MedAngel Meetup at EASD 2017 — Lessons Learned in Insulin Safety

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We attended the 53rd EASD (European Association for the Study of Diabetes), Europe’s biggest diabetes conference in sunny Lisbon this year.

It was so great to gather a group of friends, diabetes bloggers, advocates doctors and dia-entrepreneurs for a breakfast meetup, talking insulin safety and MedAngel progress before a full day of talks and meetings at EASD.

Bloggers hard at work tweeting about what is happening 🙂

We started out by looking back at EASD almost exactly one year ago, back then we had a closed beta testing program on Android with a handful of users.

MedAngel has come a long way since then: our app is available on both Android and iOS and our sensor is available worldwide with the help of distributors in the US, Canada, Australia, France & Sweden. We are super proud to be almost sold out on the first batch of 2000 Sensors we produced and we’re super excited to incorporate all the learnings as improvements in the current production round (stay tuned for an update).

We have learned so much from our early users! We shared some stories and were very thankful to discuss the current product, challenges on the way and our vision with all the critical minds around the table, most of whom who have also been using MedAngel themselves.

Here are some highlights from the conversation:

1. MedAngel as a diabetes troubleshooting tool…

Everyone around the table had that moment when blood glucose levels go out of control and you have no idea why! Could it be that my insulin lost potency? MedAngel can take that variable our of the equation. So not only does it alert in case of a problem, it also reassures when things are well:

2. Most important away from home…

Another interesting pattern we noticed across all our users demographics is the importance of transporting insulin abroad. No matter if you get your insulin for free at home or have a high co-pay, this aspect is much more important when away from home. Not only is it exposed to different climates and transported for longer times, it is the hassle of getting a new prescription in a foreign country that no one wishes for on their holidays.

We shared a few user stories from our community, you can also check two of them down here:

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Traveling with diabetes (so far)! So, just about 3 months before we started our trip my partner got diagnosed with diabetes type 1 😱 we freaked out and thought we had to cancel everything. But after learning some more and my partner learning to deal with the disease, we realized that (hopefully) the only big hurdle we will have to deal with is keeping 6 months worth of insulin (planning to buy more in Australia) fridge cool ❄️ So far (one week in) everything has worked well! We store the unopened pens in a small cooling bag together with a MedAngel thermometer to check the temperatures. On the flight it was no problem asking for some ice to put in the bag to keep it cool. And now on the safari we have been allowed to put our cooling bag into the chefs bigger cooling box which works great. Sometimes the temperature has been up to +12, but only for short periods of time. The "in use pens" are kept at below +30 using the FRIO case which works great 👍 The guesstimations on how much insulin to take for each meal seems to work ok as well, same as at home. His blood sugar has never been too low and rarely too high, which is great! #travelwithdiabetes #diabetes #diabetestype1 #medangel #frio #travelaroundtheworld

A post shared by Linda Nordström (@linda.cc.nordstrom) on

Source: Amazon.com

3. So it’s “too hot” or “too cold”, now what?

While the information MedAngel provides gives reassurance or help to store insulin right in the first place, we learned that people wish for more guidance on what to do with information if something goes wrong. Bastian brought this up by asking

Wouldn’t it be great to have a quick test strip for insulin effectiveness?

(we wish it was that easy 😉 but until today, insulin quantity can only be measured with lab equipment).

To get an idea if insulin quality might have been compromised, temperature excursions remains the best indicator. But how can we know, when an temperature out of the safe range becomes really critical for insulin? Steffi added from her experience:

I was travelling by car in Croatia and I got “too hot” alarms for a few hours, because I had forgotten my Frio bag. Did I throw out my insulin because of this? No!

Steffi, Sarah and Charlotte discussing

There was a strong consensus around the table about discarding insulin. Whether people are paying the full price for their medications out of pocket or can get a new prescription for free: everyone agreed on trying to avoid to throw out insulin. As Cathy said:

I know that not everyone has access to it and it makes me feel really bad to throw precious medication away.

The safe temperature range of medication was compared to the best before date for food — you kind of know, that this value is quite conservative and is already taking some non-optimal storage times into account. However, with for example a box of milk, one can simply smell it to judge whether or not it’s still fine. With insulin, changes in potency are invisible.

When insulin “goes bad“, it gradually loses therapeutic effectiveness without becoming harmful. A partial loss of effectiveness might be hard to assess, especially because so many other variables play into blood glucose levels. As Steffi continued:

My levels were quite high for the rest of the trip, but who knows if that was the insulin, the food or just being on vacation.

This discussion has definitely sparked some new ideas and given us new challenges to work on!

4. The frenemy: your domestic refrigerator

It was also interesting to see that people’s awareness about the conditions of storage at home considerably increase when they start to see the fluctuation.

Typically, people order a MedAngel for travelling, but first test it at home in their fridge. They are surprised to see that they need to change the spot or need to adjust settings to maintain the safe temperature range. Or it might work perfectly for a while until it doesn’t, as with Insulin Junkie who held on to his MedAngel sensor for nine months! until his misbehaving fridge prompted him to write a review.
In any case:

Thank you to everyone who joined! We are left with lots of ideas and motivation for the coming year and hope to see you all at EASD 2018 in Berlin!

Bastian, Germany https://twitter.com/tadorna
Cathy, Belgium
www.aantafelmettype1diabetes.com
Charlotte, Belgium
https://www.instagram.com/charlottecelebrateslife_type1/
Delphine, France
https://worlddiabetestour.org/
Kevin, Australia
https://twitter.com/@dr_kevinlee
Kevin, Germany
https://twitter.com/getlumind
Lea, Germany
http://www.insulea.de/
Michael, France
http://www.coloremavie.com/
Renza, Australia
https://diabetogenic.wordpress.com/
Sarah, Germany
http://www.dia-beat-this.de/
Steffi, Germany
http://pepmeup.org/
Tine, Germany
http://www.icaneateverything.com/

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Amin Zayani
Sep 22, 2017
Amin Zayani
CEO and co-founder of MedAngel, solar energy engineer turned digital health entrepreneur by accident.
@AminfiBerlin