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Another week, another opportunity to hang out with some Aussie diabetes bloggers and advocates. I’m back in Sydney for today and tomorrow, facilitating Abbott’s third Australian Diabetes Exchange meeting. You can follow along on Twitter, Facebook and Insta at #D2Sydney2018. (And you can read about previous DX events here and here.)

The timing of the event coincides with the launch of Abbott’s Freestyle LibreLink app, which allows Freestyle Libre users to use their mobile phone (Android or iPhone) as the scanner for their Libre sensor. That’s right, point phone at Libre sensor, swipe, glucose level appears on phone screen. This means no need to carry the reader with you.

Freestyle LibreLink launches in Australia on 5 June, so it won’t be available until then, but we’ve been able to have a little play today to see how it works. The app provides pretty much the same information as the reader, so as well as current glucose readings and the previous eight hours of data, there are screens that show averages, time in range, and predictive HbA1c. It’s easy to use, looks clean, and for anyone already familiar with the Libre reader, the transition to phone-as-scanner should be smooth.

I am all about making diabetes easier. I frequently say that I lament the days when I could run out the door with my phone, keys and wallet and nothing more. Diabetes doesn’t really allow us to do that, thanks to all the paraphernalia we need to carry with is. While we still will need to carry lots of kit, by doubling up our mobile phone as a sensor scanner, we are able to take one thing less with us in our (oversized) diabetes kit bag.

Now, I have been doing this for some time. I’ve been using Dexcom G5 since it was launched in Australia, and Loop since August last year, so my phone is as much a medical device as it is a Twitter machine. But I was paranoid at first that my phone battery would die and I would be unable to check my glucose levels. It’s happened maybe twice.

Some things to think about if you are new to the phone-as-receiver-of-glucose-data. Charge your battery to capacity before you leave the house. Have a charger with you at all times. (I have one in my car, one at work and one in my bag). Consider carrying a battery pack – and don’t forget you need to charge that too if you want it to be of any use. There are cases which double as a back-up battery. Consider investing in one of them. And if you are worried that you are going to be caught short, chuck the reader in your bag until you get the hang of having your phone charged at all times!

Some people may think this is a gimmick, but I firmly believe that is not the case. Having our current non-diabetes technologies become part of our diabetes gear makes sense. We want things to talk to each other, and this is exactly what this is doing. We’re seeing it more and more.

Reducing burden, making diabetes less a pain in the arse and finding ways to make things easier. I’m all for that!

Want more information about Freestyle LibreLink? Keep an eye out on the Abbott Diabetes Care website here.

Disclosure

Abbott Diabetes Care have paid for my travel, food and board while in Sydney. They provided me with one Freestyle Libre sensor and advanced access to the Freestyle LibreLink app. (However, I will be deleting it tomorrow at the end of the DX2Sydney 2018 event as it is not available for use until it is launched on 5 June 2018.)

As is always the case, I have not been paid, or asked, to write about product or this event. I’m just a caring, (over) sharing type of person.

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My favourite app on my iPhone is Uber. I love it. All the issues of having to stand around on street corners, waiting for a taxi and flagging down empty cabs as they race by you are easily and conveniently eradicated with a simple few clicks of the app on my phone. No need to worry about having cash on you – or dealing with the frequently not-working credit card machine in the car. Get in, get to where you need to go, get out. And sometimes there are snacks!

I have used Uber around the world and I love that it doesn’t matter if I am in Stockholm, New Orleans, Melbourne or New York, it works the same.

I had the most delightful Uber drivers in New Orleans a few weeks ago, including one who picked me up from a burger place in the middle of nowhere (thanks to Fredrik for always finding the most obscure, out of the way local haunts!) and chatted happily with me for our 10-minute ride back to my hotel. She gave me some terrific tips for the city and asked me about Australia.

Another night, also in New Orleans, we were picked up in a red jeep by a funny and friendly guy called Kevin who, if we had said ‘You know, we’re not done yet; how about we go to another blues bar,’ would mostly likely have joined us. And shouted us beers.

