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Children with Diabetes: Focus on Technology

Report from Michigan 2002

The first regional Children with Diabetes Focus on Technology conference was held September 27-29, 2002 at Crystal Mountain Resort near Traverse City, Michigan. About 250 people participated in the conference, which included two days of sessions for adults, teens, and school-age children. Sessions covered data management systems, blood glucose monitoring systems, new insulin delivery systems, new types of insulin, and new pump technology. There were additional general sessions and discussions addressing technology from a parent's perspective.

Jeff Hitchcock, the founder of Children with Diabetes, opened the conference with a session about diabetes on the Internet, including web sites, newsgroups, and e-mail. He cautioned parents about junk e-mail, also called "spam," and computer interactions that can result in receiving junk mail. He also talked about ways to preserve privacy while online. His presentation can be found online at Diabetes on the Internet.

Dr. Richard Rubin led parents in a lively discussion of how to decide when to change their child's type 1 diabetes management regimen, when to try new things, when to stick with what seems to be working, and what questions to ask when considering these changes. In another room, at the same time, Stefan Rubin (Richard Rubin's son) talked with teens about the challenges he encountered with type 1 diabetes as he grew from a teen to an adult. He commented after the session that the teens in attendance "sure knew more about diabetes" than he did when he was a teen trying to manage his own diabetes.

Dr. Robert Monoson, Medical Director of Animas Corporation, took a look into the future with conference participants, and examined how technology has come to be an important part of our lives, and specifically how it has related to diabetes technology in both blood glucose testing and insulin delivery.

Four insulin pump companies gave presentations relating to their newest technology. Barbara Montgomery and Steve Sutryk from Animas Corporation spoke about the new Animas IR pump, as well as the EZ Manager data management system. Steven Bledsoe from Smiths Medical presented information about the new Cozmo pump, scheduled to be released for sale in the US before the end of 2002. He also introduced the My Treatment Assistant system which is used to select those features that one deems relevant when using the Cozmo pump. Bobby Gorman from Metronic MiniMed introduced parents to the new Paradigm pump and discussed the Continuous Glucose Monitoring System and the very useful information gleaned from the data that the CGMS produces. And Dewey Sims from Disetronic introduced the new Disetronic DTron Plus insulin pump. All of the pump company representatives had samples of infusion sets to compare and pumps to play with for parents to get a hands-on sense of what an insulin pump actually feels like and how it functions. The exhibits were crowded from the opening reception on Friday evening to closing time on Sunday afternoon.

Brian Segrin from Metrika discussed the process of A1c testing, providing a very understandable explanation for a process which is often not explained to families during a visit to their diabetes team. He introduced Metrika's A1c Now home testing product, currently available by prescription, and which Metrika hopes to have available over the counter soon.

The GlucoWatch 2 was worn by Judy Stein, who was presenting at the Focus on Technology conference on behalf of Cygnus and Sankyo, the companies which are now partnering to produce and market the GlucoWatch. As the GlucoWatch has recently been approved by the FDA for use by children as young as seven, there were many questions relating to how the device should be used, whether it should be used to replace finger pokes (it should not), and how it functions to alert parents to high blood sugar, low blood sugar, and rapidly changing blood sugar, particularly in the middle of the night. Many parents voiced optimism that they might finally be able to get a good night's sleep after many years of testing blood sugars several times during the night.

Dr. William Quick, Medical Director of Children with Diabetes, and Dr. Michael Pfeifer from Aventis Pharmaceuticals discussed new insulin delivery systems and new types of insulin, both on the market and in development. Dr. Quick presented information on such methods as the implantable insulin pump and inhaled insulin. Although a variety of alternative insulin delivery systems are in clinical trials, Dr. Quick asked the poignant question: Why would people with type 1 diabetes be searching for a new insulin delivery system when multiple injections and pumping are two systems that work very well for most people? Certainly the "discomfort factor" - especially for young children - is something to consider. However, Dr. Quick pointed out that the efficiency of injected (or pumped) insulin is excellent and does control diabetes very well.

Dr. Pfeifer discussed how insulin is actually made (i.e., the chemical composition), and he discussed how the slightest manipulation of the process results in insulin which is either longer-acting or shorter-acting. He described the use of several of the newer insulins, including Lantus (glargine) and Novolog, and added that new insulins will be forthcoming from several pharmaceutical companies.

Alternate site testing (AST) was the topic of discussion on Sunday morning. Linda Parks from TheraSense discussed the general principles of alternate site testing compared to fingertip testing, and stressed that many meters on the market are now approved by the FDA for AST. She also stressed that parents should read the printed material provided with their meter, as these materials indicate under which circumstances (and why) fingertip testing should be used instead of AST (for example, when a person has hypoglycemia unawareness, or at times when blood sugar might be expected to drop rapidly). She then presented information about two new technology advancements from TheraSense, the combination blood glucose meter and data management system called theTracker and the online data management system called Co-Pilot.

On Sunday afternoon, the Children with Diabetes Quilt for Life was displayed. This quilt, which currently numbers 282 squares, depicts the lives of children from all over the world who have type 1 diabetes. Each child (or relative) has crafted a 3-foot square decorated with photos of the children, their likes and dislikes, dates of diagnosis, hand and footprints, and anything else the child cares to add to the square. What comes through loud and clear is that this is a quilt about healthy children, living with type 1 diabetes, and doing all those things that children all over the world do--playing soccer, playing hockey, riding bicycles and horses, having many, many friends, and lots of people who love them. It also comes through loud and clear that insulin is not a cure and that these children and families desperately want a cure now.

The next Children with Diabetes Focus on Technology Conference will be held in Tucson, Arizona, January 3-5, 2003, at the Sheraton El Conquistador Resort. Detailed information is available online at Tucson 2003.

CWD would like to thank the conference sponsors, TheraSense, Aventis Pharmaceuticals, Smiths Medical, and Animas, for their wonderful generosity in supporting the conference and CWD families. Thanks are also extended to CWD parents Lauren Lanning, Deb Slaby, Michelle Rago, and Kari Rosenfeld who volunteered many hours to help make this conference a success.

Families arrive for registration ...
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... and then enjoy dinner and the booths, ...
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... including the latest in pumps and meters.
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The adults listened to sessions ...
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... while kids attended their own sessions.
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During breaks, kids visited booths too to get treats, like temporary tattoos.
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Teens viewing the Quilt for Life identified with the messages.
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Michigan 2002: Focus on Technology
Michigan 2002 Conference - Registration - Program - Faculty
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