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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

#191

Post by tracker1 »

Definitely get the "vibes" statement on how much insulin... I can literally have the same meal two days in a row, and one day it takes half as much to manage, or I'll overcorrect need to drink some tang or something similar.

I'm T2D, with a completely borked metabolism and gastroperesis (thanks trulicity/ozempic). If I can manage to stick to mostly meat and eggs, I hardly need any insulin and am very stable. Unfortunately, I live with people who don't eat that way, and I'm weak in terms of temptation.

Re: Taking my diabetes treatment into my own hands

#192

Post by tracker1 »

beauzero wrote: post #190
supertofu wrote: post #145

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…

I've found I do best with a very similar diet... mostly meat and eggs, some cheese and sometimes onions, mushrooms etc. I notice that some starchy foods hit me worse than others. Legumes are pretty bad on how I feel, and spike me to no end. Similar with wheat products. Corn, rice and potatoes spike my glucose, but I don't feel physically ill the next day like with many other foods.

It sucks, and I wind up cheating 2-3x a week (I live with people that eat different than I do).

Re: Taking my diabetes treatment into my own hands

#193

Post by Mathnerd314 »

Mathnerd314 wrote: post #140
mjaniczek wrote: post #19

Earlier quoted context omitted.

Don't worry, I'm not using the app's suggestions blindly (or at all, currently). But yeah the SmartCGMS authors disclaimed as much - you're using it on your own risk. This is probably also why apps like LibreLink don't provide predictions but only show historical data - easier to not get sued if you don't give the user advice that could kill them? Re models, differential equations and finding minima: I do agree genet…

So Metropolis-Hastings for example is a probabilistic algorithm. You don't need a probabilistic algorithm. (Well, you do when you want to estimate your physiological parameters, the Bayesian stuff and so on, but that is a whole separate can of worms). I didn't look too carefully at your objective function but it looked continuous - small perturbations in input mean small changes in the objective function. Like hypogl…

Oh and regarding probabilistic stuff, I have been playing with PyMC, it seems eminently usable. There is some slightly more specialized software like Stan, and it is certainly worth looking at some Stan tutorials if you don't know anything about probabilistic programming, but PyMC is hackable and modular in a way that Stan is not. There is also tensorflow-probability but I couldn't get it to work, it seems not as active as PyMC. Haven't read it but I found https://github.com/CamDavidsonPilon/Probabilistic-Programmin... and that's probably going to be my coffee table reading for the next few days.

Re: Taking my diabetes treatment into my own hands

#194

Post by Spooky23 »

GenerWork wrote: post #177
mapt wrote: post #155

Earlier quoted context omitted.

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…

Isn't one of the selling points of universal healthcare that it's overall cheaper in total cost than private insurance? If so, the UK should be celebrated for having such a low percentage of its GDP being spent on universal healthcare.

The issue is that the Britain is stagnating, so that percentage of GDP is growing slower than costs.

Re: Taking my diabetes treatment into my own hands

#195

Post by jvossy »

coldtea wrote: post #179
supertofu wrote: post #145

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…

> 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 anyway, I am just asking you to please try to understand why they behave in such a way.

Re: Taking my diabetes treatment into my own hands

#196

Post by moffkalast »

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…

You can always trust people to act in their own self interest, everything else (including your list) can be proven from that first principle.

Re: Taking my diabetes treatment into my own hands

#197

Post by gregschlom »

supertofu wrote: post #145

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…

Get a continuous glucose monitor. You should be able to convince your doctor to write you a prescription for it. If not, there brands that will do the prescription for you after a quick video call with a doctor (but they're more expensive).

Also the FDA cleared at least one brand of CGM to be sold without a prescription, starting "summer 2024": https://www.dexcom.com/stelo

You should expect to pay $80 - $200 per device, and they last one 14 days, but the insight they give is really worth it.

Re: Taking my diabetes treatment into my own hands

#198

Post by petepete »

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…

> Abbot refused to let me download my data after I was forced off their platform to Glooko

So I've been using Abbot (LibreLink) since 2019 and if you log into LibreView (https://www.libreview.com/) there's a 'Download glucose data' link in the top right of the screen.

There's also a handy PDF report that I send to my diabetic nurse before my annual meeting, I think I'm the only one of her patients who knows how to do this because she's always thrilled and spends half the appointment going through it in amazement at the data/trends.

Abbot have been quite good overall despite the fact I reported a bug to them in their Android app in 2022 and they still haven't fixed it. If you add LibreLink to the whitelist of apps that can interrupt DND, then enabled DND, LibreLink alerts you saying "Alarms unavailable."

Re: Taking my diabetes treatment into my own hands

#199

Post by nextos »

beauzero wrote: post #190
supertofu wrote: post #145

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…

Check the work of David Unwin from NHS, who has reversed T2D in many patients using dietary interventions: https://www.diabetes.co.uk/blog/2015/08/dr-david-unwin-publi...

This publication is a good starting point to his approach. Early time-restricted eating of low sugar and low starch meals is the key: https://nutrition.bmj.com/content/bmjnph/early/2023/01/02/bm...

Re: Taking my diabetes treatment into my own hands

#200

Post by bluedino »

mapt wrote: post #155
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…

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

Is it really that low?

In the USA an entry level doctor will make around $130,000 and the 'Average doctor' makes $200-$350,000/year depending on what website you want to believe.

And we're running like 13% of the population having diabetes.

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