GoDiabetes Campaign 2012

An Open Letter to: 

Star Alliance Airline Members

 and

OneWorld Alliance Airline Members

Both of your organizations have a very impressive network of airlines and every day you move millions of people around the world. Thank you.

Now we would like you to help the many millions of travellers living with diabetes.

Around the world 350 million people live with diabetes and at least 25% need to take insulin every day. Travelling with diabetes can be difficult. Lack of information, hassles at the airport, delays, time-zone changes can ruin a trip whether it is for business or pleasure. At VoyageMD we believe that airlines can make small changes that will make a huge difference for travellers with diabetes.

To help them we would like to suggest that Star Alliance and OneWorld Alliance members work with VoyageMD as part of our 2012 GoDiabetes Campaign to:

• Make sure that all aircraft carry equipment for blood glucose monitoring
• Make sure that all flight crews are trained to recognise a low blood glucose level (hypoglycaemia) and know how to deal with it
• Provide the carbohydrate content of airplanes meals to help travellers chose a safe and accurate insulin dose and
• To work with VoyageMD to make it easy for travellers to identify a “diabetes-friendly” airline for their travel choice.

You are already offer to help bring healthcare professionals involved in diabetes care together to showcase the latest scientific medical advances at many international meetings each year.

At VoyageMD we are now asking you help travellers with diabetes. Join our 2012 GoDiabetes campaign and become a “Diabetes-Friendly” airline that travellers with diabetes will want to use.

Web:               http://www.voyagemd.com

Email:             david.kerr@voyageMD.com

Twitter:            https://twitter.com/#!/GoDiabetesMD

Happy New Year from VoyageMD

We have been rather quiet on the blog front recently but for good reason. VoyageMD.com is about to add additional features to help travellers with diabetes even more. We will shortly launch our  journey planner to help travellers by:

• Entering the departure and arrival airports with the date and time and the planner will 
• Provide specific information about the most appropriate time to check blood glucose levels and
• For insulin users - have specific information about how to mange time zone changes

This is in addition to a guide to travel covering aspects from dealing with airport security, what to pack, letters for travel, sick day rules etc etc and all of this will be on an App!

In the New Year we will also be launching a campaign to persuade airlines to do more for travellers with diabetes beginning with simple things such as: (a) carrying equipment for blood glucose monitoring, (b) making sure flight attendants are aware of the symptoms and signs of hypoglycaemia and how to deal with it and (c) provide the carbohydrate content of in-flight meals.

We will also ask travel insurance companies to think about creating new insurance products for travellers with diabetes which will cover short trips. Many of the problems that can occur are predictable and with some planning can be planned for.

We will also make it easier for travellers with diabetes to upload their experiences, photos, thoughts etc about their journey on VoyageMD.com. Our personal reviews of hotels and restaurants will continue and we hope that others will add their own reviews.

More and more people are coming to VoyageMD for travel advice. Let us know what other features you would like to see.

And for people with diabetes travelling over the holiday season - Bon Voyage and see you next year.

VoyageMD

Its a Wonder - song for all travellers with diabetes

Our good friend, Polly Morris heard about VoyageMD and thought there could be material for a song based around all the ups and downs that travellers writhe diabetes face.

We think the song, "It's a Wonder" if excellent - funny, quirky and catchy. See if you agree? Just click on our home page and there it is..

http://www.voyagemd.com/

Soon we will also move into the Journey planning space. We will be able to translate flight information into a planned journey including guidance about blood glucose monitoring as well as all the usual information. The plan is to create an app as well so things are really taking off for VoyageMD.

Watch this space for more information and developments and if you like Polly's song tell us and we will pass this on. If you would like Polly to write a song for your organisation drop me an email at david.kerr@voyagemd.com

New research studies - blood glucose monitoring

At VoyageMD we have been involved in publishing some new ideas around blood glucose monitoring with American and European colleagues. Here are the links:

http://www.journalofdst.org/November2011/PDF/Abstract/VOL-5-6-CLA1-KERR-ABSTRACT.pdf

http://www.journalofdst.org/November2011/PDF/Abstract/VOL-5-6-REV1-KLONOFF-ABSTRACT.pdf

What do they mean:

Self-monitoring of blood glucose is not easy but the results obtained could be much more valuable for people living with diabetes the results lead to positive action. It is likely that positive action will be possible with the introduction of new technologies:


 Device manufacturers could include tools to accomplish the following:

o Systems for supporting behaviour change to help people lose weight
o Using new social media to deliver education and peer support and for providing immediate feedback on a device.
o Translate blood glucose test results into understandable information and advice for diabetes management
o Bolus and basal insulin calculators for patients using multiple daily injections of insulin
o Devices for supporting home monitoring and care at a distance from specialist centres
o Aids for interpretation of SMBG data in the form of pattern recognition of hypoglycemia and/or hyperglycemia recurrence.
o Subsequent developments could include specific prompts for clinicians about potential reasons for these events occurring (e.g., inadequate insulin dosing, wrong time of administration of a bolus dose, or insulin stacking due to too frequent bolus dosing)

Also we need to move away from random measurements of blood glucose to provide a more structured approach such as focusing most of the testing between clinic visits in the 1-2 weeks before seeing the doctor.

The bottom line: SMBG is remains a very good idea provided it is thought through and structured. Random testing just for the sake of it is a waste of money.

VoyageMD meets Phineas Fogg

Nowadays there are ever increasing technologies becoming available for people living with diabetes. However it is still not easy to keep blood glucose levels as well controlled as we would like. Part of the challenge is incorporating blood glucose monitoring, taking injections, using a pump or glucose sensor etc whilst dealing with life and all of the "slings and arrows of outrageous fortune" that it brings (that's Shakespeare in case you didn't know).

As you can see from our site, travelling with diabetes can cause particular differences due to dealing with airport security, changing time zones, unfamiliar foods, delays, extreme temperatures to name but a few of the hassles.

At the same time the manufacturers of new technologies for diabetes are forever trying to persuade us that their new product or gizmo will relieve some of the burden and help to improve blood glucose control as well as reducing the risk of hypoglycaemia.

Therefore we would like to throw down the gauntlet to the manufacturers of devices for diabetes to sponsor round-the-world trips for young people living with diabetes.

The idea is that the young travellers would use the latest technologies (including pumps, pens, meters and sensors) to travel around the world in the shortest amount of time but to keep their diabetes as well controlled as possible throughout. They also must include 3 stop-overs of 3 days in order to sample local foods. Just to add a little spice we will plan the journey just to be a little off-the-beaten track....!

The winner will be the young person with the best overall control of blood glucose levels over the whole journey.

Let's see if the technology companies have enough faith in their products to let us undertake the ultimate road test...

Not All Diabetes Social Networking Sites Are The Same!

As we are all aware, the growth of online social networking for chronic medical conditions such as diabetes has been nothing short of astounding in recent years. As a clinician seeing people with diabetes (type 1 and type 2, young and old) on a daily basis it is quite clear that more and more people are becoming better informed becasue of these sites. However I am also spending increasing amounts of time “myth-busting” – changing perceptions about diabetes monitoring and treatment that have been based on dubious information obtained from some sites. So next time you log on to your favourite site ask yourself a few questions before you take on board the advice and especially before divulging information about yourself. Here are a few "check" questions:

• Does the site verify that the “experts” responding to your questions are who they say they are? Are they experienced in diabetes care or have experience living with the condition?
• Ask yourself who checks the site content for accuracy – an administrator, a person with diabetes, a nurse educator a doctor or no-one?
• Who pays for the site and is there a conflict of interest in terms of advertising and the information on the site?

Researchers from the US have recently published results of a survey of on-line social networking sites for diabetes in the medical journal Archives of Internal Medicine (the actual reference is Arch Intern Med 2011, Volume 171 (NO.17), pages 1589-91, http://www.archinternmed.com/). The researchers have highlighted the fact that high profile sites with many thousands of members can differ widely in the above aspects. many sites are dependent upon funding from Pharmaceutical, Diabetes Device and Insurance companies and that the majority also advertise products from the diet and exercise industry space. There is nothing wrong fundamentally with this but it is important to be aware of this given that there might occasionally be a conflict of interest.

I will ask the medical journal (Archives of Internal Medicine) if they are happy for me to post details of some specific sites here as you might like to see this report and check out your favourite site. Any questions ping me an email at info@VoyageMD.com or send a tweet (@GoDiabetesMD).

Clinical Research from VoyageMD

Our main aim at VoyageMD is to make travelling with diabetes safer and easier and we are making progress. Meanwhile we also believe that it is vital that we continue to contribute to medical research.

