This day, 10 years ago

This day ten years ago, the idea of Sensotrend was born.

I was attending the Mobile World Congress in Barcelona and happened to notice a session about diabetes. As a person living with type 1 diabetes, I decided to pop by and see what the mobile operators thought they’d have to contribute.

Most of the program was quite painful to watch. Presentations about how all the non-communicable diseases could be fully prevented if we’d just have apps nudging people make the right decisions…

But then there was Bastian Hauck , a patient advocate talking about his challenges. And many of the challenges were the ones I had had. Why can’t we see all the data collected by different apps and devices together somewhere, so that we could learn from that data? We use glucometers and continuous glucose monitors. We use pens or pumps to administer insulin. We have bolus calculators helping us select the right dose of insulin for each situation. We have watches that track our physical activity and apps to record our nutrition. Why don’t all these apps and devices talk with each other? Why can’t we get the data from all of them in one place and analyze it in smart ways? Or have smart apps analyze it for us and make our lives a lot easier?

A few years earlier the continuous glucose monitor had completely transformed my relationship with my type 1 diabetes. Before that, it was just too hard for me to understand all the factors that affected my glucose levels. The general advice I got was that I’d just need to estimate the carbohydrates in everything I eat and drink and dose accordingly. And perhaps pay attention to physical exercise, although nobody could tell me what the effects would be - you just need to measure it and learn. And I tried. But I didn’t seem to succeed and felt it was just too hard.

The CGM changed all this. Seeing the continuous graph finally helped me see how my glucose levels really changed. How they, for instance, lowered late at night after my bedtime and then started to rise in the early morning hours. Without that information, I would just have thought my glucose levels had been up all night. And seeing how the levels then stayed high throughout the morning and early afternoon, regardless of how much insulin I was injecting. And then crashing in the afternoon and jumping back up by themselves. What was really going on?

Having my blood glucose variations visualized like this turned a mystery into a puzzle. I was able to discuss all of this with my doctor with a completely new attitude. And she was now able to tell me that the rise in the morning was due to the cortisol effect, caused by long term stress. And the crash in the afternoon was due to that extra cortisol being excreted during the early morning hours and having a certain duration for its effect. And the rise? That’s my liver releasing glucose to my blood stream as a response to the low glucose levels. All of that is visible in just this single day. And I kept learning so much more every time I was wearing a CGM.?

There was a challenge, though. The graph was excellent in showing the challenging situations. But it was not optimal for learning. How much insulin had I dosed? How many carbs had I estimated to be in that meal? What kind of physical activity was involved? I had all that information available in the memory of my insulin pump and an activity tracking app on my phone but couldn’t see it side by side with the glucose graph.

So, I started building tools that allowed me to see all my data together in one view. I also used that app to discuss the treatment parameters with my doctor. And it worked great!

Before the Mobile World Congress 2013 I was doing all of this just for myself. Based on the feedback I got from my doctor I thought I was just about the only person with diabetes in the world that cares this much about his data, and one of the very few who care about their diabetes.

But Bastian’s presentation changed my perspective. He convinced me that there are other people, perhaps thousands or tens of thousands of people that share the frustrations I had had. And all those people might benefit from the tools I had built for myself.

That moment planted the idea that then started growing. It still took almost a year before Sensotrend was established as a company. And, alas, it has taken ten years and our service is still not what I imagined it to be and not helping as many people with diabetes as I’d like. I thought it would be easier. I thought it would happen faster. I still very much believe it will happen. And I still believe there is a need for what we do. This was confirmed again last week at the ATTD conference. We just need to keep pushing. And learning. And pushing some more.

Although we’re not yet there we want to be, I take some comfort in thinking that some of the things we have accomplished on the way have had a meaningful and positive effect on lives of many people with diabetes. Some of them have been through advocacy, some through our involvement in the open-source development community, some with our interactions with the healthcare professionals, the medical device industry, and the regulators.

I have an idea to publish some posts form the significant milestones from our journey. I’m not sure whether I’ll pursue that idea. If I will, I’ll most likely start those posts with “This day N years ago,” and tag them with #TenYearsOfSensotrend.