My takeaways from #ATTD2023

It's been two months since the latest and most well-known diabetes technology conference, Advanced Technologies & Treatments for Diabetes  (#ATTD2023). 

This year, the Advanced Technologies & Treatments for Diabetes (#ATTD2023) conference took place in Berlin, and I had the opportunity to attend thanks to the #dedoc voices program. Therefore, for transparency's sake, let me begin by stating:

"I am a part of #dedoc voices program, an initiative of #dedoc. #dedoc has granted me complimentary registration to the conference. Part of being one of #dedoc voices is to share what I learn with the diabetes community. Everything I share is in my own words."

A step back in time: My first experience with #dedoc was in October 2022, when I traveled from eastern Slovakia to Abu Dhabi, me - mother, about a year and a half after my then 5-year-old daughter was diagnosed with type 1 diabetes. I felt like several lifetimes had passed since then, what completely changed our lives was technology, social media, online community, the #WeAreNotWaiting movement and I was honestly afraid to stick my nose out of our bubble and dynamic world of Looping... the desire to meet another "live" Looper :) was my dream, and perhaps also seeking some kind of official "approval" that going the Open Source way was morally right, even though I acted according to my best knowledge and conscience. And our life and personal experience proved it. The extent of official approval that eventually took place at the end of the worlds conference for the treatment of children diabetes was something I would never have even dreamed of, and I felt like #PayItForward had literally come back to me like a boomerang. You can read about it here.

The emotional charge of being surrounded by adult people with diabetes from all over the world for the first time, as the only one in the group "without diabetes", was enormous. Among my favorite moments from ISPAD on Instagram #type1dmaniac, you will see Tino from Zimbabwe, with whom I recently talked about the life of a caregiver. (For more information, check the podcast or read the transcript in Slovak or Italian.) When they convinced me to go with them to the desert, I thought of many frightened parents on social forums who can't imagine going on a trip with their children diagnosed with diabetes in the summer or to a local pool, and so they prefer to stay in their own garden or at home...look, with diabetes, you can ride on desert dunes, even if the test strips are scattered all over the car, you simply pick them up :), learn to ride a squad, sandboard, try belly dancing, have a local dinner in the desert, and if you have no idea how many carbs there are, you can easily inject insulin at the table if needed. You can change insulin sets or sensors anywhere, even at the hotel bar by the pool. But also to meet world leaders in research, study and treatment of diabetes, have coffee or lunch with them, or just chat and at the same time change the world :). And I will be forever grateful for this blessing that, even though I don't know what it's like to live with diabetes firsthand, they accepted me among them 💙🙏. So, at the next opportunity, definitely try to apply and come to #dedocvoices, you will find that no matter which direction you go in the world, you will always come back to the same place, and among peers, you will find lifelong friends, and no distance will be so great anymore. Not even between the Philippines and Slovakia, for example :).

On the other hand, I have to say that my expectations regarding the presentation of technologies for children living with diabetes at ISPAD2022 were higher. Later on, I found out that the issue of accessibility of medical devices for the pediatric age group is actually much broader, and I wrote about it in an article here (in Slovak) before I personally attended the conference of the European working group that is calling for change in this area. You can find my contribution here.

Especially because of that, attending ATTD2023 was a big challenge. Constant innovations in diabetes management technology are my world and no one from the industry who wants to have a relevant place on the market wants to miss the opportunity to present themselves at the world conference on the most advanced technologies. I have an extra article in progress about the Exhibition area where you will learn more about each presenter in detail.

These are my highlights from #ATTD2023 that still resonate with me two months later:

• #Dedoc and the position of people with diabetes at world conferences is increasingly welcome, even demanded. In addition to the traditional personal welcome from the official representative of the organization that organizes conference, the ever-growing and increasingly crowded hall during the #dedoc symposium "What we want you to know and why" also testifies to this. From DIYAPS to access to technology in Africa: our #dedoc° symposium at ATTD 2023 touched on topics that matter to you, the diabetes community. Check out the highlights here.

