Please Help! Understanding insulin management and administration in senior diabetics

[AaronSalter]

Hi guys,

I am a student who studies Industrial Design at Loughborough University in the UK. I am in my final year, and for my major project I have decided to focus on redesigning insulin injectors from the ground up to be more suited to senior diabetics and their associated needs, as the largest and fastest growing diabetic group. To ensure I am addressing the right issues, I am completing primary research by interviewing diabetics as well as experts in the field.

This is why I would absolutely love if any diabetic on here who (preferably) 60+ , or has any problems with managing their diabetes, would consider filling out my survey (linked below). This will help give me the data I need to really help solve the many problems which exist in the current management of diabetes. TYPE 2 diabetics are preferred, but anyone who can help would be appreciated. The Surveys are FULLY ANONYMOUS, and have gone through full ethics procedures. Please send me a personal message and I will answer any concerns.

https://lboro.onlinesurveys.ac.uk/understanding-insulin-management-and-administration-in-eld-2

 

[Antje77]

Hi all, this research has been approved by DCUK.

 

[Antje77]

This is why I would absolutely love if any diabetic on here who is over 60, or knows anyone over 60 with diabetes, would consider filling out my survey (linked below). This will help give me the data I need to really help solve the many problems which exist in the current management of diabetes. TYPE 2 diabetics are preferred

We do have a few T2's on insulin on the forum, but not many. I think the majority of our forum users have found they can manage their T2 with diet, or diet and medication not being insulin.
@Annb comes to mind, she's on insulin, of the right age, and very friendly.

I'm having a look at the survey now (out of curiosity, as I'm the wrong age at 44, so I won't submit my replies). Would you like some feedback on the questions?

 

[bulkbiker]

This will help give me the data I need to really help solve the many problems which exist in the current management of diabetes.

What if adding yet more insulin to a body already producing too much is not a great idea however it is administered though?

 

[Antje77]

What if adding yet more insulin to a body already producing too much is not a great idea however it is administered though?

If BG won't come down by any other means this can sometimes be the only way to not run BG's in the 20's all the time.
I know which I would choose!

 

[AaronSalter]

We do have a few T2's on insulin on the forum, but not many. I think the majority of our forum users have found they can manage their T2 with diet, or diet and medication not being insulin.
@Annb comes to mind, she's on insulin, of the right age, and very friendly.

I'm having a look at the survey now (out of curiosity, as I'm the wrong age at 44, so I won't submit my replies). Would you like some feedback on the questions?

Hi Antje,

I still would appreciate your response to the survey, although 60+ is the target group I am sure I can have interesting responses from younger diabetics. Also yes, if you have any changes to the questions you would like included I would be very interested to hear them!

Cheers
A

 

[Antje77]

Hi Antje,

I still would appreciate your response to the survey, although 60+ is the target group I am sure I can have interesting responses from younger diabetics. Also yes, if you have any changes to the questions you would like included I would be very interested to hear them!

Cheers
A

OK, will fill it out and send.

As for the feedback, it's mostly about questions 5, 12 and 18.

5: How many times do you inject insulin per day?
You can choose 1 to 5 times a day, which assumes we all inject the same every day. While there will be more T2's for which this is correct (the ones on basal only, or on a mixed insulin who will inject once or twice a day) than T1's, many of have a variable number of injections, depending on food, activity and corrections.
For me the answer would be 'anywhere from 4 to 12 times a day'.

12: How often do you rotate your injection site per month?
You can choose answers between never and 4 times a month.
We're supposed to aim at a different spot with every injection, so for me the answer would be 'around 220 times a month'. The answers don't really make sense here.

18: Q: How comfortable would you feel about wearing a glucose monitor to assess your glucose levels throughout the day?
Many of us already do, even the ones with T2.
In my country, everyone on multiple daily injections or insulin pump gets a Libre funded, regardless of type. And many others self fund, even if they're not on insulin.

Hope this helps!

 

[AaronSalter]

OK, will fill it out and send.

As for the feedback, it's mostly about questions 5, 12 and 18.

5: How many times do you inject insulin per day?
You can choose 1 to 5 times a day, which assumes we all inject the same every day. While there will be more T2's for which this is correct (the ones on basal only, or on a mixed insulin who will inject once or twice a day) than T1's, many of have a variable number of injections, depending on food, activity and corrections.
For me the answer would be 'anywhere from 4 to 12 times a day'.

12: How often do you rotate your injection site per month?
You can choose answers between never and 4 times a month.
We're supposed to aim at a different spot with every injection, so for me the answer would be 'around 220 times a month'. The answers don't really make sense here.

18: Q: How comfortable would you feel about wearing a glucose monitor to assess your glucose levels throughout the day?
Many of us already do, even the ones with T2.
In my country, everyone on multiple daily injections or insulin pump gets a Libre funded, regardless of type. And many others self fund, even if they're not on insulin.

Hope this helps!

Hi Antje,

There is some really helpful feedback here, I am updating the question options accordingly! For question 12 i was referring to rotation between the quadrants between the general injection areas, however this is not particularly clear I guess. My intention is to identify how many diabetics actually stick to the doctors guidelines when they inject, and through that establish if there needs to be prompting within my injector to remind the user to rotate. I think this is more likely to be a problem with Type 2 diabetics though, as they are less likely to be familiar with the exact guidelines as they are usually diagnosed later in life. I will update the wording. I will similarly update 18 to give me some different data. Thanks again that was really helpful,

Kind regards
Aaron

 

[Antje77]

For question 12 i was referring to rotation between the quadrants between the general injection areas, however this is not particularly clear I guess.

