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I've been using my Smart Insulin Pens (SIPs) for 14 months now & they've been a resolution in how I feel about my diabetes, how I manage my diabetes & how passionate I am to help others & to advocate. This thread🧵collates some of the things I've been part of to raise awareness. A picture of Smart Insulin ...
I do hope you find it helpful & hopefully take something away from the thread. There are lots of pictures, links, videos and helpful resources.

If you have any questions, please fire them to me 👍 Always happy to help 😀💙

* btw- SIPs is short for Smart Insulin Pens.
To start... I'd like to ask you guys a question.

Q: Do you know anything about Smart Insulin Pens?

Have you used SIPs? How did you hear about them? What do you/don't like about them?
Please feel free to share your experiences and any pictures you have in the comments below 💬👇
Read 23 tweets
🧵How can #HCP assist people who chose to use #DYIAID?

The @OPENDiabetesEU ⤵️
▶️ Katarina Braune is a co-founder
▶️ Patient-led
▶️ 2/3 of the international team live w/#T1D
▶️ #OpenSource #AID data

#ISPAD2022 #dedoc°voices #wearenotwaiting @dedocORG @ispad_org 1/n
How can #HCP assist people who chose to use #DYIAID?

#wearenotwaiting movement ⤵️
Because DIY #ClosedLoop systems have been so life-changing for them and their kids, they decided to make it available for all.

#ISPAD2022 #dedoc°voices #payitforward @dedocORG @ispad_org 2/n
How can #HCP assist people who chose to use #DYIAID?

International consensus statement on #OpenSource automated insulin delivery ⤵️
✅ Published in @TheLancetEndo on Nov 13 2021
▶️ thelancet.com/journals/landi…

#ISPAD2022 #dedoc°voices #payitforward @dedocORG @ispad_org 3/n
Read 22 tweets
🧵#AI based decision support systems:

✅ Improves clinical outcomes
✅ Higher access to care
✅ Provides precision medicine
-Revital Nimri

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 1/n
#AI based decision support systems:

'Is the quality of care improving?
No, it isn't.
We must do better.'
-Revital Nimri

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 2/n
#AI based decision support systems:

✅ Self-management tools
✅ Diagnosis, screening, prevention of #diabetes
✅ Prediction tools
✅ Clinical management
-Revital Nimri

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 3/n
Read 6 tweets
@lifeforachild /@ispad_org survey - shifting responsibility:
'I am an advocate because I believe that evidence should be made accessible to every stakeholder.'
-Emma Klatman ❤️

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG 1/n
@lifeforachild /@ispad_org survey - shifting responsibility:
'Task-shifting & task-sharing: moving a task on from one #HCP to another & where staff from different discipline split the tasks. We are very interested in task-shifting in #T1D'
-Emma Klatman ❤️

ISPAD2022 #dedoc° 2/n
@lifeforachild /@ispad_org survey - shifting responsibility:
'We want to document the level of task-shifting and understand who from the clinical team is doing what. We established en survey in 2021 in many languages.'
-Emma Klatman ❤️

#ISPAD #ISPAD2022 #dedoc° @dedocORG 3/n
Read 8 tweets
The tragedy of non-diagnosis of #T1D, results from the #T1Dindex -G. Ogle:

Missed T1D diagnoses are legion 💔

1⃣9⃣8⃣7⃣ Sydney: a 15yo boy passed away because of misdiagnosis as he'd just had chicken pox

#ISPAD #ISPAD2022 #dedoc°voices @lifeforachild @ispad_org 1/n Image
The tragedy of non-diagnosis of #T1D, results from the #T1Dindex -G. Ogle:

1⃣9⃣9⃣6⃣ Phnom Penh: no child alive with T1D in Cambodia then.
A boy had a late diagnosis, had had a dose on #insulin, but no fluid yet. He passed away 💔

#BG: 105mmol/1890mg

#ISPAD2022 #dedoc° 2/n Image
The tragedy of non-diagnosis of #T1D, results from the #T1Dindex -G. Ogle:

2⃣0⃣1⃣5⃣ Ghana: an 18yo girl was misdiagnosed with ectopic pregnancy because of acute abdomen, died during theatre where T1D diagnosis was made 💔

#ISPAD2022 #dedoc°voices @lifeforachild @ispad_org 3/n Image
Read 13 tweets
🧵Digital health for improving self-care and mental health in youth with T1D:

Benefits of tech:
▶️ scalable particularly in mental health interventions
▶️ reduce stigma
▶️ accessible 24/7
▶️ taylored tools
-Anna Serlachius

