My Diabetes story part 2: from DAFNE to devices

From a blood testing meter big enough to fit in a rucksack to tiny continuous glucose monitoring (CGM) systems: Luci Talbot Clarke lives with T1 diabetes. Here she shares her experience of how Diabetes management has changed over the years.

For CMR’s Luci?Talbot Clarke,?her treatment journey began early:?”In my teens, my Diabetic control kit consisted of a blood testing meter?which I?used to carry around in a rucksack. It was a massive great thing! Yet I know that other people had to rely on sticks and despite its size, at least I was able to measure my readings more accurately.?

DAFNE (Dose Adjustment for Normal Eating)
The next step of Luci?s Diabetes management was to get a grip on the carbs that she was taking in. Adjusting food levels to control blood sugar is a massive part of good diabetes management and for Luci, help came in the form of the popular DAFNE (Dose Adjustment for Normal Eating) programme. It?s a package that trains Type 1 Diabetics to ratio their insulin & food intake combined with exercise to cover anything they choose to eat.

?It?s expensive, and I was on the waiting list for ages, but DAFNE changed my life for the better,? says Luci. ?It allows me to say, yes, I?ll have that doughnut and will just inject more without worrying about losing control. To live life to the full – that?s eating and drinking with family and friends – you really do need some kind of carb counting tool and DAFNE principles have been key to this.?

Since injection pens came on the market, they?ve been Luci?s chosen method for diabetes management. And she?s never caught without her silver bag containing her injecting pen, blood testing monitor and sticks, and always, a bag of Bassetts jelly babies.

To pump? or not?
More recent breakthroughs in diabetes management include insulin pumps, which eliminate the need to inject and mimic the required levels of insulin in the body.

The pump Luci used had insulin administered via a catheter. ?I liked the idea of a pump and did try one, but it didn?t work for me. I love fashion and I felt that if I didn?t wear something with pockets then there would be nowhere for the wire to go and the pump was difficult to hide. I?d be forever catching the wire on things or the kids (who were babies at the time) would pull it and play with it which drove me mad. You could see it through skinny jeans if you wore it on your leg. This was pre patch pumps.?

Giving CGM a go
Luci is always open to trying new treatments and in early 2016, she was deemed suitable to trial the Abbott Freestyle Libre Diabetes device. This device uses a sensor filament which is inserted 5 millimetres under the skin and accurately measures glucose in the interstitial fluid by the user swiping the device over the arm.

?The doctor at my Diabetes clinic said, ?This will be brilliant for you? and I was excited to try it. I had to swipe five times per day for two weeks, unfortunately I also had to finger prick as well as part of the research trial whereas a ?normal? user wouldn?t have to anymore. The monitor worked brilliantly. It gave me confidence. For example, just before I entered the gym, I could quickly swipe and check my levels knowing that I was ok. It also gives you an indicator of whether your sugars are stable or going up or down steadily or rapidly, which I found invaluable.?

So why hasn?t Luci taken the leap and purchased the Freestyle Libre? ?It?s a bit of the vanity thing again! Everyone could see the patch, even though they said they couldn?t, and would ask me about it. On the corner was a little lip which could easily catch on things. Perhaps if they made it in a selection of skin tones ? instead of plain white ? it would be less noticeable too.

Carb counting

There were other reasons too. “The device doesn?t carb count for you which my current blood tester does. I?m pretty good at that now and can work it out in my head, but it?s much easier to be told my by tester how much I need to inject. A built in carb counting function would be perfect for someone with a more recent diagnosis too. It also costs a lot of money per month which I can?t really afford at this point in my life.?

To read more about Luci’s Diabetes experience, take a look at her first blog Childhood and Diabetes.

CMR: Our Diabetes experience

We believe we are the only Diabetes medical device specialist market research agency.

Although CMR started life covering all medical device types, Diabetes is our priority. Our first project in 2000 was a usability study for a blood glucose meter and now over 60% of our work is in the Diabetes sector.

Over the past 16 years we have worked on a multitude of Diabetes device types including insulin pens, lancets, blood glucose meters, DPN monitors, Hba1c monitors, continuous glucose monitors and insulin pumps (including patch pumps). We?ve also covered user guides, med-ed, support services, advertising, sales aids, packaging and apps in the Diabetes field.

We recently undertook a piece of independent research to uncover user perceptions of Abbott FreeStyle Libre. The FreeStyle Libre came from leftfield, taking the market by surprise and having heard a lot of anecdotal feedback about its performance we wanted to find out what users really think.

To download the findings, visit CMR’s Abbott Freestyle Libre Hot Topics page. To explore how our research could help you, as a medical device manufacturer, please get in touch.