Comments
killcat t1_j1gjvvm wrote
Also people in lower socioeconomic groups are far more likely to have co-morbidity, obesity, poor diet etc
Reep1611 t1_j1h2zsi wrote
Which is down to the same reason, if you have little money, you cannot afford a healthy diet easily. Because good fresh food is behind the same monetary hurdle and cheep unhealthy processed food is much more affordable.
Excusemytootie t1_j1ihtxg wrote
You can eat healthy on a budget. I know it’s not possible everywhere but I think the problem has more to do with education and understanding nutrition. So many people, especially if they only have a high school diploma or less, aren’t taught a single thing about nutrition. On top of that, people in the US were given the opposite of nutrition education with that old food pyramid that recommended 5-6 servings of “whole grains” which is often interpreted as “bread, cereal, baked goods, etc”. What a mess, it’s no wonder we have this health crisis.
tasteothewild t1_j1h1594 wrote
No, they had access! To be included in the study you had to be on insulin. The point of this study is the complex issues related to adequate glycemic control in the-face-of using exogenous insulin. Yes, correct dosing and timing of insulin administration could be a factor since based on the population studied these are almost certainly type 2 diabetes patients who are, by definition, “insulin-resistant”. Therefore, other factors are huge; such as co-morbidities, health literacy, diet, exercise, etc.
Elfin_842 t1_j1i6ox9 wrote
Admittedly, I haven't read the article, but from the headline they have to have access to some insulin. That doesn't mean they have access to all of the advancements. Insulin pumps and CGMs are expensive, but they make a world of difference. In addition to this, type 2 diabetics don't usually have a CGM. The mindset difference that I've seen between type 1 treatment and type 2 is crazy. Most of the type 2 diabetics I've known haven't cared a lot about their blood sugar as long as they got reasonable A1C results.
The last thing I'm interested to know is how insulin use was done. Insulin is expensive and some people ration their supply.
I agree that those other factors you mentioned are important, but I wouldn't assume that these people have all of the means needed to fully support themselves.
strizzl t1_j1e3mrq wrote
Diabetes in 90% of type 2s is completely manageable with diet. Access and education to appropriate foods and poor impulse control is what drives the majority of uncontrolled diabetes. I do not fault majority of patients for this either: they didn’t create the crappy education system, lobby to the government to create a “food pyramid” that promotes carbohydrates, or elevate the costs of transport of fresh fruit and vegetables. That was all failure of our system. The fix is too complicated for a public entity with no incentive to address so it’s up to individuals to take care of themselves unfortunately.
It is a systemic problem but I just don’t see help coming from the government
bobbi21 t1_j1ebbgl wrote
If caught early possibly but thats absolutely not true once it gets going. I have type 2 diabetic patients admitted to hospital and literally not eating any food for days due to multiple factors. They still need insulin. That is the vast majority of type 2 diabetics i see.
nowlistenhereboy t1_j1fyq2t wrote
Yes but that is not the majority of type 2 diabetics, that's just the worst 'end-stage' cases. Even later on in the disease diet and exercise can majorly improve A1c and reduce reliance on meds. Exercise causes insulin-independent insertion of glut-4 transporters in muscle cells.
Just because DM2 can't be totally cured doesn't mean we should discount the value of lifestyle changes. Yea it's hard for the patient to maintain those habits but we need to find ways to help them do it.
ph1294 t1_j1ghl22 wrote
Not eating for 3 days with type 2 exacerbates the issue. You’re going to induce hypoglycemia, which isn’t a risk for non diabetics.
You diet control type 2 by eating a healthy portion of low glycemic index food on a regular basis until your body can readjust to the absence of glucose spikes caused by sugary foods and drinks.
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Viperbunny t1_j1eisa4 wrote
Two things have helped with my type 2 diabetes in ways that are huge for me. The first is having a CGM or constant glucose monitor. Seeing what my my blood sugars are in real time and by taping my phone to the device. I can see what foods effect me and how and when (which makes a difference for me). I went from an A1C of 11.1 to 7.1 in three months after being admitted to the ICU for DKA.
