The first thing David Vazquez will tell you about his Type 1 diabetes is that the disease does not prevent him from doing anything. From playing music to long-distance cycling, and traveling internationally to working as an accountant, David says he can do it all and credits advances in diabetes management technology for making it possible.
David, now 39, was diagnosed with Type 1 diabetes — often referred to as Type 1 or T1 — at age 18. He initially managed his illness with daily insulin injections that were necessary because, like all others with T1, his pancreas had stopped producing insulin, the hormone that controls blood sugar levels.
“When I was first diagnosed, I was taking multiple daily injections, about four to five shots a day in the stomach,” says David. “I was checking my blood sugar levels with a meter about four to five times daily, as well.”
A glucose monitoring meter measures the amount of glucose, or sugar, in the blood. A fingertip prick with a lancet draws a drop of blood, which is placed on a test strip and put into the meter. Based on the results of the reading, a person determines how much insulin they need to administer, usually by injection, to bring their glucose to a safe level.
Advances in T1 technology change lives
However, advances in diabetes management technology have changed the way many people can now measure glucose and deliver insulin as needed. Two products — the insulin pump and the continuous glucose monitor (CGM) — drastically changed the way David manages his diabetes.
Insulin pump — A pump can be a self-adhesive pod that attaches directly to your skin, or a small device that attaches to a belt or is carried in a pocket or pouch. It gives small, steady doses of insulin throughout the day through a small needle, which is inserted under your skin and left in place for several days. Insulin can also be injected as needed to address fluctuations in glucose levels or in response to changes in blood sugar due to snacks, meals and physical activity.
Continuous glucose monitor (CGM) — A CGM automatically tracks your blood glucose levels through a tiny sensor inserted under your skin, usually on your belly or arm, and sends the data to a monitor on an insulin pump, separate electronic device or smart device such as a cellphone, watch or tablet. The monitor works continuously to provide information on the direction and rate of change of glucose levels, and can notify users if their level goes too low or too high.
“About five years ago, I finally made the decision to switch to a pump,” says David. “I no longer had to carry syringes or vials of insulin with me everywhere I went, and no longer had to excuse myself to go give myself a shot. If nothing else, it was just a huge relief.”
He later added a continuous glucose monitor in combination with the pump. He says the benefits the updated technology provided were life-changing.
Helping patients see the connection between food and insulin, in real time
According to Dr. Louis Christiansen, an endocrinologist with Sharp Rees-Stealy Medical Group, CGM technology has become integral in the treatment of patients with Type 1 diabetes.
“Continuous glucose monitors allow patients with Type 1 diabetes to see the relationship between food, insulin and activity in real time, and make adjustments to improve glycemic control,” says Dr. Christiansen. “CGMs also let physicians see daily blood sugar patterns in patients with Type 1 diabetes, which allows for much more effective adjustments in insulin regimens.”
David credits the monitor-pump combination for allowing him to live a very full life. He appreciates that along with no longer needing to carry insulin and syringes, he also doesn’t need to constantly test his glucose levels with a meter; the pricking scars on his fingertips have vanished.
“The technology has put me more at ease with knowing what's going on with my blood sugar levels,” he says. “Sometimes I don't always feel my lows when I’m long-distance cycling, but I tend to go low in the middle of a ride. Now I simply check my phone or watch to see where my levels are without having to stop or get off my bike. I also don't have to carry a bulky meter in my back pocket.”
Furthermore, if a pattern is detected that his blood sugar is decreasing, the pump can automatically shut off until it detects that levels are going back up. This has prevented many overnight glucose lows, which can be dangerous. And if the low isn’t automatically detected by the pump, his CGM alarm goes off and wakes David or his wife, Jeanna.
What the future holds for T1 management
“In the future, the software and hardware in glucose sensors and insulin pumps will continue to evolve, and this will allow for much tighter control of blood sugar with less input from the pump user,” says Dr. Christiansen. “Ultimately, this should lead to better quality of life for patients with Type 1 diabetes, as well as fewer complications.”
David hopes that these technological advancements will lead to the release of a closed-loop system, which would use a CGM and pump working together like an artificial pancreas. If the monitor detected a trend of glucose levels going low, it would shut off the pump. If it detected a trend of going high, it would send a message to the pump to give a precise dose of insulin.
“I want newly diagnosed people to understand that this disease should not prevent you from achieving whatever goals you have for yourself, and should not define your life,” he says. “It's something we have to live with, but it's something that can be managed. And with all the technological advancements, it will continue to become much easier.”
Learn more about Sharp HealthCare’s Diabetes Education Program, for patients with Type 1, Type 2 or gestational diabetes.