It's Getting Better: thoughts for World Diabetes Day 2020

November is Diabetes Awareness Month, and as happens every year in the first half of the month, leading up to World Diabetes Day on November 14th, there is a growing frenzy of activity and excitement in the online world of diabetes. This year, that online world is the only forum in which the diabetes community can interact to any extent, and so this frenzy and hyperactivity seem particularly intense. Moreover, we are approaching the centenary of the discovery of insulin therapy (January 11th 1922), so no doubt next year’s WDD celebrations will be even bigger and better, not least because we can all hope that celebrations will by then be back in the physical world, rather than the virtual one.

Amidst all the frenzy, it’s a good moment to ponder developments in the world of diabetes, in its treatment and care. In so doing it is impossible to avoid noting how much has changed in recent years, and difficult to avoid the conclusion that the pace of that change is accelerating.

My own thoughts at this time of the year are always shaped by the awareness that I am approaching another anniversary of my own diagnosis, my “diaversary”, which falls on December 19th, this year marking 23 years since I was joined for the second half of my journey through this world by my unwanted friend. Any reflections on what is going on in the diabetes world are necessarily shaped by thoughts on the passing of time, and the increasing longevity of my life with diabetes - I have lived around one third of my life, and more than half of my adult life, with diabetes.

So, in the words of the late, great David Bowie’s last big hit before his premature passing, Where are we now?

I find it very hard to resist being bullish in my response, not least given that healthcare in general is under unprecedented logistical and financial pressure from the global pandemic. In saying so, however, I must qualify it with the very significant caveat that my thoughts apply to those like me living in a prosperous country which provides free healthcare for all. I am painfully aware that any bullishness does not apply to much of the world, including parts of the world like the USA where the state’s prosperity should enable universal healthcare to be a reality. So the thoughts that follow are made in the full and somewhat guilt-ridden awareness of my own relative good fortune.

When I was diagnosed in 1997, diabetes care and therapy had already advanced significantly beyond what many of my friends who have lived with diabetes for far longer than me can remember. A good diabetes friend, of similar age to me but living with Type One since the age of 2, has lived from the days of testing by urine strips and injecting with large syringes, to nowadays using an insulin pump and a CGM. He keeps an impressive personal archive of some of the primitive-looking gadgetry that kept him alive in his early days.

My introduction to diabetes came when injection pens with pre-filled cartridges were fully established, and small electronic meters providing rapid and accurate figures on blood glucose level from a finger prick test had become the norm, albeit fairly recently. More importantly in some ways, I came in at a time when advances in insulin types were starting to give far greater flexibility by mirroring with increasing accuracy the workings of the pancreas. Within a year or two of my diagnosis, I had moved to the basal-bolus régime which is essentially the one that I follow to this day. So things were already pretty good for a Type One here in the UK, and I never at any time felt threatened by it; however, better days were to come!

I am in no doubt that the biggest technological advance in recent years has been the arrival of non-invasive blood glucose monitoring giving more than just a snapshot of levels, and giving it in such a way that it can be done unobtrusively, frequently and painlessly: I refer, of course, to low-cost continuous monitoring devices, and in particular to the FreeStyle Libre flash monitoring system. The advances in diabetes technology have been stunning, and are accelerating as they become cheaper in real terms: this mirrors the way that, in our everyday lives, we all now keep in our pockets a mini computer of infinitely greater power, capacity and capability than the lumbering desktop with its hefty CRT screen that sat on our desks back in 1997. 

Commercially available devices have in turn been the stimulus for creativity and amateur expertise which has enabled patients to drive progress towards closed loop systems, with the prospect of a widely available de-facto artificial pancreas now looking more achievable than the proverbial “ten years from now” cure.

Alongside medical technology, information and communication technology has also made an astounding difference to those of us living with diabetes. When I was diagnosed I felt very much “at the mercy” of diabetes, and therefore very reliant on the input of the doctors and nurses assigned to my care. 1997 was very much in the pre-internet age (I first went “online” in early 1998, and as such I was an early adopter of home computing at a time when the internet was seen by many as the province of nerds and teenagers). My knowledge of diabetes at diagnosis was minimal, and beyond what HCPs told me, my only source of information was the printed word in books and magazines. What a different world it is now, with our first port of call on a medical issue being, for better or worse, Dr Google. These days, a person newly diagnosed would be signposted to a vast amount of information, to websites, to YouTube videos, to blogs, to peer support groups and a whole lot more. The problem must be to decide which resource is good, which is bad and which is ugly.

