What if Buck Rogers’ kid had type 1 diabetes?
August 24th, 2007 by Kevin
Referring to Bennet’s post at YDMV, I agree with your thoughts of course and as with most things diabetes, this topic is multi-faceted (YDMV right?).
While some kids will definitely not want the intrusion of giving someone else the ability to remotely monitor their blood sugar (and device state) in real-time, my experience in the field says there are other kids who initially say they don’t like the idea and have come around within a few hours of actually using a real-time remote monitoring system. And finally, there are other kids who absolutely love it the minute they hear about it (future geeks like me most likely). I’ve seen the same variation in parents, too.
For example, several of the families in our trials have shared their very personal experiences with me regarding the impact of remote monitoring on the parent-child relationship which I was able to repost on our website with their permission.
When dealing with the behavioral side of diabetes, especially teens, they have also told me how cool it is to come home from school and for the first time since diagnosis get treated like (in their words) a ‘normal’ kid. I said, “What does that mean?”
The answer is brilliant: “When I come home from school now, the first thing my Mom asks me is “How was your day?”, not “How were your blood sugars?”. And some kids can appreciate that if all they have to do is use a wireless monitoring meter vs a regular meter for their mom to have a little peace of mind, that’s a small thing for them to do.
My point here is that without a significant amount of varied experiences, it is very difficult to truly understand how the stuff of Buck Rogers will ultimately affect us and the way we live our lives and how they might (or might not) help us to achieve normalcy in the not-so-normal routine of managing type 1 diabetes.
Last 5 posts by Kevin
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August 24th, 2007 at 1:11 pm
Great title and I love the photo.
I think your point is well taken and I have been reading a lot of your stuff. I am pondering over your point about the reliability of data.
You make a good point about the weak link being the users getting data into an analysis. Log books certainly are falable and so is relying on a cable up load. Hence your communications link. This still however leaves the weak link of the user actually testing.
August 24th, 2007 at 2:54 pm
Ah. If the ultimate goal of the system was to get the data into the electronic logbook I would agree. Unfortunately, most of the PC and web-based diabetes management systems that I’ve seen do in fact have historical review of data as their goal. But that is nothing more than a repository and while the logbook may be complete, the data just sits there or it’s too old to do anything with.
Our technology has been designed to support programs that focus on behavioral change ‘at the teachable moment’ as the key to favorable outcomes. Thus, using the communications link to provide us with real-time behavioral insight (did the pwd check his bg according to plan or not?) is sometimes more important than a historical review of the numbers.
At some point in the cycle, we do recommend that people review their reports as a way to assess the result of choices made. Effective feedback has to be simple and obvious. As an illustration point, a significant percentage of type 2 participants in our trials, who typically check their bg once or maybe twice per day, report checking their reports every morning to spot trends. That seems a little silly on the surface. However, when you step back and consider that the only reason a person would do this is because of the value they receive from information (specially formulated automatic trend reports) vs. isolated bg checks (meter) which tell them nothing. These people begin to understand that by filling up their record with the right kinds of data makes it easier to take a few simple actions to improve their control.
So, once you solve the weak link of ‘Get Data’ as we have, you are then able to apply technology to assisting people to ‘Understand’ cause and effect and ultimately make it easy for them to ‘Act’. This is why an Automated Diabetes Management System must be built on a foundation that embraces the role of behavioral psychology for improving outcomes in people with diabetes.
Simply talking about one feature of an ADMS (ie: real-time glucose alerts) probably makes it difficult to see the difference between active technology vs. its passive cousin; diabetes software that lives on a PC.