In today's world of smartphone-everything, we all know and love Emoji, right? Those little smiley faces, thumbs up and other icons used to represent emotions, food, holidays, or just about anything on mobile phones and social media.

And if you have diabetes, you'll likely be {smiley face} to hear about a whole set of new Emoji custom-made to help express diabetes stuff, like what it feels like when our glucose is too high or too low, we're frustrated, or need to take a glucose test, and more.

Introducing the Diabetemoji (a mashup of diabetes and emoji), a way to share fun sticker icons straight from your iPhone via the iMessage app! You can share D-thoughts like "BG all over the place!" or "Get Sugar!" for low blood sugars, and aside from just static stickers there are also animated icons that can be shared -- because, that's how we roll in 2018, right?

This is actually an evolution of a smartphone app created a few years ago, spearheaded by tech-savvy and DIY-hacking enthusiast Dr. Joyce Lee who is an endo and researcher at the University of Michigan. What started out as a specific mobile app with its own emoji icons built in, has now evolved into these iOS-specific "stickers" on the iMessage app that allows iPhone users to share these stickers with friends, family, caregivers, or anyone else they might choose to when communicating about diabetes.

These emoji stickers are available for $1.99 in the iMessage store (Apple's instant messaging service supported by the Messages application in iOS 5 and later). Sorry Android folks, you're out of luck at this time for the new collection. But don't fret, as you can still find the original "Diabetes Emoticons" app on both iOS and Android that has a subset of the initial static icons like "BG Meter," a hand showing the "Feely Shaky" hypo sensation, and many more!

The story behind all this is pretty cool, especially since the genesis for these D-Emoji came from a pair of sisters who've been living with type 1 for years and wanted a better way to share their feelings about diabetes...

 

T1D Sisters Idea to 'Talk' Diabetes

Meet the Ohmer family, who are behind this app's development from the start. You may recognize D-Mom Amy Ohmer from her blog called Naturally Sweet Sisters. But you may not have met the rest of her family, including Dad Todd and her two daughters who live with T1D: 16-year-old Reece (dx'd at age 9) and 14-year-old Olivia (dx'd at 3).

They entire D-emoji idea originally came from the girls' collective experience wanting to better share how they felt about diabetes management with parents and doctors.

The Ohmer sisters in Michigan: Olivia, 14, and Reece, 16.

Here's how D-Mom Amy tells the story:

"During 2013, our two daughters decided that they wanted to improve a few aspects of their care. They had just finished a quarterly endocrinology visit and while it had gone well, it also was difficult. Reece had grown into the next transition of teenage diabetes care and during the appointment, she found herself being asked direct questions from her doctor. 

"Besides feeling tongue-tied, there were also a few tears at feeling as though she were under the spotlight. As both girls attend each and every appointment together, there were also a few sympathy tears from her sister and an outrage at why things are the way they are when it comes to T1D and kids.

"As their mom, I often am unsure of what to say to help soften their feelings and reassure them. To give myself a few extra minutes to think about the right comfort, I asked them what they could do to make it better for other kids who suddenly find themselves in the same position. My oldest daughter immediately looked up and said she would rather be prepared and have answers ready to go. She explained that part of why she was so uncomfortable was that she did not have enough time to prepare for the visit.  

"Immediately, our two girls drafted a document of questions and corresponding blank spaces. The idea was simple: give kids time before the three-month appointment to prepare an explanation of what is truly happening with them. My daughters were insistent that (the prep) needed to include not only challenges, but accomplishments. As our oldest explained, sometimes explaining accomplishments was even harder in T1D care than discussing struggles.

"That moment created a spark. We decided to create a set of prepared questions and submit it to the clinic. The questions were well-received and within a few months, were placed onto the hospital’s website. While the girls were excited to see that happen, they also felt like more could be done. Another issue with communicating to parents, teachers and friends had also been looming. Both girls were tired of explaining, over and over, of what they needed to do for their T1D care.

"That brought forth the idea to create an app for diabetes emoticons. The endocrinology unit loved it! But the staff that allowed their Teen Questionnaire Form to be added to the hospital website was not familiar with app creation. Instead of letting the idea wither, the staff mentioned that the girls share that with Dr. Lee, a U-M researcher active in the open-source and tech community.

"Dr. Lee was working on her first-ever #MakeHealth innovation event and had been inspired by the Makers Movement, where real-life ‘experts’ are able to design simple, yet effective improvements for themselves as well as others. Dr. Lee asked the girls to draft their first round of emoticons. She then assembled a group of students to begin thinking about the programming aspects.

"For the first (2014) #MakeHealth fair, the girls and Dr. Lee created an Emoticon booth. While the app creation was in its infancy, Dr. Lee mocked up emoji stickers to demonstrate how an app would work. She also offered blank stickers so other children and adults to create their own emoticons.

"After that, the girls and Dr. Lee worked on various draft versions. I also invited Dr. Lee to the spring 2015 JDRF TypeOneNation Summit to talk to 130 teens about capturing their ideas for diabetes emoticons.

"While we weren’t sure what the teens would come up with, happily, most all of the emoticons were universal -- from a toilet (need to use the restroom) to carbs for snacks (pizza and donuts ranked most important).

"After a few more updates, the app was ready to launch and go on display at Dr. Lee's #MakeHealth event in October 2015. Both Reece and Olivia talked about their design and why it was important. Overwhelmingly, they both emphasized that it is important to address the need to remove burden, even from kids. They also explained that they found strength and hope in being able to create and implement their ideas."

Their mom added this: "While diabetes is difficult, they realize that they can make it a little better in keeping with our family motto, 'Kids First, Diabetes Second.'"

 

Hacking Healthcare, via Mobile App

So it all started in 2015.

Two of Dr. Lee's students at the time -- Jawad Nasser and Omkar Moghe -- belonged to a group dubbed "Michigan Hackers," and they began developing the app. Though they don't have diabetes themselves, they showed a passion for helping kids, teens and adults find DIY solutions to making D-life better. They completed the first-generation of the app late that year, and released it for free on the iTunes and Google Play stores for download.

After they graduated, Dr. Lee says it became unrealistic to try and update the mobile app without their development expertise. So instead, Dr. Lee decided it would be best to evolve the diabetes emojis into something people could simply upload to the iMessage sticker platform -- that wouldn't require a separate mobile app.

As noted, there's a great collection of fun emoji stickers to grab -- with more likely to be added in the future -- for the low cost of just $1.99 on iMessage. Dr. Lee tells us that as of now, there's no plan to take this beyond iOS iMessage stickers. Of course, she can't say the door's completely closed on an Android possibility forever, as you never know what may happen when it comes to the hacking and #WeAreNotWaiting community!

As banal as the idea of these teeny icons might seem, we actually believe they could be a great tool not only for kids and teens, but for adults too. Think about it: I personally use Nightscout and xDrip technology to share my real-time CGM data with my wife, and we often exchange D-related text messages just to sum up how I'm doing. Instead of writing out words, I could see us exchanging these emoticons, to quickly let her that I'm OK and have treated, etc.

It really is beyond cool to see so many people of all ages rolling up their sleeves to create DIY life hacks and new tech tools to help them live better with diabetes and other conditions.

In the D-world, the #WeAreNotWaiting movement has led the charge. We love to see how it's now converging with the larger #MakeHealth initiative into so many different parts of healthcare hacking!