The Unreasonable Math of Type 1 Diabetes • Hacker News Board

Re: The Unreasonable Math of Type 1 Diabetes

#111

Post by aarondf » Thu, Feb 17, 2022, 10:22 PM UTC

grahar64 wrote: post #69

Trasmatta wrote: post #8

I'm a type 1 diabetic, and this was a helpful post at showing non diabetics why it is so. hard. Non diabetics typically think the difficult thing must be the shots and the finger pricks, right? Not really. The majority of diabetics get used to those things quickly (of course there are some of course that deal with a major major needle phobia that can make it even harder). The hard part is that it never ends. Almost e…

Having an 18 month old means we are in full control of everything he does and eats and doses and even with all that control we see wild swings and weird shit every day. Having all the energy needed to manage T1D and the self control to do it is superhuman. I wrote this post mostly because I didn’t know that before and I want more people to know. You are doing great.

I'm a dad to 9 month old twins and I'm a Type 1 Diabetic.

The picture of you and your son in that hospital bed broke me. You're doing great.

Re: The Unreasonable Math of Type 1 Diabetes

#112

Post by osrec » Thu, Feb 17, 2022, 10:22 PM UTC

Trasmatta wrote: post #8

I'm a type 1 diabetic, and this was a helpful post at showing non diabetics why it is so. hard. Non diabetics typically think the difficult thing must be the shots and the finger pricks, right? Not really. The majority of diabetics get used to those things quickly (of course there are some of course that deal with a major major needle phobia that can make it even harder). The hard part is that it never ends. Almost e…

My sister is T1 diabetic (diagnosed at 11). Your description is extremely accurate.

I used to think that if you control all the parameters, then you can control diabetes. Thinking in this way is incorrect, and my lack of understanding caused a bunch of arguments between me and my sister. I wanted her blood sugars to be better, and assumed her bad blood sugar days were caused by poor control. They weren't, and quite honestly, only God knows the real cause.

I was pretty ignorant about what I didn't know. My sister is 32 now, and I feel like she's got a very good handle on her condition in the last decade or so. It is a continual struggle, but I'm proud of the fact that she now has mostly good days, with the occasional bad day here and there.

Re: The Unreasonable Math of Type 1 Diabetes

#113

Post by richie5um » Thu, Feb 17, 2022, 10:22 PM UTC

Trasmatta wrote: post #8

I'm a type 1 diabetic, and this was a helpful post at showing non diabetics why it is so. hard. Non diabetics typically think the difficult thing must be the shots and the finger pricks, right? Not really. The majority of diabetics get used to those things quickly (of course there are some of course that deal with a major major needle phobia that can make it even harder). The hard part is that it never ends. Almost e…

Thank you for sharing. As a T1 diabetic too, I was reading this nodding my head all the way through.

Re: The Unreasonable Math of Type 1 Diabetes

#114

Post by kamens » Thu, Feb 17, 2022, 10:28 PM UTC

jorvi wrote: post #101

csnover wrote: post #63

Earlier quoted context omitted.

One of the scariest experiences of my life was going on a walk after lunch with someone who had T1D and miscalculated their insulin dose. They went from totally fine, to saying “I don’t feel well, we need to head back”, to sweaty and sheet white and barely conscious within just a few minutes. The terror I felt as we waited for the doors of the lift to open so he could get to his emergency food is burned into my brain…

> A cure for cancer is often held up as the holy grail of medicine, but even cancer patients don’t have to be perfect every day just to keep living. Wow. There is no need to dismiss the plight of cancer patients in relation to that of diabetes patients. As a diabetic, if you go through the (granted, horrible) grind, you can be fairly certain you'll live for quite some time. If you are a cancer patient, even if you ar…

I don't think there was any dismissal of the awful seriousness of cancer. In my experience, those who 'know' T1D (via themselves or close family) tend to be _extremely_ empathetic to the impact of most other health conditions, too.

What I read in that comment about "being perfect every day" -- and what I notice about having T1D compared to the awful experiences of family w/ cancer -- is the distinction b/w experiencing suffering caused by some terrible external force (cancer) vs experiencing suffering that can be interpreted as caused by yourself. Or suffering for which it's always easy to partially judge yourself.

