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Taking my diabetes treatment into my own hands

martin.janiczek.cz

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Re: Taking my diabetes treatment into my own hands

#71

Post by mjaniczek »

mft_ wrote: post #67
wwilim wrote: post #28

Earlier quoted context omitted.

See, that's the thing. I've had T1D for 26 years now and I have stubbornly refused to accept that it's not a smart idea to eat anything I want. I am not going to give up hash browns until I lose a leg.

Interesting; as a non-diabetic, there are lots of (nice) things I don't eat regularly (pretty rarely in reality) for general health reasons. Hash browns aren't a particular thing for me, but they'd definitely be on my 'not regularly' list (deep fried, comparatively simple carbs, lots of salt, etc.) Genuine question, not trying to 'gotcha': do you think your stubbornness in this regard was somehow accentuated by havin…

A datapoint of one: T1D has definitely made me crave sweet stuff more. Perhaps due to being "forbidden fruit", etc. etc.

Re: Taking my diabetes treatment into my own hands

#72

Post by mjaniczek »

InvaderFizz wrote: post #70
mjaniczek wrote: post #65

Earlier quoted context omitted.

You're definitely making me reconsider it, thanks! Along with the person in another thread saying walks after meals help as well. With a fully remote work these risky "oops I injected but there's no food yet" situations should not happen as often, considering the time-to-fridge is like 10 seconds.

Knowing little about the subject. If Insulin is a 20 minute lag, and eating is a 20 minute lag. Shouldn't you just dose immediately before eating so they hit at the same time?

It's a very rough rule of thumb, take these numbers with a grain of salt. It could very well be that some food activates in 5 minutes etc. Different insulin types also have different curves.

Anyways there are studies about the "inject 15min before food" approach: eg. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945151/

Re: Taking my diabetes treatment into my own hands

#73

Post by manmal »

oezi wrote: post #8

My uncle died after getting into a hypoglycemic coma at night. I think it is a real shame that technology hasn't been able to solve what looks like a medium-complexity feedback loop system.

The down correction is pretty much solved (injecting insulin automatically). But the body is unpredictable, so the up correction is needed to prevent hypos. The one thing we currently have is automated glucagon delivery, but this has severe downsides:

- Liquid glucagon can last only 24-48 hours at room temperature

- Once glycogen storage in the liver is depleted, glucagon does help promote blood sugar production, but the effect is way lessened and unpredictable.

- The liver‘s glycogen storage is for many T1Ds a life saver in case they have a severe hypo. Injecting glucagon can deplete glycogen so you lose this buffer when you really need it - meaning you won’t wake up again when otherwise you would have.

So ideally, one would inject glucose directly, but that’s a volume/convenience problem. It would be ca like carrying a colostomy bag.

Re: Taking my diabetes treatment into my own hands

#74

Post by tgaj »

trimethylpurine wrote: post #26
wwilim wrote: post #13

One thing you would really benefit from that you don't need a doctor for is getting your BG displayed on a smartwatch. Assuming you have an Android phone and a compatible smartwatch (Galaxy Watch4 in my case): 1. You need to install G-Watch Wear App on your phone and watch 2. You need to replace the official Libre app with a 3rd party app supported by G-Watch like xDrip or Juggluco. There are a few of those, mostly n…

Did you have good luck with these? I've tried 6 of these on my mom, at every price point, and compared with a prescription monitor (back of the tricep, needle thing). I couldn't find anything even remotely accurate.

He is talking aobut connecting the monitor like yours to the smartwatch so you can see you glucose level without pulling our your smartphone. There is no smartwatch on the market that is able to read glucose level using some kind of infrared blood sensor. All the ads are lying.

