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

Taking my diabetes treatment into my own hands

martin.janiczek.cz

Post reply on HN
Print view View original

321–330 of 372 posts

Re: Taking my diabetes treatment into my own hands

#321

Post by potamic »

throw10920 wrote: post #290
jklinger410 wrote: post #186

Earlier quoted context omitted.

There is nothing political about what I said.

> 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. > So I am not surprised to see this, and expect to see more of it. This is political. You are extremely clearly dog-whistling to the "government needs to reform healthcare" and "America ba…

I think that's a fair bit of stretch

Re: Taking my diabetes treatment into my own hands

#322

Post by GoodOldNe »

IggleSniggle wrote: post #121
flanked-evergl wrote: post #99

Earlier quoted context omitted.

> 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. I'm not sure why the educational requirements are so extreme for all doctors. Certainly for some, like surgeons, I get it, but for my GP I think it's a total farce. I don't make the rules though, I just can see a broken system when it's right…

Not sure how it is outside the US, but subscribing nurse-practitioners (requires just 2 additional years after a nursing degree) have been quickly replacing GP docs in the US for this reason. They'll send you to a specialist just like a GP would. It's all the same problems in terms of the underlying model, but the financial and time costs to the system are lower. I'm not totally sold on what I'm selling though. My sp…

Excellent article in Bloomberg on this subject: https://www.bloomberg.com/news/features/2024-07-24/is-the-nu... (non-paywall'd link: https://archive.ph/03f4u) -- not the standard r/noctor drivel, but a well-researched and sources cited article exploring this phenomenon. Not discussed in the article is the phenomenon of more unnecessary testing with less trained providers doing the ordering which has downstream effects of cost and overdiagnosis.

I agree with a lot of the critiques of our healthcare system and as an emergency department doctor share them, but I doubt LLMs or NPs are going to fix our system. I also have a lot of concerns about broader societal trends in looking for pathologies / diagnoses in ourselves to justify or validate not feeling "well", repeatedly asking for more and more tests or self-identifying with a nebulous diagnosis and then incorporating that into identity as one who is perpetually sick. Particularly with younger generation, this is a really big issue and I don't see it getting better.

Re: Taking my diabetes treatment into my own hands

#323

Post by Auracle »

reaperman wrote: post #254
jklinger410 wrote: post #242

Earlier quoted context omitted.

I don't mind point one, and it can be improved in many ways. AI being a huge one. Point two, though, is just an example of how preventive medicine is forgone due to its cost. The system doctor's use to share data could also stand massive improvements.

If you think doctors can be overly stubborn to change once they've made an initial diagnosis .... you're going to be very unhappy with an AI diagnosis model. As one of many tools, I can see some value. But I'd hate if there was no way to at least try to convince an actual doctor that my issue might be something less expected.

One of the first things I did when GPT 3.5 came out was to give it some medical symptoms I had when I was a teenager that was wildly diagnosed by my primary care doctor that I finally (at least partially) figured out by doing my own research 10 years later.

It nailed what tests I should have done one the first try, one of which I still need to get done because my current primary care doctor doesn’t know how to run it and an endocrinologist straight up refused in the past. However, one of the other two tests suggested would have led to my quality of life improving to such a great extent I would be living a completely different life right now.

I had really, really bad fatigue and we had noticed my shoe size was shrinking as well. The doctor, who is now president of the clinic itself, diagnosed it as depression. The shoe size thing was explained as my arches maybe getting taller. As it turned out, I also lost 2 inches of height as well but I don’t know if we had noticed that at that point yet, but I’m willing to bet it was being charted.

Re: Taking my diabetes treatment into my own hands

#324

Post by CollinEMac »

eep_social wrote: post #286
CollinEMac wrote: post #230

I'm a Type 1 diabetic living the United States and my experiences have been a bit different. > This is called “closed loop” or “artificial pancreas”, and getting one officially is very hard or impossible: not FDA approved yet / you need to be part of an university study to get one / … It’s one of those things that “will be here in 5 years”, they say every year for the past 30 years. These exist now. I've had one for…

> CF = 100 / (Total Daily Dose). do you have a citation? that lines up close enough with my factors but I’ve never seen the formula stated that way and would like to learn more.

I think I first learned this from my endocrinologist. Anyway, this is a good guide:

https://www.mountsinai.on.ca/care/lscd/sweet-talk-1/what2019...

