One sunny day last July, I was chatting with my cousin Kathryn as we watched her daughter Ruby, now eight, dashing around the garden of my childhood home in Manchester, England, a cute red and white polka-dot bag slung over her shoulder.
It was an idyllic scene, one that stands in stark contrast to just six months earlier, when Ruby, who had exhibited few symptoms other than inordinate hunger and thirst, was rushed to hospital and diagnosed with type 1 diabetes. What followed was a six-day baptism of fire as Ruby was stabilized and forced to deal with her mortal dread of needles, while Kathryn and her husband underwent sleepless nights and a crash course in endocrinology.
“It was like having a new-born baby, but it’s even harder, because you weren’t expecting it,” she told me. Life suddenly became about monitoring, calculating, injecting, and planning around eating, exercise and school — all on no sleep and all totally out of the blue.
That cute bag that Ruby (name changed to protect her privacy) carries with her at all times? It houses a Dexcom glucose monitor and a pack of glucose tablets, which work in conjunction with the sensor attached to her arm and the insulin pump plugged into her stomach. The final item in her bag was an iPhone 5S.
The content’s of Ruby’s bag.
It’s unusual for such a young child to have a smartphone. But Ruby’s iPhone, which connects via Bluetooth to her Dexcom monitor, allowing Kathryn to read it remotely, illustrates the way technology has transformed the management of diabetes from an entirely manual process — pricking fingers to measure blood sugar, writing down numbers in a notebook, calculating insulin doses and injecting it — to a semi-automatic one. It removes a lot of the guesswork involved with the timing and calculation of insulin doses by providing detailed, almost real-time monitoring of blood sugar levels.
Diabetes is not a small problem. Nearly 10 percent of the US population — just over 30 million people in total — are affected by the disease. Of those, 1.25 million Americans have type 1 diabetes, which puts them at risk of slipping into a fatal coma at any time and for which there’s no cure. Instead, patients must treat and manage the disease, in which the body produces little or no insulin to regulate blood sugar levels, as best they can every day for the rest of their lives.
For all people with type 1 diabetes — often diagnosed in childhood — and for some with type 2, this means injecting themselves with insulin on a regular basis.
It was Ruby’s case that inspired me to look into diabetes and how technology has made treatment less of a pain. Blood sugar levels can now be read almost in real time by devices such as continuous glucose monitors and insulin supplied via a pump continuously fixed to the body.
A diabetes pump means no injections, but does mean carrying the tech round your waist at all times.
But tech is not a complete panacea.
To start with, the most advanced tech isn’t always available to everyone, and millions around the world don’t have access to even basic gear like blood-glucose testing machines, according to Elizabeth Rowley, founder of charity T1International. It’s led to some people “hacking” their equipment to take advantage of new capabilities.
It also adds new layers of complication to an already complicated disease.
“Technology is great as it gives us lots more information, but it doesn’t take diabetes away and it doesn’t take the management of diabetes away,” said Libby Dowling, who