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The Unreasonable Math of Type 1 Diabetes

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Re: The Unreasonable Math of Type 1 Diabetes

#191

Post by grahar64 »

arka2147483647 wrote: post #70
Trasmatta wrote: post #8

I'm a type 1 diabetic, and this was a helpful post at showing non diabetics why it is so. hard. Non diabetics typically think the difficult thing must be the shots and the finger pricks, right? Not really. The majority of diabetics get used to those things quickly (of course there are some of course that deal with a major major needle phobia that can make it even harder). The hard part is that it never ends. Almost e…

I have had Type 1 for 30 years. To be honest, i don't do the math. I choose the amount of units to inject by feel. I mean, i know by eating a banana, i get something like 20g of carbohydrates, and i should take 3u. But if i feel, that the correct dose is 6 units, then i take that. I cant really explain it. But i kind of feel the state, where i am going, and can adjust instinctively. Works more often than not. I have…

There are some pros and cons to managing T1D but not being the person actually managing it. The main con is that I have no idea how he is feeling, which makes us very numbers obsessed, hence the post :)

Re: The Unreasonable Math of Type 1 Diabetes

#192

Post by mkrecny »

Mezzie wrote: post #176
Trasmatta wrote: post #8

I'm a type 1 diabetic, and this was a helpful post at showing non diabetics why it is so. hard. Non diabetics typically think the difficult thing must be the shots and the finger pricks, right? Not really. The majority of diabetics get used to those things quickly (of course there are some of course that deal with a major major needle phobia that can make it even harder). The hard part is that it never ends. Almost e…

> I'm literally crying while writing this post, because it's so exhausting and it never ends. If it helps (?), I also broke down crying reading this, because I have MS and it is so true to my experience. I've never been able to communicate well how exhausting the constant mental load is, and I imagine it's even worse for people with T1 diabetes since blood glucose can get out of whack a lot more quickly than my immun…

I'm sorry

Re: The Unreasonable Math of Type 1 Diabetes

#193

Post by kelp »

Trasmatta wrote: post #79
csnover wrote: post #63

Earlier quoted context omitted.

One of the scariest experiences of my life was going on a walk after lunch with someone who had T1D and miscalculated their insulin dose. They went from totally fine, to saying “I don’t feel well, we need to head back”, to sweaty and sheet white and barely conscious within just a few minutes. The terror I felt as we waited for the doors of the lift to open so he could get to his emergency food is burned into my brain…

Yeah, getting caught out somewhere without snacks and a looming hypo is one of my nightmares. I try to always, always, always have snacks on me (for a diabetic, this is even more important to have when you leave the house than your keys or wallet), but sometimes things happen, and you end up somewhere without anything. It's really scary, but the good news is that if there is anybody around, enough people understand a…

My wife has t1d and when we were dating we backpacked the Lost Coast trail. She was pretty paranoid of bears, so made sure we didn't have any food in our tent and did a good job of hiding our bear canisters some place where any bears couldn't move them around if they got to them. She'd had a bad experience with bears pushing bear canisters off a waterfall.

So she had a low in the middle of the night, in the middle of nowhere. She was still verbal, but barely, and sent me to get her some snacks out of the bear canisters. However I didn't know where she'd hid them. After looking in the dark for a while I had to go back to the tent and try to get enough of an explanation out of her to find the hidden canisters. Fortunately she was abele to give me enough context that I was able to find the canisters and get her something to eat.

After that, I kept my own hidden stash of snacks in the tent and make sure she told me where the canisters were.

Re: The Unreasonable Math of Type 1 Diabetes

#194

Post by kelp »

Trasmatta wrote: post #81
gruez wrote: post #77

Earlier quoted context omitted.

>Every single time you go to sleep is a roll of the dice. Isn't that the case even if you have someone sleeping beside you? I suppose it mitigate some risk on the off chance that your partner wakes up and notices you're sweating or whatever, but what if they're sound asleep? Does someone who's high/low on blood sugar exhibit symptoms that are easily picked up by a sleeping person?

The good news is that for most diabetics, your body will automatically wake you up for a hypo. It's a survival mechanism. But some people suffer from hypoglycemic unawareness, and their body doesn't wake them up. Most diabetics have CGMs these days, though, and somebody like that should be setting hypo / hyper alarms so that either them or their partner wakes up. (The problem there becomes false alarms and the subseq…

The alarm fatigue is no joke, and CGMs get less accurate the lower ones blood glucose goes, so false alarms on the low end are common.

