INPUT out West, Truro

I was delighted to be invited to attend 'INPUT out West' in Truro this weekend. Perhaps the biggest single event Input are running this year among other roadshows around the UK. The weekend allowed people interested in pump therapy to get 'up close and personal' with the technology involved, meet some pump users, find out more about NHS funding options and quiz the manufacturers.

The event was held at the very lovely Alverton hotel close to the centre of Truro which, along with Lesley, Melissa and Laura of Input looked after us all beautifully. It was great to see HCPs and patients able to handle pumps, CGMs and other diabetes-related gadgets, with companies on hand to answer questions and provide information both to 'old hands', relatively recently diagnosed families and at least two different people who are about to start their pump journey within a matter of days. Some folks had travelled from as far afield as Cardiff and Preston to attend! It was lovely to meet up with online friends and acquaintances too, to catch up with Patti from DSF and to finally meet Angela 'Diabetes Power' Allison face to face, along with her daughter, pump user and juggler extraordinaire - Claudia.

On a personal level I was slightly disappointed about the 'no show' by Medtronic as there were a couple of questions I wanted to ask them, but that was more than made up for by interesting updates from Roche and particularly an excellent conversation with Martin Harvey of Advanced Therapeutics (Dexcom G4) and the very helpful Animas pump trainer (apologies, I didn't pick up your card!) who answered lots of my pointy questions about the Animas Vibe.

But it wasn't just about the big pump-tech companies. I was delighted to see that relatively small meter company Spirit Healthcare have launched a new 'talking' BG meter to support blind and partially sighted people with diabetes (the CareSens N Voice). Strips for CareSens meters are at the more affordable end of the spectrum for those T2s who need to 'self fund' their own blood glucose monitoring (don't get me started). The accuracy of CareSens meters appears to be excellent, and the company will happily provide the meter itself free of charge to anyone regardless of diabetes classification.

Buzzy also stands out in my mind from the exhibition. It's something I had seen mentioned online ages ago but completely forgotten about. Essentially it's a gadget that reduces pain/discomfort involved in injections or infusion set insertions by up to 80% with a combination of temperature and vibration-based 'nerve distraction'. They look fun too! If your little one (or not so little one!) struggles with injections or set changes, it could well be worth a try.

Undoubtedly one of the biggest draws of the event was the afternoon talk by Professor John Pickup, whose gentle and unassuming manner belies an extraordinary career at the forefront of diabetes technology (his work at Guy's Hospital in the 1970s pretty much earns him the title 'father of the insulin pump' and though non-diabetic he was the second person ever to inject rDNA human insulin 'just to make sure it was safe'). The talk covered all sorts of exciting developments in diabetes gadgets that are waiting in the wings, some nearer to reality/market than others. Pumps seem to be moving more towards patch and micro-pump approaches and Prof Pickup anticipates greater use of pump therapy in the treatment of T2D in coming years. Naturally the work towards a closed loop 'artificial pancreas' was covered (which was introduced with a wry smile saying that such a system was suggested to be 'just a few years away' as far back as 1972). Other interesting developments in the pipeline for CGM might involve non-invasive systems using near-infrared fluorescence and/or nano-sensor 'tattoos'. Exciting work also appears to be ongoing in the spheres of islet cell transplantation (including nano-encapsulation of the islet cells to protect them and improve the success of transplantation procedures). Stem cell research continues, but once again progress is relatively slow with some difficulty in reproducing promising results reliably.

The topic then turned from technology to future possibilities for structures and systems that provide care to people with diabetes. Opening with a bold statement that 'We know what the problems are' followed by a comprehensive list of missed targets, postcode lotteries and structural weaknesses within the existing system, Professor Pickup then laid out a sparkling vision for the future. A future of agreed standards that are met across the country (with action taken where areas struggle to meet them); of universal education for all patients; of professionals incentivised for outcomes met, not boxes ticked; of a funding overhaul that facilitates a multi-disciplinary approach; of seamless integration between primary and secondary care (hospital clinic and GP surgery); of increased staff training (no more waiting lists because only one nurse can deliver training courses/pump starts across a huge area); and of equal access to the very best treatment options wherever people live.

It was quite inspiring and made me wish that Professor Pickup (or someone with the same mindset) was in charge and empowered to bring it about.

In the evening I was invited to join the Input team, Dr Pickup and various other invited guests for a cracking dinner where we talked long into the night and enjoyed learning a great deal more about a pivotal figure in the history of diabetes technology.

