The amount of kids diagnosed with diabetes type 1 has increased considerably in the last few years. If diabetes is not managed well from early years, it can lead to devastating complications later in life, such as heart disease, nerve damage, blindness, kidney failure, amputations, as well as mental illness. Having diabetes type 1 as a kid means that you go on regular hospital visits. However, at home, in-between these visits a lot of families experience a lack of support- like they are being left alone with all the responsibility.

To ease the situation for these families we created Koi, which consists of Toolboxes that Diabetes Nurses can prescribe to be used in-between hospital visits. We envision that there would exist different Toolboxes for kids of different ages, however, for this project we developed the Toolbox for kids 7-9 years old. This since it is the age where kids would normally be expected to start learning how to handle their diabetes by themselves. Furthermore, it is also the age where they would commonly start school and be put in a totally new environment where both they, but also the people around them, eg. teachers would benefit from learning more.

In order to avoid both short- and long term complications, kids need to learn how to manage their diabetes correctly. But the current learning material is complex and challenging to explain to children. In addition to this, the best way to learn is through experiences, not theory, but it is hard for parents to let the kids try and make their own decisions since the consequences could be severe. Koi aims to provide a way for kids to learn without putting them at risk. In the Toolbox for kids 7-9 years old, there are two products: Koi Companion to support emotionally, and the Education Board for practical learning.

The Koi Companion, for emotional support, enables the kid to externalize their disease. When hugging the toy, a NFC reader is used to check the kid's blood sugar level and later give visual and haptic feedback. While taking care of the toy, the kid is also taking care of themselves. The Education Board, for practical support, lets the kid practice how to behave in different situations. For example, they can be sent a task asking how much insulin they should take depending on what they plan to eat.

Finally, we envision that besides distributing these different Toolboxes to families, we could also send them to people in the community that would also benefit from learning more. For example, the Toolbox could be sent to teachers to use in the classroom and in this way, while increasing the awareness, create a safety net around the kid living with Diabetes. Our aim is to create an education tool that will make patients, their families, and the community feel informed and confident as well as give the Diabetes Nurses the ability to provide support and presence, at a distance.

Background:

Koi is a student project conducted at Umeå Institute of Design in collaboration with Region Västerbotten (the healthcare sector in mid-north of Sweden). Due to an aging population, it will be important to work preventatively within healthcare in the future, especially when it comes to chronic diseases such as diabetes. The number of kids diagnosed with diabetes type 1 has increased considerably in the last few years, and if not managed well from early on, diabetes can lead to devastating complications later in life. For example heart disease, nerve damage, blindness, kidney failure, amputations, as well as mental illness.

Throughout the process of creating Koi, we regularly met with people who would state that living with diabetes does not only affect the patient but also the people around them. Therefore we choose to interview not only diabetes patients themselves but also their parents, siblings, teachers as well as medical professionals. The main insights we got were, first, that emotional support is as important as practical. Kids with someone close to them who they can share the disease with will have an easier time adjusting. The second main insight was that there is a wish for a suitable education tool for kids, families & their community and that current learning material is challenging to explain to young children. And last, having diabetes type 1 as a kid means that you go on regular hospital visits, however, at home, in-between these visits a lot of families experience a lack of support.

Introduction to Koi:

Koi consists of a series of Toolboxes that nurses can prescribe to kids to be used in-between hospital visits. Today, clear learning goals for different ages groups already exist when it comes to diabetes. We, therefore, envision that there would exist different Toolboxes for kids of different ages following these learning goals. However, for this project, we choose to develop the Toolbox for kids 7-9 years old. This since it is, according to the learning goals, the age when kids would be expected to start learning by themselves how to handle their diabetes. Furthermore, it is also an age where they would commonly start school and be put in a totally new environment where both they, but also the people around them, eg. teachers would benefit from learning more. To tackle the main issues found in our research, two products were developed for the Toolbox for Kids 7-9 Years Old: Koi Companion to support emotionally, and the Education Board for practical learning.

Inside the Toolbox 7-9 years old: Koi Companion (Emotional Support). Koi Companion is the tool that answers to the emotional support the kid might need and is inspired by the idea that having someone to share your diabetes with is really important. When the toy is hugged it reads the values of the glucose sensor (that today most people with diabetes wear on their arm) using an NFC reader. It then retrieves the kid's values and provides haptic and visual feedback through different light- and vibration patterns. Koi Companion empowers the kid with a way to slowly learn about their blood sugar levels in an abstract way. This also allows the child to externalize the diseases — since when the Koi Companion's levels are stable, the kid's will also be. While taking care of the toy they are also taking care of themselves.

Inside the Toolbox 7-9 years old: The Education Board (Practical Support). The Education Board responds to the kid's practical learning requirements, for example, determining the quantity of insulin needed based on what they plan to eat. It is hard for parents of kids with diabetes to let go and trust their kids to make their own decisions - since the consequences can be severe. At the same time, the kid needs to learn and at some point become independent. However, the Education Board lets the kids practice without putting themself at risk. The board comes with a wide range of tokens representing different types of food and an abstract representation of an insulin pen that will be used for physical input. The board then connects to a mobile app where the kid will find different challenges. Because everyone's diabetes is different, the kid will participate in both general, as well as customized challenges assigned by their diabetes nurse.

The Nurse platform keeps everything together. Here diabetes nurses can keep track of kids' health data while, at the same time, supporting them through their learning journeys at a distance. They can see how the kids are interacting with both the Koi Companion as well as the Education Board, and how this relates to their blood sugar levels at any given time. Later they can use this material as a base for discussion with the kid and their parents during hospital visits.

Koi and the community:

When treating diabetes, it is important that members of the community, for example, teachers and friends, also learn about the disease. This is for the kid to feel safe, for the parents to be able to share some of the responsibility, and for teachers to feel confident while interacting with the kid. We, therefore, envision that besides distributing these different Toolboxes to kids to use at home, we could also send them to schools. For example, The Education Board could be used in class during math lessons since it, besides teaching the basics of diabetes, also aligns with the math goals kids at that age will learn. The Koi Companion can function as a class mascot, that each week a student is allowed to bring home and take care of, also highlighting the conversation of diabetes in their house. While increasing awareness, among teachers and classmates (and their parents) a safety net will be created around the kid living with diabetes.

Conclusion:

Finally, Koi aims to answer to both the emotional and practical support kids with diabetes between the ages of 7-9 years old might need. Koi is an education tool that will make patients, their families, and the community feel informed and confident when it comes to Diabetes type 1. It also gives the diabetes nurses the ability to provide support and presence, at a distance in-between hospital visits - providing a more holistic care system.