When we got to New York, we collected our bags at JFK and walked out to grab a cab. We settled into the back seat for the hour long trip to our hotel and mindlessly watched the little screen on the back of the driver’s seat. And there, we saw that New York’s iconic yellow cabs had a new app, Arro, which allows passengers to hail a cab and pay for their ride using their smart phone.

This was clearly in response to Uber and the convenience and ease it has afforded users.

Uber is an example of disruption in an industry that previously had absolutely no competitors and was happily providing a rut of a service that users simply had to use. It came about because the system was broken.

Healthcare hasn’t had that disruption. And it needs it, because this system is broken.

One of the most interesting sessions I attended at the ADA was an out of hours event hosted by the innovative team at diaTribe. I know that we can always count on to get us thinking.

The Musings Under the Moon session was billed as a discussion on digital health. But it was much more than just a state of play update.

I sat down with some DOC friends at had a good look who was presenting. There in front of us, all together sharing one stage were absolute leaders in digital health and technology, including the CEO of Bigfoot Biomedical, the President of Medtronic Diabetes, the CEO of Dexcom and an Executive VP at Novo Nordisk. And outside the specifically diabetes space we also had the Chief Health Officer at IBM and the VP and Chief Medical Officer at Qualcomm Life. The panel was expertly moderated by diaTribe’s Adam Brown.

To assemble such a panel is one thing. To have them candidly talking about the what is going on in the digital health space – and being challenged on why it is not moving faster – is another.

Perhaps the most candid and, for my money, the most interesting commentary came from Jeffrey Brewer from Bigfoot Biomedical. A couple of things he said have obviously resonated with many others in our community because they have been shared over and over on social media. Like this:

He is right and it is no wonder his words were met with such overwhelming support from people with diabetes. Brewer is not backwards in coming forwards and this comment also shared not only his, but many in the community’s, frustrations.

 

We have become conditioned to simply accept the status quo when it comes to developments in diabetes technology. We accept that the drivers of not only the developments, but the speed in which they arrive in our hands and attached to our bodies, are the companies whose skin in the game is, for the most part, is return on investment. I get that and, as is the case with any business, it to be expected. I also understand approval bodies and their debilitatingly slow processes.

Except it’s not really okay when the result is that we are not moving as fast as we should be.  Or that we begin to believe that what we do have at our disposal is as good as it gets.

Today, we would never believe the idea of sharpening needles or checking urine is an adequate way to to manage our diabetes. Not when there are other tools available.

And yet, we think that it is perfectly acceptable to use BGL checking four times a day (or six or ten or twenty…) as a way to manage our diabetes. This is old technology that gives a snapshot with no more information – no arrows, no suggestions of where we are going or where we have been. How is that still okay when we have CGM and flash glucose monitoring available that we know provides more information, more data, better ability to make smart management decisions?

We do nothing because we can’t or we simply accept that we use what we have. This doesn’t for a moment take into consideration the trailblazing Open APS users (currently 88 people around the world according to this tweet from Dana Lewis), and movements such as #WeAreNotWaiting.

Healthcare needs disruption. The current situation is not okay; the system is broken and it needs fixing. Because right now, we are being shortchanged. And it’s not good enough.

I have absolutely no connection to Bigfoot Biomedical other than I am very fortunate to be friends with Melissa Lee who works for them. But I did win one of their t-shirts in a competition at ADA and I proudly wore it on the streets of New York!

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At the beginning of 2015 I wrote a post saying that while I don’t do resolutions, I would be focusing on three things: health, peace and happiness. I started off the year feeling that I had all three, and I ended the year feeling the same way.

Eschewing the plethora of ridiculous inspirational and motivational quotes filling all my SoMe feeds as 2015 drew to a close and 2016 started, I decided that if it ain’t broke, don’t fix it and that I would be going with the same three things throughout the new year.

A few things that have been occupying my wonderfully-blank holiday mind over the last couple of weeks:

Said inspirational quotes don’t work. It says so here.