The reason this post (notice even the 'defensiveness' in its title) resonates so much w/ those w/ T1D is because this condition presents one with non-stop, 24/7 complicated problems to solve w/ serious consequences...and yet, any time something goes wrong, it still feels like it's kinda your fault. Like you made a mistake.

That is a non-stop mental grind that is unique to T1D and a small set of diseases. The uniqueness certainly does not make cancer less awful.

Re: The Unreasonable Math of Type 1 Diabetes

#115

Post by FalconSensei » Thu, Feb 17, 2022, 10:28 PM UTC

Trasmatta wrote: post #8

I'm a type 1 diabetic, and this was a helpful post at showing non diabetics why it is so. hard. Non diabetics typically think the difficult thing must be the shots and the finger pricks, right? Not really. The majority of diabetics get used to those things quickly (of course there are some of course that deal with a major major needle phobia that can make it even harder). The hard part is that it never ends. Almost e…

I wake up at the same time and eat the same thing every weekday morning. Still, my bg at noon will range from 3 to 12. This after having this thing for 17 years. Yeah, it's hard.

Edit: On the 42 factors, during-sleep BG is either stable or up. For me it's either side or down (but occasionally up).

I do have the 'pre-sleep' BG that usually goes down, right after brushing my teeth (is it post-brushing then?), which is a well-known factor on Reddit. Basically, doesn't matter if I'm going to sleep at 10pm or 1am. I check my BG, it's 8, arrow straight or even up (CGM indicates the trend). Brush my teeth and check again, 7 with arrow straight down to the floor :/

Re: The Unreasonable Math of Type 1 Diabetes

#116

Post by adhesive_wombat » Thu, Feb 17, 2022, 10:31 PM UTC

jorvi wrote: post #101

csnover wrote: post #63

Earlier quoted context omitted.

One of the scariest experiences of my life was going on a walk after lunch with someone who had T1D and miscalculated their insulin dose. They went from totally fine, to saying “I don’t feel well, we need to head back”, to sweaty and sheet white and barely conscious within just a few minutes. The terror I felt as we waited for the doors of the lift to open so he could get to his emergency food is burned into my brain…

> A cure for cancer is often held up as the holy grail of medicine, but even cancer patients don’t have to be perfect every day just to keep living. Wow. There is no need to dismiss the plight of cancer patients in relation to that of diabetes patients. As a diabetic, if you go through the (granted, horrible) grind, you can be fairly certain you'll live for quite some time. If you are a cancer patient, even if you ar…

Not that it's a competition, but T1D can and does just come out of left field and fuck you over. Not only for annoyingly prosaic things like forgetting a Snickers in the car and passing out alone and never waking up, but also sudden cardiac death is an order of magnitude higher.

I had cancer, it was shit, and yes, there's always a chance its not done with me, but at least the cause of death won't be "finally forgot a snack".

Re: The Unreasonable Math of Type 1 Diabetes

#117

Post by Trasmatta » Thu, Feb 17, 2022, 10:33 PM UTC

mikenew wrote: post #100

Awesome write up, but one thing I still don't understand; why is hypoglycemia such a big part of the problem? If insulin is your body's way of moving glucose out of your bloodstream and T1D means that lever is broken, why do you so often end up with too little blood glucose? Is it just because of overestimating the insulin dose? Or is there some other factor; i.e. does glyconeogenesis not work properly or something a…

> why do you so often end up with too little blood glucose?

Managing the balance between insulin and BG is normally an automatic process performed by the endocrine system. A person whose pancreas stops producing insulin now has to manage that careful balance consciously, which introduces the possibility for errors. And it's complicated even more by all the factors that can influence BG in either direction (see the chart in the OP).

A healthy body is very good at managing that balance automatically through complex feedback loops. Those feedback loops break down if the body can no longer produce insulin on its own.

> If the problem is that the pancreas can't produce insulin, I would have thought something like a ketogenic diet would make it easier since you would have less of a need for insulin

Some T1Ds absolutely do go on a ketogenic diet, or at least a low carb one. You still need insulin, just less of it. Because you still have to dose yourself with insulin, you still have the risk of hypoglycemia on a low carb diet. (Sometimes even more of a risk, because your insulin resistance typically goes down on those diets.)

