Diabetes 365: Living With Type 2

children living with type 2 diabetes
Sunday, October 7, 12
[a]
every 21 seconds, somebody is diagnosed with diabetes.

90% of those cases are type 2.

90% of those cases are type 2.

type 2 diabetes
liver stomach pancreas
[a] type 2 diabetes is a condition in which the body doesnt produce enough insulin or doesnt respond well to the insulin it produces. insulin is a vital chemical compound that regulates the amount of sugar (called glucose) in the bloodstream. Without a proper response to insulin, glucose molecules cant enter cells from the bloodstream to be converted into energy. Instead, those molecules stay in the bloodstream, causing blood sugar levels to rise. research has shown that prolonged high blood sugar levels can cause permanent nerve, eye, and foot damage, as well as lead to dangerous health conditions like heart attacks and strokes.
childhood obesity rates
type 2 diabetes in children
[k] in the past few years, childhood cases of type 2 diabetes have been rising at an alarming rate. this can almost certainly attributed to the simultaneous rise in childhood obesity, which can be a contributing factor to the development of diabetes since excess body fat puts extra strain on the insulin producing organ, the pancreas.
childhood obesity rates
type 2 diabetes in children
[k] in the past few years, childhood cases of type 2 diabetes have been rising at an alarming rate. this can almost certainly attributed to the simultaneous rise in childhood obesity, which can be a contributing factor to the development of diabetes since excess body fat puts extra strain on the insulin producing organ, the pancreas.
90% of diabetes care is self-care.
background
[k] 90% of diabetes care is self care. therefore, managing diabetes carries a great deal of responsibilitykeeping track of blood sugar levels, taking the right medications at the right time, regulating your diet, maintaining a healthy body weight, and scheduling doctors appointments, among other things.
individual needs
educational physical support
[a] educational: recognizing your own daily patterns, blood sugar spikes & lows, knowing what treatments work best for you, keeping up with latest treatments (patient empowerment) physical: diet & exercise, maintaining a healthy body weight, constant maintenance of levels support: archiving methods, technological support, measuring instruments, human/emotional support, (friends/family/doctors)
individual needs
individual needs
community needs
human support technological support
[a] support support in general play a huge role in diabetes management. unfortunately, many medical professionals dont keep up with current advancements in diabetes treatment. therefore, many patients are receiving outdated advice that doesnt necessarily apply to them. diabetes is a highly individual diseasewhat works for one patient may not work for another, which is why human support in the form of sharing experiences is extremely helpful to diabetics and the people who care for them. technological support is also a huge part of diabetes management because of patients reliance on glucose testing technology. a recent leap in diabetes management technology includes the ability to keep track of data over time with the aid of smartphones.
community needs
human support technological support
[a] support support in general play a huge role in diabetes management. unfortunately, many medical professionals dont keep up with current advancements in diabetes treatment. therefore, many patients are receiving outdated advice that doesnt necessarily apply to them. diabetes is a highly individual diseasewhat works for one patient may not work for another, which is why human support in the form of sharing experiences is extremely helpful to diabetics and the people who care for them. technological support is also a huge part of diabetes management because of patients reliance on glucose testing technology. a recent leap in diabetes management technology includes the ability to keep track of data over time with the aid of smartphones.
the independent teen
age 14 how did i feel when i was diagnosed? overwhelmed. scared. angry.
jen
[k] jen is a 14-year-old type 2 diabetic. shes been overweight for most of her young life and was diagnosed with diabetes at the age of 10. in the 4 years since her diagnosis, shes tried a bunch of different treatments in order to nd one that works, and its been a rough journey. jen is fortunate enough to be an eternally optimistic individual, but has found herself getting worn down by the diabetes treatment process. She nds managing her diabetes to be extremely stressful at times, which occasionally plunges her into deep depressive & anxious states, feeling as if she is all alone in ghting the disease. Jens family members do their best to be supportive, but since none of them are diabetic, they have a hard time understanding exactly what jen goes through on a daily basis. she could benet greatly from a support network of people her age who are experiencing the same symptoms and repercussions of type 2 diabetes.
the mother & daughter
mary & emily

