Episode 6: Carb counting and Clinical trials

Technology in Type 1 diabetes is moving fast… like really fast.

In this episode of Sweet Talk, we dive into the latest and up and coming tech shaping the future of diabetes care. From new automated systems like the Twiist System, to the growing conversation around Islet cell transplantation and what it could mean for the future of treatment, and maybe one day, a cure.

We talk about how far we have come. From finger pricks and manual calculations, to CGMs, pumps, and now smarter, more personalised systems. We also touch on what is happening here in Australia and overseas.

But it is not all just exciting breakthroughs.

We also get real about what it is like living with this level of technology day to day. The constant data. The numbers. The pressure that can come with it, and how easy it is to feel like your worth is tied to your results.

Because while the tech is evolving, so is the mental load that comes with it.

This episode is equal parts hopeful, fascinating, and honest.

🎧 Tune in as we break down what is new, what is coming, and what it actually feels like to live it.

Transcript

SPEAKER_00 0:02

Sweet Talk with Abby and Elise.

SPEAKER_02 0:07

Hey everyone and welcome back to Sweet Talk, where life, laughs, and type 1 diabetes collide. I'm Elise. I'm a credential diabetes educator and accredited exercise physiologist. And I'm Abby, a registered nurse living with type 1 diabetes. We're here to talk all things, diabetes, health, and real life. Answering your questions, busting myths, and having honest conversations about what type 1 diabetes really looks like. We share evidence-based advice, practical tips, and real-world experience to make diabetes feel a little less overwhelming.

SPEAKER_00 0:37

We want to acknowledge the traditional custodians of the land in that we're recording on and the Youngbar people and pay our respects to elders past and present. Just a reminder that this podcast is education and conversation only. For personal medical advice, always chat to your own healthcare team. Alright, let's get into it.

SPEAKER_02 0:56

Hi everyone. Today we're diving into carb counting and clinical trials. Yes. Diabetes technology. Why did I say it like that? Diabetes technology, yo.

SPEAKER_01 1:05

Where are you from, girl?

SPEAKER_00 1:07

My goodness. Oh my gosh. Look, mate, we have come a long way from basic Wii testing in the 70s to kind of looking advanced robots, which were like backpacks. I did see a photo of the Unreal. We'll have to post it. It's totally wild how technology's changed. So it was a backpack pump. We cannot complain. No, gosh. And then now the CGMs, which are amazing, and then the pumps that are getting smaller and even more clever. And then there's other smart delivery systems very clever.

SPEAKER_02 1:36

Yeah, so right now in Australia, we've got access to some pretty cool tech CGMs, insulin pumps, pods, hybrid closed loop systems. Like yours. And it can feel like things are moving pretty fast. It feels like we get a new announcement for new technology like every six months at the moment.

SPEAKER_00 1:52

And let alone what's happening overseas. Yeah. So what are the clinical trials that are currently underway? There's some in Australia, but there's some wild ones that are going on overseas. And what might be on the horizon for diabetes management globally? The killer mice. Ooh. Can we be next? Watch this. It's always the mice! It's always the mice.

SPEAKER_02 2:09

It's always the mice. Silly mice. Today we're unpacking where we are with carp counting, how it fits into new clinical research, and what innovations are being tested around the world.

SPEAKER_00 2:20

So whether you're carp counting every day or just curious about emerging tech or wondering what might be coming next, this episode is gonna be for you. So let's get started.

SPEAKER_02 2:32

Alright, so Elise, I'm hearing a lot of buzz about full closed loop systems. Yes. Is this kind of finally the set it and forget it era? Or is the robot still just the very needy CODMA?