#ISPAD #ISPAD2022 #dedoc°@dedocORG @ispad_org 1/n
Digital health for improving self-care and mental health in youth with #T1D:

Challenges of tech:
▶️ access
▶️ literacy
▶️ security
▶️ clinicians awareness
-Anna Serlachius

#ISPAD #ISPAD2022 #dedoc°voices
#diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 2/n Image
Digital health for improving self-care and mental health in youth with #T1D:

Challenges of tech:
▶️ engagement matters
▶️ make sure to include users during development
-Anna Serlachius

#ISPAD #ISPAD2022 #dedoc°voices
#diabetesadvocacy #payitforward @dedocORG @ispad_org 3/n Image
Read 8 tweets
🧵Managing preschool behaviours to optimize diabetes:

Preschool challenges w/T1D - impredictability:
▶️ food intake
▶️ sleeping
▶️ activity
▶️ higher variabiilty in #insulin requirements
-Susana Patton

#ISPAD #ISPAD2022 #dedoc°voices #patientvoice @dedocORG @ispad_org 1/n
Managing preschool behaviours to optimize diabetes:

Tips to take back:
▶️ safe space to talk about meal or changing sites that can bring distress and higher #BG
▶️ recognise what's going well
-Susana Patton

#ISPAD #ISPAD2022 #dedoc°voices #payitforward @dedocORG @ispad_org
Managing preschool behaviours to optimize #diabetes:

We promote physical activity because we found out that preschoolers w/T1D have less than other preschoolers.
-Susana Patton

#ISPAD #ISPAD2022 #dedoc°voices
#diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org
Read 4 tweets
🧵 Sleep quality and patterns in children with #T1D:

Sleep deprivation can ⬆️ mental health issues like depression, a greater emotional response & difficulty to control emotions.
-Alice Gregory

#ISPAD #ISPAD2022 #dedoc°voices #patientvoice #payitforward @dedocORG @ispad_org 1/n
Sleep quality and patterns in children with #T1D:

T1D is a 24/7 monitoring. It never stops at night.
Kids w/T1D have shorter sleep patterns and have poorer sleep quality.
-Alice Gregory

#ISPAD #ISPAD2022 #dedoc°voices #patientvoice #payitforward @dedocORG @ispad_org 2/n
Sleep quality and patterns in children with #T1D:

Kids w/T1D have a different sleep architecture with less time in deep sleep whereas sleep is vitally important and particularly for kids w/T1D.
-A. Gregory

#ISPAD #ISPAD2022 #dedoc°voices #payitforward @dedocORG @ispad_org 3/n
Read 4 tweets
🧵#ISPAD #dedoc° symposium:

Dedoc° started 10y ago on Twitter:
✅ Peer support
✅ Meetings outside of scientific conferences cause #PwD were not allowed in

#ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 1/n
#ISPAD #dedoc° symposium:

ISPAD was the 1st scientific conference that organised a Dedoc° symposium in 2021 🙏
-@tadorna

#ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 2/n
#ISPAD #dedoc° symposium:

Dedoc° is a platform for others to stand on - to have the #PwD voices heard 🔊
-@tadorna

#ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 3/n
Read 16 tweets
🧵Microbiota: can they prevent #TID?
Incidence of T1D is rising particularly in the young.
Environmental factors could drive this pattern observed across the globe.
-N. Hanssen

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 1/n
Microbiota: can they prevent #TID?
+ rapid destruction of #BetaCells in kids than adults.
#PwD with residual beta cells have higher #TIR.
-N. Hanssen

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 2/n
Microbiota: can they prevent #TID?
Poor discrimination between self/not self [#autoimmunity] happens with loss of gut microbiome.
-N. Hanssen

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 3/n
Read 4 tweets
🧵#diabetes prevention : are we on the right track?
Here are the players in the development of #T1D 👇
-M. Knip

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #patientvoice #payitforward @dedocORG @ispad_org 1/n
#diabetes prevention : are we on the right track?
The different stages of #betaCells autoimmunity:
1⃣ Normoglycemia
2⃣ Presymptomatic dysglycemia
3⃣ Symptomatic dysglycemia
Primary prevention shld start during pregnancy.
-M. Knip

#ISPAD2022 #dedoc°voices @dedocORG @ispad_org 2/n
#diabetes prevention : are we on the right track?
Early life infection may be the initiator of the endotype. There is a step autoantibodies decline among those diagnosed before 7yo.
-M. Knip

#ISPAD2022 #dedoc°voices #payitforward @dedocORG @ispad_org 3/n
Read 7 tweets
Potential role of antiviral treatment in #T1D:

