5 & 5: Technology

​Introducing a new series, hoping this gets me writing more.  I’m calling it my 5 & 5 series.  Each post will take a topic and point out 5 pros and 5 cons.  While I think it is always important to focus on the positives in life, I think it helps to recognize the negative attributes and be aware of them to help minimize the impact that you allow them to have on you.  Driving down a street you want to be able to see the potholes in order to avoid them.

So for the first topic I have chosen TECHNOLOGY.  Now this is one that may come up more than once because there are so many more pros and cons than just 5, but this is a topic that has come up in some of my conversations lately and one that is tied very closely to the advancement in treatment of T1D.

So let’s begin….
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5 Pros to Technology

1. Google

I think it is safe to say we all appreciate google. I remember working on book reports and have to look in multiple encyclopedias taking way more time and effort than simply googling for information.  I would say most often these days, however, I am searching the carb counts and ingredients in food.  

Celiacs have to be so diligent in not only knowing ingredient lists but also how the ingredients are processed and supplied.  Information not included on packaging labels.  Luckily, these days most companies have begun to put information on their websites but if not, googling can find other celiac support sites that may have already done that research.  

T1Ds are constantly calculating their insulin dose based on the carbs and fiber in their food.  So while individual packaging will list this information and make it easy, eating out at restaurants can be quite the challenge for estimating.  

So please don’t pass judgement on me next time I’m at a baseball game and standing in line at dippin’ dots glued to my phone confirming the gf flavors and finding out the carb counts.

2. Dexcom and other CGMs

Now this one you will also see noted below (example of a double edged sword perhaps), CGMs are very useful tools for folks with diabetes (all types!).  Technology has not only allowed them to be envisioned and created but it continues to improve it.  Improved accuracy comes in each new model.  

CGMs allow for less finger pricking and more knowledge on blood sugar levels in real time.  It graphs blood sugar trends showing if you accurately guessed those carbs you recently ate or how certain exercises impact your blood sugars.  It allows you to correct before you start to feel symptoms (when your number starts dropping eat a little to hold it steady, when it starts to go high give an insulin correction to stop it from going too high).

And I have to say (I am a bit biased here…), I think caregivers love it even more than the individuals themselves.  As a parent, I don’t have to constantly nag my child to find out where her sugars are at, I can just look at my phone app and instantly know she is okay.  I don’t have to wake up at 2 am every morning to check her blood sugar, I can set the alarm on the phone app to wake me up if she goes low or high.  It provides me with reassurance that she will survive, particularly while she is wearing it (note: as a parent I know how easy this disease could claim her and I never forget it, it is a constant thought in the back of my mind).

So yes, technology’s ability to bring us these medical devices that help lower A1Cs and help minimize finger pricks and provide us with more knowledge on how to manage care is always appreciated.

3. Smart Phones

This is kinda a cheat one, since it ties into 1 & 2 above.  Smartphones allow the convenience of having access to the internet in the palm of our hands wherever we may be.  Driving in our cars, at a hockey game, out hiking (sometimes at least), in a restaurant, at the airport.  Thus making google easier to use.  Through apps we can further manage care.  As noted above CGM apps eliminate the need to carry the receiver device everywhere (1 less thing to lose while out and about).  Other apps can offer training advice, company and product reliability and information as it pertains to nutrition or otherwise, recommend “safe” restaurants for celiacs to eat at, set reminders for when your glucagon will expire.  

Social media and specific apps can help bring us together as well.  Create communities and support networks for us to connect to others in similar situations.  Share tricks with each other, provide recommendations to each other.  Sometimes just knowing you’re not alone can have a great impact even if the other person is clear on the other side of the world.  There is definitely not a shortage of apps out there and we continue to improve them and create new ones that are more useful.  We might have less space for photos on our phones but we can worry less about daily risks or retaining all information when we can just make it accessible on our phones.

4. Electronic Health Records (EHRs)

I can’t imagine what my daughter’s paper file would look like at her doctor’s office if it had all the records from all the providers, and all the imaging, and all the logs and she’s only been diagnosed with everything in the past 4 years.  

EHRs make searching through records extremely easy and locating past appointments with specific providers.  It is all easily accessible which as a patient/caregiver a total convenience but also much easier for doctors and staff trying to navigate through the records.  Technology has made this part of care more efficient.

We also have benefitted greatly from EHRs by seeing multiple doctors in the same system, they can easily review what the other doctor reported without having to request and transfer records between departments.  She truly sees a team of doctors who are able to work together reviewing each other’s notes.  

5. Snapchat Filters

If I want to l want to look good or ridiculous in a photo, snapchat has me covered.