However, I believe that an equally important change in recent years is not a matter of kit and technology, but rather a far less tangible change of attitude on the part of both those living with diabetes and those who care for them. The irony is that this, too, has been driven by technology. There are still some who decry the influence of the internet in general and social media in particular, but what strikes me in the context of diabetes is that people have used technology in a very human and personal way, and that it has built bridges and brought people together in a way that harnesses the best that technology has to offer with the best and simplest of human virtues: friendliness.

Back in 1997, I would never have believed how connected we were all destined to become. I would never have believed that I would be talking, during a global pandemic, to people all over the world in little boxes on my computer screen, or that I could be constantly conversing in real-time written messages with friends. These days, my best source of “breaking news” is my best diabuddy whom I only know because we both have diabetes and started talking about it on Twitter. When anything good or bad happens in the news, or in either of our lives, our first response is to message one another. Many other people with diabetes enjoy similar, relatively new, but close, friendships.

But it’s not just peer-to-peer: we in the UK are privileged to have an online diabetes community in which patients and healthcare professionals interact freely, safe in the knowledge that each has something equally important to bring to the relationship: lived experience on the part of the patient and clinical expertise on the part of the professional. I count myself blessed with the personal friendship of many HCPs whose initial connection to me was through the diabetes community.

The community has no leaders as such, but is led by many: I shall deliberately avoid mentioning names, but we all know that there are doctors, DSNs and pharmacists of national professional repute who freely share their expertise and time online, yet just as importantly they share their lives, their interests, their passions and much more from well beyond their professional lives. Likewise, we all know that there are people with diabetes - and parents of children with diabetes - who freely share the experience and know-how that comes from living with diabetes, yet also their own personalities, their lives, their passions and much more, again from well beyond their lives with diabetes. During the pandemic, we have seen individual initiatives, notably by the organisers of the weekly tweetchat, like Zoom quizzes and the Fantasy Football league, and also larger initiatives like the Art1st Project, run by a coalition of people with diabetes and healthcare professionals. What these have in common is that they are about the people, not the condition, and it is this generosity of spirit that has enabled the community to flourish despite the inevitable fragmentation that has resulted from its growth in numbers. Alongside the partnership between patients and HCPs, the diabetes charities, Diabetes UK, JDRF, and DRWF have also become part of the community, not least through the personal and personable engagement with patients by their staff and leaders.

The blend of timeless human virtues - kindness, sharing, listening - with technology has given us a world unrecognisable from that of only a decade or so ago. Spending so much time alone at home this year, as we have all been compelled to do, I have come quite close to feeling grateful to diabetes for giving me some of the best friends I have ever made. 

When we finally emerge into the post-Covid world - sooner rather than later, we hope - it will be in many ways different, but we can surely hope that the blend of technology-driven remote connectivity and the warm relationships that technology has help to foster will leave us with the best of both worlds.

I was going to entitle this post Where are we now, taken from that rather bleak but wonderful Bowie song referenced earlier, but given that the announcement of a breakthrough on a Covid-19 vaccine came after I had started writing it, but before I finished it, another song came into my head, and I prefer to leave that as my customary song title for this post: the uplifting 1969 classic by (Mama) Cass Elliot which speaks, I hope, of where we are heading in the pandemic, and in diabetes care: It’s Getting Better.

Happy World Diabetes Day, everyone! With thanks to all who are working so tirelessly to support people with diabetes.

People places and events from my world of Diabetes

High: 21st Diaversary Musings

21 years ago today, feeling exhausted and battered from all sides after an unprecedented week off work in my sick bed with real ‘flu, I made an emergency appointment with my GP, alarmed by what appeared to be a sudden recurrence of my first bout of “proper” illness since childhood.

It was a dark, wet and windy evening, and I was far from full of festive cheer on that last Friday before Christmas as I sat in a deserted waiting room at the end of the day. A urine sample test revealed sky high blood sugar and the startling revelation that I was displaying the classic symptoms of diabetes.

The full story has been told before, here.

So my diabetes is “21 today” 😊

My "diaversary" always gives me a cause for some reflection, and these days, with a little more time to spare in retirement, I hope that those who know me as part of the online diabetes community will forgive me for the indulgence of sharing them publicly.