SPEAKER_00 2:46

Look, uh it's pretty exciting. So the for our listeners that don't know, the big guns on the market in Australia, they're currently what's called hybrid closed loop, which essentially means that you you put on your pump, yes, it talks to your CGM, so it makes automatic adjustments, which is wild, but you still need to tell the pump, A, when you're eating, you need to pre-announce it so it can adjust beforehand. And you also need to tell it when you're exercising, depending on what type of exercise you're doing, of course, because then it goes, nah, this is too much, or oh my goodness, there's so much glucose here, what's happened? Yeah. So you need to tell it, so it's a hybrid closed loop because we need to have some input. So that kind of relates back to our carb counting, like you were saying, and that's even changed over the years that when pumps were originally put on, we had to really strictly carb count to make sure we were getting the exact right amount of insulin. Now with the hybrid closed loop system, you can estimate pretty well. Yeah. Like you can kind of eyeball a meal and go, that's approximately this amount of carbs or a small meal, and then it'll adjust. But what's exciting about these new closed loop systems and the new one that's out in the States at the moment is called the twist system. So have a little look at it. We are no way sponsored, but it's exciting to see on the market. But it's basically this pump that you put on where you twist it on and it makes all these adjustments without having to bolus.

SPEAKER_02 4:01

Wow.

SPEAKER_00 4:01

Yeah, without having to say when you're exercising.

SPEAKER_02 4:04

Wow.

SPEAKER_00 4:04

Yeah. So it's pretty cool. Seems like too good to be true.

SPEAKER_02 4:08

Yeah, impossible almost. Yeah.

SPEAKER_00 4:09

Like how does that, how does it know how to do it? The algorithm's very clever. It knows to be able to preempt it as well. It recognizes patterns, so the algorithm learns the user. Wow. So if you were to put kind of your pump on someone else, it would have to kind of relearn it after an X amount of time as well. But it's pretty exciting to think that you can kind of set and forget. Yeah, that's that's coming. That's just like even crazy. Life changing. It's an external pancreas, essentially. Yeah. And they're advertising as completely closed looped, which is wild. So the clinical studies are looking pretty positive and that the individuals with diabetes are wearing the pumps and they're having, I think, about 80% time in range, which is pretty exciting. That is insane. Without you telling it anything. Nothing. Just it's got to learn you. So I think I think it's like it's a warm-up here. I imagine there'd be kind of a warm-up here where they have to, you know, input some data and have to set it up properly, but once it's up, 80% time and range. Yeah. And so is it just the pump in this twist system or is it like a pump CGM? Together. I think this one has it separate, but I think they're working on some systems having it together. Like imagine if it was just one device.

SPEAKER_02 5:17

Like something this big that's like your pump, your CGM, and like it lasts like 30 days or something crazy.

SPEAKER_00 5:23

Wild. I don't know if you'd want something inside you for that long, but I don't care. We're going to talk about that down the track as well. But I have other useless organs inside me, so the yellow. Well, it's exciting because on the other pumps as well, they've actually got the pump and the CGMs and now ketones all reading together in one device.

SPEAKER_02 5:42

How like I can imagine you see new stuff come out, like in the US and in China, and then Australia's like four years behind.

SPEAKER_00 5:49

But look, in saying that though, as well, and we're gonna talk about this later tonight, but it's a lot of data. Do you really want to see all that data as well? Like glucose ketones, the amount of insulin. You kind of just want to have it on, and if it's a problem, you can fix it.

SPEAKER_02 6:04

Yeah, am I in range or am I not?

SPEAKER_00 6:05

Yeah.

SPEAKER_02 6:06

Yeah. That's all I really think.

SPEAKER_00 6:07

So it'll be interesting to see kind of how all this new technology and new data goes, but it is very exciting. Yeah. So it's coming. So our pumps are pretty darn good. They've come a very long way, but they're still coming. And then I think after these algorithms turn to closed loop, the only limiting factor will be the insulins and making them a bit faster.

SPEAKER_02 6:22

Yeah, right. Yeah. That's so exciting. It is. So I've been hearing a lot of bars online about these one-year implantable CDMs going back to having something on you in you for a long period of time. I don't know how I feel about this. I feel a bit violated. It kind of feels like the like data chip that people use to like as locks. Like, are we are we practically a part of this whole cyborg with sci-fi group of people?

SPEAKER_00 6:48

Or we will basically call you cyborgs already because you've got so many devices in you. So what's an extra one? Yeah.

SPEAKER_02 6:54

And what how like how are these so sticky? That's my biggest concern. Like think of 10 days, mate. This CGM's hanging on for you. So think of this one like the bar.

