Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

The Unreasonable Math of Type 1 Diabetes

maori.geek.nz

Post reply on HN
Print view View original

121–130 of 315 posts

Re: The Unreasonable Math of Type 1 Diabetes

#121

Post by heisenzombie »

i_cannot_hack wrote: post #51

> A hot bath or shower can raise (then lower) BGL. I suspect the author has come to this conclusion from CGM data, and therefore also that it is wrong (or at least not a very significant effect). I also have T1D, and CGMs like Freestyle Libre (and probably also Dexcom) includes a temperature sensor and adjusts its readings based on the external temperature to increase accuracy. I think the changes in blood sugar leve…

Hm, I finger-prick test and have definitely noticed that getting in a spa or hot tub can do pretty serious things to my BGL. My hypothesis is that if I have any insulin-on-board, that the increased bloodflow causes it to be taken up more rapidly. I think this might include lantus.

Re: The Unreasonable Math of Type 1 Diabetes

#122

Post by 1auralynn »

kettleballroll wrote: post #11
1auralynn wrote: post #3

My younger brother was diagnosed with Type I when he was 4 and I've always thought I had a pretty good handle on how tough having diabetes must be. I recently had gestational diabetes when I was pregnant and boy was I wrong. It's TOUGH. Particularly getting a handle on glycemic indices. I will say it turned me into a huge proponent of massive amounts of protein and fiber in my diet (but kinda turned me off Thai food…

> I will say it turned me into a huge proponent of massive amounts of protein and fiber in my diet (but kinda turned me off Thai food :/ ) Why?

Lots of rice-centered dishes (rice has an especially high glycemic index), usually a ton of added sugar (pad thai, curries), sugar-based dipping sauces.

Re: The Unreasonable Math of Type 1 Diabetes

#123

Post by jzb »

This was a great primer. I have a senior diabetic cat. It’s not unlike trying to manage diabetes for a toddler. He might eat all his food, he might not. He might eat and throw up an hour later… it’s a tricky disease to manage. He’s had a few episodes of hypoglycemia and it’s scary. Can’t imagine having to face that with a child.

Re: The Unreasonable Math of Type 1 Diabetes

#124

Post by techsupporter »

Trasmatta wrote: post #109
richie5um wrote: post #103

Earlier quoted context omitted.

“Most diabetics have CGMs these days” - not where I come from :-(

You're right, the truth is probably actually that only a minority of T1Ds have CGMs. My post was a bit insensitive, not everyone has easy access to them.

What's even more frustrating is the disparity in who can get them and how even if they are cleared for use in your country. The author here points out that New Zealand's medical system doesn't always pay for CGMs, while the Australian system does. In Ireland, the Dexcom G6 system is available but the FreeStyle Libre 2, an updated version of the FreeStyle Libre with more frequent reads and better alarms (Libre vs Libre 2), is not.

CGMs are available over-the-counter, just like finger stick machines, in a variety of countries like Canada and Ireland. But in the United States a prescription is required for any CGM even if insurance doesn't pay for it and insurance generally only pays for it once you are actively on full-time insulin treatment, so type-2 diabetics can't avail of insurance to reduce the cost of potentially not needing to go on recurring insulin by getting a handle on being pre-diabetic. (Plus many doctors won't write a CGM Rx for someone who isn't type-1 or very symptomatic type-2. This has resulted in nutritionist businesses springing up whose purpose is to turn a credit card charge into a prescription for a CGM.)

But of course different countries have different regulatory systems, we all know that. This is to say that even when you find a system and method that has worked for others in your online community, that method might not be available to you, and it causes even more stress to have the idea, right or wrong, that a useful tool is just out of your grasp. And carbohydrates help you if you dare move between countries.

Re: The Unreasonable Math of Type 1 Diabetes

#125

Post by 1auralynn »

valarauko wrote: post #53
Trasmatta wrote: post #13

Earlier quoted context omitted.

Protein is low carb. Fiber is a carb that doesn't impact your blood glucose, because your body doesn't break it down. Thai food is heavy on noodles and rice, which are both very high carb.

Isn't this true of essentially most cuisines though, to be carb rich? Indian, Chinese, Mexican, Italian, French, etc - the typical diet in most places is heavily skewed towards carb in general. It's a matter of adjusting the ratio of protein-rich foods vs carbs within that cuisine to your needs.

Different carbs affect people differently, but for me rice was a big no no, whole wheat was OK, and corn was great (whew!).

So, Thai was pretty bad, Chinese not much better but you can find less sugary dishes. Indian was actually pretty good as long as I didn't gorge myself: The fat in the dishes helps slow down the sugar absorption so you don't get the extreme spikes, and you can pair it with a whole wheat roti instead of rice. Mexican was GREAT cause, corn + beans (beans were the best!! so much fiber and protein, barely any spike when eating them). Italian is ok as long as you make it yourself with whole wheat pasta and eat lots of meat and cheese. French is good cause they have lots of meat-focused dishes. The best meals for me were like a pork chop or steak, greens of some kind, and quinoa or whole wheat mac n cheese or polenta.