The focus of our research is 100% clinical – directly for the benefit of people living with diabetes. We are not involved in basic research or research involving animals.

We would like to keep everyone up to date with our research program. Here is a list of our recent publications since the start of 2011.

If you would like to support our research program – clinical research is very expensive then we would love to hear from you!

If anyone requires more information please ping us at: david.kerr@voyagemd.com


Here are the references with the Journal name and link together with summary “tweets” for the non-experts:

1. Hypoglycemia  decreases  myocardial  blood  flow  reserve  in  type 1  diabetes  and  in  healthy  humans. Circulation.

http://circ.ahajournals.org/content/early/2011/09/11/CIRCULATIONAHA.110.992297.long

Heart problems caused by low glucose levels may due to reduced blood flow to the heart rather than rhythm problems?

2. HbA1c 3 months after the diagnosis predicts premature mortality in patients with new onset type 2 diabetes. Diabetic Medicine

http://www.ncbi.nlm.nih.gov/pubmed/21913968

At diagnosis of type 2 #diabetes control blood glucose levels as well as possible in the first 3 months – the benefit lasts a long time

3. Insulin pump therapy with automated insulin suspension in response to hypoglycemia: reduction in nocturnal hypoglycemia in those at greatest risk. Diabetes Care

http://care.diabetesjournals.org/content/34/9/2023.long

New pumps that stop infusing insulin when the glucose sensor detects a hypo could reduce risk of severe ones #diabetes

4. Self-monitoring of blood glucose in type 2 diabetes: teaching an old dog new tricks. Journal of Diabetes Science and Technology

http://journalofdst.org/worldpress/index.php?s=kerr&submit=Search

Thinking about timing and frequency of finger-stick blood testing in type 2 #diabetes can help to achieve better glucose control

5. Using insulin in type 2 diabetes – in need of a renaissance? Journal of Diabetes Science and Technology

http://journalofdst.org/worldpress/index.php?s=kerr&submit=Search

New technologies such as bolus calculators can overcome barriers to intensive insulin therapy in type 2 #diabetes

6. Deus ex Machina: the use of technology in type 1 diabetes. Primary Care Diabetes

http://www.primary-care-diabetes.com/article/S1751-9918(10)00138-5/abstract

Health care providers in primary care need to be aware of the potential benefits of technologies for #diabetes care

Take the Alcohol and Calorie test

Many of us like to have a few drinks on holiday. However many of us are also watching our waistlines. Have you ever considered the amount of calories in alcoholic drinks? See if you know the answers to the following questions and email them to info@VoyageMD.com

We will post the correct responses in due course

Cheers!!


1. What is the daily recommended calorie intake for women?
(a) 1000     (b) 1500     (c) 2000     (d) 2500     (e) 3000     (f) Don't know

2. What is the daily recommended calorie intake for men?
(a) 1000     (b) 1500     (c) 2000     (d) 2500     (e) 3000     (f) Don't know

3. How many calories do the following drinks contain?

One standard glass of wine (175 mls)
(a) 0-50     (b) 51-200     (c) 201-400     (d) 401-600     (e) more than 600     (f) Don't know

One bottle of wine
(a) 100-300     (b) 301-500     (c) 501-700     (d) 701-900     (e) more than 900     (f) Don't know

One pint of standard strength beer
(a) 0-100     (b) 101-250     (c) 251-500     (d) 501-700     (e) more than 700     (f) Don't know

One pint of dry cider
(a) 0-100     (b) 101-250     (c) 251-500     (d) 501-700     (e) more than 700     (f) Don't know

Single measure of "Baileys" liqueur (25 mls)
(a) 0-20     (b) 21-150     (c) 151-300     (d) 301-450     (e) 451-600     (f) Don't know

Vodka (single measure 25 mls) and Red Bull (half a can)
(a) 0-20     (b) 21-150     (c) 151-300     (d) 301-450     (e) 451-600     (f) Don't know

Gin (single measure 25 mls) and Slimline tonic (half a glass)
(a) 0-20     (b) 21-150     (c) 151-300     (d) 301-450     (e) 451-600     (f) Don't know

Bacardi Breezer (alcopop, 1 bottle)
(a) 0-20     (b) 21-150     (c) 151-300     (d) 301-450     (e) 451-600     (f) Don't know

Who wants to talk?

