Imagine you’re on a long-haul flight, from, say, LA to New York. It’s very important that the airplane doesn’t fly too high, or you’ll get altitude sickness, or too low and risk a crash. But you only get to check your instruments a limited number of times, and you’ve got to keep everything on an even keel for the whole flight.
That’s what having Type 1 diabetes is like, according to Scott Hanselman. He wrote The Airplane Analogy, a useful metaphor which explains how diabetics manage their blood sugar levels.
“Food raises blood sugar – altitude. Insulin lowers it. Non-diabetics don’t have to think about altitude, as you all have a working pancreas (autopilot) and don’t sweat altitude,” says Scott. “Diabetics, on the other hand, have to constantly wonder if they are at a safe altitude. Staying at a consistently high altitude – high blood sugar – will eventually make you sick; while a low altitude – low blood sugar – will kill you quickly.”
Scott was diagnosed with diabetes at 21, and has been using technology to “hack” his health ever since.
“That’s the first thing every techie does once they’ve been diagnosed with diabetes,” says Scott. “They try to solve the problem with software or hardware.”
Scott says that that “problem” equates to a billion-dollar industry. But no one’s solved it just yet.
In addition to his day job is as a community manager for Microsoft, Scott records three weekly podcasts, runs a blog that’s been going for thirteen years, travels to conferences around the world, spends time with his young family – and looks at ways to manage his health through tech.
“I have been trying to use tech to solve my diabetes for 20 years.”
“I have been trying to use tech to solve my diabetes for 20 years,” says Scott. “Back in 2001 I did a “poor person’s connected sugar meter” experiment that I wrote up. This is before mobile internet really went mainstream – so I’ve been thinking about this a lot and for a long time.”
That experiment took place after Scott developed GlucoPilot, a diabetes management system for the PalmPilot that allowed diabetics to log their blood sugar levels, insulin, and carbohydrates, and view reports based on the data.
Scott went on a cross-country trip – the “experiment” – using GlucoPilot in conjunction with an insulin pump and a blood sugar meter to keep track of his health as he traversed timezones. The technology was useful, but it still required exporting, uploading, and moving data between three devices, which Scott described as a tediously manual process.
In a more recent blog post that reflects his reasons for writing GlucoPilot, he said “Diabetes sucks deeply, the technology we are given to manage it sucks deeply, and we are pretty much tired of waiting.”
GlucoPilot gained tens of thousands of users, in four languages, and Scott sold the technology. Unfortunately, it’s now out of date, but “the ideas behind it – how to remotely and mobile manage blood sugar – live on in hundreds of apps, and open source projects like Nightscout.
“Diabetes sucks deeply, the technology we are given to manage it sucks deeply, and we are pretty much tired of waiting.”
“These are timeless problems that any diabetic engineer will try and solve,” says Scott.
For the past seven months, he’s been testing out an “artificial pancreas;” a way of using technology that he calls “body hacking.” It involves being physically tethered to three medical devices 24 hours a day.
“The Open Source Artificial Pancreas is like a “Cruise Control” for diabetes. It automatically keeps you in the lane, generally, similar to a Tesla. It won’t bolus for you or know you’ve eaten, but if you fall asleep (for example) it will quietly try to get you back to that magic 100 number.”
“I believe that now we are inside a five-year window where we will make Type 1 Diabetes much much easier to deal with,” Scott says. “I’m hearing good things about islet cell transplants, for example.”
Being a father and husband is also part of Scott’s hectic schedule.
Maybe because of the need to focus so carefully on his health, he’s an advocate of mindfulness, something he’s trying to teach his children.
“When I was younger I didn’t know the term ‘mindfulness’ so I said “don’t live your life by default.”
I’m doing my best to teach my kids this, hopefully by example. Yes there are things they can’t change about themselves, but the one thing they can change (or try) is how they think and how they act. I catch them saying things like “I’m not good at math.” They have tapes that are already starting to run in their little heads that feed them negativity and inaction. The defaults are just doing nothing. Humans (myself included) can be very lazy. I want them to build up their reservoirs of self-esteem and “I can do it” so they don’t accept the defaults.”
Meanwhile, Scott continues to look for ways to hack his health through tech.
“Most people give very little thought to advances in medicine beyond the never-ending search for the cure for the common cold,” he wrote. “But wireless technology promises to free people with medical conditions most of us never have to deal with…. from the ropes holding their lives back.”