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The Unreasonable Math of Type 1 Diabetes

maori.geek.nz

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Re: The Unreasonable Math of Type 1 Diabetes

#301

Post by arch-ninja »

davidthewatson wrote: post #266
pimeys wrote: post #242

Earlier quoted context omitted.

A CGM, app like xdrip and a smartwatch to display the current glucose value, trend graph and insulin on body has completely removed these situations from my life. As people normally check the time, you'll be checking the glucose value when walking outside

That's the glass half-full. If that works for you, then I'm happy that at least one of us has found a solution that works reliably. The glass half-empty is... I'd be much happier if I actually had an information device that I wore on my wrist that gave me all the data I need to manage T1D at a glance without igniting arguably the worst alert fatigue ever seen in healthcare when I have a smartphone, a pump, a CGM, and…

The alert fatigue is _very real_; I have a dexcom and consistently see it:

- mis-calibrate (first day's readings are garbage after new sensor insert)

- UI on the app will sometimes mis-render by 10-15 minutes. On several occasions I have been watching the graph while dosing, didn't see any change whatsoever after 30/45 minutes, and gave more insulin because of that information. 5 seconds later the screen changes and displays 15 minutes of BG going steeply down as I would expect, but now I have 2x the dose in me -_-

While I'm swimming in sensor readings the actual impact on my treatment quality has been close to nil, but it does make the people around me feel better. I feel as if my ability to sense my own levels has worsened because I default to trusting the graph over how I feel.

Re: The Unreasonable Math of Type 1 Diabetes

#302

Post by idealmedtech »

mst wrote: post #295
idealmedtech wrote: post #211

Earlier quoted context omitted.

It's @idealmedtech.com! I did it that way to keep the bots away, but perhaps it was a little _too_ effective

The change you've already made seems pretty likely to work but maybe @ .com would be even clearer and still have the desired effect? (or since you have the URL in there some reference to that, YMMV, just the thought sprung to mind so figured I'd share in case it was useful)

Good call! I like that even more than what I did, will make the change

Re: The Unreasonable Math of Type 1 Diabetes

#303

Post by Jarmsy »

JimmyAustin wrote: post #106
arka2147483647 wrote: post #92

Earlier quoted context omitted.

Well, I have had the incredible luxury of being born in Finland, so state/municipality pays everything. Insulin, Glucose-test-supplies, Doctors. I truly fell sad when i hear what US based persons have to go through. Though, i suppose i pay it in taxes :) About devices.. The first Glucose-test-device (what are they even called in english) took 5min to process the results. Current one is 5sec. A massive improvement in…

I'm not diabetic, but I tried a FreeStyle Libre 2 continuous glucose monitor to measure my blood sugar, and I think it's basically what you are asking for. Tap your phone on a patch on your arm to get a instant view of your blood sugar, plus see the previous 8 hours. It is pricey though.

It is expensive, but testing with strips >5x a day can easily end up costing more. When I was on strips I usually needed at least that to have anywhere near decent control.

Re: The Unreasonable Math of Type 1 Diabetes

#304

Post by beached_whale »

pimeys wrote: post #94
zaroth wrote: post #5

Earlier quoted context omitted.

This is an excellent point. What makes this even harder is that some of the changes (like basal rates) the equipment is good about supporting multiple profiles and letting you switch between them. Where as the carb ratios and correction factors are set once and overwritten when you update them, and hard to generate reports on how they are changing over time... so not designed to really be adaptable. There are micro f…

The oref1 algorithm in AndroidAPS can detect unannounced meals and together with a very fast insulin such as Lyumjev can automate meal boluses for some people. I know diabetics in 85% in range using this method. Doesn't work super well for me though.

Loop does this too, in a way. But it's still delayed and the insulin peak doesn't match the carb peak. But better than not having too.

Re: The Unreasonable Math of Type 1 Diabetes

#305

Post by 1123581321 »

arch-ninja wrote: post #301
davidthewatson wrote: post #266

Earlier quoted context omitted.

