu Chek Diaport, an intra-peritoneal (goes into the peritoneal cavity in the abdomen) infusion site which is permanently fixed (as long as the host wants it, that is). It is surgically implanted and regularly maintained and allows for insulin to be much faster acting (see number 3 on my list), removes the worry of hitting a bad site and means much better control. It may not be for everyone as it is surgically implanted but for those with site problems leading to frustration and poor control it provides a very useful tool in helping achieve control over their condition and maintain use of an insulin pump effectively. Lesley has been one of the Diaport 'guinea pigs' and thanks to feedback from her, the new and improved second generation is ready to launch.
There were also stands demonstrating the Omnipod, the Accu-Chek Combo, the Medtronic Veo and my particular favourite of the moment, the Cell-Novo. I had the chance to catch up with some old friends from Medtronic, meet new ones at Roche and Cell-Novo and had a chance to thank Dexcom for supporting INPUT and in a round about way, helped me attend such an inspiring event.
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