The other thing that has made a difference is the new type of medication that is non insulin based. Things like Ozempic and Manjuro (I switched from one to the other). I hate that it is the trendy weight loss drug because it has saved my life and is now so hard to get. It wasn't just a self control issue when it came to food. My whole life I was told it was and the hunger would go away eventually. But it never did. I didn't just feel a little hungry. I felt starving all the time. Like I would pass out of I didn't eat. It was terrible. I could also eat huge portions and still no feel full. I felt bloated, but not full.
Then I started Ozempic. I didn't crave straight sugar. I didn't want to eat all the time. I felt full. I ate so much less and I didn't want more. Eating good food filled.me and made me feel good. My chronic gut pain has been better. I have more energy. I have lost 50 pounds and am still losing because it doesn't hurt to eat right. Yes, I still have to watch what I eat because I can over eat, but it is not something I even want to do. I had to go off of it for three weeks because of an insurance issue and it was hell. I was doing my best to not consume everything in sight and I was on steroids!
My blood sugars are well controlled. I can react faster to correct issues. It's great. I get why it works for weightloss, because I needed to lose weight. I even considered a gastric sleeve. I was a week out from surgery when I decided not to do it. I am so glad I didn't! My friend did and he has struggled. Everyone I talked to said they didn't regret the surgery, but would then list all these issues they had. This drug is literally saving my life.
Polishink t1_j1ggi23 wrote
Hi, fellow (new)Ozempic user here. Did you experience any kind of lethargy or fatigue when you started the medication?
Viperbunny t1_j1ghwv8 wrote
Yes. Actually, my PCP didn't put me on insulin and I ended up in DKA. So it took about a month for me to adjust. I don't know how much was the DKA and how much the Ozempic. My stomach hurts for a few weeks. But after that it was clear sailing. I am now on Manjuro. My doctor said the weight loss was slightly better. I have a coupon that requires me to have insurance, but allows me to get it for $25 a month! I had to stop my meds for a few weeks because my husband changed jobs and we went through cobra, which was allowed to take over 30 days to post! I didn't have an issue going back on or after being off it.
Polishink t1_j1gimbe wrote
Thank you for your response. My Ozempic dose was just upped from .5 to 1 and I noticed that I was very tired. Hopefully I will adjust.
Viperbunny t1_j1gj98i wrote
I think that was the hardest jump for me. I know it works in the gut, and so it takes time to adjust. By the time you get used to the 1 that adjustment may happen. It did for me. If your blood sugars were high before, the fatigue could be the purging of the sugar. I know that I get topical yeast infections when my body is purging sugar as well. It can also be really hard on your bladder. If you can tolerate the next month well it definitely gets better. I hope that it does and you have success controlling your sugars. Diabetes sucks. These medications and technology are really helpful managing it. My grandpa used to have such trouble. I think he would go nuts for the CGMs.
DoobieMcBeast t1_j1hb0bv wrote
Ive never heard of anyone getting DKA from t2 diabetes. How old are you?
2alpha4betacells t1_j1i0vpi wrote
it’s not very common
LadyJitsuLegs t1_j1i8pyx wrote
It isn't common or usually as severe as T1 DM, but it still happens. Common triggers for Type 2 are existing stressors like infection. Can also happen with alcohol abuse or non-compliance to medications. People with Type 1 can easily develop DKA from simply not taking insulin as their bodies produce none.
Viperbunny t1_j1hnu55 wrote
- It was horrible.
[deleted] t1_j1gekvf wrote
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corpjuk t1_j1il4vh wrote
Have you checked out eating whole food plant based?
Viperbunny t1_j1il82s wrote
I have tried many different things over the years.
nancyapple t1_j1e0e3e wrote
The food plays the biggest part, can’t say American diet improved in last 30 years.
Vanman04 t1_j1eagz1 wrote
Seems cost is playing the biggest part.
"Several factors may have contributed to the lack of improvement in glycemic control. First, the rising cost of insulin is likely leading to medication nonadherence.17 Approximately one-third of US adults using insulin report either rationing, dose skipping, or delaying prescription refills to save money.18 Second, only a small proportion of practitioners may be starting or intensifying insulin therapy in a timely manner.19 Third, acceptability of insulin remains low among patients, leading to reluctance to begin or continue using insulin therapy as recommended.20"
It also explains that Mexican Americans are driving a large part of the bad results which again likely points to access to newer tech.
