Diabetes Unscripted
Creating a community for folks living Type1 diabete to learn and grow from one and other. Because until there's a cure there's a community.
Diabetes Unscripted
S1E9: The future of diabetes management
Unlock the future of diabetes management with this eye-opening episode of Diabetes Unscripted. Imagine a world where diabetes is no longer a constant worry, thanks to cutting-edge technology and artificial intelligence. We promise you’ll learn about the latest innovations that are not only reshaping how Type 1 and Type 2 diabetes are managed but also hold the potential to prevent the disease altogether. From the development of smaller, more efficient insulin delivery systems to the promise of GLP-1 agonists and SGLT-2 inhibitors in reducing Type 2 diabetes prevalence, the advancements we discuss offer hope for a life with less intervention and more freedom.
Drawing from personal experiences and the collective wisdom of the diabetes community, we explore the rapid evolution of diabetes technology—reflecting on breakthroughs like the Dexcom G7 and Tandem Mobi, and imagining AI-integrated pumps that could make diabetes an afterthought. In our candid discussion, we also address the ongoing challenges and misconceptions surrounding Type 1 diabetes, stressing the critical need for public education and understanding. Through stories and shared hopes for a cure, this episode stands as a testament to the resilience and innovation within the diabetes community as we look towards a brighter, more manageable future.
You're listening to Diabetes Unscripted, where we are focused on creating a platform for people living with diabetes to share, learn and support one another, Because until there's a cure, there's a community.
Speaker 2:I think the secret for type 1 is going to be smaller insulin delivery devices, maybe the at the introduction of another molecule such as glucagon, to like, make our lows get erased? Um, I see devices that don't even include us, as what the number even is that they just literally are all in one package of a continuous glucose monitor and an insulin delivery system, aka pump, with minimal interference to our bodies, just being able to run the whole show without endocrinology involved, without patient involved. Just go. Some people like to think there's going to be some cure in which, like, we're going to start generating our own beta cells again or give immunosuppressants. But those studies have literally been looked at and the current medicines in our lifetime that are used to be immunosuppressants also, like, make you exposed to, like, possible infectious diseases. So those clinical trials have actually been halted because, like, the risk of just taking shots doesn't outweigh the risk of immunosuppression as we know it today. My hope is that the technology gets finer. It's all on like a smart device or it's all doing it by itself without you thinking about it, so you just march through life with this semi-automatic pump system for people who are insulin requiring. I really hope that for type 2 diabetes, we erase diabetes. I think that we're going to see these things called glucagon, like peptide ones or the glp1 agonist therapies, and the SGLT-2 or the sodium glucose-like transporter. Twos take diabetes type 2 off and hopefully people will not have it as much. I think the prevalence of that will hopefully go down. But for those of us with an insulin requirement, nothing but brighter days with better and better artificial intelligence slash, automated insulin pump delivery with automated glucose continual watching and predicting.
Speaker 2:Yeah, I mean that's part of the obsessive, compulsive nature and anxiety of type one diabetes. I mean that's like an existing problem. But you know what, um, I've seen it happen with patients. I've seen patients who have obsessed and compulsed about all this stuff and then they get on these things and they learn to have faith and device and now they're like they're not worrying about it. When they go play sports, they're not worrying about it. When they go play sports, they're not worrying about it anymore. When their kid goes to college, they're not worried. I mean it's a beautiful thing.
Speaker 2:I mean part of the danger of the share technology with cgm is that, like you're just bringing on more obsessive, compulsive anxiety for everybody involved, right, because like everybody's looking at it. So I'm not saying that you should never look and I'm not saying that you shouldn't have the option to look, but I do have a feeling that, like again, what would excite me is like what if we could have such good technology and delivery that we don't need to look, but like it could really happen completely on its own? Then the kid who's diagnosed with type 1 diabetes, the 60-year-old who's diagnosed with late-nonset autoimmune diabetes of adulthood you plug it on. Now they don't have diabetes anymore. They just got to change the site, they just got to reconstitute the CGM. They're not even thinking about it anymore. That's a beautiful world. I think that's really close. I think it's a lot closer than people realize.
Speaker 2:But there's approvals from I mean, remember what we're asking for here too. These devices, all of these devices, all these medicines have to be federally drug administrative approved, because they have to be as tightly or more tightly regulated than a 747, right, we expect that the 747 picks you up off the ground and puts you in the new place and you are completely the same person as before. These medicines and these technologies need to do the same thing for people with insulin requirements. They cannot fail and they cannot give too much and they cannot give too little, and when that happens, though, you don't need to know the number anymore. If it knows the number, wouldn't it be a beautiful morning when you wake up and don't even think of your diabetes? Thank you, I mean, it's really an honor, mark. You are an exceptional person. Thank you for your time. Thank you for inviting me. I'm always here for you and all of your T1D crowd whenever they need some advice.