Re: The Unreasonable Math of Type 1 Diabetes

#126

Post by johnyzee »

Sorry to hear what you are going through. A couple of comments from someone with an interest in the topic, but obviously not your practical experience on the front line as it were:

(1) You mentioned ISF (insulin sensitivity factor), but what you did not mention is that this is not a static factor. It is possible to significantly improve insulin sensitivity through diet and life style, and this is particularly useful for people with T1D. Part of this is to adapt to a significantly less carb-based diet. This is absolutely doable, carbs are not an essential nutrient.

(2) "If your BGL is high for a while (with high levels of ketones)" - this sounds wrong to me. Ketones are high when availability of glucose is low. In many ways this is the ideal to aim for. Ketones are a substitute for glucose, produced from fat. If the person is well adapted for producing and utilizing ketones, s/he can replace carb consumption with fat, which is insulin neutral, and avoid the wasting away of muscle mass which happens with T1D, because the body is energy starved and breaks down protein for glucose.

Just some well-meant input, hope to not sound glib in the context of your challenges.

Re: The Unreasonable Math of Type 1 Diabetes

#127

Post by veryfancy »

Parent of a seven-year-old T1D here. We've had him DIY looping (Omnipod, Dexcom, LoopKit) for years now. (Wow, time flies.) Cannot recommend this technology highly enough.

Actually, there were a few big wins, in series: started with MDI (multiple daily injections) and finger pricks. That was awful with a two-year-old, lemme tell ya. Then we got CGM (and Nightscout). That let us sleep at night. Sometimes. But we still had to perforate our small child several times a day, sometimes holding him down as he screamed. Eventually we got a pump, so needles were far less frequent. Got a prescription for some numbing cream, which helped a lot, too. And then came Loop. Loop streamlined the meal process and gave us a lot more margin for error, and it cut down on ad hoc corrections. With Loop, we now sleep _most_ nights. And things feel almost normal most of the time.

Carb math is still a lot of work. (Admittedly, we're probably more precise than most people.) And the whole system can just stop working well for reasons you can't discern sometimes. (Nah, it's always a growth spurt.) But this combo if T1D tech has really, seriously changed our lives. I'm so grateful to the folks who built the open source parts of it.

Re: The Unreasonable Math of Type 1 Diabetes

#128

Post by coldpie »

Trasmatta wrote: post #21
coldpie wrote: post #14

Earlier quoted context omitted.

Same here. 100% dead accurate description. > what if I start to go low during this meeting? should I pop some carbs and run high for this interview, so I don't risk a hypo partway through? Love this part. Had to do it literally yesterday to prep for interviewing a job applicant. Imagine the stress of an upcoming meeting, but also your brain might stop functioning half an hour into it! Ha ha! Good times.

Perhaps the only good thing about T1D is the immediate camaraderie you feel with other T1Ds. When I spot somebody else in public with a CGM or a pump, it's just that instant feeling of "hey, we know nothing about each other, but we have a very intimate understanding of each other's suffering". > Love this part. Had to do it literally yesterday to prep for interviewing a job applicant. Imagine the stress of an upcomin…

> Perhaps the only good thing about T1D is the immediate camaraderie you feel with other T1Ds.

On that note, feel free to send me an email if you want. Or not, no pressure. (I would've sent you one, but your profile is empty :) )

Re: The Unreasonable Math of Type 1 Diabetes

#129

Post by arka2147483647 »

JimmyAustin wrote: post #106
arka2147483647 wrote: post #92

Earlier quoted context omitted.

Well, I have had the incredible luxury of being born in Finland, so state/municipality pays everything. Insulin, Glucose-test-supplies, Doctors. I truly fell sad when i hear what US based persons have to go through. Though, i suppose i pay it in taxes :) About devices.. The first Glucose-test-device (what are they even called in english) took 5min to process the results. Current one is 5sec. A massive improvement in…

I'm not diabetic, but I tried a FreeStyle Libre 2 continuous glucose monitor to measure my blood sugar, and I think it's basically what you are asking for. Tap your phone on a patch on your arm to get a instant view of your blood sugar, plus see the previous 8 hours. It is pricey though.

My understanding is that all current devices like this use a thin sensor "fiber" that is inserted under the skin, which is then connected to the coms-unit, which is in the sticker which remains on top of the skin. So they are still somewhat invasive.

Re: The Unreasonable Math of Type 1 Diabetes

#130

Post by klipt »

csnover wrote: post #63
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…

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…

> some nuisance like heartburn

Unmanaged heartburn can lead to esophageal cancer, you shouldn't take it too lightly.

Post reply on HN