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What I wish I knew when I was diagnosed: Part 2

In his previous article, Type 1 campaigner and self-proclaimed data geek Nick Cahm shared with us his key elements for successfully managing diabetes: Motivation, Education, Technology and Support. Here, he shares his own experience with diagnosis and his hopes for the diabetes technology of the future.

This article reflects the experience, views and opinions of Nick Cahm, and should not be interpreted as being a representation of a wider group of people with diabetes.

Insulin can easily be taken for granted. It is worth remembering that insulin was first used to treat diabetes only almost 99 years ago. Its use was crude and whilst it undoubtedly enabled the management of a previously life-limiting condition, it couldn’t be considered as controlling the condition1. Fast-forward to my diagnosis in 2007. I received an hour’s training and was handed a log book, two insulin pens and a blood glucose meter. Tools to manage my newly-diagnosed condition, but I had scant knowledge of what to do with them. I had no knowledge of whether there was a choice between any of these tools or whether they were the most appropriate for my circumstances. 

I received an hour’s training and was handed a log book, two insulin pens and a blood glucose meter

-Nick Cahm

I was fortunate, I had been using the internet since the early 1990s and knew the power (and pitfalls) of finding information online. I had scientific training and knew the finding out as much as I could was the key.  Not everyone is that fortunate. I managed to keep my logbook up for a few weeks…but that soon fell by the wayside! I had much of the education I needed, I had support from peers and I had some of the technology that I needed. Looking back at that time, I did OK, but I didn’t do brilliantly. Two key elements caused me to transition from having mediocre control to exceeding my expectations considerably.

  1. Continuous Glucose Monitoring
  2. Attending an education course

Of course, it is not one size fits all. For me personally, glucose monitoring was key to understanding how to manage diabetes of any type. Blood glucose meters are wonderful pieces of technology, but they require commitment, knowledge and motivation to use effectively and for me proved to be inconvenient in many circumstances. The launch of the first flash glucose monitor in 2016 made a huge difference to me2, however, it wasn’t until I was able to get live levels transmitted wherever I needed them without intervention, that my control had a step-change improvement. Looking back it wasn’t because I didn’t have the ability to use the device effectively, but the visibility of my glucose levels motivated me to work harder at managing my control.

Looking to the future

On the horizon, there is a new innovation that is greatly exciting me. For many reasons, I use injections rather than a pump for my insulin delivery – this works best for me. The first insulin pen was sold in 1983 and become widely accepted over the next few years3. The technology in this area has not had a step-change improvement since this time. The introduction of smart pens may address this. Having the insulin dose alongside real-time blood glucose data will make my diabetes management easier as well as enabling better conversations with the clinicians I interact with4. It will be both motivating and educational, helping me to have in-depth knowledge of another part of my diabetes.

 "Having the insulin dose alongside real-time blood glucose data will make my diabetes management easier"

-Nick Cahm

Diabetes technology will continue to develop and improve. With more options becoming readily available aiming to cater to the varying needs of people with diabetes, I am looking forward to the innovations ahead to see how these technological advances can bring about more effective management of the condition.


  1. Lewis GF, Brubaker PL. The discovery of insulin revisited: lessons for the modern era. J Clin Invest. 2021;131(1):e142239. doi:10.1172/JCI142239
  2. Didyuk O, Econom N, Guardia A, Livingston K, Klueh U. Continuous Glucose Monitoring Devices: Past, Present, and Future Focus on the History and Evolution of Technological Innovation. J Diabetes Sci Technol. 2021;15(3):676-683. doi:10.1177/1932296819899394
  3. Diabetes UK. Research on insulin pens. Available from: https://www.diabetes.org.uk/our-research/about-our-research/our-impact/insulin-pen-research. Last accessed: March 2024.
  4. Lingen K, Pikounis T, Bellini N, Isaacs D. Advantages and disadvantages of connected insulin pens in diabetes management. Endocr Connect. 2023;12(11):e230108. Published 2023 Sep 27. doi:10.1530/EC-23-0108

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