Pathogenesis:
1⃣ Genetic susceptibility
2⃣ Something triggers autoimmunity in the 1st years of life or later
3⃣ #BetaCell destruction
4⃣ Diagnosis
-L. Krogvold

#ISPAD #ISPAD2022 #dedoc°voices #patientvoice @dedocORG @ispad_org 1/n
Potential role of antiviral treatment in #T1D:

'The time trend is the best proof that there are environmental factors triggering T1D.
Heredity as well.'
-L. Krogvold

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 2/n
Potential role of antiviral treatment in #T1D:

'From the 1920s we knew that T1D was of viral origin as deaths from #diabetes in Norway correlated with the mumps pandemic.'
-L. Krogvold

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs @dedocORG @ispad_org 3/n
Read 7 tweets
The last mile for #T1D cure:
'I believe that cell therapy can be the T1D cure. We've had landmark results in the last 2y.
-L. Piemonti

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs
#diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 1/n
The last mile for #T1D cure:
'We know now that #BetaCell replacement can cure T1D. This is the #BG profile of someone who used to live with #diabetes 1y 1/2 ago.'
-L. Piemonti

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 2/n
The last mile for #T1D cure:
'We started #BetaCell in Milan replacement in 1989. Had to wait for 30y for this procedure to be recognised.'
-L. Piemonti

Can you imagine living without the mental load & physical burden of #diabetes?

#ISPAD2022 #dedoc° @dedocORG @ispad_org 3/n
Read 13 tweets
Digitalization in Diabetes Education and Care:
'We know that autoimmunity starts way before #T1D diagnosis - if screened. We learnt that #cpeptide might not be relevant thanks to models'
-Dr A. Galderisi

#ISPAD #ISPAD2022 #dedoc°voices
#patientvoice #payitforward @dedocORG 1/n ImageImageImage
Digitalization in Diabetes Education and Care:
'We can find heterogeneity in #T1D even before diagnosis. Important to individualise treatment.'-Dr A. Galderisi

Yes, every #PwD has their own #diabetes.

#ISPAD #ISPAD2022 #dedoc°voices
#nothingaboutuswithoutus @dedocORG 2/n ImageImage
Digitalization in #diabetes Education and Care:
'#TIR and #BG daily variability matter though we still look at the big picture. #AI can help us understand further.'
-Dr A. Galderisi

#ISPAD #ISPAD2022 #dedoc°voices
#patientvoice #payitforward @dedocORG 3/n Image
Read 6 tweets
Betting for the next best thing in digital #diabetes technology:

'#AID systems & algorithms are very effective.
Unfortunately, they are used by a minority of ppl who cld benefit from them.'
-Steven Russell

#EASD2022 #dedoc°voices #nothingaboutuswithoutus @dedocORG 1/n
Betting for the next best thing in digital #diabetes technology:

'In addition to the challenges of getting hybrid #AID systems, they still require setups. They still require the user to #carbcount for meals & initiate correction boluses.'
-Steven Russell

#EASD2022 #dedoc 2/n
Betting for the next best thing in digital #diabetes technology:

'The #IletBionicPancreas pivotal trial results will be published by end Sept.' -Steven Russell

✅ Only setup needed: @PwD's weight
✅ No #carbcounting
✅ Fully automated

#EASD2022 #dedoc°voices #BetaBionics 3/n
Read 14 tweets
Are we becoming robots? #AID systems for everyone with #T1D:

'#CGM is the Archimedean point of #diabetes technology. This is when the idea of closing the loop really emerged.'
-Moshe Phillip

#EASD2022 #dedoc°voices #nothingaboutuswithoutus @EASDnews @dedocORG 1/n
Are we becoming robots? #AID systems for everyone with #T1D:

'#CGM opened our eyes to the fact that the data we used to get was very different from the reality #PwD live.'
-Moshe Phillip

So true. Connecting the red dots' never been our reality.

#EASD2022 #dedoc° @dedocORG 2/n
Are we becoming robots? #AID systems for everyone with #T1D:

'I'd like to convince you they are efficient. Automated Insulin Delivery is safe and efficient.'
-Moshe Phillip

#EASD2022 #dedoc°voices #nothingaboutuswithoutus @EASDnews @dedocORG 2/n
Read 6 tweets
About to start watching the inspiring advocates of the #dedoc° symposium that was held earlier today at #EASD2022 🍿

Sad I couldn't watch it live. Couldn't wait to catch up here ▶️

#nothingaboutuswithoutus #diabetesadvocacy
@EASDnews @dedocORG 1/n
I already know many happy tears will be shed listening to their inspiring advocacy work 🥲

#EASD2022 #dedoc°voices #nothingaboutuswithoutus #diabetesadvocacy #languagematters
@EASDnews @dedocORG 2/n
Dedoc° symposium, What we wish you knew and why:
'It's the 1st ever #dedoc° symposium at #EASD2022'. This is what I had in mind 10y ago - a panel of advocates at the world largest #diabetes conference.'