Speaker 3:All right. So we've talked about your journey is getting better and better. Like I said, I was on, you know, one of the first CGMs when that technology was essentially unheard of, and even the pain of that insertion and the accuracy has improved so much. The fact that I don't have to calibrate or really poke my finger anymore is just astounding to me. It is so accurate. The fact that my pump is dosing my insulin for me is incredibly helpful. So that's just every new advancement I'm just so thrilled with.
Speaker 3:I am really not a techie person, so I can't even imagine what's coming next. I think the meal prediction is going to be exciting. I think the more tubeless options we get into are more exciting for my patients than for me. But that's awesome. Stuff is getting smaller. Stuff is moving to our cell phones. I just think that's amazing. I think that's where a huge learning curve for me would take place. There's a huge learning curve if you're diagnosed nowadays, and especially if you're of that age range that is essentially a young adult or an adult. I feel like that's essentially me. Getting a taste of that experience. Just having something that you really don't have to put a lot of time and effort into is shocking.
Speaker 4:I found a pump in 1991, initially the DeSatronic pump, and so I've seen, and then CGM, the biggest technology development, in my opinion, in diabetes. I mean, if you had to, if you have to choose one piece of technology, if you only had to choose one it would be CGM for me. But that experience has really made me value technology. I don't know what it would be like, of course, to be diagnosed now, you know, in the midst of all of this. So I think that not having it has given me some additional appreciation of what life is like without it, so less likely to take it for granted, I guess. So in some ways I think that can be helpful.
Speaker 4:It may be more challenging for a person who's diagnosed now with all that's available, because you just don't have that frame of reference. How could you? I wouldn't want them, I wouldn't want you to. But what we have now is is it perfect? No, but from what we had, it's pretty, pretty darn close, almost Right, and it's not slowing down, Right, yes, Okay. So I remember, you know, being diagnosed in 1982 and the pediatric under at that point said hey, five to 10, we've all heard that five to 10 years. You know we're going to have a cure. So you know I didn't make my appointment. Five, you know I wasn't showing up five years later saying hey, where is it? You promised but yes promised.
Speaker 4:But um, yes, uh, but you know where we are now is is pretty exceptional, and I think what's I'm excited about next these algorithms are are becoming more and more advanced in a way that it translates well to improved quality of life. Think about now how many you know, how few lows you have anymore, and even the ones that you do have nowhere near the severity of you know there was. They were like sucker punches back in the day, like you didn't know what was coming, but you better buckle your seat belt. Um, and it's nothing like that, thank so, yeah, I just with the refinement of the technology, so with generation and as the new generations are being introduced of these products, it's just translating to lives that are much less impacted negatively by this disease, less less disruptive. So, yeah, looking forward to what's next.
Speaker 4:Of course, at a certain point I wonder how much the technology is limited by the insulin, you know, by the speed of the rapids, like, is that the you know, rate limiting factor at this point in terms of how how far we can go? I don't know. Oh, yes, that's, and this is an easy one and one I still mess up on not infrequently is bolusing, you know, half an hour before eating. It makes such a huge difference post-meal, glycemically, and it's easy thing to do, but it's an easy thing to ignore. So I try to remember that. It's like diabetes 101, like dude, do it. You know, why wouldn't you? So I'm, I'm, that's a work in progress, it's, it's. I should have it on lock, but something I still am messing up on here and there.
Speaker 5:Yeah, there's actually quite a few things that I'm excited that are coming up the line and I'm excited to start using them. But I think I'm most excited about is how quickly technology feels like it's been coming now, as compared to when I was first diagnosed, so 14 years ago. The idea of a insulin pump and having to load insulin into the cartridge, that still was, I mean, kind of a new idea, and trying to put it on somebody who's under, who's eight years old, that's like unheard of. They had no idea what they were doing, let alone with my little sister, who was three when she was diagnosed, and so they were just kind of taking shots in the dark, and so it felt like technology and maybe this is just my perception too, but it felt like things we would hear about something and then we wouldn't see that thing come to fruition for five more years. So now I feel like when they say something's coming up and I go to my endocrinologist and I have my A1C appointment, and she'll say like well, next time I see you in six months or whatever, it is like there might be something new out. And sure enough, there are new things coming out from one appointment to the next appointment, and that's super neat to see.
