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Taking my diabetes treatment into my own hands

martin.janiczek.cz

201–210 of 372 posts

Re: Taking my diabetes treatment into my own hands

#201

What I've learned that, as an adult in 2024 in the United States, you cannot take for granted: - That your medical professionals are acting in your best interest - That your insurance company is acting in your best interest - That your medical professional knows what they are talking about - That things that are legal to put in your body will not cause irreparable harm to you - That the legal level of pollutants in t…

Having experienced healthcare in multiple countries I can say most of the items on your list are pretty much universal, unfortunately. Skipping over the capitalistic and legal issues, which people more or less expect, I'd like to zoom in on your item #3. The fact that doctors are (often) clueless for complex diagnostics (not talking about a broken arm, etc.) is shocking to many people.

I think the two main factors driving this outcome are:

1. Due to the complexity of the problems they face and the quick diagnosis expected from them, medical professionals are taught to think in an expert system-like if-then statements. Some of these are rules of thumb, some may no longer apply due to latest research, and some may not be applicable to you.

2. Metabolisms may differ in important ways. A new doctor is trying to make a decision in a highly complicated high dimensional space with the few data points that you provide. This is OK, but they get too confident with their diagnosis.

Re: Taking my diabetes treatment into my own hands

#202
post #155

I'm T1D and currently working on something like this because diabetes healthcare in the UK is effectively non-existent past diagnosis. Managing the condition isn't too difficult after 30 years of it, but dealing with the politics of NHS diabetes care is astronomically more difficult than it was in any decade previously. In my experience, if you are not pregnant, or you aren't at risk of passing out in the next 15 min…

You guys are decades deep into an ideologically propelled plan to "Starve the beast" by denying the NHS funding so that care quality declines, and use that as justification to privatize the NHS entirely. The starting salary for a first-year doctor is below the national median income, and for a nurse significantly below. Their inability to requisition funds & time for care is something there is repeated labor action a…

>The starting salary for a first-year doctor is below the national median income

Here you are comparing a doctor at the start of their career with a population consisting mostly of workers with decades of experience.

Re: Taking my diabetes treatment into my own hands

#203

Earlier quoted context omitted.

>I understand that some people would look at that list and say I should have never expected some of those, but pardon me for being propagandized at a very young age that we lived in a country that was good and just. That's my bad I think the problem is that you were raised to think that a "good and just" world is one where there is no risk, no variability, and limited self-reliance. This is a fiction and has never ex…

> I think the problem is that you were raised to think that a "good and just" world is one where there is no risk, no variability, and limited self-reliance. I think that children are generally raised to not believe there is "risk" associated with listening to experts. This means specialists like Doctors but also politicians and military officials. The idea that there could be a grift set up to take advantage of peop…

I almost completely agree, and think we mainly disagree on the nuances.

>The idea that there could be a grift set up to take advantage of people in the medical space, for instance, which is highly regulated and supposed to be for the benefit of people first and for generating capital second, is not intuitive to children.

The first thing I wanted to touch on is the idea of grift. Just because some has their interests ahead of yours doesn't mean they are a grifter. I think the childish view is the expectation that other people put your interests above their own, like the selflessness of a loving parent. A doctor doesnt put your individual wellbeing above their own, but that doesnt make them a grifter or a bad person. Expecting that kind of selflessness is entirely unrealistic, and is what causes cognitive dissonance when it clashes with reality. Thats not to say that grifters dont exist, who actively manipulate and deceive, but simply having unrealistic expectations for something does not make it a grift.

One example would when a doctor doesn't provide the depth of care and consideration the patient wants or would expect from a selfless caregiver. Most people come to the realization that they need to provide the drive and motivation for their own care, and doctors are just hired experts to help with things you cant do. You have to manage them and tell them what you want them to do. If you dont manage them like hired help, they will do very little indeed.

>Humans have always formed societies, and those societies have always provided services for their people. In fact, before capitalism, most of these services were provided in-kind as a right of being a part of the tribe. This idea that every person is born as an individual and nothing is granted to them belongs to a certain political ideology that is designed to make sure people feel entitled to nothing, and keep things in the private industry, and keep government small. But I digress.

I didnt mean to say that everyone is an island and forever alone. I mean that these things are not guaranteed entitlements, but conditional on human relations, standing, and mutual exchange. That is to say, they took work to maintain and were subject to constant scrutiny and mutual consent. Even in a tribe, goods and services were not provided unconditionally as some human birthright associated with tribal membership. Instead, they were conditional on good standing and mutual consent.

>This idea is also untrue. We've had a lot of time to perfect these things. If we can build skyscrapers and infrastructure to maintain them, we can provide these services. You are conflating political ideology and economic motivation with literal ability. The ability is absolutely there, and was in the past as well. There is something different going on that causes these systems to be "held together with duct-tape" and it's actually other humans actively trying to destroy these systems, not that they are impossible.

Im not arguing that beneficial institutions and functional societies are beyond human ability. Im saying their existence should not be taken for granted.

Re: Taking my diabetes treatment into my own hands

#204
Why does hypoglycemia happen in people with diabetes? Healthy people can stay active for weeks without food and for many years almost without dietary carbs (on just fats and proteins - see carnivore and keto diets). How comes gluconeogenesis from triglyceride glycerol and from amino acid fails to cover the essential glucose needs?