That's the glass half-full. If that works for you, then I'm happy that at least one of us has found a solution that works reliably. The glass half-empty is... I'd be much happier if I actually had an information device that I wore on my wrist that gave me all the data I need to manage T1D at a glance without igniting arguably the worst alert fatigue ever seen in healthcare when I have a smartphone, a pump, a CGM, and…

The alert fatigue is _very real_; I have a dexcom and consistently see it: - mis-calibrate (first day's readings are garbage after new sensor insert) - UI on the app will sometimes mis-render by 10-15 minutes. On several occasions I have been watching the graph while dosing, didn't see any change whatsoever after 30/45 minutes, and gave more insulin because of that information. 5 seconds later the screen changes and…

I think you’d benefit from an app like InPen that lets you save your novolog settings and graphs the insulin remaining in your body for you. It sounds like you don’t understand the curve. It also warns you if you’re doubling doses to dangerous levels of stacking. You really need to learn not to do that no matter what the graph says. Can you get an appointment with a diabetes educator?

Re: The Unreasonable Math of Type 1 Diabetes

#306

Post by 1123581321 »

gowld wrote: post #66
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…

Now imagine what it's like for someone with T1D to live alone, if you haven't yet been to a funeral for that. Every single time you go to sleep is a roll of the dice.

It’s about a 3 in 100k chance you’ll die from hypoglycemia in your sleep over a year. So the die you are rolling every night has about ten million sides.

Re: The Unreasonable Math of Type 1 Diabetes

#307

Post by consp »

pimeys wrote: post #242
consp wrote: post #229

Earlier quoted context omitted.

I've had the "are you drunk" comments a few times while hypoglycemic. I once walked home from work and apperantly didn't notice it, walked a few busy intersections and finally sat down somewhere where someone noticed me and called an ambulance who game me a glucose iv and everything was back to normal in a few minutes. So everything was still somewhat working and the "go home" signal was set but everything else was b…

A CGM, app like xdrip and a smartwatch to display the current glucose value, trend graph and insulin on body has completely removed these situations from my life. As people normally check the time, you'll be checking the glucose value when walking outside

> A CGM, app like xdrip and a smartwatch to display the current glucose value, trend graph and insulin on body has completely removed these situations from my life.

If my body wouldn't dislike those I would agree. But my experience is after about a day the results get so mixed up and unreliable that it's pretty much worthless. Hopefully they get better over time.

Re: The Unreasonable Math of Type 1 Diabetes

#308

Post by consp »

mnw21cam wrote: post #256
consp wrote: post #229

Earlier quoted context omitted.

I've had the "are you drunk" comments a few times while hypoglycemic. I once walked home from work and apperantly didn't notice it, walked a few busy intersections and finally sat down somewhere where someone noticed me and called an ambulance who game me a glucose iv and everything was back to normal in a few minutes. So everything was still somewhat working and the "go home" signal was set but everything else was b…

One of the slightly scary things about T1D is that at first you get a weird feeling when your blood sugar is too low, and you can notice when that happens. But if it happens too often, those warning signs stop, and you can get into a really serious condition without noticing for yourself.

The worst is during the night: You are sleeping, in a partial-dream, know you have hypoglycemia --somehow you know-- but you don't know for sure but it feels like something you experienced before, you do not completely wake up, dream somewhat lucid and are aware but you cannot decide to wake up and get something to eat but keep on dreaming and it's not a happy dream and keeps on going. Usually my dream-self starts screaming at myself to wake up. I've had that a few times and it's scary as [expiative here].

Re: The Unreasonable Math of Type 1 Diabetes

#309

Post by code_duck »

prmph wrote: post #154
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…

Is it not possible to have a device always connected to the bloodstream, with a replenishable supply of glucose and insulin in different compartments, that periodically checks the blood sugar level, and injects what is appropriate to keep it normal?

There are systems that automatically deliver insulin, but I don’t know of anything that automatically delivers glucose. That would be convenient.

Re: The Unreasonable Math of Type 1 Diabetes

#310

Post by code_duck »

kelp wrote: post #202
prmph wrote: post #154

Earlier quoted context omitted.

Is it not possible to have a device always connected to the bloodstream, with a replenishable supply of glucose and insulin in different compartments, that periodically checks the blood sugar level, and injects what is appropriate to keep it normal?

This kind of exists, and here is one such system: https://www.tandemdiabetes.com/products/t-slim-x2-insulin-pu... The pump delivers insulin and gets blood glucose readings from a CGM (continuous glucose monitor) over bluetooth. Then the pump can make decisions such as stopping insulin delivery if you're going to go low, doing small correction boluses, and adjusting basal rate. However it's far from perfect and still…

I have a tandem pump. The problem I see is that you still have to wait an hour for the insulin to take affect. And like you say, it’s based on CGM data which is not always accurate enough. Perhaps in the future there will be implants that deliver insulin in a more direct route, such as intravenous or intramuscular. That would also make an overdose more dangerous, though.
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