Re: Taking my diabetes treatment into my own hands

#75

Post by caseyy »

nerdponx wrote: post #49
caseyy wrote: post #46

I completely agree with the author. T1Ds must take care of themselves. Doctors and nurses suffer from Dunning-Kruger massively. They will quite often be confidently incorrect. I’ve seen this living in large cities in the US and Europe. Or you can read about how medics often make potentially murderous decisions on diabetes treatment — there are plenty of stories. Humility is the cure. I say this as someone who went to…

> The most infuriating thing is when they say that diabetics just die in surgeries, but forget to mention that often the reason is medical negligence. I find that a lot of medical research literature is like this. A couple of "X is associated with increased mortality" papers that make no attempt at a causal analysis is enough to get doctors to recommend against X. As far as I can tell, the organizations that make the…

This is definitely at least one contributing factor to the situation. But another one is that many medics sadly refuse to learn from a patient. Even when the patient is an expert in practice.

A cure for these kinds of issues in medicine and in software engineering is humility. We must understand our knowledge is incomplete. Our learnings are often the best that circumstances allowed us to learn, but not the best one could learn.

Re: Taking my diabetes treatment into my own hands

#76

Post by janandonly »

Very dumb question here, but I don’t dare ask it to ChatGPT.

What would happen to T1 or T2 diabetics if we would stop eating all sources of sugars and carbs? So no fruit, no rice, no potatoes and so on?

Would it be possible to survive and live comfortably in a state of Ketosis? Or is a 100% ketogenic diet simply not possible on diabetes?

I’m asking because my true question is: what if insulin becomes too expensive? Then what? Do we die? Or is there some form of diet that we could live on??

Re: Taking my diabetes treatment into my own hands

#77

Post by derlvative »

Mathnerd314 wrote: post #3

> https://github.com/SmartCGMS/core/blob/dffdd89a274144d0e9ecb... > Especially, a diabetic patient is warned that unauthorized use of this software may result into severe injury, including death. I like the idea of the post - I have actually been thinking about including some biophysical models for medications in my app - but I do think that if you don't understand what a system of differential equations is, maybe tr…

Don't worry, his doctor doesn't know what a differential equation is either so this is a large improvement.

Re: Taking my diabetes treatment into my own hands

#78

Post by mono812 »

Interesting stuff! I'm a late T1D and there is just so much that subtly influences your blood sugar levels. I adhere to quite a strict diet and adapt my insuline dosage based on not just the carb contents and glycemic load of the meal, but also the starting point / trends I see in my libre readings. If you can predictably consume carbs (and glycemic load) you can also inject early with confidence (or even post-meal if your meal is really 'slow' or your blood sugar level is low). Going for a 20-30 minute walk during a meal spike (mostly after breakfast and lunch) does wonders for me too.

I manage to maintain roughly 99% TIR (4-10mmol/l) on my Libre with this, virtually no hypos and just the occassional bit of hyperglycemia when I just don't want to care. Although obviously this does require you to plan a lot of things in advance and requires effort and all of this is just based off of personal experience and experimentation and does not necessarily translate to anyone else.

I'm still really hoping for a more low-effort solution to T1D treatment (or even a cure), but I'm skeptical that we'll see that anytime soon.

Re: Taking my diabetes treatment into my own hands

#79

Post by mjaniczek »

mono812 wrote: post #78

Interesting stuff! I'm a late T1D and there is just so much that subtly influences your blood sugar levels. I adhere to quite a strict diet and adapt my insuline dosage based on not just the carb contents and glycemic load of the meal, but also the starting point / trends I see in my libre readings. If you can predictably consume carbs (and glycemic load) you can also inject early with confidence (or even post-meal i…

99% TIR... that's crazy. Well done. You're an inspiration!

Re: Taking my diabetes treatment into my own hands

#80

Post by stranded22 »

mjaniczek wrote: post #17
stranded22 wrote: post #11

Interesting read. My wife is T1D, moved to a closed loop last year. It has been life changing for her - this is not an understatement. Her mental health has massively improved because she isn't having up to 3-4 hypos a day. One thing not mentioned in the intro, hormones hugely affect T1D. She's started perimenopause and everything went out of the window. Closed loop has made this much more manageable.

Out of curiosity, is your wife's closed loop solution official, or homebrew? (If official, which country do you live in, if I may ask?)

It's official - UK (England).
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