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The Unreasonable Math of Type 1 Diabetes

maori.geek.nz

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Re: The Unreasonable Math of Type 1 Diabetes

#151

Post by alar44 »

klipt wrote: post #130
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…

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

No post body was provided.

Re: The Unreasonable Math of Type 1 Diabetes

#152

Post by tagh »

techsupporter wrote: post #124
Trasmatta wrote: post #109

Earlier quoted context omitted.

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 Libr…

>The author here points out that New Zealand's medical system doesn't always pay for CGMs, while the Australian system does.

Only for under 21s, and only recently. Once you hit 21, the rug is pulled out from under you.

Re: The Unreasonable Math of Type 1 Diabetes

#153

Post by spaethnl »

GiorgioG wrote: post #145
spaethnl wrote: post #52

I think this article does a great job covering many of the difficulties of T1D. One component I think was under-emphasized is the fact that correction insulin doses are not based on what your current blood glucose(BG) levels are, but on where you predict they will be when the dose really starts taking effect. Take for example a current best case scenario of having a Loop system via a continuous glucose monitor (CGM)…

Yep - my 10 year old son has a x2 pump and a Dexcom G6. Hopefully the software starts to improve at a faster pace with smartphones becoming more tightly integrated: https://www.tandemdiabetes.com/landing-pages/remote-bolus

Yeah, I have been looking forward to that for a while. I'm hoping that if their app isn't flexible enough to do menu-based dosing that it will be possible to side-load my own app to do that dosing.

As an aside, the OmniPod 5 was just released and already has App control[1]. The tubeless aspect of that is very attractive.

[1] https://www.healthline.com/diabetesmine/omnipod-5-tubeless-s...

Re: The Unreasonable Math of Type 1 Diabetes

#154

Post by prmph »

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…

Is it not possible to have a device always connected to the bloodstream, with a replenishable supply of glucose and insulin in different compartments, that periodically checks the blood sugar level, and injects what is appropriate to keep it normal?

Re: The Unreasonable Math of Type 1 Diabetes

#155

Post by lolc »

noodleman wrote: post #120
gowld wrote: post #66

Earlier quoted context omitted.

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…

Yes living alone with diabetes is fine given modern treatment and some robust habits.

Here's the instruction to the people I know I will be spending longer stretches of time with: When I look very tired, disoriented, or talk incoherently: fetch orange juice or some other sugary drink. Make sure I drink it. When you find me unconscious: roll me on the side, call an ambulance. You can put sugar under my tongue but do keep watching me. If you feel confident, apply the syringe from the orange box in the fridge.

Thankfully, none of this has played out so far. Except that I had to rely on friends a few times when my sugar ran out. That's already plenty scary.

Re: The Unreasonable Math of Type 1 Diabetes

#156

Post by jacquesm »

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…

Continuous delivery closed loop delivery systems are in the works, are they not?

Re: The Unreasonable Math of Type 1 Diabetes

#157

Post by vallard »

bleair wrote: post #24
semenko wrote: post #4

Hey Graham -- great post! The Medtronic / Guardian sensor combo is generally disliked by patients, though (in the US) the Medtronic 770G is FDA approved for ages 2+. Most prefer the t:slim X2 with "Control-IQ" (their hybrid closed-loop: https://www.tandemdiabetes.com/products/t-slim-x2-insulin-pu... ), which is FDA approved for ages 6+, and works great. The bleeding edge is the Beta Bionics ( https://www.betabionics.…

There's also two "open source" systems - https://loopkit.github.io/loopdocs/ - https://openaps.org/ Tidepool is also trying to take the loop project and get a version of it FDA approved. Both of the open source projects require you to do the work and actively take control of your setup (a cgm plus pump plus phone). They have really nice support communities. I would never go back to not using Loop.

Our 15 y/o son was diagnosed T1D Jan 2020. Finally got him on loop Sept 2021 and feel the same way. These developers are saints for doing this work. They've given us countless hours of sleep. We had another T1D family come visit us and I set them up on loop. I was in tears when I got text message from them telling us how they their kid is 85% in range and they are actually sleeping through the night. These are truly life changing projects.

Re: The Unreasonable Math of Type 1 Diabetes

#158

Post by stefan_ »

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

You weren't necessarily hypoglycemic, just low on glycogen. The former is a life threatening condition, the latter is more of a deep exhaustion.

Re: The Unreasonable Math of Type 1 Diabetes

#159

Post by RanTig »

Trasmatta wrote: post #143
KetoType1 wrote: post #34

Earlier quoted context omitted.

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 do want to try keto at some point, as I've heard a number of success stories for keto / low carb and T1D. It's hard to gather the motivation to start it. One important thing to point out is that you can't reverse T1D with keto, like some people are able to with T2D. It can greatly reduce your insulin requirements, but not to zero. Your pancreas will not return to normal function.

As far as I know you indeed can't reverse T1D with keto, but making it (much) easier to manage still seems like a very big win.

It's actually pretty easy to get used to a keto diet. Initially you might crave a lot of food items that you were used to eating, but eventually you stop missing them. I don't feel like I'm missing out on anything when I'm having some aged cheese and roasted nuts as a snack (which replaced eating cookies or chips for me). It is a little bit more expensive though.

As for drinks, eliminating fruit juices and opting for the 'light' or 'zero' variant as a drop-in replacement if you want something sweet is pretty easy.

Re: The Unreasonable Math of Type 1 Diabetes

#160

Post by jacquesm »

prmph wrote: post #154
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…

Is it not possible to have a device always connected to the bloodstream, with a replenishable supply of glucose and insulin in different compartments, that periodically checks the blood sugar level, and injects what is appropriate to keep it normal?

This is either in trial or already in distribution, it is essentially a metered insulin pump coupled with a continuous glucose monitor.

https://www.diabetes.org.uk/guide-to-diabetes/diabetes-techn...

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