Colette Murphy    

Professor Jacobs    

ENG 110    

10/28/2022   

As a Type One Diabetic myself I firmly state, as a fact, that Type One Diabetic equipment has evolved immeasurably over the past 15 years I’ve been diagnosed. From the older pump model Medtronic Minimed Paradigm 515 pump I grew up with to the new Medtronic Minimed 630G version I’m using as I’m typing this; on top of the methods in which blood glucose levels have been tested- everything has changed for Type One Diabetics. People don’t even need to manually take their blood glucose levels anymore with new technology like Blue Tooth working hand in hand with Continuous Glucose Monitors, even the durability of an infusion set has developed passed a point that was thought possible less than a lifetime ago. There’s even a type of sensor that acts as an ultrasound patch and reads blood glucose levels being tested at UC San Diego. Because of these technological advancements, scientists have made leaps and bounds in the kinds of Type One Diabetic equipment.   

Type One Diabetes is hard for any one person to deal with, and while advancements in technology have improved Type One Diabetic lives by a long shot, it wasn’t always like that. I was three years old when I was diagnosed with Type One Diabetes after projectile vomiting my third slice of cake at my friend’s birthday party and peeing myself eight times throughout one night. My pancreas had given out and stopped producing the hormone insulin, and I was experiencing Hyperglycemia, which eventually blurs into Diabetic ketoacidosis. To go over what this means in simpler terms, the pancreas contains, supplies, and produces insulin that circulates the blood and maintains blood glucose levels, or regulates the sugar in the blood. A Type One Diabetic’s does not, it stops working, typically in adolescence, and will never continue to. This is the biggest difference between Type One Diabetes and Type Two Diabetes since Type Two Diabetes is usually in older, unhealthier people that don’t take care of themselves and can eventually be cured. Type Two Diabetics can still produce some insulin, which is why a Type One Diabetic could never get Type Two- this would be considered a cure if it happened. There are also other types of Diabetes, like Gestational Diabetes or the lesser-known Latent Autoimmune Diabetes (only in adults), Type Three, and Type four. But no matter what type of diabetes a person has, they will always require insulin. Insulin in Type One Diabetics, or any diabetic, is mandatory. Insulin lowers blood glucose levels and prevents ketones in the blood. That night the carbohydrates in the cake I had eaten, without insulin in my pancreas to counteract it, were killing me. My blood glucose levels were rising rapidly, and ketones in my blood were beginning to occur at an alarming rate. Without insulin, even if you don’t eat any food, ketone buildup can occur which causes acidic blood. Acidic blood makes it so that one’s body is much more susceptible to diseases in general. These chemicals, ketones, which would normally be used to break down fat for energy could no longer perform their duty since I was no longer producing insulin. Another way to lower blood glucose levels is to exercise and flush the excess sugar in urine out by drinking a lot of water, but without insulin ketones will still occur.   

Type One Diabetics need insulin, injecting it with different technologies that have advanced over the years. I use what’s called a “diabetic insulin pump”, but there are other ways insulin can be given. There are two main modes of injecting it, a diabetic insulin pump and needles, or “injections” as most Type One Diabetics call them. A diabetic insulin pump, or simply a pump, is roughly the same size as a wallet or a pager. There are an ever-growing number of pumps since Type One Diabetics are always expanding upon what’s possible and re-coding them. Some are battery-operated, and others can use phone chargers. But they all have a few things in common: they inject constant, fast-acting insulin from a cartridge that holds 100-500 units of insulin (depending on the type of pump this differs), they can register blood glucose levels and carb intake to correct blood glucose levels back to normal, and that there is a tube that connects to an infusion set (or one-inch needle, but the tubing length may differ) that stays in the body to ensure insulin delivery. These needles stay in the thigh, upper arm, belly, or butt cheek for 1-5 days (insertion length differs depending on the kind of infusion set). Only fast-acting is used in the insulin pump as opposed to the other four types. As the name implies, fast-acting insulin starts to work within a few minutes and lasts a couple of hours. This is always used by Type One Diabetics, and the end goal of insulin manufacturing catered towards Type One Diabetics is to have insulin that works to bring down blood glucose levels instantaneously. There’s also regular insulin, which takes about 30 minutes to deliver through the tubing and lasts 3 to 6 hours. Intermediate-acting insulin takes 2 to 4 hours and its effects can last up to 18 hours. Additionally, there’s long-acting insulin that can take roughly a day or more to fully work. Finally, there’s pre-mixed insulin where absorption time varies because two or more kinds of insulin are combined. There are also different types of each, and I use fast-acting insulin called Humalog since I’m on a pump. When using a pump, whenever I eat food, I have to manually enter the carbohydrates into my pump and make sure my blood glucose levels are in compass. If they’re out of my personal range, 90-130 mg/dL, my pump will give me a “correction” to bring the number down. While insulin lowers blood glucose levels, food raises them.   