ages 36 & 9 pricking her finger hurts me more than it hurts her.
[k] emily is a lively 9-year-old who has just been diagnosed with type 2 diabetes. Her mother, mary, is a schoolteacher. both are working hard to cope with the changes that managing emilys diabetes treatment imposes on their lives, but theyre nding that its more complicated than they ever could have imagined. because the two are so busyemily with school and extracurriculars, and mary with her jobthey rarely get a chance to touch base and talk about managing emilys diabetes.
the medical professional
peter
endocrinologist
the more i know about how this disease works on an individual level, the better i can address treatment options for my patients.
[a] peter is a doctoran endocrinologist, to be specicwho works almost exclusively with young diabetes patients. hes starting to see a huge spike in the number of children he treats that have type 2 diabetes versus type 1. as he nds himself caring for more and more type 2 diabetics every day, peter is interested in furthering his own knowledge of the disease and keeping up on what treatments are being deemed most successful for children. but since type 2 diabetes is such a highly individual disease with symptoms and severity differing from case to case, Peter and his colleagues often nd themselves grasping at straws when it comes to keeping track of what works for their patients and what doesnt. he could benet greatly from having a single go-to repository of treatment information and patient data.
what tools are out there currently?
[a] so, whats out there for diabetes management currently?
standard glucose monitor

what it does: tests blood sugar levels measures A1C what it doesnt do: send data to mobile device and/or hub take extensive readings of body archive data for long periods of time track dietary context
[k]
iBGStar plug-in glucose meter

for the iphone & ipod touch what it does: tests blood sugar levels plugs into iPhone/iPod communicates with an app what it doesnt do: transfer information wirelessly eliminate the need to prick fingers
[k]
dexcom continuous glucose monitor

what it does: tests blood sugar levels eliminates need to prick fingers wirelessly transmits to receiver device what it doesnt do: take additional readings of body archive data track dietary context
[a]
bayer didget for nintendo ds

what it does: tests blood sugar levels specifically targets kids provides rewards for testing what it doesnt do: take extensive readings of body allow for parent monitoring eliminate need to prick fingers for blood
[a]
what isnt out there yet?
[k] so, what isnt out there yet? although there are a variety of tools for managing diabetes, there are still some gaps.
[k] our demographic, kids from age 10 to 17, spends most of their time in school, while, in most cases, their parents spend the day working. because their parents arent around to check on them, it becomes the childs responsibility to check their own levels and make adjustments as necessary without being reminded. often, this can cause anxiety on both the part of the parent and the child, and a system in which the parent could monitor their childs blood glucose levels when theyre apart could relieve some of that anxiety.
plus, no kid wants to do this
3 times a day.
problem
[a] plus, no kid wants to prick their ngers for blood 3 times a day, especially in front of their classmates and friends.
whats missing? the ideal device:
[a] working from whats out on the market now, what if we could create the ideal device? one that takes all of the pros from each of the available treatment options and rolls them into a singular mechanism to streamline the diabetes treatment process? we believe the ideal device would ... eliminate the need for kids to prick their ngers for blood, allow for parental communication and monitoring of levels, measure and record a variety of datanot just blood glucose level but other contextual data from the body as well, and lastly, could wirelessly transmit data to different devices
whats missing? the ideal device: eliminates the need to prick fingers for blood
whats missing? the ideal device: eliminates the need to prick fingers for blood allows for parental communication and monitoring of levels
whats missing? the ideal device: eliminates the need to prick fingers for blood allows for parental communication and monitoring of levels measures and records a variety of data
whats missing? the ideal device: eliminates the need to prick fingers for blood allows for parental communication and monitoring of levels measures and records a variety of data wirelessly transmits data to different devices
1 cm sensor
ipod nano watch
[k] were proposing a tiny sensor that could be implanted in a diabetes patients body, no longer than 1cm long. this device would measure a variety of bodily data and transmit that data to an ipod nano watch on the wrist of the patient. from our research into type 2 diabetes, we learned that it is often caused by being overweight. children with the disease can sometimes feel depressed and self-conscious about their bodies, which is enough without having to prick their ngers in public and make their condition known. this watch would make the experience of regulating blood sugar more discreet, which would make children feel more comfortable.
measurements taken from blood:

blood glucose level heart rate BMI hydration level A1C
[k] measurements taken from blood:
additional measurements
mood/mental state additional dietary context additional exercise context
[a] additional measurements that could be input by the patient would include indications of their mental state and mood, any additional dietary context, and any additional exercise context.
parent child doctor/parent/child
[a] our system includes an ipod nano attached to a wristband for the child or teen, a mobile app for parents, and an online hub that is accessible to both the parent and the child, as well as the childs doctor.
scenario 1
parent - child communication
[k]
[k] ten-year-old isaac is in the 5th grade and was diagnosed with type 2 diabetes about 6 months ago. hes a little self-conscious about his condition, so he wears his discreet ipod nano watch to monitor his blood sugar levels during the day. the watch receives information from a sensor that is planted in his arm, which eliminates the need for isaac to prick his ngers multiple times a day. at rst glance, his watch looks just like any other watch...
[a] but at the tap of a nger on the screen, the watchs screen transitions from the current time to isaacs current blood glucose level. he is able to see the numerical value as well as a visualization of his current condition. the screens color changes depending on whether isaac is within his target blood glucose range (which is 100-180mg/dL)
[a] After lunch, isaac checks his watch again to nd that his blood sugar is higher than his target range, and the watchs screen has changed colors to indicate that. However, this reading isnt high enough to cause concern. its normal for blood sugar to spike after every meal, but the trick for most diabetics is to keep that spike as small as possible. if isaacs blood sugar were signicantly higher, he would need to take an emergency injection of insulin. thankfully, that wont be happening today.
12:59
CURRENT TODAY PAST 3 DAYS WEEK MONTH
BMI: 27.4
A1C: 6.4
mg/dL
180mg/dL
100mg/dL 8a 9a 10a 11a 12p 1p 2p 3p 4p
Share
Monitor
Settings
[k] meanwhile, isaacs mom is busy at work but can monitor isaacs blood sugar levels with an app on her iphone. a color swatch accompanied by a number at the top of her screen allows her to keep track of isaacs levels even when the app isnt in use. additionally, she can monitor isaacs BMI and A1C levels. since isaac has been using the sensor for a few months, the app has detected patterns in his blood sugar levelsthis is important because knowing isaacs daily patterns can help him and his mother address high blood sugar spikes and manage his diabetes more efficiently. the app has detected that isaacs daily blood sugar levels are always highest at the same time each dayafter he eats his school-provided lunch. at this moment, issacs mother decides shes had it with supposedly healthy school lunches,
12:59
BMI: 27.4
A1C: 6.4
mg/dL
180mg/dL
100mg/dL 8a 9a 10a 11a 12p 1p 2p 3p 4p
Share
Monitor
Settings
12:59
BMI: 27.4
A1C: 6.4
mg/dL
180mg/dL
100mg/dL 8a 9a 10a 11a 12p 1p 2p 3p 4p
Share
Monitor
Settings
12:59
BMI: 27.4
A1C: 6.4
mg/dL
180mg/dL
100mg/dL 8a 9a 10a 11a 12p 1p 2p 3p 4p
Share
Monitor
Settings
12:59
BMI: 27.4
A1C: 6.4
mg/dL
180mg/dL
100mg/dL 8a 9a 10a 11a 12p 1p 2p 3p 4p
Share
Monitor
Settings
[k] back at school, isaac notices an icon on the screen of his watch that indicates he has a message, and he taps it to view a message from his mom: start thinking of some foods you want for lunch. im going to start packing lunches! xoxo.
scenario 2
doctors monitoring multiple patients
[a]
Welcome back, Dr. Rausch!
TODAY
1:27p
[a] Dr. Rausch cares for a large number of children with type 2 diabetes. using this online hub, he can keep tabs on how his patients are managing their diabetes. once hes logged in, the doctor can easily ip through patient records that provide all necessary patient information at a glancedaily levels, current BMI, A1C level, and diet & exercise context. having all of this information in one place makes it easier for the doctor to monitor his patients, detect patterns, and adjust their treatment plans if necessary. After checking up on 9-year-old emily miller, Dr. Rausch clicks the next patient button on the right to reveal the next patients information.
TODAY
1:27p
TODAY
1:27p
TODAY
1:27p
TODAY
1:27p
TODAY
1:27p
TODAY
142
1:47p
TARGET RANGE 115-180 mg/dL
Ben Smith
Age: 13
Diabetic for 4 years Semi-active lifestyle 8th grader at Westridge Middle
24.5 7.8
[k] Ben smith is a 13 year old who was diagnosed with type 2 diabetes 4 years ago. Since then, hes found successful treatment options that work well for him, and with the help of his parents, hes managing his diabetes just ne. As ben is trying to lose weight, Dr. Rausch decides to check up on his diet and exercise habits by clicking the view diet & exercise history button.
TODAY
142
1:47p
TARGET RANGE 115-180 mg/dL
Ben Smith
Age: 13
24.5 7.8
[k] Ben smith is a 13 year old who was diagnosed with type 2 diabetes 4 years ago. Since then, hes found successful treatment options that work well for him, and with the help of his parents, hes managing his diabetes just ne. As ben is trying to lose weight, Dr. Rausch decides to check up on his diet and exercise habits by clicking the view diet & exercise history button.
Diet & Exercise History