That being said, there are T1Ds that have a lot of success with keto / low-carb. Just don't believe anyone who says you can cure T1D with that diet. T2D can sometimes be reversed that way, but never T1D.

> But it sounds like bringing blood sugar up is a big part of managing T1D

It's less about "bringing blood sugar up" and more about balancing the blood sugar on the edge of a thin blade. Tipping in either direction is bad.

Re: The Unreasonable Math of Type 1 Diabetes

#118

Post by Trasmatta » Thu, Feb 17, 2022, 10:37 PM UTC

cleancoder0 wrote: post #105

csnover wrote: post #63

Earlier quoted context omitted.

One of the scariest experiences of my life was going on a walk after lunch with someone who had T1D and miscalculated their insulin dose. They went from totally fine, to saying “I don’t feel well, we need to head back”, to sweaty and sheet white and barely conscious within just a few minutes. The terror I felt as we waited for the doors of the lift to open so he could get to his emergency food is burned into my brain…

I once took a 5 hour bike trip on an empty stomach. At some point I couldn’t even turn the pedals. I had to lay on the ground, not feeling better even after half hour. I can still remember the feeling of eating some sweets. Felt like I was reborn. Can’t imagine what it’s like for T1

The interesting thing is that your BG levels may have actually been fine. Physical exhaustion doesn't necessarily lead to hypoglycemia in a healthy person. Hypoglycemia feels significantly different than just being hungry, for example.

A bizarre phenomenon: feeling stuffed because you ate a huge meal, but having a hypo anyway. You don't want to eat anything because you're not hungry, but feel an overwhelming urge to stuff your face with sweets anyway.

Re: The Unreasonable Math of Type 1 Diabetes

#119

Post by com2kid » Thu, Feb 17, 2022, 10:37 PM UTC

KetoType1 wrote: post #34

Trasmatta wrote: post #8

I'm a type 1 diabetic, and this was a helpful post at showing non diabetics why it is so. hard. Non diabetics typically think the difficult thing must be the shots and the finger pricks, right? Not really. The majority of diabetics get used to those things quickly (of course there are some of course that deal with a major major needle phobia that can make it even harder). The hard part is that it never ends. Almost e…

The secret to managing Type 1 Diabetes is a ketogenic diet. You will observe extreme stability of blood glucose (low variance) and because the brain uses ketones as fuel, occasional hypoglycemia will be an easily-managed non-event. You should get most of your calories from olive oil and nuts. Protein intake should be just as much as you need. Excess protein causes blood glucose instability. Carbohydrate intake should…

I'm vouching for this because there is indeed a community of type 1 and type 2 diabetics using keto for management.

Obviously it isn't a one size fits all approach, and the above poster could have been a bit more diplomatic, but IMHO it is worth discussing treatments that have been demonstrated to work.

Re: The Unreasonable Math of Type 1 Diabetes

#120

Post by noodleman » Thu, Feb 17, 2022, 10:37 PM UTC

gowld wrote: post #66

csnover wrote: post #63

Earlier quoted context omitted.

One of the scariest experiences of my life was going on a walk after lunch with someone who had T1D and miscalculated their insulin dose. They went from totally fine, to saying “I don’t feel well, we need to head back”, to sweaty and sheet white and barely conscious within just a few minutes. The terror I felt as we waited for the doors of the lift to open so he could get to his emergency food is burned into my brain…

Now imagine what it's like for someone with T1D to live alone, if you haven't yet been to a funeral for that. Every single time you go to sleep is a roll of the dice.

This is a bit melodramatic. I've lived alone with T1D for the better part of a decade without any problem. I went to uni, alone, without any problems.

Frankly, I think depending on other people is a liability. I can't count on my hands how many times I've had to explain to people that you don't give an unconsious diabetic insulin, you call an ambulance and follow the instructions you're given. I just don't trust the average person enough to burden them with the responsibility.

The only people I would trust to look after my unconsious body during a severe hypo are medical professionals - and there are medical professionals that I still wouldn't trust!

Yes, the maths is unavoidable. Diabetes burnout is real. But if you've it had for nearly 3 decades, like I have, then you learn coping strategies. My advice is to spend some time finding a specialist who listens and answers questions. Use the devices available to you and learn them well. Don't make changes to your insulin regimen when you're angry or hypo. Most importantly, don't strive for unattainable perfection.