American Girl, previously a place of fear and terror for our credit cards, has redeemed itself with the launch of the diabetes kit. Excited? Doesn’t even touch the sides!

There is a cure for diabetes and it is, of course, juice. Here you go! (Send cupcakes as gratitude.)

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Woolies, it’s January. Put away the Hot Cross Buns!

My sister has been talking non-stop about her Veggeti. And she bought me one (yet to use it). Just me, or could the marketing people come up with a slightly better name? Anyway, Veggetti recipes to come.

I decided that I needed a mermaid. Isn’t she beautiful?

(Click on image for details.)

(Click on image for details.)

I am doing the #30DaysofDexcom (or any CGM) challenge because: a/ saw a bandwagon, so I jumped on it, and b/ my BGLs are better when I use CGM. It’s just an undeniable fact that for me when I am sensing, I pay more attention to my blood glucose and am more in tune with ‘doing diabetes’.

If you don’t wear CGM, but are looking to do something similar, the good folk at MySugr have a #30DLogging challenge. My mate, the wonderful Scott Johnson is one of the poster boys! Check it out here.

And that’s about it. I am still on holidays for the remainder of the week and continuing to do very little other than hang out around the house, occasionally venturing to a local café and working on eliminating my sleep debt. It has been what I would consider a very successful ‘nothing’ break!

I’ve spent the day in our nation’s capital for a meeting. And here are two things.

This one made me smile. Because whether it be designing seats on planes or health services, consumer engagement is key.

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And then this. Which made me cringe.

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Why, Canberra, why?

Have a great weekend!

I’m in the middle of a lovely four day long weekend. Because of a horse race. Thanks, Melbourne!


See you on Wednesday!

Over the last couple of days, this meme has found its way across my social media feeds several times:
  
Each time I’ve scrolled past it, I have felt uncomfortable. For a number of reasons. 

Firstly, I wouldn’t wish diabetes on anyone – even for a day. 

But mostly, because for this to be true and fair, then surely it could be said of each and every health condition. Surely if people with diabetes expect others to walk a day in our shoes pumps (see what I did there?), then those with every other condition would expect the same. 

Living with a chronic health condition frequently means lots of health checks. This could mean regular blood tests, X-rays, scans or other things performed by HCPs. Or, as in the case with diabetes, it means ongoing, regular, daily (and several times daily) BGL checks.

Hopefully health checks are all meaningful. By that, I mean they are done for a specific reason and with particular action taken depending on the result. 

I thought about this the other day. I was speaking with someone who had argued with her GP after she had made an appointment for a routine check – a Pap smear. Now, this woman (who is happy for me to share this story) is very connected with her healthcare. She sees her diabetes team regularly and is always up to date with her complications screening. She gets pats on the back from the compliance police.

Her GP knows this because she makes sure that her diabetes team update her GP. 

The GP’s role in diabetes is different for everyone. I have a great GP, but he knowns that when it comes to diabetes, his role begins and ends with ‘You still have diabetes, right?’ And then we laugh and tick ‘diabetes’ off the list. Others have their GP as their primary care physician. 

My friend has the same sort of relationship with her GP as do I. She is also as vocal as I am when it comes to being very clear about the direction of medical appointments. So when she walked into her appointment, she made it very clear that she was there for a Pap test and that was it. 

After she had her Pap test, her GP asked her to step on the scales. ‘Oh,’ said my friend. ‘Why?’ 

It’s exactly the question I would ask. ‘Why?’ And it is the most useful question when it comes to healthcare. I ask it all the time which is really important when your healthcare professional is more from the school of ‘you will do this‘ rather than ‘this is an idea for us to discuss.’

I am more than happy to be thought of as a petulant toddler in the eyes of my healthcare professionals. I expect things to be explained to me – how else am I meant to make an informed decision about my healthcare?

Too frequently, we are asked to submit to tests (as basic as weight, or something far more complicated) or change our medication or treatment without an explanation as to why this is a good thing.

And frequently we do it without thinking. 

