NUTRITION411: THE PODCAST, EP. 26

Diabetes Technology: Game-Changer or Double-Ddged Sword?

Lisa Jones, MA, RDN, LDN, FAND

This podcast series aims to highlight the science, psychology, and strategies behind the practice of dietetics. Moderator, Lisa Jones, MA, RDN, LDN, FAND, interviews prominent dietitians and health professionals to help our community think differently about food and nutrition.

In this episode, Lisa Jones interviews Jennifer Smith, RD, LD, CDCES, and Susan Weiner, MS, RDN, CDN, CDCES, FADCES, about the benefits and pitfalls of diabetes technology, including ways to overcome challenges. This is episode 3 of a 4-part series.

Additional Resources:

Listen to part 2 of this 4-part podcast series here. 

Listen to part 4 of this 4-part podcast here. 

TRANSCRIPTION:

Narrator:

Hello and welcome to Nutrition 411: The Podcast, a special podcast series led by registered dietician and nutritionist Lisa Jones. The views of the speakers are their own and do not reflect the views of their respective institutions or Consultant 360.

Lisa Jones:

Hello and welcome to Nutrition 411: The Podcast where we re-communicate the information that you need to know now about the science, psychology, and strategies behind the practice of dietetics. Today's podcast is part of a series of short episodes on diabetes technology featuring a Q&A with Jennifer Smith and Susan Weiner.

I want to introduce Jennifer first. Jennifer holds a bachelor's degree in human nutrition and biology from the University of Wisconsin, Green Bay. She's a registered and licensed dietician, certified diabetes educator, and certified trainer on most makes and models of insulin pumps and continuous glucose monitoring systems. She's an active member of the American Diabetes Association, and American Association of Diabetes Educators, and was an active member and educator for Team WILD, which means we inspire life with diabetes. She's also in contributing author for the Diabetes Sister's website. For the past 10 years, Jennifer has been the director of Lifestyle and Nutrition with Integrated Diabetes Services. Jennifer has also lived with Type one diabetes since she was a child, so she has firsthand knowledge of the day-to-day events that affect diabetes management. Welcome, Jennifer.

Jennifer Smith:

Thank you. It's wonderful to be here. Yeah.

Lisa Jones:

Thank you for being here.

Jennifer Smith:

Of course.

Lisa Jones:

And now I want to introduce Susan. Susan is an award-winning nutrition, health, and diabetes expert, and the owner of Susan Weiner Nutrition. Susan served as the 2015 ADCES Diabetes Educator of the Year and is an ADCES fellow. Susan is the diabetes in real-life columnist for Endocrine Today and is the on-air host for video interviews and content for helio.com. She's the co-author of the Complete Diabetes Organizer: Your Guide To Less Stressful and More Manageable Diabetes Life and Diabetes 365 Tips for Living Well. She has extensive TV, radio, podcast, and video experience and is well-versed in media communications. Welcome, Susan.

Susan Weiner:

Thank you so much, Lisa. It's great to be here.

Lisa Jones:

Well, welcome to episode three. In this episode, we're going to be talking about exploring key topics and debates in dietetics, and during our last episode, we covered emerging technological advances. Susan, if you had to sum up that conversation in one or two sentences, what do you think the key takeaways would've been?

Susan Weiner:

To keep a person centered on where a person is right now on their diabetes journey in terms of what they're ready to take on, what would work best for them? Have there been any recent changes critically in their life? Has their insurance changed? Has their marital status changed? Their job changed before adding any additional technology, which is a great way to get data and share data, and to make seamless and frictionless decisions in care. It may not be the correct fit at the correct time if the person with diabetes is not ready to take it on. And additionally, if you are making any suggestions, make sure it's a good fit in terms of the person's insurance, language skills, literacy skills, and numeracy skills as well.

Lisa Jones:

Yes. Thank you, Suzanne. It's a good soundbite too. Correct fit at the correct time, easy to remember. So thank you for that. How about you, Jennifer?

Jennifer Smith:

I'm glad that Susan brought in making sure to check into availability. Again, make sure you keep up with somebody's insurance. While that may be something that they do even before they check in with your visit, if you are going to make any recommendations about new products, also consider whether they've changed devices, right? If they might be using an Apple based or an Android-based, there are some apps that don't necessarily cross over yet, although most of them do. Some have to have a specific platform to or operating system to work on. So that's certainly something to consider as well. Just keeping up with the person on their personal level and what their needs and abilities are. They may have also shifted jobs or changed locations and all of those things will impact the use of technology in one way or another.

Lisa Jones:

Yes, it almost sounds like you need, whether it's written down somewhere until you're doing it, like both of you do this so often that you probably have this checklist in your head that you go through when you're asking these questions, the type of phone they have, that's even something that you have to ask about and find out. So that's a lot. So that's another thing to keep in mind, that checklist.

Jennifer Smith:

Yes, absolutely. I work with technology so much with the people that I have the opportunity to work with that it's almost a background. You're still using this, you're still doing this. And I can also see with some of the uploads that I look at, what type of device they've changed to or they're looking at using. Many people also reach out and ask me, is my system going to work with this? Do I need to think about anything in particular? But it is something to keep up with. And sometimes from the professional level, it can be kind of overwhelming for you too.

