#18ADC included the latest research on technology, complications and emotional health: read more about our highlights
By ACBRD Staff
The ACBRD team attended many enlightening presentations over the course of the Australasian Diabetes Congress [1]. Below the team have summarised a few that caught their attention.
Consumer co-design: working with people with diabetes to design better services
by Jasmine Schipp
An exciting inclusion in this year’s ADC program was the ADEA symposium on consumer co-design (also known as participatory design). At the ACBRD, we are strong supporters of the principles of consumer co-design and integrate them into our research and evidence-based development of new resources. The consumer co-design session was convened by leading diabetes blogger, Diabetes Australia’s Renza Scibilia [2] and NHMRC Early Career Research Fellow Dr Kirstine Bell [3] (University of Sydney). They began the session with an outline of the principles [4] of co-design and stakeholder engagement, exemplified in the ‘Better Together’ [5] initiative. This was followed by examples of how health professionals and researchers have incorporated the principles into their work. Perth-based registered pharmacist and Credentialed Diabetes Educator Teresa Di Franco [6], and diabetes blogger Frank Sita [7] spoke about the Young Adult Diabetes Committee [8] and its co-design relationship with Perth Diabetes Care [9]. NDSS [10] Diabetes in Pregnancy Priority Area Leader Dr Melinda Morrison [11] spoke about the co-design process the NDSS undertook as part of their work in pregnancy and diabetes [12]. ‘Twice diabetes’ blogger Melinda Seed [13] closed the session by speaking about her experience with the Type 1 Diabetes Network [14], and how we can develop resources that are relevant and helpful for people with diabetes. Overall, the consumer-based co-design session offered an excellent foundation for how health professionals and researchers can work with people with diabetes to design services, programs, resources and research that are relevant to, and meet the needs of, people with diabetes. If you would like to help the ACBRD to do this, why not take part in research [15]?
Moving more and sitting less – a new approach to type 2 diabetes prevention and management
by Ralph Geerling
This presentation by Professor David Dunstan [16] (Baker Heart & Diabetes Institute) offered an overview of the research on the impact of both physical activity and sitting in relation to type 2 diabetes. For the past 20 years, rates of sedentary behaviour have remained virtually unchanged despite a vast number of health promotion campaigns with ever more strategic and sophisticated messaging. Uninterrupted or prolonged sitting is significantly associated with increased mortality but can be reduced if sitting is interrupted approximately every 30 minutes.
In an intervention led by Prof Dunstan, participants either performed a short (2-3 minutes), light component of physical activity every 30 minutes, or continued with prolonged sitting completing their duties as normal. Various biomarkers were collected continuously on participants throughout the intervention period. Multiple biological changes took place in the body with prolonged sitting including heightened blood glucose levels and systolic blood pressure which were not seen at the same level in the active group. This has considerable implications for the health of all persons, but in particular those with diabetes and cardiovascular disease. The research also found that the differences between groups continued to be significant into the evening until levels began to equalise.
Professor Dunstan concluded his presentation by discussing other research, which found that in order to counteract the effects of prolonged sitting (seven or more hours per day), more than twice the level of recommended physical activity would be required, i.e. 300 minutes of moderate to vigorous exercise per week. With many people unable to attain current recommendations of 150 minutes per week, this is clearly concerning, and highlights the need for more innovative approaches to encouraging active lifestyles.
Diabetes DIY tech symposium: Real time data to manage a real time condition
by Shaira Baptista
In this innovative symposium, Renza Scibilia [17], Cheryl Steele [18] and David Burren [19] talked about their lived experiences of using DIY ‘loop’ [20] technology. Loop technology involves using novel cloud-based algorithms to enable existing hardware (insulin pump and continuous glucose monitor) to communicate with each other. The movement is driven by people with diabetes [21]. As this approach does not have regulatory approval, for safety reasons, each new user is required to build their own ‘app’ and teach themselves how to set it up and use it. Of course, they do this with advice and support of others in the diabetes community who are already doing it. The movement is not limited by regulatory processes or profitability, and benefits hugely from peer support, driven by a group of people with diabetes who are prepared to take responsibility and make the choice to exercise their right to choose how to manage their condition. The speakers stressed that, as with any other form of diabetes technology, there is a risk of inappropriate use and the need to get the settings right. However, ignoring this movement is ‘futile’ and a ‘lost opportunity’ and urged health professionals to keep up with patient-driven innovation. Although preliminary evidence [22] for efficacy from small studies are promising (e.g. increased time in range, reduced hypoglycaemia, improved HbA1c), few studies have assessed the psychological impact of these technologies and more research is needed in this area. The ACBRD is currently offering a funded PhD scholarship [23] to investigate the lived experience of DIY diabetes technologies.
Diabetes Complications
by Dr Amelia Lake
Worry about the future and the possibility of serious complications is the leading problem area for people living with diabetes1 [24]. Furthermore, the potential for vision loss or blindness from diabetic retinopathy, the most common and feared complication of diabetes2 [25],3 [26]. Thus, it was unsurprising that the ADEA Masterclass on Eye Diseases and Diabetes, presented by Simon Hanna [27], Professional Development and Clinical Policy Manager, Optometry Australia was well attended. Mr Hanna’s presentation covered many aspects of diabetes-related optometry, including retinal screening, billing models, the impact of diabetes on the eye, and diagnosis of eye disease. Questions from the floor indicated a keen interest in the topic, particularly from healthcare professionals. During his presentation, Mr Hanna acknowledged that eye health practitioners play an important role, as progression of known diabetic retinopathy, or indeed an initial diabetes diagnosis, can be made via eye examinations. As such, a key consideration for optometrists is the way that such information is delivered. Both diabetes diagnosis and progression of complications are known critical periods of psychological risk4 [28], and Mr Hanna acknowledged that communication on these issues requires a sensitive approach, with consideration of the “whole” person, as opposed to the “pair of eyes sitting in the chair”.