by Amy Grobe RD
I’m not sure at exactly what age a person starts to feel old, but with my first high school reunion looming overhead, I think I am just about there! Watching these young children navigate the latest high tech devices and gadgets, I feel almost embarrassed that my cell phone does not double as an MP3 player, and it cannot be used as a floatation device in cases of emergency. My two-year old cousin can scroll through the menus on her father’s iPhone faster than I can turn mine on. However, I do feel confident that I am up to date on the latest advances in technology as used in diabetes education, which has to count for something.
In my five years of working as a Registered Dietitian, I have witnessed so many exciting changes in diabetes testing supplies, insulin delivery devices, and computer software that I cannot even imagine what the next five years will bring. I’ve seen the size of the glucose meters shrink right along there with cell phones and cameras. Several models weigh in at less than two ounces, making them much less burdensome for patients to carry their testing equipment. The sample size of blood required to check blood sugar readings has gotten smaller as well, which makes finger sticks that much less painful.
In addition to these mechanical changes, perhaps the greatest advancement enabled by technology is how patients’ blood sugar readings can be interpreted and used to empower the individual to hone his self-management skills. With most glucose meters come computer software programs that allow the user to upload blood sugar readings from the meter’s memory onto the computer. Once uploaded, the data can easily be configured into a variety of charts and graphs, making pattern management much easier. Physicians and educators can average the patient’s blood sugars or view the standard deviations to make medication and/or meal plan adjustments. If a patient wishes to have closer contact and more frequent communication with his Diabetes Educator, he can select a software program that allows him to enter and save his blood sugar readings on a web site, which his treatment team can view from any computer with internet access using a password selected by the patient.
For those technologically savvy individuals, the insulin pump is perhaps as ‘cool’ as it gets. Mimicking a pancreas, the pump releases small amounts of insulin into the pump wearer through a small, flexible catheter that is inserted under the skin. This constant insulin flow, called the basal rate, can be adjusted all the way down to one hundredth of a unit, whereas the insulin syringes and pens can only be adjusted by one-half unit. Just before eating, the pump wearer tests his blood sugar and counts the total amount of carbohydrates he will consume. Using individualized ratios, the person with diabetes can then bolus himself the proper amount of insulin to match the amount of carbohydrates in the meal/snack. Certain pump companies are compatible with specific brands of meters, enabling the meter to ‘beam’ the most recent blood sugar reading into the pump via infrared beams, which then allows the pump to calculate the correct insulin dose for the wearer. Calculators need not apply.
Maintaining a current knowledge of the most recent technologies in dietetics allows us Registered Dietitians to remain the expert and leading authority in nutrition. By incorporating these newest tools and research into our practice, we are not only providing our patients with the best care, but also providing ourselves with valuable education and skills. The extent of these technologies is limited only by our imaginations. As I was counseling one of my teenage patients, a seventeen-year-old boy about to start on the insulin pump, I wanted to ensure that he had a solid knowledge of carbohydrate counting. When I asked him to reassure me that he was comfortable with the information, he replied, “Well I have the iPhone, so I can just Google something if I don’t know.” That about summarizes how far we’ve come!
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