The Unreasonable Math of Type 1 Diabetes • Hacker News Board

Re: The Unreasonable Math of Type 1 Diabetes

#311

Post by mikenew » Sat, Feb 19, 2022, 11:45 PM UTC

sgmoore wrote: post #279

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 th…

Ah thank you, that makes much more sense to me now. The other answers weren't quite was I was looking for.

I really hope the CGM and "artificial pancreas" technology continues to progress. It really sounds like a very difficult thing to deal with day in and day out.

Thanks for taking the time to help me understand it a little better.

Re: The Unreasonable Math of Type 1 Diabetes

#312

Post by lewishogan » Sun, Feb 20, 2022, 2:25 PM UTC

coldpie wrote: post #49

tamaharbor wrote: post #40

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.

I don't know how long ago that was for you. I was diagnosed at 13 (in 2001). If it's managed well and she has support, and it sounds like it is and she does, then it does indeed get better. It sucks, but it doesn't need to dominate one's life, it just becomes a part of you and you move on with it. Best.

I was diagnosed sometime during my second year of secondary school (which I think was 2010-2011, which would make me 13 at the time as well, although I admit I don't remember much) and I can definitely back up the importance of a good support network.

I don't know anyone else with this condition and it can be incredibly isolating, and as is the case with many chronic conditions it definitely has a negative impact on mental health.

At least in my experience, it's not something that one can just move on with, as it tends to pervade every experience: "Is my blood sugar going to go too low during this exam/interview/event?" is a common thought and there have been many times where I've taken less then an appropriate amount of insulin to ensure that a hypo doesn't occur at the worst possible moment.

Ever since the pandemic began health care has been harder to access and it's been much easier to slip through the cracks, though I can't really blame anyone considering the demand on health services, it's certainly a reminder of the importance of taking an active involvement in your health.

Re: The Unreasonable Math of Type 1 Diabetes

#313

Post by DavideNL » Sun, Feb 20, 2022, 4:42 PM UTC

kelp wrote: post #199

cadr wrote: post #86

Earlier quoted context omitted.

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.

In The Netherlands there’s a group of a few 100 people using a device like this already: http://inredadiabetic.nl/en_GB/

It’s sort of in a testing phase…

Re: The Unreasonable Math of Type 1 Diabetes

#314

Post by archi42 » Mon, Feb 21, 2022, 1:10 PM UTC

pimeys wrote: post #243

archi42 wrote: post #240

Earlier quoted context omitted.

300 USD? That is incredibly expensive! In Germany, the general public can order a Libre 2/3 from their website for 60 EUR. That's 150 USD per month (assuming 26 devices per year). Though that's a purely theoretical price: As with insulin, the mandatory health insurance seems to pay for it anyway. Even with import taxes/tariffs applied, I could imagine a vacation to Europe being massively subsidized by just bringing b…

In Germany a Dexcom G6 sensor is 80€ per 10 days. A transmitter about 400€ per 90 days. TK pays for all of this if you can show nightly hypos and jumpy glucose values, which should be easy for any T1d... Dexcom is the only one accurate enough to use with SMB looping. And the only one in germany that sends the glucose numbers to your phone with BLE. Libre 2 can be hacked to do the same though.

Hm, possibly? I mean, I luckily don't have diabetes and know the Libre 2 only second-hand (my Dad uses it to monitor his non-T1d). So I am not too familiar with the details, hence first of all thanks for the clarification of what that device can or much rather can not do.

However, I was under the impression that the GP [emj] was "only" considering good monitoring to improve their decision about insulin application. Not a closed loop system. But yeah, if they meant a closed loop and if the Dexcom is the cheapest option here, then the 300 US$/month is actually cheaper than the 380 US$/month you outlined.

Re: The Unreasonable Math of Type 1 Diabetes

#315

Post by m_kos » Thu, Mar 03, 2022, 9:18 PM UTC

sweston4 wrote: post #204

m_kos wrote: post #181

Earlier quoted context omitted.

> gluconeogenesis I am very curious about gluconeogenesis. I am well aware of this pathway but have read a few times that glucose generation from protein happens very rarely. Have you ever tried eating zero carb whey protein in a fasted state? If yes, have you noticed a spike in glucose? I am genuinely very interested in your experience with gluconeogenesis as a person with diabetes.

Oh, I am very happy to answer this to the extent I can. Whey protein impacts my blood glucose in confusing ways! Most days, I'll have a whey protein shake that consists of one scoop whey protein, a little bit of coffee for taste, and some almond milk. This will typically be my first meal after ~12-16 hours without eating. The correct dose of insulin for this shake can vary from 2 units of insulin to 4. First, I belie…

Thank you for such a thorough and informative response!