Diabetes is actually really common, basically everyone has heard of it. However, lots of people don’t fully understand it and because of this there is a lot of misinformation out there. I can’t really tackle all of that in a single article, but I will do my best to give you a very basic overview of diabetes followed by a more in-depth description of how it fits in with technology.
So, why do I know anything about diabetes? Well, back in August 2020 I was diagnosed with Type 1 Diabetes (T1D). T1D develops when your beta cells (beta cells are responsible for the production of insulin, a hormone that allows your cells to absorb glucose from your bloodstream) get destroyed, either by your immune system or by a viral infection. This means that my body can no longer produce any insulin, and I need to inject it to survive. This comes with a lot of adjustment and challenges, but ultimately it becomes routine and you don’t see it any differently to brushing your teeth. Also modern technology has a large role to play in making handling diabetes easier and it is amazing what it can do. More on this in a minute.
T1D is not the most common type of diabetes, that would be Type 2 Diabetes. Type 2 usually develops as a result of a sustained high-sugar diet, and can come with additional complications. Type 2 diabetics can still produce insulin, but their cells become resistant to it so they need to inject more insulin to make sure that they can absorb glucose normally. T2D can develop as a result of genetics as well.
There are other types of diabetes, however T1D and T2D are the main two. I’ll be writing this article from the T1D perspective, but the technology that I talk about will be transferable. My goal is also to make this article accessible to people without diabetes knowledge or experience, so whether or not you’re affected by diabetes, I hope to be able to show you how everything works.
Diabetes Myth: T1D means that you can’t eat sugar. This is just untrue. People with T1D can eat basically as much sugar as they want, as long as they make sure to inject an appropriate amount of insulin beforehand.
🧪 Monitoring your glucose levels
One of the biggest challenges for most diabetics is keeping your glucose levels under control. Your glucose level is simply the amount of glucose (effectively sugar) that there is in your blood. When your cells need energy to do something, they can absorb glucose and then convert it into energy (ATP via mitochondria), this process allows you to continue to live and happens constantly.
But if there is not enough insulin in your blood, then your cells can’t absorb glucose to make energy, so they can’t function as well. Equally, when you’re high there likely isn’t enough insulin in your body to allow your cells to absorb the glucose. If you’re high for a sustained length of time, then you will start to go into diabetic ketoacidosis (DKA), which is where dangerous toxins called ketones build up in your body. DKA can caused organ failure. This is why it is important for diabetics to stay within their target glucose levels.
When you want to measure your glucose level, you would traditionally need to prick your finger and measure a small blood sample with a reader, like the one pictured below.
This can cause some very short-term pain and it can also be a bit of an annoyance as you have to pierce your skin so frequently. Also, if you’re low or high you could lose valuable time trying to confirm your glucose levels, when you should really be taking corrective action.
This is where technology comes into the mix. You can get a glucose meter that is worn on the arm 24/7. With this meter, you can use your phone to scan (NFC) and get a reading there and then. With more modern meters you can even get alarms pushed to your phone via low energy bluetooth, so you know as soon as you go low or high.
I currently use the Freestyle Libre Sensor 2, made by Abbott Laboratories. Apart from a few issues with the usability of the mobile app, it works really well and definitely makes my life a whole lot easier. Each sensor lasts for about 14 days and can give you continuous data throughout. Data can even be shared with friends, family and medical practitioners in real-time. The Libre sensor is not the only sensor available, there are others that do a very similar thing.
🩸 Managing your glucose levels
So being able to monitor your glucose levels with this modern technology is all well and good, but what about actually doing something about them? Luckily, there are a range of different insulin pumps available, these are larger than a glucose sensor but they are still wearable. The pump has a cannula that gets inserted into the skin and then allows it to pump insulin into your body whenever it needs to. Pumps are significantly more convenient than using an insulin pen, and they are also more comfortable.
The pump I use is an Omnipod DASH, made by Insulet. It comes with a standalone device called a PDM (Personal Diabetes Manager), this device is running Android and it allows you to interface with the pod (this is how we refer to the pump). The PDM can calculate insulin doses based on how many grams of carbs you’re going to eat and your glucose level. It can also infuse basal insulin (your body naturally releases glucose, so basal insulin is required to allow you to absorb this. It’s like a very small but constant dose of insulin) constantly, rather than with one hit of long-acting insulin a day. Omnipod is designed for T1D.
You can also upload data from your PDM to a website like diasend to allow medical professionals to review it.
If your glucose levels are low, then a pump can’t really do anything to make your glucose rise. You can definitely reduce or suspend basal insulin to stop your levels dropping any lower, but what you really need is more glucose. And luckily that does mean eating or drinking anything that contains sugar (in moderation) will help to recover your glucose levels.
Diabetes is complex and it is often hard to manage, however with new technologies emerging all the time it is always becoming easier for people to manage and live with. The Libre sensor and Omnipod DASH have changed my life for the better, as well as those of millions of other diabetics.
With the current rate of technological improvement, there may be a fully closed-loop system available within just a few years. This would mean that people could just wear a pump and then not have to do anything to manage their diabetes, just let the technology handle it for them. And then eventually, there may even be a fully-fledged cure for the condition. Who knows what the future has in store?