[stranded22]

Yep.

My wife is T1D and this is infuriating for her.

She’ll think that she’s cracked it, and then the next day, with the same meal at the same time, her sugar levels go high.

Her words: there is nothing else where you have studied for over 30 years and STILL feel like you know nothing.

It is incredibly demoralising for her sometimes - especially when she’s suffering also from a high/low sugar level. I have the upmost respect for anyone having to do the amount of work, to get to zero (sometimes).

[coldpie]

I'm also T1D and yep. That's how it goes. Despite having one of the same two breakfasts pretty much every workday for a decade, it's a crapshoot whether I'll be 300 (very high) when I get to work or 50 (very low) or 110 (good). I just have to adjust when I get in to the office. Most days I deal with it fine, but every once in a while I get fed up with it and want to throw something.

[rigrassm]

Right there with ya. The most frustrating aspect of the beetus for me is how inconsistent glucose/insulin responses are, drives me absolutely mad

[je42]

More data can help inform semi closed loop systems to deal with this variability.

For example, AAPS has since version 3.2 dynamic IFS. ( https://androidaps.readthedocs.io/en/latest/DailyLifeWithAap... )

For me this works quite well

[rigrassm]

Still pissed my insurance stopped covering the Omnipod Dash last year, especially since the 5 is just an artificially locked down dash. Omnipod 5 automated mode is garbage compared to aaps

[mikelward]

*ISF (Insulin Sensitivity Factor)

[stranded22]

Thank you, I’ll check it out

[RHSeeger]

I like to say that the CGM is, far an away, the biggest life improvement for diabetics since the invention of insulin. And this plays into one of the reasons

- You able to learn better about how your body responds to different foods

- You are more secure about your blood sugar dropping when you don't expect/realize it (sleeping, driving, etc)

- You better able to detect when your body isn't behaving the way you would normally expect it to (the point we're discussing here)

[stranded22]

She’s on closed loop and it has certainly changed her life - perimenopause was really difficult but the loop has meant she has much better control. The fact it cuts out when it drops has given her confidence to sleep better etc

[ddorian43]

How about just not eat carbs at all and have more consistent & lower blood sugar? (this was an interesting case https://www.youtube.com/watch?v=CG8UU7P8FBU)

I do keto diet long term but for other reasons, often the epilepsy version where it's more strict and higher fat.

[jzacharia]

Keto works well, but I'm concerned about the extreme fat intake. I did manage to lower my A1C from 9s to mid 5s using Keto as a T1D, but eventually settled into a high protein, moderate fat, low-ish carb diet and that has worked pretty well without being hyper-restrictive. Heavily inspired by the late Dr. Richard K. Bernstein.

[ddorian43]

I target for high ketones (1.5+) & low glucose 4-5mmol (blood test 1 hour after wake up) and higher protein interferes with both of them.

[jzacharia]

Curious - what's the reason for targeting ketone levels?

[ddorian43]

Better mental health.

[GuinansEyebrows]

every endocrinologist i've ever had says you need at least some carbohydrates. that said, they're usually not nutritionists, and there's historically been so little focus on food as medicine within western medicine that i think we "officially" know as much about that as we do about diabetes at all (which is a lot, but still surprisingly little).

there are plenty of good reasons we eat carbs (especially complex carbs, plus trying to avoid processed stuff); as a diabetic you just have to prepare ahead of time. it sucks, but honestly, as a 20+ year T1D, not eating cake sucks more than having to plan to eat cake :)

[ddorian43]

> not eating cake sucks more than having to plan to eat cake :)

But you have never felt the alternative. It's not just eating cake. You have to see the whole video that I linked to understand the differences (they might not all apply). Think a smoker who've never known what's it like without smoking.

[broost3r]

dad of an 8 y/o T1D here, and tbh, "how about just ..." is about the worst thing you can say to anyone dealing with this, especially given the subject of this post. things are just never the same. maybe they will be later in adulthood? i feel like i'm in a position to beta test this with my kiddo and i don't like it at all.

[ddorian43]

I understand that T1D is special, but this is said for every disorder.

There are many levels to keto diet, and believe me, you can't do the epilepsy version even if you'd wanted, it takes time and hard effort, for children it's done inside a hospital.

So assuming you watch everything they eat, you can keep track of GCM, and try very slowly. Like going from 60-30-10 carb-protein-fat to 50-30-20 ratio, do they have better consistent blood sugar ?

There should be protocols to do this for T1D the safest way.

Watch the video.