SPEAKER_00 7:04

It's all like physically inserted like an implanton. I still have my scarf. Yeah. Um, so this particular CGM, I saw it. Yeah. This particular CGM is implanted under your skin. Right. And they have 180 day, but they also have a 365-day one. It's called the EverSense. It's over in the States.

SPEAKER_02 7:23

It's I have through Pharmacope. Some people on some of the support pages I'm on who have done a bit of part of the clinical trials. Not for the not for the year one, but there was some guide that 1801. Yeah, the 180 one talking about it.

SPEAKER_00 7:37

I'd be curious to see what the accuracy is like because it is obviously sitting in the interstitial fluid as well. So it's not measuring blood glucose, so similar to the CGMs. Yeah. So you'd wonder kind of what that delay is. But in saying that, if you don't have to change your CGM every 10 days, every 15 days, if you've got this device in and it's there for a year and yeah, occasionally you've got a finger prick if it's slightly delayed. I think that's pretty darn good. Yeah. We've got to check the accuracy on it. Totally. Um, so it'll be interesting to see what the clinical trials come out with. But cool that it's providing options. And some people might not feel comfortable with that, some people might like the fingerpricks or the CGMs or whatever they want. But it's cool that there's options out there.

SPEAKER_02 8:13

Yeah, and it looked like there was still something on that that sat on the outside. In some, but the new ones not. Oh, so it's just literally like a trick. That's crazy. Proper cyborg. So it's coming. I'm kind of into it though.

SPEAKER_00 8:25

Yeah.

SPEAKER_02 8:25

Oh well. The less minutes to do and remember to do is the better.

SPEAKER_00 8:30

Yeah. But test it on everyone else first. Yes. All our micey friends that you keep mentioning about. See how the mice go. See how the mice go.

SPEAKER_02 8:38

So what are smart pens? So I have some friends working in public hospitals. I work in private, so obviously we're often a little bit behind when it comes to new tractology, but they've got smart pens on their impress now. And one of them was asking me about them, and I was like, I honestly have no idea what that is. Smart pens on the impress, that's crazy.

SPEAKER_00 8:58

Yeah, so essentially these smart pens, they've been around for a little while. Probably the two big ones that we tend to see more frequently are for our users that are using multiple daily injections or MDIs instead of using a pump. Yeah. So there's what's called the Novo Pen 6, and there's also the InPen, which is through Medtronics. So each talk to their own CGM. You have to physically scan the Novo Pen 6 one into the phone, but it can save your dosage, it can track when you inject it, it can track and link it to your CGM. So it makes it really pretty with the data and things like that as well.

SPEAKER_02 9:28

And so is it kind of like our old like your OG, like wind up pen? Yeah. Where you use a needle on the end of that's it. So same, same like concept for injection, but it's just got some smart data included.

SPEAKER_00 9:42

It's a refillable pen. So you get the cartridges of your insulin. Okay. And then same thing, you put your pen needle on just the same, inject just the same. Yeah. But it's got extra batteries at the back. I know. And it's got that extra NFC that you can scan to your phone and you basically hold it to your phone and it uploads all your data. Yeah, right. You don't have to upload it after X amount of time. I think you only have to upload it every three, three months or something like that. It's pretty cool. That's cool.

SPEAKER_02 10:03

Can I quote me on that?

SPEAKER_00 10:04

Can it go on the fridge? Or do you take it out and I reckon just put the new cartridges in. I would be checking with the manufacturer. I'm not quite sure on that one. But I would be putting just your insulin that you're about to inject in. I don't know if I'd put a whole battery in the fridge. Because you know, when you go to Japan and you take photos and your GoPro gets all hunky dory because it's too cold, I reckon the batteries might have a hissy fit. Yeah. But look, check with the manufacturer. They might be.

SPEAKER_02 10:25

And obviously, if you're not going through a lot of insulin and like this cartridge has what, 200 units of insulin?

SPEAKER_00 10:31

Yeah, 300 usually.

SPEAKER_02 10:32

Yeah, you know.

SPEAKER_00 10:33

And you're you know, I don't use 300 units in textbook, you meant to change it every month. Yeah. Textbook. But in saying that, that's a really good point. Maybe they just take the cartridge out or something like that.

SPEAKER_02 10:43

We will find out. Yeah.

