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The Unreasonable Math of Type 1 Diabetes

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Re: The Unreasonable Math of Type 1 Diabetes

#271

Post by chrisdotcode »

KetoType1 wrote: post #174
jacquesm wrote: post #171

Earlier quoted context omitted.

This is a pretty dangerous comment, if you consider going the Keto route and are a diabetes type 1 patient please consult your doctor, there are some risks involved and it definitely does not work for everybody.

Thank you for your concern, friend! Tell us, how long have you been diabetic? Anecdotally, I have maintained a HbA1c below 5 for more than 20 years using small variations on the ketogenic diet described above. I need just 6 units of Humalog (short-acting) and 16 units of Lantus (long-acting) per day. It makes diabetes very, very easy to manage. If anyone reading this is tired of struggling with diabetes, please consi…

I'm not sure why you're being downvoted. I know jacquesm is a very well-respected poster, but unless he's got diabetes himself, he's providing his opinion with absolutely no real-world-experience vs someone who has been managing diabetes with keto for two decades.

Even if keto "isn't for everybody" (and KetoType1 should have put a disclaimer), I'd certainly much rather take advice from someone with skin in the game.

Re: The Unreasonable Math of Type 1 Diabetes

#272

Post by jacquesm »

chrisdotcode wrote: post #271
KetoType1 wrote: post #174

Earlier quoted context omitted.

Thank you for your concern, friend! Tell us, how long have you been diabetic? Anecdotally, I have maintained a HbA1c below 5 for more than 20 years using small variations on the ketogenic diet described above. I need just 6 units of Humalog (short-acting) and 16 units of Lantus (long-acting) per day. It makes diabetes very, very easy to manage. If anyone reading this is tired of struggling with diabetes, please consi…

I'm not sure why you're being downvoted. I know jacquesm is a very well-respected poster, but unless he's got diabetes himself, he's providing his opinion with absolutely no real-world-experience vs someone who has been managing diabetes with keto for two decades. Even if keto "isn't for everybody" (and KetoType1 should have put a disclaimer), I'd certainly much rather take advice from someone with skin in the game.

By this reason any doctor that doesn't have the disease they help curing should be disqualified as well. Maybe think a bit longer and realize that expertise can be gained in more ways than experience alone.

I've posted a pretty good link below from a respected source if you don't believe what I wrote and whether or not I have diabetes type 1 is not relevant.

Re: The Unreasonable Math of Type 1 Diabetes

#273

Post by jacquesm »

kakoni wrote: post #234
bleair wrote: post #24

Earlier quoted context omitted.

There's also two "open source" systems - https://loopkit.github.io/loopdocs/ - https://openaps.org/ Tidepool is also trying to take the loop project and get a version of it FDA approved. Both of the open source projects require you to do the work and actively take control of your setup (a cgm plus pump plus phone). They have really nice support communities. I would never go back to not using Loop.

+ the funny thing is that both openaps/androids + loopkit are more advanced than the commercial offerings that we are starting to see now. Medtronic licensed their artificial pancreas system MD-Logic from Israeli company DreaMed in 2015. Dexcom bought TypeZero (who have system called inControl) back in 2018.

That's to be expected though, self experimentation goes a lot quicker than a regulated track. Even so they are doing great work, and I'm sure the industry is watching this development like a hawk to see what they can pick up.

Re: The Unreasonable Math of Type 1 Diabetes

#274

Post by reddiky »

liamwire wrote: post #247
paulcole wrote: post #144

Earlier quoted context omitted.

> What if there is an earthquake and you can't get to somewhere with snacks? I’m a Type 1 diabetic (diagnosed in my 30s) and have been living with it for about a decade now. This really isn’t a “what if” situation. I know what will happen. I will die or hopefully just become incredibly ill. It’s not really scary at all. It’s just something I live with and prepare for as best I can. The one thing that I’ve learned fro…

Please forgive my ignorance, how is it possible that you lived until your thirties without knowing you have T1D?

diagnosed at 25, it happens :-/

Re: The Unreasonable Math of Type 1 Diabetes

#275

Post by reddiky »

irrational wrote: post #140
Trasmatta wrote: post #79

Earlier quoted context omitted.

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…

I never thought about how being diabetic takes emergency preparedness to a new level. We saw people unexpectedly stuck for a couple of days in traffic because of snow recently. What if there is an earthquake and you can't get to somewhere with snacks? There are so many situations that could unexpectedly arise that could cut you off from food. If I'm cut off from food, I'll be fine for a few days. Not so much a diabet…

I always have 4 or 5 glucose gels in my car. My diabetes kit has a couple more. You learn pretty quick you need to be able to treat at least a couple of hypos by yourself

Re: The Unreasonable Math of Type 1 Diabetes

#276

Post by reddiky »

Trasmatta wrote: post #118
cleancoder0 wrote: post #105

Earlier quoted context omitted.

