Today we continue our coverage of the big American Association of Diabetes Educators (AADE) annual meeting that brought nearly 3,000 educators and a several thousand more D-experts together in New Orleans last week.
Our own Wil Dubois reported on the Exhibit Hall action, and contributed to this report on the theme and content of the event.
This whole conference is of course about how Certified Diabetes Educators (CDEs) can best do their jobs, so there were a number of seminars on new technologies, and much talk about e-prescribing, social media use and telehealth, and using mobile health apps instead of brochures (right!). You can also browse through about 60 posters that were on display at the event, showcasing educator-specific research on various D-management topics.
Many of our fellow D-Advocates from around the Diabetes Online Community (DOC) were also there participating in this annual gathering. Which is a good thing, because the 2015 theme of this 42nd annual conference was Jazz it up with Innovation and Engagement.
The opening keynote speaker, setting the stage for all the talk on tech, innovation and engagement, was health data researcher extraordinaire Susannah Fox, who was recently named Chief Technology Officer for U.S. Health and Human Services (HHS). She walked attendees through the explosion of social media use in managing our nation's health, the rise of self-tracking, and how to empower people to employ this data. (See this great recap of the opening session from AADE past president Joan Bardsley).
For this emphasis on the online world (that’s transformed the experience of being a patient for so many people), we can thank new DOC-friendly AADE leaders Deborah Greenwood and Hope Warshaw. What was really exciting to us, aside from that, was the new focus this year on type 1 diabetes.
Finally, a T1D Focus
Yes, this year for the first time ever, AADE offered a so-called Type 1 Day composed of a set of evening programs, followed by daylong string of six educational opportunities -– two poster sessions and four presentations (two of the latter happened simultaneously, which made scheduling tough). The day topics included new type 1 treatment guidelines, coping with exercise and utilizing data, strategies for eating gluten-free and even the impact of type 1 on family members.
“We were being forward-thinking with this program. The future of diabetes management is patient engagement,” says the 2015 AADE Program Chair, CDE Charlotte Hayes from Atlanta, GA, who also happens to be the official CDE for Team Novo Nordisk..
Hayes said the type 1 community is such an “informed, wonderful, vocal and engaged group” that AADE needed to assure that their educators are clued-in. "To be able to answer difficult questions, we have to keep up with the informed community.”
For sure! But we wondered why it took so long for AADE to add a focus on T1s, especially since our DOC group has been so engaged in the conference over the past several years (I helped conduct several AADE sessions on social media myself).
When asked, Hayes thought for a beat, shrugged a shoulder and said, “I don’t know why it was not done before.”
Hmmmm... Neither do we.
Evening T1D Action
The T1 Day “Eve” offerings included a case study built around treating a toddler with T1, an Artificial Pancreas briefing, and a session T1 and Eating Disorders, led by the DOC’s own Asha Brown, who knocked it out of the park with an eloquent monologue depicting the thought process behind eating disorders. Normally during sessions, there’s a fair amount of noise generated by the audience -- rustling papers, computer and cell phone noises, whispered conversations, and the like. But Asha silenced the house.
Wil tells us that later on, one of the CDEs approached Asha in the lobby of a local hotel to tell her that her presentation was the highlight of the entire conference. We too are huge advocates of the notion that those who experience it are the best teachers!
(On that theme, Wil also reports seeing a large number of Ominpods on the backs of arms of attendees.)
Also on T1 Day Eve, well-known CDE and author Gary Scheiner moderated a jam-packed panel session on optimizing CGM (continuous glucose monitor) use.
And in one of the most lightly attended, yet powerful sessions, CDE of the Year Susan Weiner and super-doc and type 1 himself Jason C. Baker of Marjorie’s Fund talked about the resource-poor, both abroad and here at home.
and Susan had some fun playing "king and queen" too, bringing some
laughs but also acknowledging the star-power these two bring to the AADE and
T1 Meat and Potatoes
A bit about the content of the four Type 1 Day seminars:
- Building the Next Generation of Diabetes Technology: Three Patients and Their Stories. The three patients were actually also developers heavily involved in creating this new technology: Brandon Arbiter of Tidepool, Doug Kanter of Databetes, and Craig Bobick of the Jaeb Center for Health Research. Kudos to AADE for inviting this great group!
- Type 1 Diabetes Management for Exercise and Sport. Founder of Diabetes Training Camp and type 1 himself Matthew Corcoran led this session, that explained “exercise-induced hypoglycemia and its potential impact on subsequent hypoglycemia risk as well as exercise performance.” He also discussed basic strategies for hypoglycemia prevention in exercise and sport. While it sounds like a no-brainer, this is still a nebulous area that is undergoing much research. (See this AADE post for more detail.)
- Going Gluten Free: Strategies for Success for Kids with Celiac and Type 1 Diabetes. This was a deep dive into celiac disease and its implications for diabetes care by pediatric diabetes nutritionist and CDE Colleen Farley-Cornell. Focus was on kids, but as an adult with gluten intolerance, I would’ve loved to catch the part on “creative strategies for eating a gluten free diet away from home.”