I was an anomaly when it came to my own diabetic insulin pump, when I was diagnosed in 2007 it was rare for Type One Diabetics to ever immediately be assigned to an insulin pump. At three years old I skipped injections all together and was put on an insulin pump. I’d been slowly indoctrinated into the life of a Type One Diabetic, and it’s why even now I always like to say that my life began in that hospital bed eating sugar-free ice pops while watching the Disney movie Brother Bear. It’s there that I was introduced to Diabetic Glucose Meters, the technology that I’d mainly be using to this day. There are numerous versions of the same meters, all sharing the one principle that they have to absorb and analyze a blood sample to determine a Type One Diabetic’s blood glucose count by drawing blood from one’s finger with a tiny needle. To me, and many other Type One Diabetics, this has always proven taxing. “One of the challenges – and frustrations”…”is multiple finger sticks each day to test blood sugar levels.” Diabetes Research News comments in their April 2020 article “ADVANCEMENTS IN TYPE 1 DIABETES MANAGEMENT TECHNOLOGY”. Because of the many different versions of pumps and meters and injections, these necessities have fallen under a few major brands like Dexcom, Medtronic, Novo Nordisk, and Eli Lilly. I’ve always used a mix of supplies from these companies- a meter from Medtronic, an infusion set from Novo Nordisk, and a Continuous Glucose Monitor from Dexcom. As a Type One Diabetic myself, I mix and match a lot. But my journey with Type One Diabetes started with Medtronic.   

If there’s one thing you must know about Type One Diabetic companies, it’s that they are not affordable. Finger pricking, or testing blood glucose levels with a meter, is the cheapest way Diabetics can test their blood glucose levels. But it takes time and isn’t practical, Type One Diabetics are constantly throwing out test strips, losing the testing kit that keeps the supplies to test glucose levels in, and emergency prescriptions prove difficult even getting. That is until the first CGM, Continuous Glucose Monitor, was released in 1999. I began using a CGM, a small device that I can attach to any part of my body, in 2018 so that it could take continuous blood samples while being attached to my body for ten days. Though more expensive, it’s proven to keep my blood glucose levels down since I can check it through my phone. It connects with a code and Bluetooth, which is refreshing considering I no longer need to carry a testing kit around with me every day. While I’ve always fed into the fondness that I have for my CGM, it is cumbersome and bulky on my arm, where I usually insert it. It also requires unhealthy heaps of plastic to insert it- all for a one-time usage every 10 days.   

When I was originally diagnosed with Type One Diabetes back in 2007, my experiences with it were much more complicated than now. I used to have a Medtronic Minimed Paradigm 515, a slightly bigger and less aesthetically designed model of my now refined Medtronic Minimed 630G. With an older model like that at such a young age, I was constantly giving myself insulin at random points in the day since I hadn’t fully processed what the thing, now attached to my hip for well over 10 years, was. I didn’t have a pump with a child lock until 6th grade when I finally received a Medtronic 523 Pink Insulin Pump in 2016. Getting that pump was when I began noting the change in the Diabetic industry in general, I could now see how much active insulin was in my blood on the screen, and my pump wiring was much longer so I could put my pump in my pocket instead of wearing a fanny pack- I remember being specifically alleviated and excited about that. The buttons were still clunky, and it couldn’t hold as much insulin, however. At that point in time, Continuous Glucose Monitors hadn’t been fully introduced yet, either. You were lucky if you even knew someone with that technology- but in 2018 my parents and I finally got our hands on one.   