Here I am, 21 years on, having lived a third of my life, or half of my adult life, with an incurable, 24/7 medical condition which requires constant treatment and monitoring combined with an awareness of the effects and risks of activities as basic as eating, drinking, sleeping, moving or not moving.

Sounds pretty grim, doesn’t it?

But I’m an incurable optimist, a believer in silver linings, and whilst I don’t seriously believe that “everything happens for a reason”, I do believe that we all have the power to turn negatives into positives.

So 21 years on, I can also reflect on the fact that I have in recent years acquired activities, contacts, acquaintances and friends from within the community of people with diabetes, their families, and the healthcare professionals and medical companies who help to care for them. My life has been greatly enriched by them and I find it very hard to imagine what my life would be like without the diabetes community.

And I recently came upon some proof of this: a recent printout from my GP of my HbA1c level over the past five years revealed that the two most striking improvements in my level had occurred as a result of my starting to use flash glucose monitoring in early 2015 (no surprise there) and my starting to interact with the world of diabetes online in 2013. 

My HbA1c, 2013 -2018

Coincidence? Possible, but unlikely.

I think it is highly credible that I became significantly “better” at walking the tightrope of life with diabetes once I started to associate with others who do so, or who help others to do so. The knowledge that there are others out there who “get it”, who understand the frustrations and the triumphs, is of immense benefit, and I very much hope that in receiving that benefit, I have also contributed to it in my own small way.

So thank you to all out there in the #GBDoc and well beyond it: I wish I’d known you were all out there back in December 1997, but then again, many of you didn’t even have diabetes then. Indeed one who has become one of my best friends from the community was celebrating her first birthday on that auspicious date, and was herself still eleven years from developing the condition. Such is the fickle nature of diabetes, yet it gives a strong and lasting bond, borne of a very difficult adversity which in a very strange way makes me feel blessed. Blessed, at least, to have acquired diabetes in the modern world, not that of less than 100 years ago, when it was, in effect, a death sentence. Thank you, Prof Banting!

Faces of GBDoc

Of course, all my posts require an appropriate song as their title, so for this one I've landed on a song that is exactly the age of my diabetes, and which for me evokes memories of some dark days in January 1998 as I adjusted to a life of injections, testing and clinic visits: High by the Lighthouse Family not only gives a nod to my blood sugar level in late 1997, but also has a wonderful sense of optimism, a sense that better days lie ahead. As they did for me on that dark Friday in 1997.

"When you're close to tears remember
Someday it'll all be over
One day we're gonna get so high

Though it's darker than December

What's ahead is a different colour

One day we're gonna get so high"

Listen to the whole song here:

My best wishes for Christmas, 2019 and well beyond, to all those whom I now know as an indirect result of that fateful GP visit back in 1997.

I Will Survive - but I'd like a bit of help, please.

Cure for Type One Diabetes? “If there’s a cure for this, I don’t want it” sang Diana Ross back in 1976.

Well of course, if someone offered any of us living with Type One Diabetes a cure that was permanent and free from nastier long-term side effects, we’d grab it with both hands. There’s a running joke among people with Type One that a cure is “ten years away” - I remember hearing this when I was diagnosed back in 1997 - and for a while I kidded myself that it might be true. I remember my late mother saying she would gladly use her pension pot to help fund any treatment that would cure me, and whilst I politely thanked her, I soon realised that her life savings were not in any danger.

“Ten years away” isn’t true, never was and possibly never will be. I’m fully reconciled to seeing out my time on this earth in the company of my unwanted friend T1D. I hope I’ve got thirty odd years left, and it would be great to make it to 50 years, especially having been diagnosed as an adult. That’s my life goal, but it will require me to see my 90^th birthday and a little more for that to happen.

But if that sounds negative and defeatist, it isn’t. It’s just realistic, and I have to say that I had a “light bulb moment” after attending the wonderful Type One - Rise of the Machines event in London last Saturday, 24^th February 2018. 

Quick shout out to Partha Kar for making it happen, all the speakers, and Ben Moody and the team at TechUK for hosting. My light bulb moment is nothing particularly new, but rather just a clarity of focus about the way forward for managing Type One. Let me explain:

Rise of the Machines was all about the use of technology in managing - not defeating - Type One Diabetes. It was an inspirational day: we heard from some of the medical technology companies about their work in developing the gadgets and gizmos such as insulin pumps, CGMs and Flash Glucose monitors which have done much to improve the lives of those lucky enough to have access to them, and they deserve our applause and recognition for the work that they have done and continue to do to make our lives better. I am lucky to live in the era in which I do, and in the country in which I do. Then we heard from the big two charities, Diabetes UK and JDRF, who do so much to raise the funds required to fund technical and medical developments.