My wife has a Tandem T:Slim and Dexcom G6 and she can't turn off the urgent low alarm. The alarms drive her totally crazy.

Though I'm happy to know at least the system will disable her basal rate if she's heading low.

Re: The Unreasonable Math of Type 1 Diabetes

#195

Post by kelp »

westoncb wrote: post #164
shadowtree wrote: post #141

Earlier quoted context omitted.

Non-zero chance you might see a cure for type-1 in your lifetime. https://www.clinicaltrialsarena.com/analysis/vertex-stem-cel... It's a stem cell therapy, in human trials (not the usual "in mice" crap). A single patient already had their diabetes disappear: https://www.fiercebiotech.com/biotech/vertex-diabetes-cell-t... The downside of stemcell therapy is that it is essentially an organ transplant, aka requires immu…

I wonder if there's any good reason to reduce my pessimism about it: I can't help but think there are such strong economic incentives against having a cure (vs ongoing treatment) that it's very unlikely to become available during my lifetime.

I don't know much about medical research, but I've looked into some of these trials. They are generally being done by startups and not the established players who sell the diabetes management stuff.

So think disruptive tech. A new player comes into the market with something that obsoletes the old tech, and maybe destroys a whole market. But that new player makes their own money off it.

So yeah, maybe Tandem, Dexcom and Medtronic don't have a big incentive. But someone else can make some real money if they can find a cure or novel treatment that obsoletes all those others things.

Re: The Unreasonable Math of Type 1 Diabetes

#196

Post by grahar64 »

i_cannot_hack wrote: post #51

> A hot bath or shower can raise (then lower) BGL. I suspect the author has come to this conclusion from CGM data, and therefore also that it is wrong (or at least not a very significant effect). I also have T1D, and CGMs like Freestyle Libre (and probably also Dexcom) includes a temperature sensor and adjusts its readings based on the external temperature to increase accuracy. I think the changes in blood sugar leve…

Cheers for pointing this out, a few others have as well. I have updated the post to reflect the "measured BGL" increases:

> A hot bath or shower can raise (then lower) the measured BGL. This might be an incorrect reading, so may be dangerous to treat.

I think the reason why this is a problem is less concerning than someone correcting after a hot shower based on faulty data.

Re: The Unreasonable Math of Type 1 Diabetes

#198

Post by UnpossibleJim »

sah24 wrote: post #139
UnpossibleJim wrote: post #132

Earlier quoted context omitted.

My doctor had to fight to get me one. I workout and was highly insulin sensitive (she made me workout less and gain some weight by doing less cardio - drives me nuts, I liked running). The insurance companies didn't want to fork over for the upfront cost, even though I had been to the hospital several times for low blood sugars. This included a stroke caused by a severe low blood sugar (yes, I lived alone at the time…

Hi, do you live in the USA? I had a similar experience to you. I am considering doing a research project for grad school about patients in the USA who experienced insurance denials for CGMs.

I do live in the US. Yes. And actually, my endo is probably a better person to chat with. Let me drop her an email and see if she A) is allowed and B) has the time

Re: The Unreasonable Math of Type 1 Diabetes

#199

Post by kelp »

cadr wrote: post #86
gowld wrote: post #67

Earlier quoted context omitted.

If you have an insulin pump, can you also have a glucose pump?

Or a glucagon pump: https://beyondtype1.org/future-artificial-pancreas/ (causes your liver to release its glucose)

Thanks for sharing this. I wasn't aware of this, going to keep on eye on it.

Re: The Unreasonable Math of Type 1 Diabetes

#200

Post by nmhancoc »

I just happened to do some reading and listening recently on a topic in exercise science that may be helpful for diabetics.

Tl;Dr: The body has two basic metabolic systems, glucose oxidation and fat oxidation. Fat oxidation can be trained to be more powerful (as in wattage of output) through high volume, low intensity exercise. Clinicians have observed higher insulin sensitivity in patients who undergo this training, as their bodies simply use their blood glucose system less and thus use insulin less day to day.

Here’s a link to the paper [pdf]: https://sci.bban.top/pdf/10.1007/s40279-017-0751-x.pdf

And here’s a link to a (several hour) podcast between the author and a clinician talking about the results. It also has time stamps to sections about diabetics. https://peterattiamd.com/inigosanmillan/

I’m not affiliated with the paper, author, or podcast in any way. I just came across this research and my dad’s diabetic so I was motivated to learn more.

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