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Taking my diabetes treatment into my own hands

martin.janiczek.cz

111–120 of 372 posts

Re: Taking my diabetes treatment into my own hands

#111

Earlier quoted context omitted.

Type 2 has had a high correlation with obesity and high carb diets.

But interestingly also a very high genetic factor with 90% of identical twins both having T2DM (which is greater than that of type 1 which if I remember correctly is 40%)

Sounds like Nature vs nurture to me. Until there is a proposed genetic marker... it's just another item confusing the public about correlation vs causation.

Re: Taking my diabetes treatment into my own hands

#112

Not a diabetic and I live in one of the richest countries with a social medical system, but the medical industry is an abject failure. My experience with most Doctors who are not surgeons has mostly been that are overpaid for doing essentially nothing and think all their patients are hypochondriacs.

Something similar, u just switched to private clinic where i pay 500euros/year for general doctor(even when they work for insurance) and I pay like 100E for specialist. Never happier, fast and good communication.

Re: Taking my diabetes treatment into my own hands

#113

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? T…

I've lived low-carb as a T1 and my blood sugar was very stable. I would still take sugar to stabilize levels when dipping low. A completely ketogenic diet would be very hard for a T1 and not a sensible goal. Insulin management was simpler, but still required. On many days I would just do the one injection of long-lasting insulin.

While the scantly researched health risks associated with a ketogenic diet remain, the diet is very effective to keep blood sugar stable. A low-carb diet protects most people from T2, and people with T1 profit from simplified insulin management.

For a T2, eating ketogenic could be healthier than eating carbohydrates. Depending on progression, they would recover quickly and not be a T2 anymore.

Re: Taking my diabetes treatment into my own hands

#114
post #106

Not a diabetic and I live in one of the richest countries with a social medical system, but the medical industry is an abject failure. My experience with most Doctors who are not surgeons has mostly been that are overpaid for doing essentially nothing and think all their patients are hypochondriacs.

Agree - most of the advice is WebMD level. Anything outside the check list leaves them scratching their head. They’re terrible debuggers. I had early high blood pressure since high school. Four blood pressure medications, one being a diuretic. Signs of edema. It’s not like my condition required any complicated diagnostics. I met the checklist. 5 cardiologists 2 nephrologists in my lifetime. Nothing but more pills for…

In reality, there are few things a GP can do better than a nurse or some technician with an LLM, and the sooner that shift happens, the better for society.

Re: Taking my diabetes treatment into my own hands

#115

One thing that I would object to is this characterization from the article: >There are people who take insulin pumps (which provide insulin in very small very frequent doses and are ~permanently injected into your body, but are otherwise dumb as a brick) and combine them with continuous glucose monitors, and make the glucose measurements inform and control the pump. This is called “closed loop” or “artificial pancrea…

Hey, thank you for the correction! I am not keeping up to date with how are the closed loops progressing, and from quite a few of comments here it seems like the future is already here :) Maybe just not evenly distributed - I just need to wait for it to get from US to CZ. I'm glad closed loops are already helping people around the world!

Re: Taking my diabetes treatment into my own hands

#116
I highly recommend the book "The Diabetes Solution" by Dr. Bernstein. It's written by a T1D-since-childhood who was a manufacturing engineer and used his engineering skills to "debug" his diabetes despite his doctor's efforts to the contrary. However the medical industry rejected his findings on blood sugar control because of lack of medical credentials so he went and got an MD and suddenly more doctors started listening. He basically got ahold of an early glucose tester and turned it into a CGM by pricking himself dozens of times a day and around meals to collect data.

Re: Taking my diabetes treatment into my own hands

#117

Earlier quoted context omitted.

> My experience is that GPs are over-worked, under paid (given their responsibilities Their work hours are no longer than anyone else, their pay is way above the average, and their liability is as low as possible. > and can only afford to do shallow diagnostic in the 5-10 minutes they've got per patient. My doctor spends it explaining to me how I should just not care that something is wrong and accept that the medica…

> Their work hours are no longer than anyone else, their pay is way above the average, and their liability is as low as possible. YMMV but as a software developer I am certainly not going to start throwing stones in a glass house. :) Also consider additional time and cost of a doctor completing their education while working up to a max of 80h per week, which would be illegal for any reasonable profession.

> > Their work hours are no longer than anyone else, their pay is way above the average, and their liability is as low as possible.

> YMMV but as a software developer I am certainly not going to start throwing stones in a glass house. :)

I have absolutely no idea of what's involved when working as a GP/consultant, so I probably grossly underestimate their job, but in my interaction with them (involving my health as well as my family's) most of them seem to just put your case into a flowchart and prescribe along, because that's what reduces the liability to 0 and works most of the time. But if that's their job, they'll eventually be replaced by LLMs.

When you don't fall into the typical case, you'll have to go through retelling the whole story to all the flowchart ones (easily 80%) only to find along the way snake oil salesmen (10%), honest "I can't take your case" individuals (5%), and the 1-5% which actually feel like scientists and problem solvers.

(percentages pulled out of my rear but that's roughly my experience)

Re: Taking my diabetes treatment into my own hands

#118

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? T…

It's worth while reading the literature on pre-insulin treatments, but for type 1 diabetics, the answer is: you might be able to live, if just, for a while (a decade or so), but lifespans are greatly shortened. Probably depends exactly on the particular characteristics of the disease for a patient.

I thought this was a neat discussion: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3062586/

A transcript of a speech Joslin gave https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1827782/pdf/can...

Re: Taking my diabetes treatment into my own hands

#119

Not a diabetic and I live in one of the richest countries with a social medical system, but the medical industry is an abject failure. My experience with most Doctors who are not surgeons has mostly been that are overpaid for doing essentially nothing and think all their patients are hypochondriacs.

In the US, my experience has largely been that it's not healthcare, it's sickcare. Wait until sick, get treated. Annual checkups are a weight check, blood pressure, a few questions, maybe a blood panel if you're lucky, and then a "you look great see you next year", aka, come back when you're sick.

I spent the last few years seeking proactive healthcare and the "system" is very much stacked against you. If you're fortunate enough to have the resources to push through, you can get all sorts of stuff done -- broader blood panels, body scans (eg. Prenuvo), VO2 max, metals tests, mold tests, genetic tests, GI tests, etc etc. But these are luxuries and if you ask most doctors, you'll get back "you look great why would you do that?", aka, come back when you're sick.

A friend of mine in the middle east says you can do all that for almost nothing by walking into any hospital, but it's subsidized by government (oil) dollars.

[edit] Reading more of the comments this seems par for the course in many "wealthy" countries.

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