In July I will be using some of my leave to go back to Bolivia to carry out further staff training at our diabetes centre and to help plan the development of the centre. A current problem faced at the diabetes centre is access to insulin. The Bolivian government provides free insulin to a patient with Type 1 Diabetes, providing that the patient has routine (but rather detailed) blood tests every four months. Some of the patients are unable to afford the cost of these blood tests and as result have been unable to receive their insulin. It is a constant worry for our director of nursing that one of the youngsters will run out of insulin and not get to the centre in time for an emergency supply.
I could not help but think about these dilemmas faced by patients thousands of miles away, as I was chatting to a patient here in the UK this week. He also has Type 1 Diabetes. We were discussing a new piece of equipment from Sanofi called the iBG Star. This clever device, the size of a memory stick, plugs into an iPhone, has a flip out test strip and takes a glucose reading exactly like a traditional blood glucose meter. The accompanying iPhone app collates and stores all of the details about the readings and prepares it in neat graphical form, ready to be emailed off to your specialist nurse, GP, consultant or anyone else with whom you wish to share the information.
This was the first time that I fully understood the meaning of a comment I heard in a presentation some months ago by a senior consultant surgeon – I may have even mentioned this in a previous blog. He said that, “it will not be long before the most important piece of equipment that a doctor has is their smart phone”. I am not especially technologically savvy but the thought of having detailed information in an easy to understand format, literally at my fingertips, does have exciting implications for the management of chronic disease. There are clear parallels that could be drawn with monitoring blood pressure, respiratory measurements such as peak flow and oxygen saturations. How long will it be before these small, plug in devices can analyse urine samples or accurately detect electrolyte levels alongside a glucose reading?
When it comes to the management of chronic disease, there is nothing like planning a trip to Bolivia to bring me back to earth with a bump, but it does not stop me getting excited by the almost science fiction like advances in medical technology.