The recent change to Facebook whereby Pharmaceutical and Medical Device companies are no longer “protected” from comments being posted on their walls has led to some removing themselves from this form of social media completely. Others have basically said “no worries” and seem to be happy to continue to embrace this form of communication with patients and healthcare professionals.

To us at VoyageMD this is a discriminator between companies – those who have confidence in their products are unconcerned and will use social media more and more. Perhaps those who have not even dipped a toe in this particular water have something to hide? The excuse that some companies are waiting for the FDA (Food and Drug Administration in the United States) to produce guidelines before developing their social media presence is curious given that others are more than happy to post, blog and tweet.

In the diabetes space NovoNordisk (@Novonordisktbl), Animas (@cgc0211) are very responsive to questions from VoyageMD (@GoDiabetesMD) as are Roche (@accuchek_us). Here is a snippet of our recent dialogue with them on twitter:

@GoDiabetesMD

@Accuchek_US We would like to include a short summary of what you can offer travellers with #diabetes: bit.ly/ocPsrM Please reply

@accuchek_us

@GoDiabetesMD No special instructions for air travel, but travelers should always carry plenty of spares in case of high BG readings

@GoDiabetesMD

@accuchek_us How often should sets be changed and advice on if sets need changing more frequently if flying? #diabetes #travel #insulin

@accuchek_us

@GoDiabetesMD Accu-Chek infusion sets should be changed every 1 - 3 days, depending on instructions for use that came with set

@GoDiabetesMD

@accuchek_us Does that include the tubing? Sorry to be so specific but it matters

@accuchek_us

@GoDiabetesMD Yes, that includes tubing - again, check instructions or call customer care 800-280-7801 if there is any question. Thanks!

Social media is here to stay and at VoyageMD we are using social media to develop our site for travelers with diabetes. Hopefully the larger companies will no longer shy away from social media – after all it is how increasing numbers of us communicate with each other, why not with them?

Conversations with Airlines - Tweet first

The world of airlines is extremely competitive and all of them try very hard to differentiate themselves from each other. This is good for travellers in general. After all, as travellers, we are also customers and have a choice. At VoyageMD we are very keen to help airlines become much more diabetes-friendly and have suggested a number of ways to achieve this.

One thing is clear however – if you need to contact an airline to glean information, solve a problem or simply check out the latest offers then our suggestion is to use Twitter first. Avoid phoning them before tweeting as there will not be a record of the conversation and generally sending an email results in a less than helpful response usually from a individual called "customer service". A tweet is a record and in the public domain.

To help here is a list of Twitter accounts for all of the airlines currently listed on VoyageMD.com. Not all are as diabetes-friendly as they could be but at least they are listening. We will add to this as time goes on. You can always make additional suggestions to the ones from VoyageMD – soon 1 in 10 of adults will have the diagnosis of diabetes and a huge number will need to book a flight at sometime. The airlines are working with us to improve things so if one is particularly helpful towards travellers with diabetes let us know and send a tweet to help others.

Soon we will be using social media to try to have the same level of conversation with diabetes Pharma and Device companies. Their responses will be interesting to say the least.

Bon Voyage

AIRLINE	TWITTER
Air Canada	@AirCanada
Air New Zealand	@FlyAirNZ
Alaska Airlines	@AlaskaAir
American Airlines	@AmericanAir
British Airways	@BritishAirways
Delta	@Delta
Emirates	@FlyingEmirates
Hawaiian	@HawaiianAir
Jet Blue	@JetBlue
KLM	@KLM
Lufthansa	@Lufthansa
Malaysian	@MAS
Qantas	@QantasAirways
South African Airways	@SAAUSA
South West Air	@SouthWestAir
Swissair	@SwissAirLines
United	@United
Virgin Atlantic	@VirginAtlantic

An Open letter to Star Alliance Airlines

At VoyageMD.com we are delighted that Star Alliance™ has been appointed the "official airline network" for the European Association for the Study of Diabetes Meeting (EASD) 2011 in Lisbon and World Diabetes Congress 2011 in Dubai.