5 Cons to Technology

1. Dexcom & CGMs

Since I already mentioned this one above I’ll start with it.  Two words:  Information Overload.  While there are so many benefits to CGMs it can become overwhelming and increase the pressure to always be “good” or successful in care.  

I hate to use the term “good” because it implies that there is a bad but that is often how our minds operate.  It is unfortunate for diabetics because there are simply too many factors that can contribute to blood sugars responding and it is impossible and unrealistic to think you can always manage to have your numbers between 70-120.  Now, don’t get me wrong, there are those out there that achieve that for years at a time but I would be very surprised if it weren’t different for them before that started or if at some point they face a “burnout” period.

Having that information at our fingertips (pun intended…) can be helpful but it can also lead to setting unrealistic goals and cause stress when goals are not met.  We may see posts of those straight dexcom lines on social media and look at our own roller coasters and think what am I doing wrong?

It’s important to not blame ourselves or others when things don’t go right, we are all different and have different genetics and genetic responses.  So we need to be aware of when that information becomes too much for us, when it becomes depressing for us, when it discourages us, when it creates self-doubt, when we start comparing ourselves to others.

2. Fake News

Has anyone created a drinking game yet for how many times they say “fake news” on the news?  Just wondering.  Seems like we hear this term a lot lately and I get it.

But…

We created it.  Hear me out.

The internet brought us instant communication.  Instant.  We live in a competitive society.  We want to beat each other instinctively, and the news is no exception.  Journalists used to have time to research, interview and reflect on those interviews, validate sources, cross reference, etc.  We have applied a pressure on journalism to give us instant news which takes away the time needed to truly represent the story with full validity.  They are forced to trust their sources and pass the information along as quickly as possible.

This can be a good thing, but more often than not, we lose out.  

Technology has also allowed for photoshop and various video/sound/print manipulations.  We may see something and think it is real, when in all actuality it is contrived.  But before we know it is unreal it has already been seen because it spreads on the internet at super speed.  Once something is seen, it is usually hard to unsee it.  

We strive on this instant gratification and cannot wait for information.  We want to see the headlines as they are happening on twitter rather wait for the newspaper the next day.  But it comes at a cost, and that cost is the legitimacy of information.

This is important for all of us to think about and I can link it to T1D and Celiac pretty easily - “Just eat cinnamon and it will cure your diabetes” “Cheerios are now gluten free per labeling standards so enjoy!”. But this issue really is a bigger discussion and one we should start having as a society.

3. Dollar Cost

As a single parent it is hard to afford to keep up with the latest technology.  We may have great technological devices to help us, but if we can’t afford them we cannot benefit from them.  

Celiacs online are all raving about the Nima gluten tester, but it has a high purchase price with high ongoing prices on the test strips.  It becomes a budgetary commitment at a cost.

T1Ds are no strangers to high cost care - insulin alone is out of control on pricing in the US.  Meters and test strips just add to it.  So when we have those NEEDS its hard to have the budget leftover for the WANTS.  Over a thousand dollars for 3 months of Dexcom sensors - that doesn’t even include the transmitters or receiver.  
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Technology is beneficial if it is accessible and affordable.  If we have these great devices to improve care, should we not as a society want those for all that are affected?

4. Privacy and Security

Are we opening ourselves up to more vulnerability?  By putting so much personal and medical information in technology are we leading blindly in the trust of these systems and those that have access, legally and illegally.  Who are all these people that have access, what could they achieve with that access?  Could someone sell the data for a profit?  Could the government use it to deny government funded medical care?

So much of the security we have established today, could easily change tomorrow.  

As we continue to elect government officials, we need to remember how much access to our information they have and how they may change how it is managed.

5. Social Media and “A” Side

There is an NCIS episode in which Jimmy is on a ledge with a victim (both literally and metaphorically) and the young man is talking about how he is comparing his life to those he watches on Facebook and the like.  And Jimmy explains that he can’t compare himself to those because those are just the “A” sides.  They are the good moments, the edited and approved photos.  They are not the everyday all day.  They do not always show the bad moments.  Life’s mistakes.  The ugly sides of things.

Technology is allowing us to instantly edit the stories of our lives and try to manipulate the perceptions others have on us.  While we all benefit from this, it really should only be done to an extent.  We cannot deny the bad moments in our lives.  We can’t pretend they don’t happen just because we haven’t put them on facebook.  We tend to isolate ourselves because we become afraid of what others will think when we do share those moments with them.  

The younger generations are relying much more on the virtual relationships and losing the in person ones.  How will they cope when they don’t have the friends and relationships that accept them for who they are in their entirety.  

So there you go - my thoughts for today.  The first 5 & 5.