I once took a 5 hour bike trip on an empty stomach. At some point I couldn’t even turn the pedals. I had to lay on the ground, not feeling better even after half hour. I can still remember the feeling of eating some sweets. Felt like I was reborn. Can’t imagine what it’s like for T1

The interesting thing is that your BG levels may have actually been fine. Physical exhaustion doesn't necessarily lead to hypoglycemia in a healthy person. Hypoglycemia feels significantly different than just being hungry, for example. A bizarre phenomenon: feeling stuffed because you ate a huge meal, but having a hypo anyway. You don't want to eat anything because you're not hungry, but feel an overwhelming urge to…

This necessity of eating after you overate but mis-treated is one of the worst feelings in T1. You know you screwed up and you know you're going to pay for it, because you'll probably spike later and you don't know if it is the big meal you just ate or the snack you ate to keep from going low first. I love pizza, my body hates pizza

Re: The Unreasonable Math of Type 1 Diabetes

#277

Post by mathstuf »

kelp wrote: post #193
Trasmatta wrote: post #79

Earlier quoted context omitted.

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…

Oof. For finding my bearcan, adding conspicuity tape (the red/white reflector tape used on tractor trailers) makes them stand out like a beacon with a headlamp (which, so far as I know, bears have not learned to make use of). It also has adhesive good enough to stick to their slick plastic.

Re: The Unreasonable Math of Type 1 Diabetes

#278

Post by md2020 »

idealmedtech wrote: post #172

Hi, I'm an artificial pancreas developer! Our device has been approved for human trials which we're going to begin shortly, probably near the end of this quarter. One thing that the article (which is very well researched, by the way, kudos!) does not quite get right is that the insulin sensitivity _changes_ hour to hour, day to day, month to month. It changes nonlinearly with exercise, stress, sleep, diet, and in a m…

My girlfriend has T1D, she diagnosed when she was very young. She’s great at managing it and has a pump and a CGM, but there’s still so much bullshit that she goes through when parts break. It’s really made me furious at the medical device industry, so I’m happy to see you’re working on new solutions. As a software engineer, I often wonder if there’s anything I can do to help with T1D management, so if anyone knows of projects/companies that need devs, I’m all ears.

Re: The Unreasonable Math of Type 1 Diabetes

#279

Post by sgmoore »

mikenew wrote: post #100

Awesome write up, but one thing I still don't understand; why is hypoglycemia such a big part of the problem? If insulin is your body's way of moving glucose out of your bloodstream and T1D means that lever is broken, why do you so often end up with too little blood glucose? Is it just because of overestimating the insulin dose? Or is there some other factor; i.e. does glyconeogenesis not work properly or something a…

> But it sounds like bringing blood sugar up is a big part of managing T1D, so I'm just wondering why that would be the case for a diabetic but not for a non-diabetic.

If you think of insulin as moving the glucose out of your blood stream into a storage area, eg your liver, then, when a normal person's blood sugar goes low, their body stops producing insulin and at the same time dumps some glucose from storage (eg the liver) back into the blood stream.

But if I have injected some insulin, the insulin will still be working and I can't just tell it to stop. So even if my liver tries to help me by dumping glucose into my blood stream, the injected insulin will try to move it back! So it is harder and takes longer for my blood sugar to rise on its own.

Hence non-diabetics can increase their blood sugar levels when needed, but that is a lot harder for diabetics who are on medication.

The biggest problem that I find controlling my BS levels, is not overdosing, but dealing with the unexpected. For example, taking insulin before a meal and then dropping my dinner plate and then trying to find something similar that I can eat quickly or getting an important phone call and being interrupted before I get a chance to eat. Or maybe just getting stuck in traffic and missing a meal.

Keto/low carb diets seem to work better for non-insulin dependent diabetics who are producing some insulin, just not enough. I think most Type 1's would still need some (significant) amount of insulin even on a keto diet, so the hypo problem still exists.

Re: The Unreasonable Math of Type 1 Diabetes

#280

Post by idealmedtech »

md2020 wrote: post #278
idealmedtech wrote: post #172

Hi, I'm an artificial pancreas developer! Our device has been approved for human trials which we're going to begin shortly, probably near the end of this quarter. One thing that the article (which is very well researched, by the way, kudos!) does not quite get right is that the insulin sensitivity _changes_ hour to hour, day to day, month to month. It changes nonlinearly with exercise, stress, sleep, diet, and in a m…

My girlfriend has T1D, she diagnosed when she was very young. She’s great at managing it and has a pump and a CGM, but there’s still so much bullshit that she goes through when parts break. It’s really made me furious at the medical device industry, so I’m happy to see you’re working on new solutions. As a software engineer, I often wonder if there’s anything I can do to help with T1D management, so if anyone knows o…

OpenAPS is the big one, though I think they need _documentation_ more than code. Reach out to Dana on Gitter or Twitter, she's always been very helpful in the past!
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