SPEAKER_00 10:44

But it's cool that for people that don't want pods or don't want CGMs, that there's an option that can even help them with their bolusing and things like that as well. So they can look at their meal, they can see what their CGM is, they can put it in their phone app and say, hey, I'm about to eat about this size. Yeah. And then it will tell them how much to inject on their smartphone and then they dial up close.

SPEAKER_02 11:02

It's almost like getting the smart effects of like an insulin palm. Yeah. But it's not having, if you choose not to wear a pump not having like that.

SPEAKER_00 11:11

It's just telling you so you have that extra control to inject yourself. Yeah. So some people might find that quite appealing step. Yeah. Which is fun. Always always welcome. Yeah, yeah. Take some of that pressure off carb counting because you've got that bolus calculator in the app itself.

SPEAKER_02 11:24

Yeah, right. Yeah. Yeah.

SPEAKER_00 11:26

So as long as you set that up with your healthcare team so that you've got your levels right, like your carb ratio and your sensitivity factor and all that, then you'll be good to go and all your settings will be right. And you can just kind of eyeball your meal, give it an estimation, and it'll tell you how much insulin to inject.

SPEAKER_02 11:39

Sounds like a good backup for travel for like worst, worst, worst case scenario. If you put sales to like not have to carry around all these insulin pens and just have the cartridge and have your smart pen and stuff.

SPEAKER_00 11:51

Yeah.

SPEAKER_02 11:51

So it's a lot less baggage, essentially.

SPEAKER_00 11:53

Totally. Yeah. So good. For your diabetes bag, which we talked about in one of our earlier episodes. Yeah.

SPEAKER_02 11:57

Yes. And I did have someone message me about that. Oh good! Because a real estate agent was telling her that that wasn't a thing.

SPEAKER_00 12:04

And you're like, yeah, mate.

SPEAKER_02 12:05

So I like got all this paperwork and stuff, and I sent it and I was like, just bring this on and send it to her. And it's right. And it was right. Amazing. We were right. Love that. Love that. Alright, we were talking about mice earlier. Yes. Very fun for mice, guys. Mice are getting their type 1 diabetes cured. Must be nice. But there is a lot of human trials. There's a lot of research. There is a lot, a lot of research. So specifically about our eyelet.

SPEAKER_00 12:30

Eyelet cell transplantation. Yeah, can we kind of go into that a little bit? So one of the big guns on the on the research frame, I guess you could say, um, University of Edmonton in Alberta, it's very exciting. They're actually transplanting eyelet cells into the liver. Now, so for our listeners that don't know, eyelet cells are the cells that are in your pancreas. They've got what's called alpha cells and beta cells. The beta cells is what produce insulin and the alpha cells is what produces glucagon. So we'll go into a bit more detail about this in a second. So my science node's gonna come out here, people. Just bear with me. I love it. Amazing. Let's see. Listen close. Listen close. See how we go, see how my explanation is. So when people have type 1 diabetes, essentially your immune system is attacking those beta cells. And so they park it, so you can't produce insulin. Yeah. So what this is cell transplantation does is that they put these cells, these donated cells, into the person's liver. Okay, and they start multiplying. And what people are actually finding in the trials go little cells. Go little cells, mate, they're going good because most of the people are 80 to 100% insulin. Like they don't need insulin anymore. 80 to 100% less insulin.

SPEAKER_02 13:47

Yeah. So it's like, imagine being in like a honeymoon phase and then getting given that and you're just like, not diabetes anymore.

SPEAKER_00 13:53

I know, and you could catch it early, right? It's good. So what they're finding is that this particular transplantation, as well, you some of these stem cell transplants and all this kind of stuff, people have needed quite hectic autoimmune drugs to stop it from rejecting.

SPEAKER_02 14:07

And I was talking with research people about a clinical trial that was around like immunotherapy and stem cells and stuff. I didn't end up continuing with it because I was just at a point in my diagnosis where it was a lot to help.

