🧵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
How can #HCP assist people who chose to use #DYIAID?

@OPENDiabetesEU ⤵️
✅ 48 authors from 25 countries
✅ 44 #HCPs
✅ 4 legal experts
✅ Supported by @ispad_org @IDFEuropeBXL @DTN_UK @ADCESdiabetes and other #diabetes organisations

#ISPAD2022 #dedoc°voices @dedocORG 4/n
How can #HCP assist people who chose to use #DYIAID?

#OpenSource systems ⤵️
▶️ Safe and effective
▶️ Glass ceiling of ethical evidence: RTCs + @NEJM
▶️ Real-world data > commercial systems
⬆️ #TIR
⬇️ #BG variability & lows

#ISPAD2022 #dedoc° #wearenotwaiting @dedocORG 5/n
How can #HCP assist people who chose to use #DYIAID?

Respect for the #PwD's autonomy to make informed decision about their own medical care is one of the fundamentals that we learn in the first year of medical school.
-K. Braune

#ISPAD2022 #dedoc° #wearenotwaiting @dedocORG 6/n
How can #HCP assist people who chose to use #DYIAID?

#HCPs have the responsibility to learn about all treatment options including #OpenSource systems.
-K. Braune

#ISPAD2022 #dedoc° #wearenotwaiting @dedocORG 7/n
How can #HCP assist people who chose to use #DYIAID?

#transparency is key
✅ Commercial #AID systems should disclose how they operate to enable informed treatment decisions
-Katarina Braune

#ISPAD2022 #dedoc°voices #wearenotwaiting @dedocORG 8/n
How can #HCP assist people who chose to use #DYIAID?

Benefits:
✅ Availability & access
✅ Interoperability
✅ Personalisation
✅ Peer support

Limitations:
▶️ No regulatory evaluation
▶️ No commercial support though peer support is huge

#ISPAD2022 #dedoc° #wearenotwaiting 9/n
How can #HCP assist people who chose to use #DYIAID?

Safety can have a ❌meaning for #PwD, #HCP or regulator.

▶️ Risks of using #MDI/stand alone pump [my personal experience is that this is more risky]
🆚
✅ Safety of DIYAID 👇

#ISPAD2022 #dedoc° #wearenotwaiting 10/n
How can #HCP assist people who chose to use #DYIAID?

▶️ The value of real-world experience and evidence should be considered by device regulators

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #patientvoice #payitforward @dedocORG @ispad_org #wearenotwaiting 11/n
How can #HCP assist people who chose to use #DYIAID?

@friendocrino's key takeaways:
✅ Evidence is huge
#OpenSource #AID studies are legion
✅ Resources are available
✅ Consider #PwD as experts

#ISPAD #ISPAD2022 #dedoc°voices @dedocORG @ispad_org #wearenotwaiting 12/n
How can #HCP assist people who chose to use #DYIAID?

'It is not about a seat at the table.
This IS the table.'
-Tim Robinson @JDRF

#ISPAD #ISPAD2022 #dedoc°voices @dedocORG @ispad_org #WeareNotWaiting #LanguageMatters #NothingAboutUsWithoutUs 13/n
How can #HCP assist people who chose to use #DYIAID? Q&A

An #HCP said it took her time to learn and asked for #OpenSource resources

▶️ The community is huge & responsive, 30,000+ on the Facebook groups. Loop and Learn provides synthesised resources

#ISPAD2022 #dedoc° 14/n
How can #HCP assist people who chose to use #DYIAID? Q&A

@TBattelino said that #PwDs actually teach his team and that this is the best way to learn.

Thank you 🙏 Real-life user experience does matter.

#ISPAD2022 #dedoc° @ATTDconf @ispad_org @dedocORG 15/n
How can #HCP assist people who chose to use #DYIAID? Q&A

#OpenSource development is ahead -@CaroGoLoop:
⬆️ #TIR
✅ Targets/devices personalisation
✅ Unannounced meal
▶️ The #DIY community is willing to share with #HCPs

#ISPAD2022 #dedoc° #WeAreNotWaiting 16/n
How can #HCP assist people who chose to use #DYIAID? Q&A

#OpenSource and commercial #AID can work together. DIY developers have actually been hired by commercial companies.
-@friendocrino

#ISPAD2022 #dedoc° #WeAreNotWaiting #NothingAboutUsWithoutUs #diabetesadvocacy 17/n
How can #HCP assist people who chose to use #DYIAID? Q&A

In some countries, where commercial systems are not available (access/cost), DIYAID is the ONLY option for #PwDs who want to use #AID.
-@kate_gajewska

🙏 Kate

#ISPAD2022 #dedoc°voices #WeAreNotWaiting 18/n
How can #HCP assist people who chose to use #DYIAID? Q&A

There is not one system for all. They're all effective whether #DIY or commercial. #PwD have a choice.
We should be thankful for DIY: they have pushed the field.
-Lauren Messer

#ISPAD2022 #dedoc° #WeAreNotWaiting 18/n
Thank you so much @friendocrino for your inspiring lecture ❤️

I got goosebumps 😅
I guess we'll have to keep demonstrating the evidence until #DIYAID is accepted as a safe and efficient option.

T H A N K Y O U 🙏
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*Laurel Messer

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More from @1derfultype

Oct 16
🧵#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
Oct 16
@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
Oct 15
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
Oct 15
🧵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
Oct 15
🧵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
Oct 15
🧵 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

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