But we also heard from some of the stars of the world of #WeAreNotWaiting - those highly motivated people with diabetes, or parents of children with diabetes, who have used their skills in ICT, especially coding, to take what the medical technology companies have done and move it onwards in a way and at a speed that could not be achieved in the - rightly - cautious and regulated world of corporate medical technology.

Whilst the work of the #WeAreNotWaiting people on closed loops, artificial pancreases and the like is not for me and unlikely to be (it depends as a starting point on the use of insulin pump therapy, for which I am unlikely to be eligible in the foreseeable future), it shows what can be done and points the way to a longer-term future in which Type One Diabetes will be artificially managed to the extent that it can be a mere inconvenience rather than the full-time occupation that it all too often seems to be.

And therein lies the crux of the matter, and there are encouraging signs everywhere that people with diabetes, healthcare professionals and the scientific research community are starting to recognise it.

Diabetes is a condition, not a disease. Type One will not be “cured” in the foreseeable future. The best hope for those of us living with it is therefore to have access to the best possible assistance in living with it, and for that to happen, technology must increasingly be seen as an essential, rather than some kind of desirable add-on.

A condition not a disease: most diseases require drugs, either to reverse and cure them, or to make them bearable and prolong life. However, a condition, especially one like Type One Diabetes which is not degenerative, requires assistance with self-care to ensure that those living with it can do all that they would do without the condition, and not become a burden on an overstretched healthcare system.

In this sense (and I know that to say so is controversial) Type One Diabetes is perhaps a disability, and people with other disabilities, however minor, benefit from an increasing range of technological solutions to make their lives liveable and as normal as possible. Some examples are so common that they are overlooked: those with less than perfect vision wear glasses; those with tooth damage or decay get fillings and crowns; those with hearing loss use hearing aids; those with minor heart problems use a pacemaker; those who have lost limbs use prosthetics or wheelchairs. The list is endless.

So why the apparent unwillingness to use technology to help those with Type One Diabetes? There is at present great frustration in the Type One community at the postcode lottery of access to FreeStyleLibre flash glucose monitoring, a high-tech but relatively low-cost innovation which allows people with diabetes to carry out the all-important monitoring of their blood sugar levels in a manner which is convenient, non-invasive and infinitely more informative than finger-prick testing. There is suspicion and even hostility towards it from some, even within the healthcare profession, yet people with diabetes and many of those who care for them are overwhelmingly convinced of its short and long term benefits. The CCGs who are resisting accepting it to their approved listings for NHS availability cite its cost, yet appear focused on just the headline up-front cost of around £70 per month. This despite the fact that it is already widely accepted that this cost is broadly comparable to that of an adequate supply of finger prick tests, without even considering the longer-term cost benefits of improved control.

However more significantly, I was struck by the views of a consultant who spoke at the Rise of the Machines event. He pointed out that there are many drugs in very widespread use whose cost is far greater. For example some treatments for Type Two Diabetes (a far more common condition) such as GLP-1 Agonists cost £68 -78 per month. This is a minor cost when compared with other drugs such as Infliximab which is used to treat auto-immune conditions such as Arthritis & Crohn's. Patients typically receive infusions every 8 weeks, costing £1500-2000 dependant on dose.

The consultant who spoke argued that FreeStyleLibre sensors at £70 per patient per month would have been accepted readily and with minimal dissent if it were a drug. The suspicion and even hostility comes from the fact of it being a piece of high-tech kit and as such points to the need for a change of mind-set.

I for one very much hope that we are on the cusp of just such a change. Technology is everywhere, and devices of a level of sophistication that would have been unimaginable even twenty years ago are now part of all that we do. Smartphones and satnavs for example, have taken over how we communicate and travel, yet would have appeared to be expensive luxuries in the recent past.

Those who regulate the access of people with Type One Diabetes need to realise that for most of us, we need gadgets as well as drugs. The “drug” for Type One is well-established, fully effective and aside from minor potential developments such as smart insulin, what we use today is fine. The unusual, arguably unique, thing about Type One is that a highly effective drug - insulin - keeps us alive yet threatens our day-to-day well-being 24 hours a day, every day. We survive and flourish best when helped by machines which can help us to monitor and react to the insulin which keeps us alive.