SPEAKER_00 14:21

But I remember like that's what it was kind of focusing on. Yes. And so what they're actually finding now is that you don't have to have these like autoimmune suppressors or not as much. It's a different type. Yeah. So these cells can live and you don't have to keep, you know, affecting your immune system so you don't get sick as often. So it's a game changer. Go through like chemotherapy and correct, and your immune system's really down. So it's exciting that you can have this transplant. So far, I think they're about three to six months into the trial. Some of these people are completely off insulin or 80% down the amount of insulin they were on. It is. And then what they're also finding is that other cell I mentioned as well, the alpha cell, that is also there, which means that their ability to combat hypose is improved. So if they're going low, their little alpha cell, which is also affected in people with type 1 or long-standing type 1, it kicks in and goes, hey girl, you don't need to hypo. Here's some glucose, and it produces glycogen to process glucose from the liver, and bam, it combats your hypose. So not only does it stop the really high highs from the insulin, but it also stops the really crazy lows. That's crazy. So even if they're not 100% time and range, just like that wild high to low, they're producing their own insulin stuff. Like stable. Yeah, instead of roller coastering everywhere.

SPEAKER_02 15:33

Isn't that cool? Right. So do you do you know where we get like these stuff? Is it like a blood donation type thing where you have to make it?

SPEAKER_00 15:39

There's a few different studies that are looking into different ones. People are actually looking at deceased donors to see if they've got them that way.

SPEAKER_02 15:45

Can I like get all my brothers and be like, everyone start donoring? Can I have some pleas? Everyone, this is this is your moment.

SPEAKER_00 15:52

This is your moment. I need me. I need your cells. I need your eyelet cells. After the war, after the war. So I don't get some script from script. That's bad. And then I think the other ones that they're looking at are pig cells. Pigs. Yeah. Pigs. Little piggy cells. Three eyelet cells. Go to the pigs. So there's a there's actual human ones and there's actual pig eyelet cells that they're transplanting and they're having a look into the research. So watch this space. Like it's in real early stages.

SPEAKER_02 16:19

It sounds so promising.

SPEAKER_00 16:20

Yeah, to the point where there's like, I think there's under 20 people that have had this happen to in these studies, but it's looking very promising. That's yeah. Very exciting. I can imagine it's incredibly expensive. Yes. Um, and it'll be interesting to see what the side effects of these kind of new auto anti-rejection drugs are, given that they don't have the effect of it. So watch the space, have a look at the research, but it's very exciting to see. And the fact that it's gone from the micey trials to the human trials is really positive too. Totally. Yeah.

SPEAKER_02 16:48

Yay! Exciting. So there's also a game changer, inhalable insulin. Sure is. You heard about it? Yum yum yum.

SPEAKER_00 16:58

So instead of injecting, you can chuck her up your nose. It's called a freza or a frenzer or a freza, I think it is. Sounds like a street drug. It's street drug. Basically, you should see the device. We'll have to put it up on our page. But essentially, you inhale the insulin in, it's absorbed into the mucosa in the. Sounds like my sinuses would hate that. Yeah, either in your nose or actually in your mouth. So there are two options. Yeah, it could I don't know if you'd call it a vape, but like you can inhale it back up. Like some strawberry insulin? Maybe, maybe not like that. Maybe more like the inhaler. Strawberry flavoured insulin. I think we'd be millionaires, totally. What do you mean? What do you mean we are millionaires? Um, but no, kind of kind of think of it like like simbactor, like an asthma drug. Yeah, like a medicine that you're showing your Asian chief, anyway. Like in a club medicine. Not a vape, it's a medicine. It it's it's like an asthma medicine. Wrong, wrong. Nope. Anyway, so it's an available insulin, but I've also looked at kind of like nasal spray insulins as well for like little bobbers so they don't have to do it. So I think naloxone is like in the US is up with the nose. It's pretty cool. Yeah. Yeah. And so essentially it's a fast-acting insulin, absorbs an action time within 15 minutes, like to twent 12 to 15 minutes, and its action period is about three hours. So it basically covers your meals. Oh, how long did you say? Three hours. Oh, I think 12. My brain just No, not at long acting. Oh, it's fast acting. No, no, no. Three hours. So 12 to 15 minutes action time. Okay. And then it's yeah, it's long acting. It's action, I guess, could say is three hours. Right. Yeah. So one of the things compared to you don't have to inject. Yeah, I mean, I guess. Yep. So if you've got kids that can inhale, or that can sh that can deal with nasal things.

