(Hat tip to Professor Tim Skinner for the title of today’s blog post.)
In an effort to terrify the bejeezus out of healthcare professionals get the word out about Loop and OpenAPS to a group of diabetes healthcare professionals, I decided to work my Loop story into my talk at last Friday’s #ADATS meeting. I was a little nervous about it, but being on the ADATS Committee, and recognising the name of the conference – Australasian Diabetes ADVANCEMENTS and TECHNOLOGIES Summit – I knew that there was no way I could talk about the latest diabetes tech advances and not talk about the DIY movement.
To set the scene, I started with the old chestnut of showing how far diabetes technology has come:
Then showed a slide with all our shiny new tech:
But then I stopped, and changed the slide a little, leaving the same photos, but altering the title to ask a question:
And then, I showed them what cutting edge diabetes tech really looks like:
I used the next slide to explain how I drive my Dtech these days, and how my iPhone and Apple Watch are part of my diabetes tech arsenal.
‘So…How many of you know about OpenAPS or Loop,’ I asked. Very, very few hands went up.
‘What about Nightscout? How many of you know about, and understand,d Nightscout?’ A few more went up – but really not many.
I nodded my head, completely unsurprised.
Then I told the audience I’ve been using Loop for almost three months. I explained how I ‘hacked’ an insulin pump, ‘became an app developer and built an app’… and now, my basal insulin is fully automated. I showed a screenshot of the app, and pointed out the dozens and dozens of small basal rate adjustments automatically made every day.
I explained how much better I feel, how much more time my glucose levels are in range and how I simply wouldn’t be without this technology now. I told them how I now wake up feeling that I can move mountains because night after night after night my glucose levels remain in a flat, straight line thanks to those micro basal adjustments, and I wake to a number that ranges no more than between about 5mmol/l and 5.8mmol/l.
‘How many of you are a little scared by this?’ I asked and waited. Hands shot up; many heads nodded. I waited some more, shrugging my shoulders a little.
‘This isn’t the scary future,’ I said. ‘It’s not dangerous, futuristic or downright terrifying – which is what I’m sure some of you are thinking. This is happening here and now. There are two other people in this room using one of the two systems and there are probably around thirty people across Australia who have started using one of them.
‘And if you are a healthcare professional working with people with diabetes, it makes sense to be aware of these technologies. Also, Nightscout has been around for a number of years now. It’s really not okay if you are working with people with diabetes and you don’t know about Nightscout…’
I know that my talk received a mixed reception. There was a lot of nervousness from some of the device company reps in the room – especially the maker of Loop-able pumps. Some HCPs were simply aghast and did nothing to hide their feelings, one person telling me that I was being irresponsible doing such a thing and even more irresponsible talking about it.
But others were far more interested. The rep. with type 1 diabetes from a device company who announced at the end of the day that he was ‘going home to hack his insulin pump’ was obviously interested. As were a number of other people with diabetes in the room. A couple of HCPs spoke to me about my experience, and one told me that he knows someone in the process of setting up Loop.
But mostly, there was nervousness and shock that not only is this happening, but that there are step-by-step instructions online so that anyone can get onboard. ‘You mean that ANYONE can access the instructions? For free? So any of my patients could do this if they knew about it?’ asked one endocrinologist while a diabetes educator he works with stood behind him sharing his horror. ‘Yep!’ I said cheerfully. ‘It’s all open source. No one is trying to make a buck out of this. It’s for everyone. Isn’t that fantastic! They didn’t share my enthusiasm.
Here’s the thing…I wasn’t (and am not) for a moment suggesting that it is the role of HCPs to start recommending this technology to the PWD they see. But it is naive of them to deny it is happening, or that the only way people with diabetes will find out about it is if their HCP mentions it. Also, I’m not recommending that everyone with diabetes should find a suitable pump and start Looping. I’m simply sharing my story – which is what I have always done here on this blog, and elsewhere as a diabetes advocate.
The title of this blog post came about when I mentioned the mixed reception a little later on in the day. I was sitting with three others at ADATS (who I knew would be sympathetic), and psychologist Tim Skinner commented that one of the reasons that HCPs might be so uncomfortable is because I am going beyond simply not following their directions of how I should be managing my diabetes. ‘You’re actually being a deliberately non-compliant diabetic,’ he said cheekily (Tim was one of the authors on the Diabetes Australia Language Position Statement, so he knew the response he’d get from me using such terminology). ‘This is a lot more than simply being ‘non-compliant’. You have actively hacked a diabetes device and are using that to change the way you are managing your diabetes. Deliberately non-compliant!’
He’s right. I never thought I’d wear the term ‘non-compliant’ as a badge of honour, but right then and there, I kind of was.