Last but not least this report seems to end right at the beginning of when closed loop systems started to come online. The new tech in insulin pumps is pretty amazing but the cost to use them is pretty insane.
My son is type one. He uses an insulin pump that is connected to a continuous glucose monitor. His pump has the ability to monitor his glucose level and deliver or stop insulin as needed. The results are nothing short of amazing. That said it is expensive as hell.
The pump itself cost 6k with insurance our cost was closer to $300 but then you need supplies for it which run somewhere in the neighborhood of $90 per month. On top of that you need the supplies for the continuous glucose monitor that adds another $90 -160 per months after insurance. Add insulin for another $30 per month after insurance. This is with pretty decent insurance.
Without insurance it becomes completely unworkable unless you are high income. There are a ton of people still using shots and pricking their fingers which causes all kinds of issues with control.
I feel like the title sort of obscures the reality. It's not that the tech is not good enough to improve outcomes it is much more that the barrier to to getting that tech in peoples hands is too high.
muinamir t1_j1ef60n wrote
Anecdotally I know of so many people who have struggled to afford their insulin and meds. I wish we'd stop trying to pin this solely on diet and realize we're shutting people out from the treatment they need.
TheConboy22 t1_j1fu6ze wrote
I am one of those somebodies. Type 1. This condition has made me a slave of the corporations. Without their life giving insurance premiums I’d have moved away from them a long time ago. My meds are stupid expensive…
Reep1611 t1_j1h3gaq wrote
If you are a somewhat capable worker, especially if you learned a craft, you might want to learn German and think about moving here. Our current Gouvernement is updated and codifying new laws regarding immigration, so it will be mich easier to live and work here and enjoy all the benefits like our very good healthcare.
[deleted] t1_j1elw9z wrote
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nowlistenhereboy t1_j1fzxkm wrote
> I wish we'd stop trying to pin this solely on diet
You can perfectly manage your glucose levels by meticulously testing and administering yourself extra insulin to cover but all of that extra insulin is not without its own cost to your body. Having all of that extra exogenous insulin creates its own set of side effects because insulin does a lot more in your body than just allow glucose into cells. Insulin facilitates growth of adipose tissue and can lead to hypertension, atherosclerosis/heart disease among other things.
Getting exercise and reducing your caloric intake to more closely match your caloric expenditure is the MAIN thing EVERYONE should be doing.
RigilNebula t1_j1gbn9f wrote
>Having all of that extra exogenous insulin
For type 1 diabetics, all insulin is exogenous. It's not "extra", it's simply insulin.
nowlistenhereboy t1_j1gkn7d wrote
That totally depends on how much they eat. If they eat enough to the point they are administering more insulin than their body would normally produce if they did not have diabetes, then it's absolutely excess insulin.
drugihparrukava t1_j1gmvj6 wrote
We (type 1's) don't take insulin just for food. We can fast and need insulin because we don't produce it. Several hours if you're pumping, or a days/a few days if you're MDI, of no basal,(background insulin) and we're in DKA. Nothing to do with food.
It's a never ending balance of working out levels, as we have over 42 known factors that we do calculations for. Getting it exactly right isn't even possible with existing closed loop pumps.
nowlistenhereboy t1_j1gnd4n wrote
Yea, not getting it absolutely perfect is not what I'm talking about. What I'm saying is that you can potentially eat a very large amount of calories, cover it with a bunch of insulin, and your sugar will appear to be fine. But all the negative effects of that over consumption and excessive insulin will manifest in the same way it would affect a type 2 or even someone who doesn't have diabetes.
This issue is way more pertinent to type 2 diabetics. But even a type 1 could develop insulin resistance in this way as well as the negative side effects of hyperinsulinemia.
drugihparrukava t1_j1gof55 wrote
Hyperinsulinemia is when the pancreas releases large amounts of insulin so that doesn't happen in a T1 body. Insulin resistance can occur in T1 for several reasons, but it's not the same as hyperinsulinemia which is one of the possible causes of T2. So we generally use the term IR which can happen temporarily in a type 1 (due to one's period, ovulation, or many other hormonal changes, illness, scarring causing bad sites etc) or from having T1 for decades on its own can cause some resistance.
If a T1 does choose to eat large amounts of calories, of course that's not healthy for anyone, diabetes or not. But no the glucose (or "sugar will appear to be fine") isn't necessarily the case. It's a struggle to work out boluses and we dose differently for carbs, proteins and for many other reasons.