All in all it was a thoroughly enjoyable weekend, and as often is the case with these events it is the small, incidental conversations had with other patients, pump users and parents of children with diabetes that made it special just as much as the 'big' presentations.


Disclosure-y gubbins: I was invited to attend the weekend but was not paid or asked to write this post. I paid my own travel and accommodation expenses, but was treated to dinner on the Saturday night.

Guest post: BG monitors for blind/visually impaired people

A few days ago we had a comment on our D-Tracker review from someone called 'Faulty Headlights' who was wrestling not only with diabetes but also with blindness. I can't imagine how hard that would be. As the conversation continued I became increasingly interested in the challenges faced by blind and partially-sighted people, especially in relation to available blood glucose monitors and their usefulness (or otherwise). Julie (Faulty Headlights) kindly agreed to write a guest post sharing her experience of the currently available options. If you have any experiences to share please add a comment below.

Three Blind M.... Monitors???

Living with diabetes can be challenging enough for some people, dealing with injections, blood monitoring, carb counting and so on.

I've lived with diabetes for 21 years now but 5 years ago I lost my sight do to bad control. If I thought it was difficult controlling it then, I was pretty darned puzzled as how I was going to manage not being able to see. I know I have help if I need it but I have always tried to be as independent as possible and didn't want my independence taken away from me just because I had lost my sight.

So not long after I learnt to use a computer I started looking into accessible products for diabetics with visual impairments. Mainly blood meters.

The first monitor I came across was the SensoCard plus (now discontinued), I liked this machine very much. Nice large display with one large tactile button on front and two smaller buttons on side for navigating menus, also. Clear speaking voice for reading results, a slot for easily coding machine and USB port for connecting to PC. Why oh why did they discontinue this one!

I asked around about another and was pointed towards the RNIB who specialise in audio products for the blind and visually impaired. They told me about the Clever Chek machine and there not seeming to be any other option I went for it.

Big mistake! It was awful! I’m sure there are other people using this machine who like it ok but they're probably all over 60 and still using phones like bricks too. Oops sorry, did I just write that?

The Clever Chek machine is bulky and has five buttons on the front, it has a large display and volume control which I guess would be good for people with hearing problems as well as sight. It has many features the same as the SensoCard plus but much much more difficult to use and there is way too much spoken information on start up which just isn’t necessary .If put in a pocket or bag it switches itself on with a merry little tune and tells you and everyone else in the vacinity thank you for using this product followed by date and time. Who ever designed this machine did not have the blind in mind. The strips seem to need more blood and I’ve been given so so many false readings in the past. I’ve compared them against my dad and sisters machines and readings were well off, maybe this is just my machine? I might have got a faulty one but I'll not be asking for another. One good thing about this machine is that it is codeless and... and... um? Nope, I'm struggling to think of anything else!

I was pointed towards the RNIB yet again and now they have a new audible blood monitor. It's called the SuperCheck2. It looks a bit like an mp3 player and has only two buttons. GREAT! It too has volume control, USB port for connecting to PC where you can store results and print for your doctor, large display, memory for up to 500 results and gives you averages over a week month and so on. It has a nice clear voice which reads pretty much everything a sighted person can see on their machine and is also codeless. Brill! On each of the three machines there is a 'dipped' area so you can feel where to insert the strip. The strips have one rounded edge and one flat edge so it's easy to know what end is inserted into the the machine.

What I like about this machine is that you can set alarms to remind you when to test your blood sugar and it doesn't look like a brick.

Technology has come on so so much over the years and it is good to see companies thinking about accessibility. One company I am pleased with is Apple who have made many of their products accessible to blind and visually impaired people with their voiceover.

I was recently told of new blood monitors called the BGStar and the IBGStar which connects straight into an ipod where your results can be displayed and stored. I don’t have a lot of information on these yet but am excited to see how it works and if it will be made accessible with the voiceover on iPod touch and iPhone. Technology really has come a long way, can you remember the old machines from many moons ago? Again, BRICKS!

I have now downloaded and tested 4 different iPod apps designed for diabetics to store their blood readings, exercise plans and carbs and so on. I was disappointed to find out that none of them were completely screen reader or voiceover friendly. Some of the icons were read aloud but others like time and date were not. I think apps like these are a great idea for both sighted and visually impaired diabetics, I mean, how many times have you shown up to your diabetic clinic with out your record book? Many of these apps also allow you to sync it to your computer or to email your results straight to your doctor. Nice one!

Julie.

UPDATE: See also the Caresens 'Voice' Blood Glucose Monitor for Blind/Visually Impaired people that I saw at the INPUT event in Truro