Part of being in control of my healthcare is to have full understanding about why we are doing what we do. I check my BGL to give me information to use when it comes to deciding what I will eat or how much insulin I need; I have my blood pressure checked to see if it has changed from the last time I had it checked and if so, if anything needs to be done. I also know it can be a predictor of other things related to diabetes, so it’s something that needs to be checked regularly.

But I refuse to have a check done unless there is a good reason and ‘Oh, just because’ is not a good reason. And that is the reason that my friend’s GP gave her. ‘Do you have some concerns about my weight?’ asked my friend. ‘Do I look different to last time I saw you? I don’t have any concerns, so I’m confused as to why you would suggest  it?’

Now, you can absolutely say that my friend was making a big deal over nothing, I disagree. If there is no reason, why have it done? I could go into something about weight being a fraught issue for a lot of people ( I won’t step onto the scales unless I absolutely have to), but actually that doesn’t matter.

There needs to be a reason. If there is no satisfactory and satisfying response to ‘why?’ it doesn’t happen. Simple as that!

I like a themed biscuit! How cute are these cookies‽

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The real reason I wanted to post today was to (one last time, I promise) urge you to make a little donation to Spare a Rose, Save a Child.

We don’t really celebrate Valentine’s Day; we’ve always scoffed that it’s a Hallmark occasion. However this year, we have marked the day by making a donation. No roses, because flowers die but children really, really shouldn’t.

Enjoy your weekend. We’re enjoying the cookies! For breakfast.

The New Year is but a week old, yet Twitter outrage is already in full force.

Jamie Oliver released a photo the other day. There was the cheeky lad standing in front of a giant Coke can, holding up sixteen sachets of sugar. It took me a moment to see why this photo was flooding my social media streams.

But there it was: in the familiar Coca Cola font, across the giant can, the word ‘diabetes’.

And my heart sank.

Not because it was there; unsophisticated messaging at its worse, and we’ve all seen it before. It’s unimaginative and, quite frankly, boring.

No. The reason was because I could taste the outrage. I could see what was happening and I could see that the outcome would be. Without reading them, I knew the words. I could feel the anger.

I’d seen it all before. Countless, countless times.

Jamie’s response was swift. He apologised on Twitter and removed the photo.

I love Jamie Oliver – I always have. I think the work he does supporting better nutritional choices for kids at school and people everywhere is really important. His profile allows for great reach and he usually is spot on with what he says.

His messaging is generic – it needs to be to reach the masses – but one of the things that I admire is that he doesn’t overstep the mark like some other celebrities. I can’t recall him ever making health claims, other than urging people to eat as much fresh food as they can and encouraging people to cook at home. ‘Teach your kids to cook,’ he says. That’s good advice!

Of course he missed the mark here – drinking too much Coke doesn’t cause type 1 diabetes and really, it’s far too simplistic to say that it causes type 2 diabetes.

But can I get angry about it? Not anymore.

Maybe my response is clouded by the fact that I am currently in the middle of an enormously enjoyable holiday where the most stressful thing I’ve encountered each day is deciding which hat to wear to face the cold. Perhaps I am too relaxed and chilled out and basking in the glow of doing nothing but spending time with my husband, daughter and some wonderful friends.

In my incredibly fortunate position of enjoying said holiday, maybe it’s easy for me to just dismiss this. It’s easy to not let it add to stresses and pressures of work and life. It’s actually quite liberating! Perhaps something to try more of when reality returns at the end of the month and I go back to work and back to ‘real life.’ Life can be stressful enough without adding social media outrage to the list!

Wishing you all the happiest of holidays, merriest of Christmases and most joyful of times – however you choose to celebrate.

We’re celebrating with dear friends in New York. Missing our extended clan back home in Melbourne, but so lucky and pleased to be sharing the season with a great family, and enjoying a northern hemisphere Christmas. (Message to Santa – could you please make it snow? Please? Pretty please?)

Thank you for dropping by this year; for the support; for the laughs and for the love. It’s been a tough year, but 2015 is looming bright. Bring it on!

Much love from my gorgeous family to yours.

Renza

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Take it away, Bruce!

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