With the help of technology and machines, accessible to the many and not just the few, there is every reason for me to believe not only that with Diabetes I Will Survive, but that I and my many friends with Type One will live long and prosper. And we'll cost the NHS a whole lot less in the long run.

Deal??

Kiss from a Rose

This is a brief post, the first of two that I shall be publishing in the next two days. 

Tomorrow’s is about my experience of a DAFNE course, and as such it is typical of the sort of stuff that I and many others post because we have diabetes. I hope it is at least interesting to others and potentially helpful to them. But in the end, it’s self-indulgent and trivial.

However, this one is anything but. I’m writing this post because of a campaign which has been drawn to our attention by one Chris Aldred, better known to the dia-world as the Grumpy Pumper

For this, Chris deserves endless credit: beneath that grumpy persona beats a heart of pure gold, as we all know, and he has done us all a favour by reminding us just how lucky we are, or more importantly, how unlucky others are. And to do something about it.

It’s about the Spare a Rose Campaign, which aims to draw attention to the grotesque inequalities that exist as regards diabetes care and treatment in different countries. Quite simply, this should remind all of us in the UK that however badly done by we may feel, our life with diabetes is – excuse the pun – a bed of roses compared to many other parts of the world.

We were reminded in the news only yesterday by the clergyman father of Lauri Love, the English computer hacker threatened with extradition to the USA for allegedly stealing details from the FBI, that "To be born English is to win first prize in the lottery of life" This is variation of a quotation originally attributed to Cecil Rhodes, yet despite that provenance from a man who represents much that is wrong about our past, it is not a bad thought to carry in the context of healthcare.

We are the lucky ones.

Take this as an example: A few minutes ago, I received a delivery of FreeStyle Libre sensors, brought to my door by a courier, and paid for by me. I had tracked their arrival on an app on my phone, and immediately announced it to the world of Twitter, because there has been an issue regarding delays in sensor supplies to UK customers, caused, it is alleged, by the spike in demand caused by their availability on the NHS. It’s the sort of thing we all tend to do on social media. We moan because we can.

How pathetic am I, that I have been bothered about a delay – only a delay – in the availability of a device which is, yes, of great value to my diabetes management, but essentially a luxury in a worldwide context.

Elsewhere in the world, it is a shortage, or unavailability of, insulin which is the issue. In the USA, it is the extortionate price of insulin which is the issue. And indeed less than a hundred years ago, insulin therapy had yet to be invented. Successful treatment of Type One Diabetes started within living memory, and in many parts of the world is still not a reality.

So let’s just remember that next time we moan about some frankly trivial aspect of our care and treatment by the NHS. We are the lucky ones. And before anyone accuses me of finger pointing, may I remind myself that whenever you point a finger at someone, there are three fingers pointing back.

Let’s all join our man Grumps and donate the cost of a Valentine’s rose – or more if we can. Let’s all Spare a Rose. The website is here:-

https://lifeforachildusa.org/

Chris will be leading a #gbdoc tweetchat on the topic tonight, Wednesday 7 February 2018 at 21:00 GMT from the @GBDocTChost account. Please join in if you can, and let's give some less fortunate than ourselves a metaphorical Kiss from a Rose

Summer Night City

Sitting outside a bar, drinking a refreshing glass of Öl at around midnight in the sultry warmth of  a still-light Stockholm night, I tried briefly to step out of the moment and reflect on where I was, what I was doing and why I was there.

I was sitting there in the Summer Night City talking, laughing and drinking with a group of  young women: a Canadian scientist who lives in Paris, an Italian electrical engineer who lives and works in London, a Welsh student dietician who is an accomplished and successful athlete, a medical secretary from Birmingham and a first year university student from Doncaster. Of the group, I had only ever met the latter two briefly before; the others were, until 24 hours previously, strangers. At other tables in the same bar were about twenty other people, all unknown to me previously, but now new friends: Germans, Dutch, French, Swedish, Irish and British.

As I paused for thought (not easy in a noisy and lively bar), I just had to smile. Why was I, by some years the oldest in the group, enjoying such a fun night out? The answer, dear reader,  you will probably already know. It's because I, and all the others there, suffer from an incurable and life-threatening condition about which I have chosen, only in the past couple of years, to talk online.