• The thing that interests you the most: The future we are all waiting for; before the cure comes, life will be a fully closed loop, i.e. the smart pumps that already exist today will become even smarter. They won't need to be told when we're going to eat. 

• Note: When will this happen? If you have a young child like me, they will certainly experience this reality. It still holds true: open-source resources will get there sooner (for some people, it already applies today), commercial ones later, top countries in access (USA, Germany, UK) sooner, Western EU countries later, Eastern ones - the latest, if at all... "Consolation" that many countries are worse off will remain (unfortunately for a long time)... What until then? The only way to improve life with diabetes (for both first-line and caregivers) remains education; knowing how your body and insulin work in combination with your daily management tools, counting carbohydrates,... still applies - minimal flexibility on the MDI with a high-carbohydrate diet, if a pump, then a closed loop. Access and availability of closed loop insulin pumps remain the biggest barrier for Slovakia. However, while many countries have at least started moving in this direction, Slovakia has not only a lower political, professional, and patient willingness to fight, but also much harder conditions to be an attractive market for the industry.

• Women - although the Berlin Cube was mostly filled with men wherever you looked, ATTD in 2023 belonged to women in many ways; from the opening words of Chantal Mathieu, to more attention in research on pregnant women, and finally, research solely focused on women. Because diabetes management is not the same for both genders. Menstrual and ovulatory cycles have a significant impact on cyclic changes in glucose and insulin sensitivity in women.

• Inclusion of type 2 diabetes - (or at least insulin-dependent type 2 diabetes); type 2 with the use of technologies is receiving more and more attention, the scientific community is speaking and acting towards changing the established patterns of thinking, presenting, and approaching people living with insulin-dependent type 2 diabetes. Here I just want to add; stop stigmatizing type 2, even if you may feel wronged due to living with type 1... it can only help us all. Type 2 is much more complex than it may seem at first glance and personally, I wish that the enormous mass of people living with type 2 would be "granted the right to be dependent on technologies" as soon as possible. And I hope that the industry (and the world) is adequately preparing for this revolution.

• What people living with diabetes really want and need (right after access and availability) is one big unfulfilled need: INTEROPERABILITY. Total. Some have understood it completely, for example, INNOVATION ZED, although paradoxically they are not yet on the market. Others less so, and some, it seems, not at all. We are not interested in ONE brand tech, if (especially) the biggest players in the industry understood this, people with diabetes would live incomparably better, which would subsequently bring a whole range of benefits for society, public finances, and ultimately for the industry itself the most.

• Growing smarter all the time - everything is moving towards being more and more smart, even ordinary insulin pens, and although many of us find it difficult to accept, especially parents, remember that for children, technology is natural today and necessary for their future. Life without technology in diabetes is possible, but it is so demanding (yes, not the other way around)... make sure that what you want for your child diabetes management is also what they want, and don't let your own fears hold them back.

Preview from Tech:

• The market will increasingly flood us with apps for analyzing overall metabolism, monitoring personal habits to help manage glycemia, and understanding its impact. Some of them are trying to cooperate with the healthcare sector and insurers to minimize (or eliminate) the final costs for the user.

• Eversense & Chris Rudden (US) - an example of how to show that the user is in the first line - I will never forget the moment when a guy with diabetes and an "iron arm" came to talk about the most accurate CGM in the world.

• Dexcom Liberty project or #TypeZero - a grand presentation of a future life without counting carbohydrates - will it be a first fully automatic closed commercial loop from Dexcom? Probably yes!

• Dual-hormone pump with a fully closed loop already exists (more in the article about exhibitors)

• Low-cost insulin pumps and devices for treatment or diagnosis are on the way, but don't expect them from the big players (yet).

ATTD 2023 through my eyes in pictures can also be viewed in a public album on Facebook here.

Check out what other #voices have written about #ATTD2023,Anna Maria Alvarez from Spain, Michelle Law UK, Joanne Milo US, Santiago Paulos Scotland. The full list of #dedocvoices for #ATTD2023 can be found here.

👈Čo dokáže zvládnuť prváčik                      Takto budeme liečiť diabete typu 1.👉