Re: Taking my diabetes treatment into my own hands

#325

Post by autoexec »

s1artibartfast wrote: post #226
dleink wrote: post #220

Earlier quoted context omitted.

The quality of the American medical system has deteriorated to such a point that if the Doctors are not the grifters they may at least be culpable for enabling the grift.

That hasn't been my experience. I have never experienced or heard of a doctor deceiving or lying in real life. I dont think I can think of an example from hospitals either.

> I have never experienced or heard of a doctor deceiving or lying in real life.

Meet Dr. Stella Immanuel who tells her patients that medications are made from alien DNA and that their illnesses are caused by demon sperm. In the USA she gets to keep her medical license/practice. (https://en.wikipedia.org/wiki/Stella_Immanuel)

See also: every doctor that accepted bribes from Purdue Pharma in exchange for knowingly prescribing excessive amounts of opioids to people who never needed them.

Re: Taking my diabetes treatment into my own hands

#326

Post by autoexec »

moffkalast wrote: post #305
jklinger410 wrote: post #240

Earlier quoted context omitted.

And this makes for a pretty lonely and downright harmful society, when viewed through that lens. And I'm not going to feel stupid or naive for feeling like children are tricked into believing the opposite is true. I want to also say, this state that everyone is acting in their self interest is not something we should promote, or be proud of, or assume is the natural state of things. It is a state that we are being fo…

Being good and working in your own self interest aren't mutually exclusive though. In fact most of good things are genuinely done out of complete self interest, and practically all good things on the corporate or bureaucratic level. There's always someone involved in the decision who directly benefits, luckily sometimes it's all/most of us too. Society gets better when the self interested goals of an individual are a…

> Being good and working in your own self interest aren't mutually exclusive though.

Being good and selfish/doing whatever is in your own self interest no matter who else gets hurt are mutually exclusive. The reason we can't trust the food we eat is because companies are selfish and don't care that you get sick. They'll feed you poison because even though they already have billions in profits, it makes them a few extra cents every time they do. That's where we're at, and allowing it to continue isn't the natural state of things.

Re: Taking my diabetes treatment into my own hands

#327

Post by s1artibartfast »

influx wrote: post #315
s1artibartfast wrote: post #284

Earlier quoted context omitted.

Do you think they lied and completely made it up? If so, I hope you refused to buy the filling.

I don't know, but in hindsight I would have asked for an X-Ray. I think it was a borderline call and they went on the side of doing it because I had good insurance.

I don't see anything wrong or nefarious with deciding a borderline call based on ability to pay.

Better preventative medicine and proactive treatment is one of the perks of having good insurance, so I would expect a recommendation from a good dentist to take it into account.

Ideally there is some discussion, but at the same time, the idea that someone with great insurance would want to use it seems a reasonable assumption.

Re: Taking my diabetes treatment into my own hands

#328

Post by beauzero »

hombre_fatal wrote: post #249
beauzero wrote: post #190

Earlier quoted context omitted.

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…

Sounds like a good way to trade one problem for another.

Which is why I went paleo after 2.5 months minus oxalates. I honestly have concerns about stomach cancer (family tree) and it allowed my to substitute coconut oil for a lot of the animal based fat I needed to consume for those 2.5 months. It is hard to do 20% of your calories in animal fat (male) and 30% (female) to maintain hormone levels. I don't know if those are hard and fast rules but they were the generic guidelines given to my by my PA.

Re: Taking my diabetes treatment into my own hands

#329

Post by s1artibartfast »

autoexec wrote: post #325
s1artibartfast wrote: post #226

Earlier quoted context omitted.

That hasn't been my experience. I have never experienced or heard of a doctor deceiving or lying in real life. I dont think I can think of an example from hospitals either.

> I have never experienced or heard of a doctor deceiving or lying in real life. Meet Dr. Stella Immanuel who tells her patients that medications are made from alien DNA and that their illnesses are caused by demon sperm. In the USA she gets to keep her medical license/practice. ( https://en.wikipedia.org/wiki/Stella_Immanuel ) See also: every doctor that accepted bribes from Purdue Pharma in exchange for knowingly p…

I included real life as an intentional qualifier. I know that quacks, grifters, and criminals exist.

The fact that they exist doesn't bother me. Some will always exist. What matters is how common it is and what the average experience is.

I don't think most doctors treat their patients the same as Stella Immanuel. Same for the two doctors that perdue was convicted of bribing

Post reply on HN