SPEAKER_02 18:45

That would be a big benefit.

SPEAKER_00 18:46

Absolutely. People that are needle phobic, so they're scared of needles, it provides another option for them as well. Some people that need more rapid acting insulin that may not respond to injecting in the subcutaneous tissue anymore, it's a different space that they're basically absorbing it. So people might find that more beneficial as well.

SPEAKER_02 19:03

Yeah, it could increase advocacy of insulin for some people.

SPEAKER_00 19:06

Yeah, so it's it's it's a different type of insulin, it's absorbed slightly differently. So for people that are really having, I guess, that trouble to the kick to their meals and things like that, saying, Oh gosh, I have to wait like half an hour before my insulin kicks in. Right. Whether it be the absorption side of things, they might find this really helpful as well.

SPEAKER_02 19:20

Yeah, that's cool.

SPEAKER_00 19:21

Yeah, it is very cool.

SPEAKER_02 19:22

Always good to have options. We need to bring it to Australia. Yeah, I think I've seen it on TikTok.

SPEAKER_00 19:27

Yeah.

SPEAKER_02 19:29

I do love a bit of tiki dick. Oh, you're youngin'. Anyway, that's all right. Okay, so back to research. Yes. So there is some new research into mRNA vaccines. Yes. And preventing the onset of type 1 diabetes. Can we go into that a little bit?

SPEAKER_00 19:43

That's it. So these mRNA vaccines, again, these are only in the early stages of the trials in mice. But what they're finding that if they mice. These mice. These mice. Always up for everything. Always up for everything. Must be nice. And what they're actually it must be nice, mice. What they're actually finding at the moment is that if they inject this mRNA vaccine, it essentially tells their immune system to calm that down. Okay. It tells them to calm down so it stops attacking their pancreas before it's a problem. Yeah, right. So how kind of this could come into practice is that in Australia, and I know across the world, they're doing what's called the type one early screen. So in babies, they actually do like heel prick tests and send it off.

SPEAKER_02 20:24

It's funny, we were talking about this at work probably last year. Yeah. I work in postnatal mums and bubs. So we do something routinely if consented by the parents, called like a we call it a heel prick test. Yeah. Right tests for a range of metabolic kind of genetic diseases in children. And it is like quite it's like a heel prick test. We send off some blood and then it screens for the all these things and it comes back as positive or or not. Um really sure it's the same. Yeah, we were talking about whether you know you could screen neonates for type 1 diabetes and then obviously not right now because you can't really prevent or cure type 1 diabetes. Well, but with something like this, could we actually like decrease numbers of people getting diagnosed? Or the severity of it as well, or how early it's diagnosed. Yeah, or like prolong this kind of honeymoon phase.

SPEAKER_00 21:16

Phase, correct, yeah. So I think the idea of it is that if people had this type 1 screen, they were like, cool, you're at high risk, but they're checking on their pancreatic function, they can say, yeah, no, look, it's it's okay for now. But then if they go, oh, your your beta cells are starting to, you know, decrease in their function, something like having an mRNA vaccine just kind of puts that immune system on hold, I guess you could say, and say, hey, these beta cells aren't actually. We need those. We need those, we need to use them. And so it's essentially the vaccine is kind of telling it, hey, these beta cells are safe. So it's it's showing really promising signs for people that are early in their diagnosis to try and prevent any further decline, but also in terms of what they're doing for those that are higher risk of having type 1 diabetes to prevent it from actually onsetting. Yeah.

SPEAKER_02 22:00

Sounds really cool. Yeah, so very cool. Modern medicine. Trying to stop it before it's a problem. Totally. Yeah. Which is very cool. I love that. That would be cool for someone like me to be, I would be super interested in something like that, because being a triplet, obviously. My concern or my fear for my, especially my brothers who are very close to me genetically, would be the likelihood of them getting or I mean I know I remember Jordan and I having a conversation when we were talking about like planning for kids, like my fear around the likelihood of giving it, even though it's giving it to a child, you know what I mean?

SPEAKER_00 22:36

So it's not like that. We we don't think that there's there's look, there could be a genetic link, but majority of people like yourself with type one diabetes, they have no genetic link. Yeah, yeah.

