The Dario folks

When roughly 3,000 diabetes health professionals and 189 exhibitors convened in downtown Indianapolis for the 2017 annual meeting of the American Association of Diabetes Educators (AADE) last week, our team was right in the fray. 

Three-thousand attendees may seem a small subsection of AADE's total 14,700 members, but it's important to note that certified diabetes educators (CDEs) often rotate their yearly attendance, and the middle of the U.S. often draws a smaller crowd than the coastal venues.

Anyhow, I’m proud to report that I co-presented a session on “Diabetes Technology in the Wild” alongside diaTribe technology editor and fellow T1D advocate Adam Brown. We covered everything from how patients share and learn about new tools from each other on social media (hello, grassroots tutorials! And Tumblrbetics! etc, etc.) to practical tips and tricks for getting the most out of CGM use (that was all Adam). Our Saturday morning session was a packed house, and we got incredible feedback from many attendees eager to learn more about the #DOC (Diabetes Online Community) and how it might help them and their patients.

But what perhaps made me most happy and proud was seeing such a strong lineup of sessions covering social media, peer support, the DOC in particular, digital health tools, and even the DIY/Open Source movement, with D-inventor Dana Lewis herself giving an hour-long talk on the homemade closed loop #OpenAPS system.

The opening keynote was on embracing Digital Health, a DSMA Live session was recorded on-site, and a new Twitter Lounge on the exhibit hall floor offered CDEs hands-on help getting started with tweeting.

One of the biggest news announcements at this show was Welldoc launching a collaboration with AADE called the Digital Diabetes Health Learning Network -- in which selected leading AADE members will "develop best practices for using technology to generate patient data to improve population health."

All this is a far cry from where the AADE was on recognizing the significance of social media and the “ePatient revolution” just a few short years ago.

Did I mention that this year’s event theme was “Driving Change and Innovation” (with a nod to the racing scene in Indy)? Not sure the AADE can call themselves a driver just yet, but they’re on their way...

Last Fall, they hired a new head of technology and innovation, Crystal Broj, who’s kicked off a number of programs including a Workgroup on Technology and a new tech training program for CDEs called iData, along with an AADE-DOC Collaboration Workgroup, both of which Adam and I are part of. Among other things, the Tech Workgroup is helping to support a new AADE certification program for diabetes apps, and the DOC group plans to meet up in Chicago this October to brainstorm how AADE and the Diabetes Online Community can best collaborate for mutual benefit. We’d love your input on that!

As to the annual meeting from Aug. 4-7, here are our observations on standout talks and expo floor activity:


#AADE17 Presentation Talk

* mHealth expert Chris Bergstrom, formerly of WellDoc, presented the opening keynote to an enthusiastic crowd Sunday morning with the title “Let’s Get Digital.” He talked about technology's crucial role in both treating and preventing diabetes, and called on CDEs to “assume an active role in digital health" (!) 

 *In a session called "Non-FDA Approved Photo Surveillance of Real-Time CGM Use," Utah CDE Michelle Litchman presented a unique that study she led, exploring the 21st century trend dubbed "Infoveillance" -- or how social media images can be used to pinpoint real-life healthcare trends, as has been done with influenza and Ebola outbreaks globally. Litchman focused focused on how patients wear their CGMs based on Instagram posts, and her group found that 64% of individuals in their sample were not wearing their Dexcom in an FDA-approved spot on the body -- which is fascinating. But perhaps most importantly, Litchman is leading the way for social media-based research identifying how PWDs (people with diabetes) are faring in the real world.

* There was a lot of talk about how "Words Matter" and the importance of positive thinking. A session on language by CDEs Jane Dickinson and others highlighted how important it is to use words that don't alienate certain patients, while an Sunday morning keynote by Alison Ledgerwood of UC Davis urged how important it is for diabetes educators to “retrain their brains” to focus on the positive rather than negative sides of D-management. A classic example is the ever-debated use of "diabetic" vs. "person with diabetes." While opinions may vary on this, many CDEs on hand were seen nodding in agreement with the notion of using "empowering messages" with patients. That also came into play during talks on Mental Health and Health Literacy, important issues that present significant challenges for CDEs trying to provide the best possible care. 

* In one of several sessions on "Beyond A1C," the JDRF's Chief Mission Officer Aaron Kowalski explained how the org is finally getting consensus around other measures that matter to patients' lives and should be considered by researchers and health insurers when making decisions. This has been a long process, involving the AADE, ADA, FDA, T1D ExChange, Endocrine Society and a number of other D-leadership orgs. Formal guidance will be published soon, and we're excited to report more details as this develops.

* It never ceases to amaze how little we actually know about diabetes itself, in that experts can't always figure out what type someone actually has. That leads to so many heartbreaking and frustrating misdiagnosis stories. Amazingly, even now in 2017, LADA (or Latent Autoimmune Diabetes in Adults), often referred to as Type 1.5, isn't even officially recognized by experts and no clear management strategy exists. It was also eye-opening to hear that deadly DKA is often the only way to distinguish between the types, when people show up in emergency rooms from very high blood sugars! And some rare forms of diabetes like MODY can only be identified by genetic testing. This all causes confusion and complicates the process of getting a correct diagnosis and proper plan of care.