- Hypoglycemia in Type 1 Diabetes: The Impact on Family Members led by Behavioral Diabetes Institute founder and DOC-fave Dr. William Polonsky.
“Polonsky presented some horrifying research about the impact of low blood sugar on our so-called Type Awesomes (loved ones) and discussed how this can lead to ‘Diabetes Police’ behaviors. He made suggestions on how couples can negotiate areas of joint responsibility in diabetes management to lower relationship stresses from diabetes. He also talked about the sleep deprivation issues our loved ones are suffering with the advent of CGMs and their incessant alarms, and he told us that he and D-advocate Kerri Sparling are working together to create a new etiquette card on how to deal with invasive data sharing from Nightscout, Dexcom SHARE and similar devices.”
Social Media: Do No Harm
There were a number of different social media-specific presentations this year, with a good amount of “social media 101” mixed in for those who aren’t hip to Twitter, Facebooking, blogging or the whole DOC spectrum.
President-elect Hope Warshaw teamed up with CDE Melissa Joy Dobbins from Chicago to host a session and hands-on workshop on using social media in clinical practice. From what we could see trending on the #AADE15 Twitter hashtag discussions online, it was a well-received presentation with the room jam-packed with educators waiting to learn more (and tweeting about it!).
Our fellow D-peep Christopher Snider presented some intriguing stats as part of his new gig at as Patient Community Advocate at data analytics company Symplur, and it was great to see some remarkable impact of the weekly #DSMA (Diabetes Social Media Advocacy) chats on Twitter. He’s posted his entire slide presentation online, and also sums it up in a blog post over at his site, A Consequence of Hypoglycemia.
Photo tweeted by Scott K. Johnson
Our DOC friend Brian Cohen, who’s living with type 2 and is one of our Patient Voices winners this year, attended that session and shares these thoughts with us here at the ‘Mine:
“Diabetes education is still navigating its way through the wave of change as patients turn to online communities and resources for knowledge and support. Educators have had fundamental questions about whether the DOC really helps patients in measurable ways and whether there are serious risks of harm.”
“In her presentation, Michelle Litchman finally spread some light on these questions. The conclusions of her work suggest that involvement in the DOC is associated with better glycemic control, self-care behavior and quality of life.
“Litchman further found very little reporting of harm, with no serious harm reported and only 2% of her respondents reporting ‘minor harm.’ This probably suggests the DOC is a safer environment than a hospital. She further observed that the DOC seemed to fill a fundamental gap in the current healthcare system, providing information, emotional support and a sense of community and belonging that is simply not provided as part of the current system.
“This study does have some limitations… and one cannot conclude that the DOC was the direct cause of all these positive outcomes; it may simply be that motivated patients sought out the DOC.
“But Litchman concluded that (what they observed among) those participating in the DOC, was that patients had significantly improved glycemic control, self-care, emotional health and quality of life. She further concluded that participation in the DOC should be considered for all adults with diabetes.”
Getting Real About Type 2 BG Monitoring
Brian also attended a presentation by Dr. Dana Brackney from North Carolina, on the relative benefits having patients with type 2 diabetes use home glucose meters -- which believe it or not is still a controversial topic among healthcare providers (!)
“There remains a huge controversy on whether Self-Monitored Blood Glucose (SMBG) is effective and worth the cost in diabetes patients who are not using insulin. This presentation was a breath of fresh air as it described purposeful SMBG and efforts to measure positive outcomes,” Brian reports.
“While this was a small and limited study, hopefully it will kick off more interest in doing studies looking at SMBG in a way that is truly patient-centered and purposeful. There are many patients who’ve learned to ‘Eat to Your Meter’ with great success. It is really too bad that studies of SMBG effectiveness have been so deeply flawed although they claim to be ‘intervention’ studies. If you don't use SMBG in a purposeful way then you don't really have an intervention,” Brian concludes.
Bringing It Home (to the Patients)
At the close of the conference, the featured keynote speaker was Jeff Arnold, who created the online health platform ShareCare along with Dr. Oz, but is best known as the founder of WebMD.
He spoke about how connected the patient and healthcare communities have become, thanks to innovative tech and data. But he said that at the end of the day it comes down to relationships with patients. How the educators engage with people in the Diabetes Community, the future of personalized healthcare and precision medicine, and overall how educators can be the torchbearers when it comes to patient engagement
He's written a good recap blog about his own AADE experience, but our favorite Tweet that seemed to sum it up perfectly was this: “Ultimate algorithm? Better #relationships is better #health #keynotejeff15 #AADE15
Will Type 1 Day Live On?
So will the Type 1 Day be repeated at next year’s AADE conference?
That, said AADE event planner Hayes, is up to the 2016 program committee, who are “already hard at work” planning for the 2016 event in San Diego, CA. Hayes says she hopes they’ll continue to build on the type 1 track, given that there’s so much new technology emerging so quickly. “Pumps, CGM, closed loop — all these things happen in T1 first” and then eventually roll out to type 2s, Hayes points out, so AADE should keep its eyes on the cutting edge.
We sure echo that thought on being forward-thinking, AADE. Let’s just make sure that educators understand all of this innovation isn’t some space-age vision, but the Here and Now of diabetes care in 2015.