SPEAKER_02 22:45

But I think it it would play a big role in like parents and people with siblings in like Well look into it when that day comes. Preventing our fear around it being like, okay, we could potentially have this vaccine that we could give and if they are at high risk.

SPEAKER_00 22:59

Yeah, yeah. Well look, type one screen, look into it when you guys are deciding to have kids. It's definitely a thing. Um and it's free and they will come out and do all the stuff for you. And I'm fairly sure, don't quote me on it, you'd have to look it up, but I'm fairly sure it's kind of similar to a heel prick test. Yeah, that's really cool.

SPEAKER_02 23:14

I'll definitely look into that.

SPEAKER_00 23:16

Yeah, it's very cool.

SPEAKER_02 23:17

Okay, we love talking about what could come in the future, but back to reality. Yes. We've talked about our diabetes and alarm burnout on this podcast before. Yes. What are your thoughts around all this new tech? Like, at what point does it become too much? And it's like too much for us as individuals, or maybe like a bit working with someone who has type 1 diabetes, like understanding the role that all this technology can take in like contributing to burnout.

SPEAKER_00 23:48

As amazing as technology is, it can be a real hindrance at time as well. Yeah. I think I don't know if I've given these yes. And I've I've got like some individuals that come through the clinic and they're obsessed with looking at their CGM. I wonder. To the point where I can physically see each dot that they're checking. Yeah. And it was hundreds of times a day. That was me. So imagine if you've got that to check your glucose. Yeah. Imagine if you've got that to check what your ketones are doing. Yeah, right. Imagine you've got that to see what your pump is automatically doing.

SPEAKER_02 24:18

Yeah.

SPEAKER_00 24:18

And then, of course, like this tech is great. Man, come of the days where a hundred years ago where they literally just discovered insulin and they were just, you know, giving someone dog insulin and pig insulin at one point. Yeah. Kind of guessing what their glucose was based on the amount of sugar that was on their shoes. And like their weed test and be like, there is some sugar in your weed.

SPEAKER_02 24:38

Yeah, I could see how that much data would be beneficial for an educator or an endocrinologist. Yes. But I don't necessarily want to know. I mean, I can't talk to anybody.

SPEAKER_00 24:47

I don't necessarily want to. Even if saying that for an educator or an endocrinologist, sometimes it's too much as well. Because if they're going good, there's only certain dates that we're looking at. We need it, we need to average. We look at the trends.

SPEAKER_02 24:57

We don't look at every single trend. And the individual as well, like what point does I mean, as clinicians, we're always talking to look at the person. Absolutely. Not necessarily look at the numbers, like judge the clinical situation from everything and especially how that person is telling you they feel. Yeah. Um, I think, yeah, they could.

SPEAKER_00 25:13

So if they're really motivated and they're like, hey, I've seen this, this looks unreal. I want to learn more. And they're motivated to put in the hard work to get it on to make sure that it's right. They're motivated to learn how to carb count for us in Australia that we still have to with our hybrid closed loop systems and things like that. Great. Pumps and CGMs might be really great for them. Yeah. Even particularly with like parents with young kids with type one. When we spoke with Steph, how great is technology in terms of taking that burden off them so they can sleep at night.

SPEAKER_02 25:39

Yeah, and the external as well, if kids at school and you're at work or at home.

SPEAKER_00 25:43

Yeah. To be able to have that thing and be like, hey, teacher, I can see that he's going low. Where is he? Oh, he's running around the um the playground like a headless shook. Cool. Go get on that.

SPEAKER_03 25:52

Yeah.

SPEAKER_00 25:52

Yeah, exactly. So look, there is lots of benefits, but of course, all this data, it can be really mentally overwhelming. Yeah. And you can burn out. And like we talk about as well, alarm fatigue is a real thing. Like if your alarms are going off because you've set your high alarm to 12, mate, it's gonna be going off all the time. It's gonna be a long day. Yeah. So it's got it's gonna be a long day. It's gonna be a long day. It's gonna be a long day. So if your alarms are going off when you're having highs, if they're going off when you're having lows, if they're going off to remind you to check your glucose after your boluses. So, yes, like all these alarm settings, they're great options for some people. But honestly, I would be putting alarms on for safety. Yeah. I would be using tech for the individual. So, like you said, look at the person. If they're really motivated, it should be great, but it shouldn't be something that should be a burden. And sometimes taking a break away from tech totally just as healthy wearing tech to help get you in range. And look, yes, in range textbook, we love that 70% time and range number. But for some people, if they're sitting at 50% majority of the time and they do nothing with their pump, amazing.

