Digital inclusion: age doesnt have to be a barrier. Charlotte James, Director of Communications, Engagement and Marketing at Eastern AHSN, explains how we are supporting people overcome the digital barrier to manage their type 1 diabetes from their smartphone. I n todays society it is easy to think we all live in an entirely digital world, but if you like me have been trying to video call your parents during lockdown, or help them shop for groceries online, you might not be as surprised that in reality there are 12.6 million people in the UK What is type 1 diabetes? who lack basic digital skills and a further 5.3 million people have never been online before.1 When it comes to health, individuals of an older age are one of the main groups less likely to engage in digital technologies.2 a danger that the inequalities in health and care already felt by this group become more pronounced.3 To avoid this danger, we should always consider ways innovations can reach people who are digitally excluded. The digital divide has been shown in even sharper focus during the pandemic. It is critical that health and care services provide digital inclusion and training programmes, such as the NHS Widening Digital Participation programme, and readily consider these individuals for digital-led interventions, even if it may require additional training and support. One individual who we have worked with this year, who once considered himself digitally challenged, is Roger, aged 69, a retired headteacher from Cambridgeshire, who has lived with type 1 from glass syringes and thick needles sterilised in a saucepan of boiling water to a sophisticated smartphone app CamAPS FX which uses an adaptive algorithm to continually respond to and administer his optimal dose of insulin 24 hours a day. Eastern AHSN has supported CamDiab, the company commercialising CamAPS FX, by working with it to develop its key messages and communications to succinctly tell its story and engage people living with type 1 diabetes. We also helped it develop an animation to easily explain how the app Type 1 diabetes is a life-threatening chronic condition that requires ongoing monitoring through life and has a life-long impact on both those diagnosed with it and their families. It occurs when the pancreas no longer produces insulin, which helps the body to keep blood glucose levels from becoming too high or too low. This means that people must constantly monitor their glucose levels via fingerprick tests or glucose monitoring devices and adjust their insulin doses via injections or insulin pump according to their diet, activity levels and lifestyle. works and its positive impact of making living with type 1 diabetes easier. Eastern AHSN helped CamDiab develop an animation to explain how the app works If I can do it anyone can What is the CamAPS FX app? Developed by researchers at the University of Cambridge, the CamAPS FX app helps people more easily manage their diabetes by mimicking the key functions of a working pancreas. The app communicates autonomously with the persons continuous glucose monitor and insulin pump and uses a complex adaptive algorithm to automatically calculate and administer the optimal dose of insulin, reducing the burden of living with diabetes and allowing them to lead more flexible and spontaneous lives.4 Rogers story When my two children heard Id be At the time I was diagnosed, knowledge and treatment of diabetes was very limited compared to now. I was given very little support, although my mother-in-law lent me her British Diabetic Association handbook and I can remember sitting in our kitchen with my wife holding open the pages of the book while I taught myself how to do the injections. managing my diabetes from a smartphone they laughed their Admittedly, I hadnt heard of the CamAPS FX app before, but when my two children heard Id be managing my diabetes from a knowledge of using a phone was switching it on, making a call and switching it back Addenbrookes Hospital, I got on really quite well with the smartphone and the CamAPS FX app. Its ability to control and treat your diabetes is just tremendous Now, when we go out for meals, all I need do is take out my smartphone, enter the carbohydrate count and away it goes. I can see my levels instantly and can do everything I need to do on the phone. Before I had the app, I needed to carry around with me needles and insulin and would go to the Good Things Foundation. NHS Widening Digital Participation [online]. Good Things Foundation. [Viewed 11th December 2020]. Available from: https://nhs. goodthingsfoundation.org/ 1 Thats all taken care of now with complete discretion. beginning of the COVID-19 pandemic when Id taken a real bad turn. I was thinking the worst, but the app was providing a continuous reading of my blood glucose levels, which was a great reassurance. At one point, I fell asleep and my wife was worried I may be going into a diabetic coma, but she quietly checked my blood glucose levels on my phone while I slept and could see all was well. The app provides wifes quality of life. using a smartphone, so I can use my phone to contact my grandchildren on WhatsApp, which was fantastic during lockdown, and even get the weather forecast. Before I started on the app, Id never have been able to do anything like that. It is amazing how much treatment has changed since I was diagnosed. I really feel like Ive come from the desert into the digital world. The CamAPS FX app really is transformational and if I can do it anyone can. Share this article Davies AR, Sharp CA, Homolova L, Bellis MA., (2019). Population health in a digital age: The use of digital technology to support and monitor health in Wales [online]. Public Health Wales and Bangor University. [Viewed 11th December 2020]. Available from: https://phw. nhs.wales/topics/digital-technology-andhealth/population-health-in-a-digital-age2/ 2 Bennet, J. et al., (2018). Contributions of diseases and injuries to widening life expectancy inequalities in England from 2001 to 2016: a population-based analysis of vital registration data. The Lancet: Public Health [online]. 3(12), E586-E597. [Viewed 11th December 2020]. Available from: https://doi. org/10.1016/S2468-2667(18)30214-7 3 Lawton, J. et al., (2019). Participants experiences of, and views about, daytime use of a day-and-night hybrid closed-loop system in real life settings: longitudinal qualitative study. Diabetes technology and therapeutics [online]. 21(3), 119-127. [Viewed 11th December 2020]. Available from: https://doi.org/10.1089/ dia.2018.0306 4 References Want to know more? Find out more about our work with CamDiab on our projects page