DIABE T E S
Mobile tech redefining diabetes management
While insulin offers a valuable lifeline, it is not a well-understood treatment and a staggering 89.8% of patients who use insulin to treat their diabetes are still unable to meet their medical targets. Isabella Degen discusses the limitations of contemporary diabetes treatment and the potential for technology to help create a more effective regimen.
Isabella Degen, Founder and CTO of Quin
When we hear the term ‘diabetes’, we think of one disease with two distinct categories. Type 1, causes your immune system to mistakenly attack the cells in your pancreas and prevent it from producing insulin, whereas type 2, means your body is unable to make enough insulin or the insulin you do make doesn’t work properly. However, diabetes is not a single or pair of conditions, but an umbrella term for a group of metabolic disorders which result in a high blood sugar level. People with diabetes have insufficient levels of the hormone insulin, which controls how the body uses glucose, among other things. They must take insulin to maintain stable blood sugar. However, choosing the correct dose and time to take insulin can be complicated. Research has identified at least 46 factors which can affect insulin needs, and everybody reacts to each variable differently. For instance, an individual experiencing medical stress will produce more cortisol and adrenaline, which inhibit insulin’s function. The body must then rebalance to maintain homeostasis – which the individual must take into account when injecting their next dose of insulin. Similarly, other hormones
like oestrogen also affect insulin, meaning that women need to consider different doses throughout their hormonal cycle. Beyond the baseline complexity of a person’s genetics and their hormones, environmental considerations including everything from diet to sleep to activity level can also have a significant impact on how a person produces and uses insulin. Consequently, there is no one-size-fits-all solution for insulin dosage, and individuals are left to use trial and error to attempt to approximate the appropriate amount and time of day to administer their insulin. On the most basic level, insulin treatment demands that people take over the functioning of an organ in their body, which even medical science does not fully understand. The medical formulae for understanding diabetes, such as carbohydrate ratios and insulin sensitivity ratios, are still far too simple to represent the complex reality that every individual and situation is unique, and they often yield inaccurate doses. People with diabetes are frequently hospitalised for taking too much or too little insulin or for related illnesses, producing a significant impact on the healthcare system. Nobody is at fault here; it is simply an
People who used apps to manage their insulin intake reported a significantly higher self-care score than non-users across the areas of blood glucose monitoring, general diet, and physical activity.
SEPTEMBER 2020
unfortunate reality that managing diabetes is incredibly complex, poorly-understood and error-prone. Even when working as intended, this uncertain process imposes a significant cognitive and psychological load, in addition to dealing with the symptoms of diabetes and the inconvenience of taking insulin. Those with diabetes are three times more likely to experience fatigue, anxiety, stress and depression, leading to ‘diabetes burnout.’
State of diabetes research An estimated 4 million people across the UK are currently living with diabetes, including an estimated 500,000 living undiagnosed. The incidence of diabetes is also increasing – the number of people diagnosed has more than doubled in the past twenty years. As that trend continues, the British Diabetes Foundation estimates that the costs of treating complications from diabetes will almost double from their current total of £7.7 billion to £13.5 billion by the year 2035. The need for a better understanding of diabetes is more apparent than ever before, but progress remains limited. Fundamentally, researching the set of related hormonal and metabolic disorders that we call diabetes is an incredibly complex and challenging task. According to estimates, diabetes research receives approximately £60 million each year, compared to £165 million for cardiovascular disease research and £500 million for cancer research. As with all chronic illnesses, diabetes researchers are forced to
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