Common Misconceptions in Diabetes Technology

Lisa Jones, MA, RDN, LDN, FAND

In this podcast, Lisa Jones MA, RDN, LND, FAND interviews Rachel Stahl Salzman, MS, RDN, CDN, CDCES, about common misconceptions in diabetes technology, including misconceptions about simplicity, responsibility, automation, and more. 

This podcast is an excerpt from “Nutriiton411: The Podcast Ep., 14: Smart Solutions for Diabetes Care.” Listen to the full podcast here.



Lisa Jones: There are probably many misconceptions that come up about using technology, especially when we're talking about managing diabetes. And my question is, since there are so many, could you start by just telling me about what is the one that you see the most?

Rachel Stahl Salzman: Well, one that is fresh in my head from this past week in my clinical care was the misconception that using technology is going to be too complicated. For some people, there is, and thinking about my patient this past week, a fear of change. We want to remind patients that the goal of this technology is used to help decrease the burden for them and ultimately help improve our collaboration by having all this data and all this technology to support them. It is important for the dietician as part of that care team to help patients overcome it, and I love doing that by bringing them into the office. It is kind of like a show and tell–showing them all the different options out there.

My goal is to help give them the knowledge and tools so that they could ultimately make the decision and know that we're here to support them in whatever it might be. And this example of this patient was like an eye-opener and a game-changer when she decided to try a CGM, we just placed a sample on her. She tried it for 10 days and she came back to me and said, "I can't believe I waited this long." Those were her words. It is just so powerful for us to be able to provide patients with these things that are going to help them.

I also think it is so important to meet the patient where they are. Technology, there are simpler types of systems to more advanced, and certainly we want to give patients what we feel is the highest level. But we need to remember to meet the patient where they are and what is going to be most helpful for them now in their diabetes journey.

Lisa Jones: Yes, so true. Excellent point. Now, if you had to mention another misconception, I know there are probably many, but which is another one that you would say?

Rachel Stahl Salzman: Yes, great question. I think another common misconception for some patients could be this idea that once they start the technology, it is kind of like a plug-and-play, right? The minute they start it, they are going to be cruising, their numbers will be perfectly in range and they just kind of sit back. We need to remind patients that it is not fully a plug-and-play system. Maybe ask me in 10-to-15 years from now with all the advances we will see, they certainly will get patients closer to that. But we need to remind patients that they are still in control at the most, and these systems help move them towards what I consider cruise control. When we think about driving, we think about how cars can go on cruise control, but we still need to be there to monitor if some variables change and be able to quickly address anything going on.

It is important to teach our patients about the benefits of these technologies. What are the components that are going to be automated and what is part of what they still need to control? A perfect example that I just had with a patient recently who was starting an insulin pump from using multiple daily injections of insulin, I needed to remind her that the insulin could do various things. The pump is going to help them to provide a basal rate and help keep their numbers tight overnight and between meals, it is going to help with these automated systems to correct high glucose values. But she still needs to be in control of putting in for meals, the carbs and control some of that mealtime insulin dosing decisions. While the pump provides a lot of support, she is still in the driver's seat.