Lisa Jones:

Yes, exactly. And that dovetails nicely into my question and that is the use of technology in diabetes management a game changer, or is it a double-edged sword? So I'm curious to what your thoughts are, Jennifer, and Susan.

Jennifer Smith:

Yeah, I think a double-edged sword is, I don't know, it makes it sound kind of nasty, but honestly, I don't think there's a better way to describe it. I do believe that the new technologies that we have and these apps are absolutely positive. I think that personalizing, as we've made emphasis in all of these questions and discussions is really, really necessary. I think the backend is to make sure that you're recommending the right thing. That's where that double-edged sword part can come in. If you're recommending something that isn't going to be as beneficial to somebody, talking to the person, and really again, getting to know them becomes the way that you can make it the better side of the sword than the sharp side of the sword, if you will.

I think that we have a lot better connection with the apps and the technology that we have today. Even the use of electronic medical records has made it easier for most people to be able to reach out and make a quicker connection and get quicker answers or quicker feedback on something that has shifted or changed. And they need to know right now what to do about it. So I think overall, the emerging technology and where we're going with the use of technology in medicine and many medical conditions is very beneficial if we as the provider remember to use it the right way.

Lisa Jones:

Yes, use it the right way and put down the sword, and actively listen. And I'm thinking Susan's probably going to agree with that, but let's find out. What do you think, Susan?

Susan Weiner:

I definitely agree in today's day and age to put down the sword, I'm going to leave that one right there. And I would like to add that we remember as clinicians that the data that we're getting from apps is just information. It's not a report card. It's not something for us to shake our fingers at the people that we're trying to help. It's information to help develop their individualized care plan and to update it. And as Jenny said, the emerging technology that's coming out is coming out really fast and really furious. And that may for some people, go back to the double-edged sword of cybersecurity and privacy concerns, remembering that not most apps don't have to go through FDA approval. Again, CGMs and pumps, continuous glucose monitors, and pumps are FDA-approved, but apps may not be so some people may have that concern as well.

So we have to also delineate what part of the technology we're talking about in terms of adoption. Everything may look really shiny, but we have to go a little deeper and see who it would work for when something that may work for somebody now may not work for them in six months. Someone who may be turned off by the ideas of apps now may want to revisit it as a dietician in six months. They may be more open with it depending on where they are on their diabetes journey.

Lisa Jones:

Yes. And excellent points about cybersecurity and privacy. Another thing to add to this checklist that we have going here. Now the shortest is shiny, but we're going to put that away for a second. But there are any other comments that either you Jennifer, or Susan have about this particular topic? It just sounds like it's definitely a game-changer.

Jennifer Smith:

It is. It's a huge game-changer. I think back, even again from a personal standpoint, and having my mother still thankfully around, she sees the major difference in the use of my technology today. And when I tell her with the work that I do with all of the wonderful people, I get the opportunity to help, she's like, "Gosh, what it would've been like to be able to have an alert overnight, not to have to come in and do a finger stick by setting my own alarm and actually checking to see how things were for you." So there is an enormous benefit to the technology that we have today.

I think burnout is a really big piece to remember and that it can become overwhelming and you again have to really listen to the people that you get to work with and find the sweet spot of navigating the use of it, but you also can teach people how to not make it so overwhelming. I mean, with the CGMs that we have today, gosh, you can look all the time. You could have that CGM open and sitting on your desk and that's all you're paying attention to. So we have to also be able to teach people healthy use of this technology so that it doesn't become an additional burden.

Lisa Jones:

So it goes back to balance, just like we balance what we're eating, we're balancing how we're using the app. That's a great takeaway. And how about you, Susan? Any additional thoughts?

Susan Weiner:

I was thinking one way, and now that Jenny just made that excellent comment about balance. It's extremely important to evaluate where someone is over the course of time at critical times, where they are upon diagnosis, and where they are annually upon a visit if anything else comes up in their care. If a person has developed an issue with vision or visual acuity or with hearing loss or with balance issues, these may be all things that affect technology, the ability to use technology or the need for more technology and more connection with the care team. And one of the biggest benefits I find with apps and with technology, in general, is that somebody can find support, whether through the healthcare team or through peer support, there are many peer support aspects of diabetes-related apps where they want to have a private conversation about something that's going on that they may not want to have with their dietician or their physician or their nurse practitioner.

So I think that there are a lot of very positive aspects of it. We have to, and we must, when we speak about technology with people living with diabetes, discuss with them that if something does not work, there are many other things to try. It's not a be-all-end-all, even though it might be what we are familiar with, as Jenny said in our organizations. And that's where I think it's really important for us to stay very open-minded, keep up with the latest technology, but listen to what the person with diabetes needs at a specific time in their lifespan.

Lisa Jones:

Yes, yes. So true. And the other thing that you were talking about with the support, and I think many patients or clients, if you will, will stay someplace just because they feel supported and they'll stay with you as a client, as a patient. So an excellent point about the support. So thank you very much for this great conversation we've been having around the debate in dietetics.

Jennifer Smith:

Thank you for having us.

Susan Weiner:

Thank you so much.

Narrator:

For more diabetes technology content, visit consultant360.com.