A $250 Biohack That’s Revolutionizing Life with Diabetes
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Re: A $250 Biohack That’s Revolutionizing Life with Diabetes
#2I have type 2 diabetes and I've always been a bit envious of insulin pumps, not because I love having a machine plugged into my body (I don't), but because they offer better control of blood glucose peaks, since they use fast-acting insulin exclusively. The pancreas secretes insulin in pulses and pumps can mimic that. What has turned me off from pumps (apart from doctors generally not recommending them for type 2 diabetes) is the lack of a sensing mechanism. This DIY system sounds absolutely perfect. It could keep my blood glucose perfect at all times. At the moment, I'm injecting in the mornings and the evenings and have little control over my peaks apart from adhering to a strict diet (and we all know how hard that can be), and every peak does a little bit of damage to my eyes, nerves, etc. I've always wanted to have a more sophisticated treatment option, and this may be it.
Re: A $250 Biohack That’s Revolutionizing Life with Diabetes
#3I have type 2 diabetes and I've always been a bit envious of insulin pumps, not because I love having a machine plugged into my body (I don't), but because they offer better control of blood glucose peaks, since they use fast-acting insulin exclusively. The pancreas secretes insulin in pulses and pumps can mimic that. What has turned me off from pumps (apart from doctors generally not recommending them for type 2 dia…
Why don't doctors recommend them for type 2 diabetes? Well, my general impression is that doctors live under this illusion that patients will somehow succeed in making lifestyle changes that will cause the disease to go into regression or disappear altogether. Also, they prefer to try medications like glucophage before they resort to insulin. There just seems to be less eagerness to finely manage type 2 diabetics, maybe because it is felt that the patient is partly to blame for the disease, whereas type 1 diabetics are innocent victims of their own immune systems. I honestly don't know what they're thinking. An artifical pancreas would vastly improve the situation for type 2 diabetics too.
Re: A $250 Biohack That’s Revolutionizing Life with Diabetes
#4I have type 2 diabetes and I've always been a bit envious of insulin pumps, not because I love having a machine plugged into my body (I don't), but because they offer better control of blood glucose peaks, since they use fast-acting insulin exclusively. The pancreas secretes insulin in pulses and pumps can mimic that. What has turned me off from pumps (apart from doctors generally not recommending them for type 2 dia…
Why don't doctors recommend them for type 2 diabetes? Well, my general impression is that doctors live under this illusion that patients will somehow succeed in making lifestyle changes that will cause the disease to go into regression or disappear altogether. Also, they prefer to try medications like glucophage before they resort to insulin. There just seems to be less eagerness to finely manage type 2 diabetics, ma…
I’ve heard that Type 1 diabetes is due to lack of insulin (malfunctioning pancreas) while Type 2 diabetes is caused by too much insulin (leading to insulin resistance.)
If this is true, insulin pumps for Type 2 diabetes don’t help, because they can only add more insulin, when the fundamental problem isn’t lack of insulin, but lack of response to insulin.
Re: A $250 Biohack That’s Revolutionizing Life with Diabetes
#5Earlier quoted context omitted.
Why don't doctors recommend them for type 2 diabetes? Well, my general impression is that doctors live under this illusion that patients will somehow succeed in making lifestyle changes that will cause the disease to go into regression or disappear altogether. Also, they prefer to try medications like glucophage before they resort to insulin. There just seems to be less eagerness to finely manage type 2 diabetics, ma…
I’ve heard that Type 1 diabetes is due to lack of insulin (malfunctioning pancreas) while Type 2 diabetes is caused by too much insulin (leading to insulin resistance.) If this is true, insulin pumps for Type 2 diabetes don’t help, because they can only add more insulin, when the fundamental problem isn’t lack of insulin, but lack of response to insulin.
That's more or less it on the dot!
Edit: I'd add that type 2 is associated with increasing insulin resistance, causing the pancreas to work harder. Over time, this can cause the pancreas to essentially burn out, at which point exogenous insulin would be needed. Type 2 diabetics who are able to manage the associated risks - namely diet and exercise, almost universally focused on losing weight - can often improve or even reverse the disease altogether.
I'll also add that this is not the entire discussion of diabetes. There's an increasing recognition of forms of diabetes outside of the known definition of type 1 and type 2. A so-called "type 1.5" is being further delineated and may explain why some type 2s don't behave the way we think they should.
Re: A $250 Biohack That’s Revolutionizing Life with Diabetes
#6God bless Scott Leibrand and these folks.