This means that Star Alliance Airlines will be bringing many thousands of professionals involved in diabetes care together to provide an opportunity for them to discuss the latest scientific breakthroughs and innovations for people living with diabetes. You certainly have a very impressive network:

·        Member Airlines: 27

·        Number of aircraft : 4,023

·        Number of employees: 402,208

·        Passengers per year: 603.8 million

·        Sales Revenue (in US$): 150.7 billion

·        Daily departures: 21,000

·        Number of airports: 1,160

·        Countries served: 181

How about also using working with VoyageMD to help the many millions of travellers with diabetes?

We have already been in contact with Star Alliance members but many have not replied to our simple question:

“I have diabetes and I take insulin every day. I need to travel. What do you offer to make my journey easier and safer?”

To help travellers with diabetes we would like to suggest that Star Alliance members work with VoyageMD to:

• Make sure that all aircraft carry equipment for blood glucose monitoring
• Make sure that all flight crews are trained to recognise a low blood glucose level (hypoglycaemia) and know how to deal with it
• Provide the carbohydrate content of airplanes meals to help travellers chose a safe and accurate insulin dose and
• To work with VoyageMD to create easy to use software that will
• Allow travellers to identify a “diabetes-friendly” airline
• Provide information about how to deal with crossing times zones and the impact this can have on controlling blood glucose levels
• Provide contact information at the destination in case of loss of diabetes equipment or illness

You are already offering to help healthcare professionals involved in diabetes care. We now ask that you also help travellers with diabetes.

Please feel free to contact me at David.kerr@VoyageMD.com

What is VoyageMD?

VoyageMD.com

“ A journey is measured in friends not miles”

It is said that travel broadens the mind. I agree with this and so do very many other people. Think of how important travel is for pleasure, for business and for staying in touch with family and friends. The enjoyment from travel is the anticipation and arriving at the destination. Actually getting from A to B is often the least attractive part of a journey. If everything goes according to plan and there are no delays this part of the journey is tolerable. However remember the last time your flight was delayed, the driver didn’t turn up at the airport on time or your hotel was actually not quite so luxurious as the brochure had suggested.

If you have diabetes the hassle associated with travel has the potential to be multiplied many times. People living with diabetes have an unenviable task. They need to spend on average 1-2 hours every day taking care of their condition. Taking care means checking blood glucose levels, balancing the effects of food and exercise, remembering complicated treatment regimens and at the same time putting up with the insecurity that comes with living with a chronic disease and it’s potential to cause serious complications. For people using insulin they have the considerable added challenge of taking their injections (or using an insulin pump) aiming to keep blood glucose levels within acceptable limits but avoiding the scourge of hypoglycaemia.

 If then you add on the complexity of having to travel with diabetes it is not surprising that many report real problems keeping their condition under reasonable control on a trip. Furthermore the problems of changing time zones, unaccustomed exercise, unfamiliar foods, delays, unhelpful airport procedures, loss of vital diabetes medication and monitoring equipment can wreck a holiday or a business trip for someone with diabetes.

Diabetes is not a small problem as estimates suggest that soon more than 300 million people worldwide will be living with the condition. For the 25% who need to take insulin everyday travelling with diabetes has the potential to become a nightmare.

What if a person with diabetes on insulin could chose an airline that understood the problem and could help, what if the hotel could provide important information about meals, where local pharmacies are located, who is the best local source of help for a diabetes-related problem etc. What if a person with diabetes could simply type in their destination and they could instantly access the most affordable “diabetes friendly” airline and stay at the most “diabetes friendly” hotel? What if they could on one click of a mouse also purchase the most “diabetes friendly” travel insurance?

These “what ifs” are not pipe dreams or some fantasy. They can and need to become reality and that is why I have set up VoyageMD.com.

VoyageMD

Welcome to Diabetes MD

Soon 350 million people will be living with diabetes and at least 25% will need to take insulin every day. 

Travelling with diabetes can be difficult - lack of information, hassles at the airport, delays, time zone changes can ruin a trip whether it is for business or pleasure. It doesn't have to be like that.

We will be asking major Airlines, Hotels, Travel Sites and Travel Insurance companies to help as well as companies that are already in the diabetes space - manufacturers of insulin, pumps, pens, glucose strips and the medicines that people living with diabetes have to take every day. We will also be keeping you up-to-date with advances in technology that have the potential to make travelling with diabetes just that little bit easier.

Wherever possible we will use the new Social Media to achieve our goals. Most importantly we need feedback from travellers themselves - tell us your stories, share your photographs and memories. At present we cannot cure diabetes but we can make living with diabetes a whole lot easier.