SPEAKER_02 26:51

Yeah. And I think a lot of people living with type 1 diabetes are often pigeonholed into their worth being tied to their time and range or what their numbers are doing. And I think it's important as clinicians and as humans to be reminded that people are worth more than more to life than time and range. Than data. Yes. Yes. And I think we're wrong more than your data. And we love this whole cyborg idea and like your technology has is amazing in that sense. But at the end of the day, we are humans and humans are not a hundred percent 100% of the time. Yeah. And you know, you're your worth definitely it's not tied to what your time in range is. I don't think that's important.

SPEAKER_00 27:33

If you're having, you know, if you're having 60% that's above 13, that's look, you're probably gonna have blurry vision. Yeah, your risk of diabetes-related complications is higher, but it doesn't mean you're a terrible person. No, no. Or that your diabetes is bad. No, or that you're bad. Yeah.

SPEAKER_02 27:49

No, that's it. So we don't need more technology telling us.

SPEAKER_00 27:52

If I had someone I already feel that exactly, and if I had someone coming into my clinic and they had majority of their time that was sitting above 13, I'd be saying, Cool, how do you feel about that? Like, are you happy with those numbers there? And so for some people then maybe like, look, I don't feel well when my glucose is above 15. I'm I'm motivated to make difference. Cool. Well, for some people it might be bringing them back down nice and slowly, for other people, it might be something to do with their health, or if they have a procedure where we have to get them back a little bit closer. Yeah. But at the end of the day, like you said, just because they've got glucose that's above a time in range doesn't mean they're a terrible person. Totally. Yeah.

SPEAKER_02 28:27

So this has been a really interesting episode. I think I learned so much. So exciting. So if anyone listening um is keen to find out more about what's happening or coming in 2026, or keen to, you know, read the fun medical jargon in relation to these uh clinical trials, like where can they go? Who can they reach out to? Yep. But look, go see your clinicians first.

SPEAKER_00 28:48

That's my best advice. Sometimes go to your diabetes team. They know about clinical trials, they're gonna be aware of it. So, particularly here in Australia, we're lucky that we often get researchers reaching out to us saying, hey, these are the studies that we've got currently. If you've got people that might be interested, feel free to hand on our flyer. And so we have them to the ability to hand them out. There are some really cool people on places like TikTok and Instagram. However, take it as a grain of salt. Totally. Use it as a that's interesting, and then maybe take that research further to Google Scholar or other journals to actually read a bit more and be like, cool, this is really cool that they've got this particular technology, but they've only trialed it on two people. Yeah. And actually, those people were dogs. You know what I mean? Like I've got excited about it yet. Yeah, yeah. Yeah. Or like, oh, this has only been done once in the outskirts of Russia, so there's no chance it's coming to Australia in the next 20 years. You know what I mean? So look into it, make sure that it's credible. Yeah. Uh if you but go see your team, go talk to your family and friends, but you've got to do what's comfortable for you.

SPEAKER_02 29:45

Yeah.

SPEAKER_00 29:46

Yeah.

SPEAKER_02 29:46

Super. It's been a bit of a longer episode, but that's just because there's been so much to talk about.

SPEAKER_01 29:52

So much is very exciting. And I'm excited to see what we bring up next. I know. I'm excited for this. The twist. The twist. The twist. Watch the space. I know. Check it out on socials.

SPEAKER_02 30:01

Yeah. We'll be uh sure to post info for anything we've talked about that is available. We'll post it on Instagram or in our show notes. Amazing. Until next time, we'll see you then.

unknown 30:14

Bye.

SPEAKER_00 30:16

This is your life, your body, and type 1 diabetes just fits into your schedule.

SPEAKER_02 30:20

Thanks for listening and join us next month for a whole new episode of Sweet Talk with Abby and Elise.