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Having good support really matters to the caregivers and those living with type 1 diabetics.
It literally makes the difference between life and death, and then surviving versus thriving.
I cannot emphasise enough the role of various kinds of medical support—doctors, medical devices, and innovators who continually put in countless hours and effort into cutting-edge research to develop newer technology and methods to make life as normal as possible for those of us, especially younger children with type 1 diabetes.
In the early years, nine years ago, I had to take around 11 to 12 blood tests daily and inject myself six to seven times with insulin. All this as a seven-year-old. It was painful and tiresome, for both my family and I, getting up several times during the night to check the sugar and inject.
A couple of years later, toward the end of third grade, I got my first insulin pump—it was a wired pump attached to my body. Yet, it was a huge relief as now I didn’t have to inject myself all the time. I only had to change it every three days. The multiple blood tests continued. The tubeless pump was not available in India. I am grateful to my family that they were able to get the pump from outside the country. My family’s resolve to give me the best possible quality of life ensured that I got the latest medical devices available. For the last few years, I have been using CGMS—Continuous Glucose Monitoring System—which eliminates constant blood testing.
A few weeks ago, though, were what could be considered transformative in my life’s journey living with type 1 diabetes.
I became the first person in India to use the hybrid loop system from Ypsomed, a Switzerland-based innovator and developer of devices for Diabetes management.
The system, sometimes referred to as an artificial pancreas, a long-time dream, now a reality, takes decision-making on autocorrected basal dosing away from the person and helps improve the percentage time with normal glucose while reducing stress. It will further safeguard against long-term complications and preserve future health.
I’m excited about this technology—the Ypsomed Mylife Hybrid loop system used in combination with my Dexcom G6 Continuous Glucose Monitoring System.
On May 10, I accidentally broke my Medtronics insulin pump, but just a few days before that, we had learned of a system where people hack their insulin pumps into a loop system in India, which means the pump is able to inject insulin based on the glucose readings provided by the CGMS. We were considering shifting to this DIY looping system with this different pump, but then we realized that it would mean carrying a lot more devices. Seemed somewhat impractical for my active lifestyle and for my brother’s young age.
Simultaneously, we came across the Ypsomed pump and found out that it was available in India. Dr. Sanjay Rajpal who heads the India division of the company checked for us if it was the same model available in Europe that worked on the loop system.
He had us connected to the Netherlands team and confirmed that it’s the same pump used all over the world. This got us excited. However, even though the pump was available in India, the Camaps fx App that allows it to loop wasn’t available in India. The other device that it needs is the Dexcom G6 CGMS, which I already had.
The app not being available in India was a bit disappointing, since it is a game-changer. We didn’t give up, though.
My mom requested her friends in Europe to create PlayStore App accounts for me and my brother, and we got new Android phones to download the app. And we were set to go!
It was my privilege to have been introduced to this technology personally by Dr. Sanjay Rajpal of Ypsomed India along with four other members of his team. They aided us in the installation of the pump and its functioning.
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When I say this pump and the looping technology have been a gamechanger, I am not exaggerating. The whole week we slept like babies—myself, my brother, and my mother (our primary caregiver). It has been so calming. In the last nine years, there has not been a single day when we haven’t had to get up in the middle of the night to check blood levels. But this technology makes sure the blood sugar levels are maintained more stable than before since there is a regular feedback loop Dexcom CGM System and the insulin pump, wherein the App adjusts the insulin delivery on the pump.
The technology has taken away the burden of Basal calculations, reducing my hypos and hyper-glucose levels. My period glucose readings have never been as stable as in the last couple of weeks. The simplified and user-friendly pump functions couldn’t be better.
A few days after starting on this new pump and technology, we met Mr. Sébastien the Sales Head of Ypsomed, Switzerland, the parent company. We were able to discuss some important issues around the availability of the technology in India. Their pump is available in India but not the looping App, nor the Dexcom G6 or Libre 3 CGMS devices that work together with the pump. I was lucky to already have the Dexcom G6 that we bought from outside India. But that is not feasible for most people. The non-availability of these two components means kids and adults in India with type 1 diabetes are denied a cutting-edge diabetes management solution available elsewhere. And I don’t see any reason why that should be.
Another important thing we discussed was the launch of the full loop technology, which would eliminate the need for calculating the calories I intend to read and then inject the appropriate insulin amount. This technology is currently available only in the United States with another pump company.
The response from him was encouraging. And I hope to see some action in this regard, hopefully.
My goal is now not only to live a fulfilled life but to also strive to help others to get the same. With many acute diseases like cancer, heart disease, and even diabetes type 2 getting a lot of focus, somehow chronic conditions such as type 1 diabetes have not yet received the attention that is needed. Due to my family’s proactiveness and passion for giving me and my brother a healthier life, we have been able to access diabetes care that most other children/people from India cannot. My goal through advocacy and networking is to get access to the latest technology and devices for all.
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More about the technology from the innovator’s website:
“’Smartphone-based therapy management is the future of diabetes treatment. The combination of the mylife YpsoPump insulin pump, the mylife CamAPS FX mobile application and the Dexcom G6 Continuous Glucose Monitoring (CGM) System makes an automated insulin delivery system managed directly from the smartphone.
The Dexcom G6 sensor sends glucose data every five minutes to the mylife CamAPS FX app. Based on those readings, the app adjusts insulin delivery on the insulin pump every eight to twelve minutes to prevent low and high glucose levels.
The mylife CamAPS FX app is personalised and adaptive; it constantly learns and quickly adapts to ever-changing insulin needs. It adjusts to diurnal and day-to-day variations in insulin requirements and compensates for over and under-dosing of the meal bolus. For increased privacy and convenience, you are able to deliver a meal bolus directly from your smartphone.
Prof. Roman Hovorka, developer of the mylife CamAPS FX app, explains how the mylife CamAPS FX algorithm learns.
“The learning takes place on three levels:
Level 1
Overall learning: This learning is based on the body’s overall insulin need: the insulin needed on average and during the day.
Level 2
Diurnal learning (over 24 hours): This learning is based on how much insulin is needed for a specific hour in a day.
Level 3
Post-meal learning: When the user delivers a meal bolus, the system will observe whether the insulin amount was appropriate. If a user constantly over or underestimates carbohydrates, the system will start to adjust insulin delivery post-meal.
All these learnings are occurring continuously.'”
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