-Bastian Hauck, @dedocORG founder

#nothingaboutuswithoutus
@EASDnews 3/n
Read 19 tweets
Advanced Therapeutic Approaches In Type 2 Diabetes is exploring the mystery of how gastric surgery puts Type 2 into remission (note that insulin requirement can disappear in a week after surgery before any weight is actually lost) @ATTDconf #ATTD2021 #dedoc°
The suggestion by Dr. Pories is broken gut signalling breaks the glucose processing leading to poor energy production, excess glucose and insulin. #ATTD2021 #dedoc°
If this is the case, this offers new avenues of research to fix/disrupt the broken signal and restoring normality in a way similar to what is seen with gastric surgery. It also suggests obesity does not cause Type 2 but rather Type 2 causes obesity. #ATTD2021 #dedoc°
Read 4 tweets
Advances in Closed Loop conclusions:
- A more aggressive target improves Time in Range (79% achievable) but does not increase Time Below Range
- Improvements, especially in younger adults when compared to open systems
- Closed Loop is safe.
@ATTDconf #ATTD2021 #dedoc°
Moreover, it is as safe for children as adults. #ATTD2021 #dedoc°
Results not exclusive to Medtronic. Omnipod shows similar results in terms of improvements over open systems #ATTD2021 #dedoc°
Read 6 tweets
The next presentation I'm in is "Artificial intelligence (AI): Tangible Applications to Improve Diabetes Care". AI has come far in the last few years and the poster I mentioned yesterday shows how it can tailor closed loop systems. What else I wonder? @ATTDconf #ATTD2021 #dedoc°
Stephane Bidet is saying with as little as 10 days of data, the AI can be trained effectively to smartly manage the user's BGLs. I believe it. Microsoft's Azure AI can effectively read forms with just 5 examples and images with 15 examples. #ATTD2021 #dedoc°
Knowing the likely error in the predictions made, this variance is then used to ensure safe recommendations are made. This is smart. It will slightly hamper accuracy but ensure super-high or super-low BGLs do not happen. #ATTD2021 #dedoc°
Read 6 tweets
With Dexcom being at the forefront of pumps and CGMs I'm hoping for something special in this one. @ATTDconf #ATTD2021 #dedoc°
Control IQ gave users 2.6 hours additional Time in Range over "Sensor Augmented Pumps" (open loop pump therapy) #ATTD2021 #dedoc°
The number of people getting a Time in Range over 70% tripled with Control-IQ over the open loop therapy group. For long term complication management, this is a great result. #ATTD2021 #dedoc°
Read 10 tweets
Next is a presentation on Smart Pens for diabetes management @ATTDconf #ATTD2021 #dedoc°
The research specifically refers to the Novo Nordisk NovoPen 6 but I'll try to keep it general. #ATTD2021 #dedoc°
The NovoPen has a five year battery which is impressive in comparison to the Medtronic InPen which only lasts 1 year and the battery cannot be replaced.
#ATTD2021 #dedoc°
Read 6 tweets
Next is Medtronic talking about the outcomes for the first 4,000 users of the MiniMed 780G and the future for this commercial looping system. It will be interesting to see how it stacks up to the homegrown systems. @ATTDconf #ATTD2021 #dedoc°
Dr Chantal Mathieu makes the point that the patient living with diabetes gets a few more hours with the disease than their health care team ;) #ATTD2021 #dedoc° Image
Time in Range for the 780G was similar across the multiple countries involved in the analysis suggesting there was no bias from country-specific factors. #ATTD2021 #dedoc°
Read 7 tweets
First session at #ATTD2021. As a honeymooning T1D LADA who takes a GLP-1RA to help preserve my beta cells, I'm interested to see what's new with these "Great Little Peptides" #dedoc° @ATTDconf Image
If you are unfamiliar with GLP-1RAs, get the cliff notes here: practicaldiabetic.com/2020/10/10/the… #dedoc° #ATTD2021
The talk is about the oral version of Semaglutide which was also discussed at the EASD2020 conference last year. Many may be familiar with the injectable form which is sold under the name Ozempic. #dedoc° #ATTD2021
Read 8 tweets

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