Ever wish non-diabetics could experience their own blood sugar crashes just to "get" what it feels like for us people with diabetes, if even for a few minutes?
Well, some Pharma companies have gone to the trouble of building a "Hypoglycemia Simulator" for just this purpose...
No kidding. They really did!
Two different models of Hypo Simulators meant to mimic our hypoglycemia experiences were on the exhibit floor at the annual European Association for the Study of Diabetes (EASD) conference that drew in about 17,000 people in Berlin, Germany, in early October.
Much like the annual ADA Scientific Sessions, EASD is aimed at medical professionals, featuring everything from research posters, educational sessions, to a huge expo hall spread over two gigantic hangar-like spaces with sprawling, shiny Pharma displays.
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The AstraZeneca/Bristol-Myers Squibb (BMS) and Novo Nordisk booths both offered visitors a chance to strap in and "test run" a hypoglycemic event! AstraZeneca's setup included egg-shaped chairs equipped with a steering wheel for the person to sit and essentially "drive while low" (Oy! That brings back scary thoughts of my real-life low driving issues.)
We've heard of people trying to get a firsthand feeling of going low, like parents who've dosed some insulin themselves to try to replicate what it's like for their child. But this Pharma-made experience is the first of it's kind that we've heard of!
Note that we weren't able to be in Germany personally for this year's EASD, but we learned about these Hypo Simulators from multiple attendees and were able to confirm some details from Pharma PR folk.
The AstraZeneca/BMS simulator was most like a test drive; the user climbed into the egg-shaped unit and donned a headset which simulated the experience of driving a short distance, turning corners, avoiding traffic and trying to stay in the correct lanes — all while seeing the fuzzy simulation of what a person with diabetes experiencing a hypo might see (as explained at the start of the video).
Over at the Novo Nordisk booth, its Hypo Simulator was set up to give people the sensation of what it's like to experience a low while doing a variety of tasks on their feet. Attendees stood around a table and donned a Star-Trekky white plastic headset playing pre-recorded audio and video, showing different scenarios through the eyes of someone having a hypo: waking up in the morning with a low blood sugar, walking downstairs, going to work as a passenger in a car, being at work, and waking up during the night unable to understand what's happening. The audio described the feelings and symptoms of the hypo as the storyboards played out.
Oddly, both simulators were based on someone living with type 2 diabetes (?), and both simulations lasted roughly three to four minutes. Ambre Morley, who serves as Novo's product communications director for diabetes marketing, tells us the storyboards for their simulator were created based on scientific data and research about hypos, as well as interviews with patients, doctors, caregivers and experts in the field.
"We want to make sure it's authentic," Morley said. "People outside of the diabetes community might not have a good understanding of hypoglycemia and might not understand the symptoms. It might not hit you over the head (when you see someone having a low), but you might have seen and not known it was a hypo. This puts a name and whole new perspective to it. For now, it's an educational resource and tool that we're taking to a small number of meetings and conferences."
Indeed, this was the first time the Hypo Simulator was displayed at EASD, although it has been at other medical and caregiver conferences and events throughout the world — all outside the U.S., since it's not approved here, of course!
Morely told us she couldn't even share a video with us, because the simulator is not "approved" for the U.S. at this time. That is, if Novo's global marketing sought to bring the simulator Stateside, the company would first have to go through internal marketing and legal review to ensure it's FDA compliant with rules about promotional displays. Then, Novo would have to submit the display info to FDA for their evaluation as permitted "educational material." So no decision has been made about attempting to bring their Hypo Simulator to the U.S. but it "remains possible down the road" (?!).
Sadly, we couldn't get a response from BMS or AstraZeneca about their displays or what the future may bring.
PWD Reactions? (Pun)
Some fellow PWDs who attended EASD as part of a European D-Blogger Summit and served as our sources also shared their thoughts on the displays. How realistically can you "simulate" a hypo??
"In different ways, both (displays) managed to convey how a hypo feels without actually creating the physical effects," said Laura Cleverly from Portsmouth, England, a type 1 who blogs at the UK-based Ninjabetic (not to be confused with U.S. D-blogger George Simmons, who's been a the original "Ninjabetic" for years).
Laura said she found the Novo standing-hypo experience quite realistic.
"I even felt myself swaying as I was looking through the eyes of the person trying to walk down the stairs," she said. "This simulator was also based on a hypo of someone who has type 2 diabetes, but I found that I related to a lot of the feelings and found myself thinking that it reflected my mild hypos quite well."
Laura said she found it difficult to judge the driving scenario since she's been fortunate to never experience low blood sugar while driving (!) But she could imagine from what she's experienced with her hypos that the confusion and lack of awareness could contribute to slow judgements and reactions displayed in the simulation.
"Overall I felt that the way the hypos were conveyed was very good as every hypo is different. Both simulators captured some of the main factors of hypo such as confusion, blurred vision and dizziness... I was impressed that these simulators are being used at diabetes professional conferences as it shows me that companies and health care professionals are interested to see what we go through," she said. "I think it's important for HCPs to experience as much as they can and from a source which can make the experience as real as possible. In my eyes, only so much can be learned from text books and this as part of diabetes education is impressive to the patient as well as the professional!"
Fellow type 1 Renza Scibilia from Melbourne, Australia, who blogs at Diabetogenic, also attended EASD as part of the Blogger Summit and used the driving-scenario Hypo Simulator, but she was not impressed.
She says: "Gingerly, I climbed into an egg chair, was fitted with a headband, goggles and earphones, and given a steering wheel. With the press of the 'start' button, I was, apparently, driving whilst low. The vision in the goggles moved from blurry to bright and the sound was muffled at times and startlingly loud at others. I crashed constantly, unable to keep control of the car I was meant to be commandeering. (I should probably note the fact that I kept crashing had more to do with how I was meant to be driving on the left-hand side of the road, not that I was actually low...what's with that, England!?)
"I understand the aim of this simulator, but really, I feel it was a big fail! Sure, the idea of vision being impaired and hearing being diminished could be simulated. But obviously the physiological symptoms like racing heart, adrenalin rush, sweating, and shaking couldn't be. Really, it was just like playing a video game with a television that wasn't tuned properly. Annoying, but not really effective!"
Danie Louize Branton, a 25-year old type 1 in East Yorkshire, UK, who blogs at The Danie Diaries, said reaction was mixed at the event, but she personally was pretty impressed.
She says the driving simulator "was a little rough around the edges and exaggerated," especially since all the symptoms came on so quickly and all at once. Her experience came to an abrupt end when she crashed into an oncoming truck with the steering wheel vibrating viciously (she assumes this was to incorporate the "shakes" many PWDs feel during lows).
But Danie found the Novo simulator more realistic since it had "more seamless interactions" between the symptoms.
"Even though I knew I was firmly grounded, I did feel as though I was entering a hypo — the slowed down events of life, lead legs and the dream-like light-headedness that always accompanies my hypos was fantastically represented and made me unsure of whether it was the simulator or myself that felt that way!" she said.
"To say I felt a little woozy afterwards would be an understatement; it was scarily realistic to me!"
— Danie Louize Branton, on testing the Novo Nordisk Hypoglycemia Simulator
"To be disappointed would be, I feel, unfair," she added. "It's an incredibly hard feat to create a hypo simulator when everyone experiences something so personal and individual each time," she said. "To have to cram so many feelings into a short movie and try to prove un-attachment to real time is nearly impossible, and both simulators did very well in portraying this."
No matter how you slice it, these Hypo Simulators sound like something we could sure use Stateside, too, to help doctors, as well as friends, family and others without diabetes actually "get it" by taking a ride in our shoes!