Yes, I was at #DXStockholm, a weekend conference for diabetic bloggers organised and paid for by Abbott Healthcare, a global giant of a medical equipment company, makers of the FreeStyle Libre monitoring device of which I am so fond that I call it "Libs" (not original - copyright Amber Rose)

Such are the rewards for responding to the rubbish hand that fate has dealt us in a positive and constructive manner.

Two days earlier, as I boarded a Stockholm-bound plane on a sunny Manchester morning with my good friend and fellow sufferer Lydia, we reflected on the chain of events that had brought us to that in many ways surreal situation. Which twists of fate, which decisions made by each of us in our hitherto unconnected lives had brought us to those aircraft steps? You really couldn't make it up.

Much else over the weekend was gloriously surreal, and enormous fun, and merits some thanks. How about the logistics for a start: flying somewhere, and checking in to a top-of-the-range hotel, with the bookings and payments done by a company account just doesn't happen to schoolteachers like me: at best, we book our tickets and our budget hotel rooms and claim it back, and at worst, we just pay ourselves. Thank you, Abbott! Or how about bopping  to Mamma Mia in an Abba-themed disco pod on a Sunday lunchtime with two of the big cheeses from Abbott and a friend with his 6 month old baby daughter in her baby sling?  Tack, Benny, Bjorn, Anna-Frid and Agnethe! Or how about bantering on Twitter with a new German friend when she and I had badly failed to respond with an appropriate level of seriousness to the calming voice of a Mindfulness coach? Yes folks, I can exclusively reveal that Germans do indeed have a sense of humour every bit as subversive and cynical as ours! Vielen Dank, Steffi! Or how about hearing the story of the 1973 bank robbery which gave rise to the so-called Stockholm Syndrome, from a cool Australian tour guide and local resident called Ryan, standing outside the building where it all happened, now a high fashion store. Cheers mate! Oh, and while he was telling the story, an even cooler old gentleman dresssed in an immaculate bright blue suit came out of the store and calmly confirmed that the tale being told by our guide was 100% true, "because I was there". Tack, Mr Random Swede! Somehow, we believed him. We were in such a good mood already, so why would we doubt him?

So was this just a corporate "jolly"? Just a p***-up funded by the profiteering of a giant corporation? An easy accusation to make, but one which I, and all my diabetic friends, would strongly refute.

For a start, we actually deserve a bit of fun. Life with Type One Diabetes is a 24-7 battle, a 365-days-a-year balancing act from which there is not a moment's respite. We don't look ill, we don't look like we're just one small error of judgement from a hospital admission or worse, but that's the way it is. And people forget or don't realise, because we're so damn good at it. Occasionally, it goes wrong, and one of our number keeled over at breakfast on the last day. Needless to say, she was helped and nursed back to health by the rest of us. But it was a sharp reminder for us all of what can go wrong.

But Abbott wouldn't put this on just because they feel sorry for us. We were invited because, in a variety of ways, we have all helped to build the wonderful trans-national support network that has helped to transform the lives of people with (mainly Type One) diabetes since the advent of the internet and social media. We have helped to develop, share and promote new diabetes technology in a way that, of course, helps Abbott, but also helps each other.

To be told, as I was, by senior managers in Abbott that my FreeStyleLibre film is valued and used all around the world to help people understand the importance of the gadget was humbling. And to meet in the flesh a veritable Euro-Army of well-informed, canny diabetics was inspirational....and fun. The event was called #DXStockholm because it's an exchange. An exchange of ideas and expertise between the people from Abbott who develop the stuff we need to stay alive and healthy and the users of that stuff. And as far as I can see, it's a valuable and valued meeting of minds....and hearts. I've already waxed lyrical about the value I place on the #gbdoc and the friends I have made from that, but now that same feeling of camaraderie was replicated at a European level.

I'm going to leave it there, because there's another post to be done about what we did over the weekend. That needs photos and video, which I can't do on a plane or a train. But I'm not home yet, so I'll just post this straight away as a massive THANK YOU to all who helped organise the event, and those who came and made it what it was. I'll say that thank you in Swedish, because it's such a cool word:

TACK !

Much love to all my diabetic friends - you are, collectively and individually, simply awesome - and lovely!

Watch out for my #DXStockholm diary when I get time. For now, I'm nearly back home to see the lovely and long-suffering Mrs L, @RosanaghL and Godiva the cat.

However sad I am about the end of the weekend, it's nice to be back home too...