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The Unreasonable Math of Type 1 Diabetes

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Re: The Unreasonable Math of Type 1 Diabetes

#31

Post by berkes »

beached_whale wrote: post #2

The one that a lot of people seem to neglect is that the factors change. This can be slow or abrupt and often or rare. It happens and learning to recognize(the hard part) and then adapt can lead to better outcomes. Waiting for a MD/Nurse to suggest changes is often too long.

> is that the factors change.

Indeed. The weather, (lack of) sleep, stress, mood, etc. All can have a big influence on the rates and factors.

For me, for example, summer is entirely different from winter (and spring and autumn). if everything else would remain the exact same, then still I'd have to switch rates at least twice a year because in summer my body works different. apparently.

Re: The Unreasonable Math of Type 1 Diabetes

#32

Post by newbie789 »

semenko wrote: post #4

Hey Graham -- great post! The Medtronic / Guardian sensor combo is generally disliked by patients, though (in the US) the Medtronic 770G is FDA approved for ages 2+. Most prefer the t:slim X2 with "Control-IQ" (their hybrid closed-loop: https://www.tandemdiabetes.com/products/t-slim-x2-insulin-pu... ), which is FDA approved for ages 6+, and works great. The bleeding edge is the Beta Bionics ( https://www.betabionics.…

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Re: The Unreasonable Math of Type 1 Diabetes

#33

Post by [deleted] »

kahrl wrote: post #27
whatshisface wrote: post #20

Earlier quoted context omitted.

> Consider that there's a +/-20% margin of error on the reported carbohydrates on nutrition facts. Is this accounted for by product-to-product variation or package-to-package variation?

The toothless FDA allows for a 20% margin of error on nutrition facts labeling, so it could possibly be one or the other or both. Some products may just have variation. Some foods will be maliciously mislabeled with 19% less calories/sugar/fat but may have little to no variation within the same product.

[deleted]

Re: The Unreasonable Math of Type 1 Diabetes

#34

Post by KetoType1 »

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…

The secret to managing Type 1 Diabetes is a ketogenic diet. You will observe extreme stability of blood glucose (low variance) and because the brain uses ketones as fuel, occasional hypoglycemia will be an easily-managed non-event.

You should get most of your calories from olive oil and nuts.

Protein intake should be just as much as you need. Excess protein causes blood glucose instability.

Carbohydrate intake should be as low as possible.

Here is a sketch of a ketogenic diet that works long-term:

  - 2 eggs over medium with 4 tablespoons of olive oil
  - walnuts/almonds/pecans with a little cheese
  - hazelnuts, peanuts, macadamias for hunger
  - a little chia seed (2 tablespoons)
  - salad with avocado (14g of fat) and 9 tablespoons of olive oil, with vinegar
The salad is by far the largest meal of the day should include wide variety of vegetables. Leafy greens, broccoli, brussels sprouts, zucchini, tomato, etc. Add walnuts.

Get a lot of salt. Take a multivitamin and fish oil capsules.

Once a week, eat a burger with no bun. Cheese and meat. This should be eaten after hard exercise (e.g., a hike). You might eat other cheat foods (e.g., seafood, steak) but avoid carbohydrates.

Re: The Unreasonable Math of Type 1 Diabetes

#35

Post by mellavora »

sweston4 wrote: post #19

I'm a type 1 diabetic and data scientist. Estimating the causal effect of a unit of insulin or food on blood sugar is an absolute crap shoot. Consider that there's a +/-20% margin of error on the reported carbohydrates on nutrition facts. We might consider this irreducible error that just cannot be modelled (Maybe you could get a calorimeter, estimate the distribution of errors, and reduce that error somewhat). There…

> that would kill you if the resulting low blood sugar is not dealt with.

My wife is type I, so I have a sense of what you live with.

She bought a book, "The Insulin Murders", which looked at a number of cases where insulin was the weapon of choice. The good news is that it is actually really hard to die from low blood sugar, assuming good medical care is available.

Coma to death is > 12 hours, more like 24 or 48. Assuming other people are around, there is plenty of time for medical response. And treatment is easy, glucogon turns it around in minutes.

And I'm not sure a 20% insulin overdose would trigger coma. Definitely hypoglycemia, but blood sugar has to be pretty low for coma.

Look, I'm not saying it is easy, and risk of harm from getting it wrong is high (as you wrote), but risk of death is much lower than you might think

Re: The Unreasonable Math of Type 1 Diabetes

#36

Post by brainlessdev »

Trasmatta wrote: post #26
brainlessdev wrote: post #22

Earlier quoted context omitted.

I've been following the press about closed loop artificial pancreases closely, too. Currently, the open-source solutions there are require using insulin pumps that are pretty big and for some, that's not a choice they're ready to make. I too hope this tech continues to advance quickly.

The Omnipod 5 just received FDA approval, and looks really cool. I'm going to wait a bit and see reactions from other diabetics, though, before I jump onboard.

Oh, sweet! It looks like it's not out yet in Germany. You can get the Omnipod Dash here. It does look like it's going to be available soon, though. Will keep an eye out, thanks for the tip!

Re: The Unreasonable Math of Type 1 Diabetes

#37

Post by barbazoo »

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…

This all sounds really really hard, I'm sorry you have to go through that.

Re: The Unreasonable Math of Type 1 Diabetes

#38

Post by MattGaiser »

kahrl wrote: post #27
whatshisface wrote: post #20

Earlier quoted context omitted.

> Consider that there's a +/-20% margin of error on the reported carbohydrates on nutrition facts. Is this accounted for by product-to-product variation or package-to-package variation?

The toothless FDA allows for a 20% margin of error on nutrition facts labeling, so it could possibly be one or the other or both. Some products may just have variation. Some foods will be maliciously mislabeled with 19% less calories/sugar/fat but may have little to no variation within the same product.

I am beginning to believe those who count calories and lose less weight than they anticipate.

Re: The Unreasonable Math of Type 1 Diabetes

#39

Post by [deleted] »

Trasmatta wrote: post #15
brainlessdev wrote: post #12

Earlier quoted context omitted.

Although I haven't experienced this first-hand, my partner has T1D and I can see her reflected in everything you say. I'm hoping for a near future where technology paliates some of the dread of living with T1D. Some lines of research, such as implantable insuling-producing islets [1] seem promising, at least to someone without the chops to judge what's going on. [1]: https://www.clinicaltrials.gov/ct2/show/NCT0351393…

Thanks for the kinds words. The primary problem with those types of treatments is you have to be on immunosuppressants, or the immune system just kills the cells again. That type of treatment is typically not recommended unless the patient is already on immunosuppressants, or has extreme hypoglycemia unawareness, or extreme needle phobia. Immunosuppressants are typically considered a worse outcome than properly treat…

[deleted]

Re: The Unreasonable Math of Type 1 Diabetes

#40

Post by tamaharbor »

I cried for days after my 11 year old daughter was diagnosed with Type 1 Diabetes. The first week we almost killed her with an Annie’s soft pretzel. It’s been better since then. It is possible to live a good life, and be healthier than many without the disease.
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