LOOP!!! I know you want more info. You can read my last couple of posts about my experience here and here, but the full details, continually updated by the brilliant Loop and OpenAPS brains trust can be found here. Read them. Also, you may want to join the (closed) Looped Facebook group. And if you are in Australia, we have our own (closed) page dedicated to local issues at Aussie Aussie Aussie. Loop, Loop, Loop. (And just a reminder – no one can build your Loop system. You have to do it yourself, but it is actually super easy once you have all the components.)
Disclosure
My travel costs were covered by the National Association of Diabetes Centres, the organisers of ADATS. I was on the ADATS organising committee.
15 comments
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October 25, 2017 at 4:11 pm
Cheryl Steele
We are doing it for ourselves!
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May 13, 2018 at 10:10 pm
Lisa
Hi Cheryl, I am a Type 1 Diabetic and wanting to use the closed loop DIY system. Is Riley-link the best/latest computer that I can purchase? Kind Regards, Lisa
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October 25, 2017 at 6:07 pm
Jenny
Hi Renza – welldone. After developing your own loop but you have discussed openly your experience to HCP’s of various qualifications . A very fine presentation so that you have reaffirmed that you own your T1D and that you vhat is best for you ! Good on you .xxxxxxxxx
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October 25, 2017 at 10:54 pm
rachelzinmanyoga
gosh! I am crying at your courage to tell it like it is to our HCP…I hope to be as brave as you one day.
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October 26, 2017 at 1:27 am
John Haitch
Love the post, and I love that T shirt. Where did you get that?
John H, a fellow looper from USA
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October 26, 2017 at 6:55 am
RenzaS / Diabetogenic
Thanks for reading, John. Click on the pic with the t-shirt and you’ll see where to order. It was designer by fellow Looper, David Burren (also from Aus).
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October 26, 2017 at 4:34 am
FatCatAnna
Excellent post Renza – and I’m passing this onto my team at the hospital I go to for my health care with diabetes. At the Diabetes unConference a few weeks ago in Alexandria … the tech talk by Melissa Lee … along with a few other T1D’s who I’ve got their “calling cards” to help with setting up LOOP system … frigging amazing. I am often told off for how I manage my T1D by my medical team that I see now (previous one in another province was less judgemental). If they’re seeing this reply (if they look at your blog post) – I may be fired as a patient … ’cause I’m such a #diabadass and #noncompliantdiabetic
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October 26, 2017 at 7:35 am
Jo Watson
OK.. I’m ordering my bits and bobs really soon! Great post xx
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October 26, 2017 at 10:00 am
Ian Randall
Good on you for shaking them up!
In the Business Industry they would classify you as a Disruptor and applaud your innovations. Other famous Disruptors include Richard Branson who shook up the Banking and Airline industries.
You can add that to your new title. 🙂
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October 26, 2017 at 10:37 am
GB
I’m incredibly sick of the attitude that HCPs have to patient empowerment.
You’re being irresponsible by taking change of your own outcome? My god, the arrogance is astounding.
Perhaps if healthcare teams kept up with advancements and gave advice that helped us live long and health lives instead of them pushing for numbers which gets us diabetic complications and issues in later life we’d actually listen to them.
I don’t feel I can trust medical professionals with my care because so many I’ve encountered have not demonstrated they have my interests at heart.
At this point, they prescribe me medication and lab tests. That’s all.
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October 26, 2017 at 11:37 am
ShirleyJ
Pioneers and innovators are often met with skepticism and animosity. You are upsetting the paradigm and causing those experts to feel less than brilliant. How did they all miss this? Better to call it heretical than fess up to the fact that they are not staying on the cutting edge or looking for what is best for their patients/clients.
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October 26, 2017 at 12:40 pm
Helen (@heltweet)
You made me laugh, feisty Renza. Damn girl, you are bodacious!
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October 26, 2017 at 10:31 pm
Loop Curious – The Enlightened Diabetic
[…] on the other hand, has piqued my interests. It was this amazing post from the lovely Renza at Diabeticogenic, that pushed me over the edge. Seriously. […]
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October 27, 2017 at 9:28 am
Blood Sugar Trampoline
Yes! We sat, listened and waited for too many decades. Not it’s our turn to take control of where we want the treatment and technology to go.
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November 14, 2017 at 9:24 pm
"Looping and Alive" and other apparel - Bionic Wookiee
[…] Earlier this year I released a T-shirt design which related to having Type 1 Diabetes. Since then there have been several additions based on requests from other PWDs, and the collection has grown. The “Deliberately Non-compliant” one you see above was inspired by Renza at Diabetogenic. […]
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