Ah, I get it now!
I was never instructed a particular way of rotating (diagnosed at 39, initially as a T2) except to mind not injecting in the same place all the time.
The practice nurse did offer me some kind of cardboard template with holes I could put on my leg or belly to follow the holes but I declined.
My strategy is to just randomly inject all over, fits my chaotic character!

 

[AaronSalter]

OK, will fill it out and send.

As for the feedback, it's mostly about questions 5, 12 and 18.

5: How many times do you inject insulin per day?
You can choose 1 to 5 times a day, which assumes we all inject the same every day. While there will be more T2's for which this is correct (the ones on basal only, or on a mixed insulin who will inject once or twice a day) than T1's, many of have a variable number of injections, depending on food, activity and corrections.
For me the answer would be 'anywhere from 4 to 12 times a day'.

12: How often do you rotate your injection site per month?
You can choose answers between never and 4 times a month.
We're supposed to aim at a different spot with every injection, so for me the answer would be 'around 220 times a month'. The answers don't really make sense here.

18: Q: How comfortable would you feel about wearing a glucose monitor to assess your glucose levels throughout the day?
Many of us already do, even the ones with T2.
In my country, everyone on multiple daily injections or insulin pump gets a Libre funded, regardless of type. And many others self fund, even if they're not on insulin.

Hope this helps!

Hi Antje,

Ive updated the survey in the first post, and posted a link here. Please let me know if you have any more comments! If you would consider filling it out again with the updated questions, I would really appreciate it as well!

https://lboro.onlinesurveys.ac.uk/understanding-insulin-management-and-administration-in-eld-2

Kind regards
Aaron

 

[Antje77]

If you would consider filling it out again with the updated questions, I would really appreciate it as well!

Done. But this was the last time!
Much better, although I still couldn't choose a logical answer for the site rotation.
Long acting goes in my arms (front, back, shoulder, everywhere), bum or thigh as a rule, quick acting mostly in my belly (up to just below my breast and all the way to the sides too).

 

[lovinglife]

@AaronSalter - I have filled in your survey from the point of view of my father who was an elderly T2 with blindness and dementia- he really struggled with administering his insulin in last couple of years and I thought it might be helpful to you

 

[JMK1954]

I'm a type 1 and have been since the age of ten. I am now 68. I have arthritis (it runs in the family) and my hands are severely affected. As a result, I find insulin 'pens' too heavy to use, When I last switched insulin, the Diabetic Specialist Nurse insisted that I should use an insulin pen that was heavy enough to use as a cosh. As I couldn't dismantle the thing to get the insulin cartridges in, it went rapidly into the bin.
I am not the only diabetic who has arthritis in their hands, but we find that nobody can suggest anything helpful. The previous insulin injector device made my hand ache for an hour or so every time I did an injection. I currently use disposable insulin syringes. They are light but less than ideal. I have to make several attempts to draw up the correct number of units.As osteo-arthritis just continues to get worse over time, I am likely to reach the point whrte I depend on someone else to do my injections. Could we have the lightest possible injector designed, please ? Apologies for hijacking your post.

 

[Antje77]

Could we have the lightest possible injector designed, please ? Apologies for hijacking your post.

Doesn't sound anything like hijacking to me, on the contrary, I think this is exactly the sort of information Aaron was looking for!

As I couldn't dismantle the thing to get the insulin cartridges in, it went rapidly into the bin.

You might want to give it another shot (don't mind the pun) if it gets to the point where you do need help with your injections, provided you can get the needle on and off.
The refillable pens (at least those by NovoNordisk, so NovoRapid, Fiasp, Tresiba and Levemir) have a spring built in, so much less pressure is needed to inject than with disposable pens.
If you can work the pen, you'd only need help putting in the penfills, which is a lot less often than injecting.

Another thought: Have you looked into using a pump? You'd likely have the same problem of needing help changing your site/applying a new pod, but it would give you 3 days of being able to administer insulin, and likely without pain, so at least you'd only need help once every 3 days.

 

[Riva_Roxaban]

@AaronSalter Another couple of thing you should consider when designing your "wonder device" for older people to manage their insulin with, is cost effectiveness, and will will it be made from recyclable materials.

I have seen to many uni projects that end up reinventing the wheel in my lifetime.

I have not done the survey.

 

[JMK1954]

Just to clarify, I don't want a pump - end of story. Don't want to discuss it futher.

 

[Antje77]

Just to clarify, I don't want a pump - end of story. Don't want to discuss it futher.

No need for further discussion at all, not wanting one is perfectly fine, no matter what your reasons are!

 

[JMK1954]

Thanks for accepting my decision.

 

[EllieM]

I'm a month too young and the wrong type for the survey, but I would love to have a pen that automatically recorded my insulin use and sent it to my bg app. It's way too easy for me to forget to add my insulin use to my dexcom app and that would solve the (have I had my insulin, was it the right time and was it 4 units or 5?) quandary. But I for one value the fact that my insulin pen is compact and reusable, not sure I would sacrifice that for a more co-rdinated insulin record.

 

[Antje77]

I would love to have a pen that automatically recorded my insulin use and sent it to my bg app.

Are you still on Humalog? You might want to have a look at the InPen.

Not as sophisticated but very useful if you use any of the NovoNordisk insulins are the Novopen5 and Novopen Echo, which record your last dose, both time and amount.
Looks like they now have the Novopen6 and Novopen Echo Plus, which do something with an app as well, again, only for NovoNordisk insulins.

And then there are the Timesulin caps for different pens, which don't record your dose, but do record the time you last took off the cap from your pen. Sounds rather useful for long acting insulin to me.