Speaker 5:So things like the G7, I'm so excited to see that for Dexcom G7. And most of the time they're just making them smaller and more convenient too. There's even the Tandem Mobi is coming out too, and that's also a super small version of the insulin pump that I'm currently using, and I think they're awesome for people that live an active lifestyle and want to continue to make diabetes a secondary thing in their life. Obviously, you still have to think about it, right, but there's all these other things that you also want to be achieving, and then you kind of want diabetes to take a back seat sometimes. So I like seeing all these things and I just think the future of technology feels so promising, and so I'm just so excited that things are actually coming out quicker than anticipated and that we're seeing them at such a steady pace too. I think both those things feel great, and I can't remember if I'm just totally making this up right now, so you'll have to fact check me but isn't there something coming up where some type of pump, or an AI part of the pump, is able to have an idea of when you're eating and then how many grams that you're eating and then kind of regulate mealtime for you so you're eating and then how many grams that you're eating, and then kind of regulate mealtime for you so you're not even entering carbs in anymore.
Speaker 5:Yeah, I agree, because it feels like it's been my entire life. I hardly remember my life before being eight years old and having diabetes. So it's crazy to think about some of those things where you are no longer thinking about the thing that you've thought about for 14 years, like carb counting, and that just seems like a radical idea. I think post-diagnosis I think about that a lot too like after the cure, like whenever, because it's always five years down the road. So whenever the cure, yeah, yeah, um, whenever that idea comes out, like what life is going to look like afterward, I I do think I'm like going to continue to count carbs.
Speaker 5:Like there's going to be a lot of unlearning, um associated with whatever the cure looks like, even if it's that um like a pancreas, like they've talked about a bunch of different things like a, an automated pancreas, and then there was the automated pump and then there was all kinds of crazy ideas.
Speaker 5:So whatever that does come out and come to actual patient use, I think that will be crazy to see what life post-diagnosis and then post no longer having diabetes is going to look like. No longer having diabetes is going to look like. But then I think the technology coming up the line for stopping diabetes before it starts in somebody I'm not super familiar with that either, but I know that's becoming more prevalent. So, even if it's not for me, but like future generations or learning, if you have the same kind of beta cells and you can see the markers in somebody that could potentially have diabetes and working to prevent that, that just seems like wonderful technology as well. So I don't know, I'm just I'm excited for whatever they they're putting out. Yeah, yeah, thank you, I'm. I'm so honored and this is one of those silver linings of diabetes right, it's building the community and getting to chat with people that totally get it, so I appreciate it so much first came out, and I have to believe.
Speaker 6:I don't know if I'd say it's the late 70s or early 80s, but I remember the first blood machine that I ever got. It took us five minutes to check your blood sugar. It's one that you'd have to give your right finger.
Speaker 7:I think I definitely have a lot of dreams of how I see diabetes in the future, and I don't know if all those will ever get accomplished, but I just know that eventually I would like to see diabetes become much more compact and not something that people are even thinking about Kind of minimize, like all that preparation that we were talking about. Been thinking about kind of minimize, like all that preparation that we were talking about. Um, so if that meant no more sight changes and a big pump on your waist, that would be awesome. As a girl, finding places to put my insulin pump and cover it up, it's something that I continue to be like where do I put this? I don't like. This is a day that I don't want anyone to see it. So where do I put it? Or I don't care because I have jeans on, I'm just going to my class. I'll put it on my hip.
Speaker 7:That's something that I wish I could fix, because I also don't want to wear a big old bulky insulin pump on my arm because like an Omnipod, if I'm allowed to say that, because I am a student athlete and I know I'm already sweating off the ones that aren't super big. So I think something that's more condensed and smaller and being able to just oh hey, I have time, I can go to the gym real quick and I don't have to carb load, or I'm allowed to go eat that bagel like the rest of my team, because my pump knows that I'm eating the bagel and it will put insulin in, or things like that. I think it's little things because day-to-day stuff really doesn't affect me, but the times that something like that, I wish it was a little bit easier. And then this doesn't have to do with technology, but I've always stressed this, but I think it would be so much better if people just understood, kind of what type 1 diabetes really was, and letting people embrace their knowledge of diabetes and not spreading things and saying things that aren't true.
Speaker 7:It's been something that I've always like kept with me, like all the weird comments that I've gotten from people or overheard conversations, and I think it's something that you just have to deal with. But until that day happens which I know it will people will understand eventually, probably when that cure comes out. But I think that will be the day that I'm like bouncing off the walls because I'm no longer like explaining to people that I can have sugar, or I need sugar right now, or don't even give me that because I'm high. I feel like they're probably thinking, wow, that girl really changes her mind a lot. Yeah, or I don't know.
Speaker 1:Thank you for listening to this episode of Diabetes Unscripted. The information presented in this podcast is for general knowledge. The mention of specific products, medication treatments or services does not constitute an endorsement or recommendation. Always seek the advice of your physician or qualified healthcare provider with any questions you may have regarding your care.