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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

#141

Post by tornadofart »

mjaniczek wrote: post #65
tornadofart wrote: post #51

I'm a T1D and I mostly agree with the author. I think this simulation is very interesting. I disagree with the author however on the following point: "injecting insulin ~15min before you start eating would do wonders for neutralizing the BG spike, the issue is, nobody does it, because what if you then get a smaller serving at the restaurant or it gets delayed?" My doc told me the same, which I think is insane. "Here…

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.

It's hard at first. It is a habit to take, and you have to withstand a bit of social pressure first, when you're late with taking insulin and still want to wait. But I root for you, you can do it!!

Re: Taking my diabetes treatment into my own hands

#142

Post by apwell23 »

cameronh90 wrote: post #136
Swizec wrote: post #126

Earlier quoted context omitted.

> 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. Proactive tests are great! Except for the false positive challenge. If the test has a 99% accuracy and it detects a problem that presents in 0.1% (1 in 1000) of general population, do you have the issue? Should you do something about it? Well it turns out you only have a 3% (…

It's funny that we only apply this "more data = bad" logic to things that aren't readily visible. If you have a palpable or visible likely-benign condition that isn't causing symptoms, such as a mole, rash, or lump, every doctor will recommend getting that checked out. Most of the time it'll turn out to be completely innocuous, but you'll go to the doctor and they'll decide between it's fine, monitoring, invasive inv…

> Obviously if the test itself is invasive (e.g. has a dose of radiation) then that is something that needs to be compared against the potential benefit.

A test isn't always a binary 'you have X ' . Look at PSA screening for prostate cancer starting in your 40s is not recommended for that reason.

Re: Taking my diabetes treatment into my own hands

#143

Post by Neff »

cpwright wrote: post #98

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…

My wife is T1D and she is really scared about the idea of moving to a closed loop system with a pump, but her endo is constantly pushing her towards it even though she is keeping her A1C at like ~6% with her Dexcom CGM.

The concern is the the G7 CGM seems to have times where it is so wildly off with readings that a closed loop system could kill her. This weekend the CGM was saying she was all the sudden at 40, but she was at about 115. I am scared to think what would happen in the night if the closed loop system thought it needed to raise her blood sugar... Logically I know it wouldnt raise it to a point that would cause medical harm, it would still put it higher than would be ideal for her health.

Maybe there are differences between the different brands, but the G7 from Dexcom's big selling point was "no more calibrations" and the FDA approval for that tagline, and we've been seeing a need to calibrate more than the G6, which is disappointing. Granted... sample size of n=1 so...

Re: Taking my diabetes treatment into my own hands

#144

Post by rhinoe »

noodleman wrote: post #134

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…

This is a surprising view given that I'm T1D in the UK and the healthcare I've received, along with the tech, support and collaboration with diabetic consultants has been first class. You are making an assumption that every doctor is like the one you have (I guess), but its simply not the case.

Good luck with your programming, but the agenda you're pushing for it is remarkably short-sighted.

Re: Taking my diabetes treatment into my own hands

#145

Post by supertofu »

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 years, I have gotten great data on the foods which spike me and the foods which are neutral to my blood glucose.

A lot of foods doctors/the internet tout as "diabetic friendly" (like beans, lentils, corn in any form, brown rice, buckwheat groats, non-granny-smith apples) spike me like crazy. Other foods are totally fine (bananas, snap peas, nuts, steel cut oatmeal, fermented dairy, fish).

Having an autoimmune disorder on top of the prediabetes, I've learned that the only one who cares about my health and longevity is me. My doctors care about my inflammatory markers and nothing else.

Re: Taking my diabetes treatment into my own hands

#146

Post by tornadofart »

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?

You forget one very important rule: it's all vibes :D No but seriously: insulin starts to act after 20mins. Its action is more like a flat parabola.

Glucose acts more in harsh peaks. So you want the glucose peak to hit when you are at the maximum of insulin action. Hence the 15mins delay.

This is all roughly speaking, YMMV.

Re: Taking my diabetes treatment into my own hands

#147

Post by stonethrowaway »

jklinger410 wrote: post #137

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…

At the same time I would emphasize that people who offer any kind of advice online around life-threatening ailments do put down if they have a related degree, are currently practicing and are licensed in that or a very related field, or if they are conducting self experiments and sharing their results (with YMMV caveat to go along with it).

Reasons why should be obvious, but listening to podcasts, or reading pop-science books, connecting the dots and thinking you’re qualified to give, again, life-threatening advice, does not mean you’re actually qualified or you have an idea of how deep the rabbit hole goes (as we are learning, nobody really does).

Unfortunately, in my experience I encounter a lot of people who haven’t opened up an intro to biology book since their teenager days let alone an undergraduate biochem book, but they listen to podcasts and think they have it figured out and have the audacity to speak with confidence. I’ve been in situations where the practitioners are wincing but are too polite to call people out - it’s easier to let them just yap out what the podcast said and then change the topic. Don’t be one of these people.

Re: Taking my diabetes treatment into my own hands

#148

Post by oldgradstudent »

janandonly wrote: post #76

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 would probably a very good idea if you can keep to it.

Doing so with mild T2 diabetes could lead to complete remission (as long as the diet is kept).

In more advanced T2 diabetes it could lead to significant improvement, and reduction of required medication.

People with T1 diabetes simply don't produce enough insulin. External insulin is required.

Management of T1 diabetes is also way more complicated and mistakes are immediately life threatening.

Are you familiar with Dr. Richard K. Bernstein's approach? It is a very low carb diet (he doesn't call it Keto as Ketosis is not the aim) combined with a lifetime of experience managing it.

See his book The Diabetes Solution, his Youtube channel, and the Type1Grit facebook group. There are a lot of type 1s running He's definitely very contreversial, but I always found his reasoning extremley presvasive. Not to mention that he's a 90 year old with T1 from childhood, still practicing medicine and seeing patients (or at least he's been practicing up to a few months ago).

https://www.diabetes-book.com/

https://www.youtube.com/@DrRichardKBernstein/videos

https://www.facebook.com/Type1Grit/

There's also the great Gary Tabues and his books, especially Rethinking Diabets

https://garytaubes.com/rethinking-diabetes/

Re: Taking my diabetes treatment into my own hands

#150

Post by wordpad25 »

MajimasEyepatch wrote: post #127
carimura wrote: post #119

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…

None of those things are necessary most of the time, and they’re usually just going to make you paranoid. It’s why doctors don’t generally like to do full-body scans on healthy people: they’re rarely going to find anything clinically significant, but they’re often going to find something that causes a scare and some unnecessary tests. (And if the scan is a CT scan, on average, the radiation may cause more cancers tha…

People in high risk categories are warranted to go further than that
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