Good news - yes, healthtech can transform lives

A decade of progress for young diabetics

This Substack tries to accentuate the positive when it comes to the power of technology but sometimes I think all of the hype around the subject has made me a little too cynical. So how good it was on a cold grey February morning this week to wake up to a message of hope.

It came in the form of an Instagram post by my cousin Andrew. Ever since his daughter Bia was diagnosed with type 1 diabetes at the age of 5, he has tried to keep up with latest developments in the fast-changing way doctors treat this condition. As I wrote here two years ago he worked with a network of parents who were impatient for the arrival of the closed loop system - otherwise known as the artificial pancreas - which promised to automate the delivery of insulin, and thereby save their children from a lifetime of remembering to inject themselves several times a day.

Andrew’s post was celebrating the tenth anniversary of Bia getting her first insulin pump, with pictures of her at 9 holding the device and at 19, now a student studying geography at Glasgow University. The caption described how the tech had developed over a decade:

“Started off with tubes & a cute belt, now it's a tiny tubeless pod, hidden away. If the move from nearly 4 years on injections to a pump was dramatic, the upgrade to the closed loop two years ago was the real gamechanger.”

When I called Andrew he described in more detail how Bia and the whole family had lived through a technology revolution. First, those four years of injecting Bia, initially gving her set amounts twice a day, then getting into the complex business of assessing every single thing she ate, doing a blood test, and adjusting the dose accordingly.

While getting Bia her first insulin pump at the age of 9 was a big step forward it was a pretty cumbersome affair and the process still involved constant monitoring of what she was eating and her blood sugar levels. What made the closed loop model which came along in 2023 so life-changing was that apart from changing the OmniPod pump - about the size of a matchbox - every three days his daughter can let the system run itself: “She doesn't do finger prick tests any more. She has a glucose monitor on her called the Dexcom. And there's an algorithm whereby the Dexcom and the OmniPod talk to each other.”

When I got through to Bia between her lectures she told me that the impact of the new kit had been amazing: “Before, even the whole thing of going to uni was a bit of a worry- you know, drinking, partying - and the closed loop has meant that I've stopped thinking about diabetes a lot more because it's regulating all my blood sugars for me,”

While Bia, her parents and her doctors have constant online access to all those blood sugar readings, they no longer have to obsess about them. In fact, says Andrew, they have been encouraged not to second guess the system, adjusting the dose if there is a high or low blood sugar level. ”Just trust the tech,“ he says.

Bia agrees.”It’s's really liberating to be honest. It’s genuinely amazing. any diabetic I meet, I’m like ‘you need to get on it!’””

There is a lesson here for other areas of medicine where advances in technology are being adopted more slowly. Show your patients - and their parents - what the tech can do for them, and you will have an activist army demanding progress.