TODAY
9/30/12
10/1/12
10/2/12
10/3/12
10/4/12
10/5/12
10/6/12
Ben Smith
Age: 13
24.5 Current Weight 180.9
[k] Dr. rausch nds that all is well with this model diabetes patient, and logs off of the site to take an appointment.
[a] by creating a system of devices that all work together seamlessly, we can make it possible for young diabetes patients to learn about and manage their condition easily and efficiently with the help of their parents and doctors, ridding them of anxiety and self-consciousness, and helping them take steps toward a healthier lifestyle.

Diabetes 365: Living With Type 2

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children living with type 2 diabetes

every 21 seconds, somebody is diagnosed with diabetes.

90% of those cases are type 2.

90% of those cases are type 2.

liver stomach pancreas

childhood obesity rates

type 2 diabetes in children

childhood obesity rates

type 2 diabetes in children

90% of diabetes care is self-care.

educational physical support

educational physical support

educational physical support

human support technological support

human support technological support

the independent teen

the mother & daughter

mary & emily

the medical professional

what tools are out there currently?

[a] so, whats out there for diabetes management currently?

standard glucose monitor

iBGStar plug-in glucose meter

dexcom continuous glucose monitor

bayer didget for nintendo ds

what isnt out there yet?

plus, no kid wants to do this

whats missing? the ideal device:

ipod nano watch

measurements taken from blood:

[k] measurements taken from blood:

parent child doctor/parent/child

parent - child communication

100mg/dL 8a 9a 10a 11a 12p 1p 2p 3p 4p

100mg/dL 8a 9a 10a 11a 12p 1p 2p 3p 4p

100mg/dL 8a 9a 10a 11a 12p 1p 2p 3p 4p

100mg/dL 8a 9a 10a 11a 12p 1p 2p 3p 4p

100mg/dL 8a 9a 10a 11a 12p 1p 2p 3p 4p

doctors monitoring multiple patients

Welcome back, Dr. Rausch!

Welcome back, Dr. Rausch!

Welcome back, Dr. Rausch!

Welcome back, Dr. Rausch!

Welcome back, Dr. Rausch!

Welcome back, Dr. Rausch!

Welcome back, Dr. Rausch!

TARGET RANGE 115-180 mg/dL

Welcome back, Dr. Rausch!

TARGET RANGE 115-180 mg/dL

Welcome back, Dr. Rausch!

Diet & Exercise History

24.5 Current Weight 180.9

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