As we've learned through the Diabetes Community over the years, there's something very powerful about a "looks like me" experience -- when you see someone you can relate to living with the same challenges or health condition.

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Well now, that goes for avatars* as well!

(*You know, those digital characters that represent us users in video games, online forums, etc.)

Yep, get ready for Microsoft's first-ever diabetes avatar -- designed for Xbox gamers, but good for us non-gamers, too, as once you've created yours, it can be ported into just about any digital platform you like.

 

Thanks to Scott Hanselman

This comes courtesy of Scott Hanselman in Oregon, a well-known technology blogger and author who was out there sharing his story online long before most folks ever even heard of social media. He's lived with type 1 diabetes since his early 20s and some may remember that Scott created the first PalmPilot Diabetes Management software way back when Palms were a big thing. (We've featured him here at the 'Mine, and hosted him as a speaker at our DiabetesMine D-Data ExChange tech forum, critiquing the "Sad State of Diabetes Technology" back in 2014).

Video games have been a big part of Scott's life as an early tech adopter and programmer; he's quite familiar with that universe, especially since he works for Microsoft's web platform team as his day job.

That is where the avatar conversation came up. Amazingly, Microsoft's been crafting Avatars dating way back to 2008. But the choices of characters have been mostly simplistic, with just a few different skin tone colors and facial features like eye color to choose from. Then in 2017, Microsoft announced a big overhaul to its Avatars system for Xbox Live allowing for more customizable, personalized avatars with diversity and disabilities featured.

"The way the world's been working, people realize they're healthy and happier when they can see themselves... whether it's a movie like Black Panther, someone wearing an insulin pump on stage at the Miss America contest, or the ability to make an avatar that has a wheelchair or augmented arm or eye patch," Scott says.

Of course he was stoked when Microsoft embraced disabilities and immediately searched the online store for "diabetes." But unfortunately there were no results -- no pumps, sensors, BG meters... nothing. At first, he created a stop-gap by adorning his avatar with a Terminator robotic arm, meant to represent his own "bionic limb" in the form of a DIY closed loop system. But then, Scott decided to fix the diabetes avatar gap.

Representation matters, Scott points out.

Since there's a whole marketplace for avatar accessories ranging from pets and Christmas trees to your fave sports team jersey, Scott wondered why he couldn't just approach one of those third-party designers to make him a special diabetes avatar? He started by calling up two friends -- one active with the diabetes open-source non-profit Nightscout Foundation, and another who works for the digital avatar creation firm Konsole Kingz. It took some special coding expertise, but within a couple of months, they got the job done.

You can now buy the Nightscout Diabetes CGM avatar at the Xbox Store for $2.99.

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It's basically a Nightscout T-shirt that comes in a choice of colors, that adds a "generic" CGM (continuous glucose monitor) on your avatar's arm. Scott says Konsole Kingz used advanced coding to create the CGM sensor so it appears to be worn separately on your avatar's arm, but it actually comes as part of the T-shirt package.

 

'A Whole Series' of Diabetes Avatars

Scott is pretty excited about this and says he's hoping to see at least 4 or 5 more diabetes-specific avatars in the future.

He says he's now working to prove to the non-profit Nightscout org that this freshly launched D-avatar is a success (so purchase yours!).

"If this proves successful, it will be the first in a whole series of diabetes avatars," he says. "I would like them to make me an insulin pump attached to a pair of pants, and then 'emots' where the little avatar can dance or do some emotion. We want a blood sugar check emot, where he or she stops for a moment and to prick a finger to check glucose. We also would like to have a little Nightscout emot, where the avatar could have an iPod or phone to display a blood sugar of 100 and would jump up and down." He's hoping for summertime for the next one to debut in the Xbox Store.

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For non-gamers who have a Windows machine, you can also go into the avatar store and get the Xbox Avatar Editor for free, and then make a little person with your own body size, face shape, etc., and purchase this diabetes avatar for just under $3.

Because Scott isn't interested in making money off this, he coordinated an arrangement where the Nightscout Foundation gets all the profits, after Konsole Kingz recoups the costs of designing this avatar and getting it into the Store.

"If you have a 'thing,' you can model it and your little person can have that in the game," Scott says. "The point is, we've proven this can be done, and we could have a dozen different diabetes ones... or take it even further."

He's thinking of this as a proof of concept that could be applied to any type of "diabetes avatar" where other charities could get involved. And it certainly opens the door for avatar creation for other health conditions, for example a sleep apnea machine for your little avatar that might be sponsored by a sleep-related charity.

Scott also imagines the possibility of moving beyond avatar gear, to things like the ability to ask Alexa for your current blood sugar number and having that be displayed within the game or forum.

 

Gamification, Diabetes, and "Feeling Seen"

Gamification in diabetes and healthcare isn't new; it's been tested over the years in many different ways. There are video games and mobile apps that feature animations and sometimes offer incentives for those with diabetes to manage their daily tasks as part of the "game." But this diabetes avatar brings a whole new level of personalization.

And while some in the #WeAreNotWaiting and D-Community at large had already "toyed" with creating their own little diabetes-themed avatars (including a soccer ball wearing a CGM!), creating something official for the Xbox Store takes it to a far broader level of access and awareness.

Why would you want to show off your diabetes in your digital avatar?

In many ways, Scott sees this on the same level of celebrities sharing their D-experiences with the world -- from Nicole Johnson wearing her insulin pump while being crowned Miss America 1999, to Sierra Sandison's "show me your pump" campaign in 2014 and her successors on the beauty pageant scene over the years, or the most recent example of T1D peep Jackson Gillies sharing his diabetes and healthcare stories while singing his way onto this season of American Idol.

"This is all an experiment," Scott says. "And I'm also interested in what it might do for kids to feel 'seen,' or feel represented. We take kids to all these diabetes camps for that peer support. Would this resonate with a 10-year-old? Or do they just not care? I don't know the answer to that, and I want to find out if kids light up the way I did when I set this up for the first time. Do you want your person in a game to look like you? Sure, maybe... he might have a super machine gun or be able to fly, but he's also living with diabetes. Just like me."

Cool.