I finally received the pump I’m using now in eighth grade, my Medtronic 630G. The most improvement in diabetic technology that I’ve witnessed has occurred in the making of this device. It gives a live time of how fast insulin is working in the body, and can directly connect to a CGM so that manually entering blood glucose levels are a thing of the past. It has a new design and, while the buttons are hard to press and the tubing is constantly bent, I feel that it has been one of the most worthwhile advancements in medical technology. A recent advancement that the Type One Diabetic camp I’ve worked at over the summer for the past few years discovered how there’s a prototype releasing that would allow Type One Diabetics to enter insulin and blood glucose levels through their phones. According to the article “New Diabetes Technology: What to Expect in 2022” written by Mike Hoskins in January 2022, “Tandem Diabetes Care will likely be the first to cross the finish line in getting FDA clearance on a smartphone app that can be used to control an insulin delivery device.” Hoskins goes on to describe the app, t:connect, and how a new mini pump called Tandem Mobi is on the rise. This new pump is “Roughly 50 percent of the t:slim X2 size” but the tubing is only 4 inches. I’ll never understand why pump manufacturers can’t make tubing longer, it’s been a struggle for many years. Thicker tubing would be nice as well so that it doesn’t get punctured or bent wrong. Hoskins explains something new in the Diabetic community: built-in adhesive so that the pump can stick to the skin without needing to use a pocket or belt. But another flaw is how since it’s a mini pump, the insulin cartridge can only hold 200 units of insulin- meaning changing infusion sets a lot more often. What surprised me, even more, is how, unlike any pump I’ve ever seen, there is “no display screen at all, will be operated solely by an iOS or Android smartphone app, and allows for wireless charging”. This is huge news in the Diabetic community, being able to do everything from one device instead of two without so many extra things to worry about, like batteries, is relieving.   

According to the article “ADVANCEMENTS IN TYPE 1 DIABETES MANAGEMENT TECHNOLOGY” by Diabetic Research News, published in April 2020, at The Laser Biomedical Research Center at MIT a group of scientists have discovered yet another way to track blood glucose levels using lasers. “The device they developed uses Raman spectroscopy” the article states. This means that to find a chemical composition, near-infrared light is displayed on the skin. Using this method, the machine ends up finding glucose hiding in interstitial fluid surrounding skin cells. While this may seem like a great alternative to piercing the skin every time with a needle or having a bulky tube be inserted every 10 days, it’s not truly all that it seems. The meter itself is “approximately the size of a desktop printer” according to the article by Diabetic Research News. This would be such a pain to deal with, Type One Diabetics already wear so much equipment. I don’t know anyone that would want the personal burden of carrying around something the size of a printer when something as small as a CGM already exists. Instead of putting money into curing diabetes, companies like JDRF, the Juvenile Diabetic Research Foundation, just want to make more equipment and technology for profit.    

In the end, Type One Diabetic equipment has evolved immeasurably over the past 15 years I’ve been diagnosed. But people around the world want not only no technology as a cure for Type One Diabetes but at the bare minimum manageable equipment to alleviate the pains of this disease. Preferably a wireless system using Bluetooth that will connect from an insulin pump to a phone that will complete automatic, remote boluses when reading blood glucose levels. On top of this, no needles would be satisfactory, or at least more efficient time in changing them. While I’m just fine with the pump I have compared to the ones I had growing up, bigger insulin cartridges would be much easier on Type One Diabetics to lessen the amount of time it takes to change an infusion set. Not to mention a 10-day time period in between infusion set changes rather than the recommended three. Though Type One Diabetics around the world can agree that technology has come far, there will always be room for improvement.