Re: Taking my diabetes treatment into my own hands

#205
post #155

I'm T1D and currently working on something like this because diabetes healthcare in the UK is effectively non-existent past diagnosis. Managing the condition isn't too difficult after 30 years of it, but dealing with the politics of NHS diabetes care is astronomically more difficult than it was in any decade previously. In my experience, if you are not pregnant, or you aren't at risk of passing out in the next 15 min…

You guys are decades deep into an ideologically propelled plan to "Starve the beast" by denying the NHS funding so that care quality declines, and use that as justification to privatize the NHS entirely. The starting salary for a first-year doctor is below the national median income, and for a nurse significantly below. Their inability to requisition funds & time for care is something there is repeated labor action a…

> You guys are decades deep into an ideologically propelled plan to "Starve the beast" by denying the NHS funding so that care quality declines, and use that as justification to privatize the NHS entirely.

Mind providing some sources for this? Rather tired of hearing this unfounded conspiracy theory from people

> Maybe more funding will fix it?

Where does the money come from?

Re: Taking my diabetes treatment into my own hands

#206
T2 diabetic. Metformin, and Trulicity. Although Trulicty has been hard to find recently, so I'm doing without and working harder on my management practices, which is working well. I am not a doctor and I don't know you.

Interesting range of comments.

I think that whatever you do to manage your diabetes, logging data (meds, food, glucose, weight and bp for me) makes it more effective.

I've found that managing my diabetes and weight is better when I log. Just a text file. It keeps me honest with myself, and keeps my management practices front-of-mind. It's encouraging when I'm doing well, even very slightly exciting. And since I've learned not to beat myself up, it's gently self-corrective.

Going off logging, I slide out of control.

Anyway, that works for me, so it should work for anyone. Right? :-)

Re: Taking my diabetes treatment into my own hands

#207

I'm prediabetic with two T2 parents and a T2 grandparent and my primary care doctor is entirely unconcerned about it. My lowish tech solution to delay (and hopefully prevent!) the onset of T2 is to use a glucose monitor every 2 hours, every day, and create a database of foods with my postprandial blood sugar reaponse at 1.5 and 2 hours. I also keep track of how exercise affects my blood sugar. Over the last couple ye…

Just anecdotal. Was T2 and getting kidney stones every two or three months (cause not related but treatment was). Cut out oxalates which restricted diet. Monitored sugar 3-5 times daily. Switched to carnivore diet + onions and mushrooms and went on Metformin. All at the same time. Did this for 2.5 months with no additional exercise. This dropped me down below T2 level. Went off Metformin and am maintaining with same…

Sumo wrestlers kind of fascinate me in this regard. It's very rare to find a professional who is diabetic, even though they eat one big carb-heavy meal a day and are morbidly obese. IIRC, this is explained by their low visceral fat levels, which are driven by high adiponectin levels that are themselves driven by their intense workouts and consistent sleep habits. Their high subcutaneous fat proportion is actually thought to be protective. T2D catches up to them after they retire and stop exercising and sleeping well.

Their experience touches on 3 factors:

>Exercise volume (which, according to newer research, should be spread out over the course of the day)

>Diet (which should be focused not just on maintaining steady, low blood sugar levels, but on dietary factors that encourage subcutaneous rather than visceral fat deposition)

>Sleep quality

The last, I think, is extremely undervalued. My father developed T2 in his 30s, and it progressed consistently until he was diagnosed with sleep apnea and received treatment. Around the same time, his work schedule finally became more reasonable after a career of early mornings and late nights. This is someone who had to pass annual physical fitness exams for his job, cooked and ate relatively healthily, etc. I'm convinced it was the years of poor sleep that set him up for insulin resistance.

Re: Taking my diabetes treatment into my own hands

#208
post #195

Earlier quoted context omitted.

> My doctors care about my inflammatory markers and nothing else They care about your payments, more likely...

They're doctors, not CEOs. They are advising based on the behaviors they see from most of their patients, who probably come in asking for quick solutions and are unable to make lifestyle changes stick. Patients who are educated about their own conditions, willing to listen to advice, and able to keep to that advice over the long haul are a very small proportion. Not that doctors shouldn't offer this sort of advice an…

I was talking to my physical therapist this morning about my experience with the recent exercises he'd given me, and I pulled up my Garmin workout calendar to show him my inconsistency. He'd told me to do a particular stretch every 3 hours or 6x/day, and I'd been having several days a week where I'd only completed the routine 4 or 5 times.

He said that level of consistency was fantastic, that at least a third of his patients flat-out told him they hadn't done any of the exercises at all, another third showed no improvements above baseline and he suspected they had lied about it, and the remainder had moderate compliance. When he'd told me 6x/day, he was anticipating 2x on the high end. We adjusted to 4x/day, where morning, lunch break, after work, and before bed were easier habits to stick to than trying to drop and do press-ups in the middle of my 9:00 meetings.

And that's at a sports and fitness-focused PT organization, not an average general practitioner working with median diets and advising a society that by default trends towards diabetes.

Re: Taking my diabetes treatment into my own hands

#209
post #74

Earlier quoted context omitted.

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.

Thanks for clarifying. I can see that's what he meant now.

Re: Taking my diabetes treatment into my own hands

#210
post #187

Earlier quoted context omitted.

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 fort…

>Annual checkups are a weight check, blood pressure, a few questions, maybe a blood panel if you're lucky This isn't my experience. Every time I've gone in for an annual check, the doctor has either suggested that I get or asked if I would like a blood panel. Maybe you should try another doctor.

In my experience, a blood panel doesn't cover everything typically. My A1C, Insulin, and fasting Glucose levels are all within normal range, but actually I have insulin resistance, likely genetic that wouldn't appear in my general panel for at least two or three more decades. This is common in people whose family history includes poverty or subsistence farming. I'm glad I have the resources to address this while I'm still a young professional with no children of my own to manage and full healthcare benefits including out-of-network, but I had to find my own specialists to investigate what was going on with me.
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