Re: A $250 Biohack That’s Revolutionizing Life with Diabetes
#7I have type 2 diabetes and I've always been a bit envious of insulin pumps, not because I love having a machine plugged into my body (I don't), but because they offer better control of blood glucose peaks, since they use fast-acting insulin exclusively. The pancreas secretes insulin in pulses and pumps can mimic that. What has turned me off from pumps (apart from doctors generally not recommending them for type 2 dia…
Why don't doctors recommend them for type 2 diabetes? Well, my general impression is that doctors live under this illusion that patients will somehow succeed in making lifestyle changes that will cause the disease to go into regression or disappear altogether. Also, they prefer to try medications like glucophage before they resort to insulin. There just seems to be less eagerness to finely manage type 2 diabetics, ma…
From a 2013 [1] paper, one obstacle may be getting the government or private insurance to pay for it outside of type I DM. Exceptions noted were France and Israel. In the U.S. only an exceedingly limited percentage of patients would be able to pay for the device and long-term supplies out of pocket. Until that changes, there may be little motivation for widespread adoption (until for example a large study is published in NEJM or JAMA showing extreme benefit).
Many patients are able to achieve stable control of their glucose and HbA1c on metformin (Glucophage) alone. However especially for type II DM patient needing insulin, finely controlling glucose levels might reduce long term risks as mentioned above and in the paper [1], and a pump might indeed be far superior to the typical injected insulin regimen. Interestingly, there are trials on clinicaltrials.gov about pumps in type 2 DM sponsored by MedTronic (which makes sense) [2].
As a disclaimer, I am not an endocrinologist or internal medicine guy at all. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3920779/ [2] https://clinicaltrials.gov/ct2/show/NCT01182493
Re: A $250 Biohack That’s Revolutionizing Life with Diabetes
#8How much are the continuous glucose monitors alone now? You could use it for dieting.
Re: A $250 Biohack That’s Revolutionizing Life with Diabetes
#9Earlier quoted context omitted.
Why don't doctors recommend them for type 2 diabetes? Well, my general impression is that doctors live under this illusion that patients will somehow succeed in making lifestyle changes that will cause the disease to go into regression or disappear altogether. Also, they prefer to try medications like glucophage before they resort to insulin. There just seems to be less eagerness to finely manage type 2 diabetics, ma…
I’ve heard that Type 1 diabetes is due to lack of insulin (malfunctioning pancreas) while Type 2 diabetes is caused by too much insulin (leading to insulin resistance.) If this is true, insulin pumps for Type 2 diabetes don’t help, because they can only add more insulin, when the fundamental problem isn’t lack of insulin, but lack of response to insulin.
That is the general characterization, though insulin is prescribed for some "type 2" patients, so the situation is more subtle than that.
Re: A $250 Biohack That’s Revolutionizing Life with Diabetes
#10I have type 2 diabetes and I've always been a bit envious of insulin pumps, not because I love having a machine plugged into my body (I don't), but because they offer better control of blood glucose peaks, since they use fast-acting insulin exclusively. The pancreas secretes insulin in pulses and pumps can mimic that. What has turned me off from pumps (apart from doctors generally not recommending them for type 2 dia…
Why don't doctors recommend them for type 2 diabetes? Well, my general impression is that doctors live under this illusion that patients will somehow succeed in making lifestyle changes that will cause the disease to go into regression or disappear altogether. Also, they prefer to try medications like glucophage before they resort to insulin. There just seems to be less eagerness to finely manage type 2 diabetics, ma…
> my general impression is that doctors live under this illusion that patients will somehow succeed in making lifestyle changes
> Also, they prefer to try medications like glucophage before they resort to insulin.
A couple of points: 1- the targets set by associations like the ADA actually assume the patients won't be able to make significant lifestyle changes; for example the ADA A1C targets are higher than for healthy patients. The diet changes they preach are not that radical, e.g. cake is bad for you but you can have a really tiny slice and offset it by not eating bread. This belief isn't that unreasonable; FDA requires that medical labeling be targeted at a 5th grade reading level.
2 - And glucophage is much easier for patients to manage than insulin both in dosing regime and simply caring for the drug.
3 - Finally the insurance companies' actuaries have figured out that maintenance therapy of this nature has the best cost/outcome ratio.
To that last point: I had "adult onset type 1" due to an autoimmune condition. The endocrinologist I was sent to was only interested in maintenance therapy and not at all in looking for root cause, even though I presented with a body fat of about 14%. She finally admitted that even if she did look into it the insurance companies would hassle her for going off the reservation without a good excuse.
But my no-insurance primary doctor and I and a rheumatologist were able to dig into root cause and now I am "cured" (of diabetes at least) thanks to treating the underlying condition (note: this is glossing over a lengthy period of unpleasant work). Which is actually cheaper for the insurance companies, but honestly how many patients have the training to be able to be involved in their care to this degree?