Ep. 27 — T1D Looping Blind Making the Impossible Possible Together

TL;DR

Roger has lived with type 1 diabetes since age two and has been totally blind for more than 35 years. Modern automated insulin delivery (AID) promised safety and reduced burden — but commercial systems were effectively inaccessible without sight.

In this episode, Roger and diabetes educator Robin Lucciantonio walk through how they used the open-source Loop app with iPhone VoiceOver, a stepwise rollout (simulator → saline → insulin), and a handcrafted tactile pod-filling station to make AID genuinely autonomous.

The result wasn’t just better numbers: it was independence, reduced hypoglycaemia, and a blueprint for what “accessibility” should mean in diabetes tech.

Read the full Inspiring Story with extra detail:
Roger’s T1D journey toward freedom

Episode Summary

This Inspiring Stories episode is about the difference between having diabetes technology and being able to use it. Roger was diagnosed with type 1 diabetes at age two, long before blood glucose meters were commonplace. In his twenties he lost his sight, and for decades managed diabetes through touch, routine, and workarounds.

When CGM and AID arrived, they brought a new problem: much of the interface and onboarding assumes sight — graphs, sub-menus, unlabeled UI elements, and touchscreen workflows with no tactile landmarks.

For Roger, the “safety upgrade” became a locked door.

Rather than accept exclusion, Roger and Robin built a solution around first principles: autonomy, repeatability, and safety.
They describe how VoiceOver made Loop usable non-visually, how they identified and ironed out accessibility quirks, and why they progressed in controlled steps: simulator first, then a prolonged saline trial, then going live with insulin.

You’ll also see (on YouTube) one of the most practical pieces of accessibility engineering you’ll encounter in diabetes care:
a custom wooden tactile pod-filling station designed to prevent misalignment and make pod filling reliable by feel.

This conversation is informational only and does not constitute medical advice or a therapeutic relationship. DIY AID carries real risks and requires appropriate training, oversight, and contingency planning.

Who is this episode for?

• People with type 1 diabetes who are blind or have reduced vision — and want a realistic picture of what autonomy can look like
• Clinicians and educators supporting technology access, training, and safety in the real world
• Device designers and digital health teams building “safety” systems that still default to visual-only workflows
• Family members and supporters who want to understand the hidden labour of accessibility

Key Themes Explored in This Episode

1) Living with T1D without visual feedback

• Diagnosis at age two; diabetes care before modern meters and disposables
• Blindness in early adulthood and the shift to tactile, routine-based management
• Why “independence” in diabetes isn’t motivational — it’s safety-critical

2) Accessibility failures in mainstream diabetes tech

• CGM and app interfaces that don’t expose key information to screen readers
• Pumps with complex menu structures and no practical non-visual navigation
• Why “it exists” is not the same as “it’s usable”

3) The build: Loop + VoiceOver + stepwise safety

• How open-source Loop became the viable doorway for AID
• Algorithm build/maintenance support (so the burden doesn’t fall on the patient)
• Simulator → saline trial → insulin: de-risking the transition without leaps of faith

4) Practical accessibility engineering: the tactile pod-filling station

• Why pod filling is a safety problem without tactile alignment
• Mark 1 → Mark 2 design evolution
• Repeatability, error-proofing, and building confidence by feel

5) Outcomes that matter: numbers, burden, and autonomy

• Improved glucose stability and reduced hypoglycaemia
• Less time spent firefighting highs and lows
• “Freedom” as restored dignity — not just convenience

6) What clinicians can learn: hand-over-hand training and real inclusion

• Why tactile orientation and landmarking can’t be skipped
• How to translate a visual workflow into a non-visual one safely
• Open-minded teams as a determinant of access

Episode Timestamps

• 00:10 — Why this podcast exists
• 01:11 — Introducing Roger and Robin: why this story matters
• 03:10 — Diagnosed at age two; diabetes tools before modern meters
• 03:58 — Losing sight: what changed, what became harder
• 04:18 — Tactile insulin delivery: Count-a-Dose, routine, and risk management
• 06:15 — Talking meters and workarounds: necessity as engineering
• 10:45 — CGM: what VoiceOver did (and didn’t) reveal
• 13:51 — Why commercial AID systems weren’t viable for independent use
• 15:19 — The genesis: “What about Loop?”
• 18:54 — Simulator and accessibility testing: learning the interface safely
• 22:11 — Saline trial and staged rollout: building competence, not gambling
• 23:12 — The tactile pod-filling station: Mark 1 → Mark 2
• 28:01 — VoiceOver in action: what the system actually reads out
• 31:19 — Outcomes: HbA1c, time in range, and hypoglycaemia
• 37:22 — Clinical lessons: hand-over-hand teaching and landmarking
• 41:27 — Closing reflections: survival → thriving, and what should change next

About our guests

Roger Moore

Roger has lived with type 1 diabetes since early childhood and has been totally blind for more than 35 years. Through necessity-driven problem-solving and a refusal to accept exclusion, he developed a fully tactile workflow to use automated insulin delivery independently — including a handcrafted pod-filling station to make the process reliable and safe.

Robin Lucciantonio

Robin is a diabetes educator based in Edmonton, Alberta, working in a general endocrinology clinic. In this episode she shares the practical realities of translating diabetes technology into accessible workflows, including the importance of tactile landmarking, hand-over-hand teaching, and staged implementation to maintain safety.

Read the Inspiring Story (more detail)

This episode connects to a written case summary with extra context and practical details:
Roger’s T1D journey toward freedom

Closing Message

Accessibility is not a feature. It’s a safety requirement.
If a therapy meaningfully reduces risk, then excluding people who can’t use a touchscreen or read a graph isn’t a neutral limitation —
it’s a preventable harm.

Roger’s story shows what becomes possible when a person has the skills, the persistence, and a team willing to think from first principles: build around the human in front of you, not the default user you imagined.