#AADE17 Product Buzz

The exhibit hall at this educators' conference is always lower-key than at the giant ADA Scientific Sessions in June, and there tends to be a bigger emphasis on "lifestyle" products like food, lotions, dishware, and even comfy orthopedic shoes.

That said, some exciting stuff we learned about includes:

Afrezza inhaled insulin seemed to be finally getting its fair share of attention and traction. Their early-morning Product Theater session led by famous CDE and author Gary Scheiner was standing-room only, and MannKind execs tells us their last-minute decision to host an exhibit booth at this year’s meeting definitely paid off.

We personally overheard a lot of chatter about Afrezza among conference attendees, and our own use of Afrezza inside the convention center hallways certainly kick-started conversations about the inhaled Insulin.

Recent exciting developments for this company include:


Ascensia Diabetes, successor to Bayer, had a dynamic presence touting its Contour Next Link Meter as “the only FDA-approved meter for use with the Medtronic 630G and 670G systems.” The booth and meter were getting good attention – color coded on app and on test strip area light. What’s cool about this meter is the in-your-face color coding for BG results – green, yellow, red – that shows up both on the partner phone app and right on the meter itself. A little light just adjacent to the test strip port (called smartLIGHT Technology) glows to alert the user if their number is too high (yellow), too low (red), or in-range (green).


Also, Ascensia’s next-generation easy-to-use lancing device, the Microlet Next, was on display and is set to start shipping with new meters soon. (Hint: you can already buy it at Walgreens). It’s extremely compact, features a safety-lock endcap to prevent oopsies, and is supposed to be less painful. It also has a little lever on the side to easily eject used lancet needles, which we like.

The Dario folks out of Israel were actually handing out free meters in their booth. Remember, this is the compact all-in-one system that based around a tiny meter that plugs into smartphone jack. The lancing device and strips are all housed in a handy case that is in itself smaller that most glucose meters. No kidding!

They also just got approval for the Android version of their app, and company reps tell us they’re in talks with Glooko and possibly other partners to provide a full D-Data platform to their customers soon. The meter is still only available via direct sales from the company, but they’re working hard to get on drugstore shelves (and websites), we’re told.


"Type 2.0 Lab" was interesting crowdsourcing concept booth on the show floor, where CDEs were asked to use an oversized touchscreen to vote on the most important features of an insulin therapy tool for T2s, and the results were being displayed in real-time. On further investigation, it turns out this was a program by BD, to help them determine priorities for their product pipeline that now includes a new patch pump under development for T2 patients that they hope to launch in 2018 (discussed in last earnings call). The results of this on-site crowdsourcing won’t be made public, of course, but we thought the concept was pretty darn clever.


Korean-based Arkray, makers of the low-cost Glucocard and Assure Prism meters, seem to have been under the radar for quite a while. So their bright booth touting “NEW FORMULARY CHANGE!” was something of a surprise. Turns out they’re focusing on underserved communities by becoming a contracted supplier for the so-called “340B Prime Vendor Program” managed by Apexus, which “provides discounted drugs and medical supplies to qualifying healthcare facilities to help vulnerable patients…”

A company exec explained exuberantly that they are getting great traction on the East Coast, and working to expand nationwide.


Launching Soon, etc.

Also on hand, displaying cool new items set to hit the market soon were:

Aegle Palette – a new food tracking solution that is essentially the world’s first smart placemat. Seriously, sensors in the placement connect to to the Palette app via Bluetooth, which then provides personalized food recommendations and can send information to your physician as well, so they can help analyze your diet choices. This is one of those things that could either be revolutionary or mostly useless depending on the system’s accuracy and what kind of “recommendations” users can expect.

DiabNEXT – the China and Boston-based company creating a suite of diabetes tools based on Artificial Intelligence (AI), is launching its Clipsulin pen data tracker in just a few months, we’re told. They’re also in discussions with Joslin Diabetes Center on setting up a study of their integration toolset. 

On the diabetes-friendly food front, we were impressed with new AlluLite chocolate, made with natural Allulose sweetener; and Sola Foods that makes baking sweetener, plus a new line of granola and yogurt, all of which taste awesome, at least in sample form! These are all purportedly ultra-low-carb, high-protein items that make great choices for PWDs. We can’t yet really speak to their nutritional value or BG effect, but are hoping to dig into that soon J

And the ‘Irony of the Show’ award goes to… the Sugar Association exhibiting on the show floor, touting its commitment to “making a difference by continuously supporting scientific research and sharing our knowledge of sugar to increase consumer understanding and confidence in the role that sugar plays in a nutritious, balanced and enjoyable diet” --  not far from the Abbott Freestyle “Know Your Sugar Tour” bus, a  cross-country tour to raise awareness about the (ill) effects of sugar on the body.

Some folks were also miffed to see Cinsulin (a prominent cinnamon-vs.-blood sugar supplement) as a key sponsor of the AADE event this year. 

Well… nothing’s perfect. And the #AADE17 program certainly delivered on a number of other fronts.