TLDR: yes no one should be eating excessive quantities anyway with that I agree. T1, however, and insulin dosing is very complicated and not caused by diet.
​
Just an FYi if anyone's interested; it's understandable if you don't live with T1D to know just how much of a mental load this disease is. We have an additional 180 decisions to be made per day while acting as our own pancreas 24 hours per day. This is a rather simple chart of the 42 factors that affect blood glucose, and not all are listed here either: https://diatribe.org/42-factors-affect-blood-glucose-surprising-update
mamallama2020 t1_j1htgpz wrote
That’s…not how it works.
RigilNebula t1_j1j0v05 wrote
The things that you're saying are just the consequences of overeating in general though. If a non diabetic eats too much food, they'll see a growth of adipose tissue, and this can lead to hypertension and heart disease.
Unlike non-diabetics, if a type 1 diabetic overeats without taking 'exogenous' insulin, they will not gain weight, and there's no risk of a growth of adipose tissue. (There are, however, significant other risks, including death.) However, if they take insulin for the food they ate, they'll see the risk of weight gain and excess fat that non diabetics would see from overeating.
So you may be arguing that there are health risks to overeating. And this is true, but it's not specific to type 1 diabetics.
[deleted] t1_j1h119h wrote
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Dolphintorpedo t1_j1eobvn wrote
Well tons of people are dieting themselves into type 2 diabetes so maybe it's fair to talk about dieting out of it as well. Why talk about a cure of the symptoms and not the source cause?
meeseek_and_destroy t1_j1eqmyp wrote
The people I know rationing their insulin are type one. So no diet can fix it as they were born that way.
justsomeplainmeadows t1_j1fhqz0 wrote
Bc we still need to be able to treat those people while they recover?
cashibonite t1_j1f2y1v wrote
I have a can of tomato today it has 16 grams of sugar in it
fitandhealthyguy t1_j1fucap wrote
If it comes in a can, I don’t eat it.
2alpha4betacells t1_j1i1aik wrote
I still use shots just because I hate wearing the pump (falls off, reinserting sucks, I’ve accidentally had in torn out many times)
Hate inserting CGMs too, but now I have one that is implanted under my skin and only needs to be reinserted (by a doctor) every 6 months
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yoortyyo t1_j1e1ga7 wrote
Industrial food chemistry is amazing stuff. They cut, bleach or leach things into pure starch, fat, protein & zazzy flavors from ( you really dont want to ask about some).
Lacking fiber in your diet from real green leafy things, fruit or whole grains exacerbates things.
Balance in diet greens - starchs - fats - proteins in the least processed way helps.
Isenrath t1_j1es4mc wrote
Reduction of sugar and increase in fiber is by far the most important. How the food is processed has minimum to do compared to the content of what is being eaten.
Now there can be an entirely different debate of costs of healthier foods vs ease of access but reduction of all types of sugars and increased intake of fiber will better help to control the issue.
Isenrath t1_j1jt5yp wrote
Yep, sugars cause a number of inflammatory responses as well as the promotion of less than desirable gut microbiome. A high dietary fiber diet will also slow absorption of sugars through the intestinal walls, so it's a stacked response when you do that. Lower intake and less sugar being available for your body to use.
kslusherplantman t1_j1eg7v9 wrote
30 years ago we were being told Fat was bad for your diet, ignoring all the sugar and processed carbs.
Now we know the opposite is true essentially.
Yes avoid bad fats, but fats are highly important to our diet. And they don’t do as much damage to the body as the sugars and processed carbs
Dolphintorpedo t1_j1eni09 wrote
Hahahaha, ok. The amount of fat you must ingest from your diet is laughably small compared to the amount the average american eats. A perfect example of this is saturated fat. The leader for research and social programs on heart health in the US (The American Heart Association) sets saturated fat intake at no more then 10% of your caloric intake. Also according to them >90% of Americans consume more then that recommended amount.
terrymr t1_j1fhd4d wrote
And according to my heart surgeon cholesterol and fats seem to be irrelevant. The people getting blockages have poor glycemic control.
nancyapple t1_j1fu631 wrote
Yes, it’s a far more obvious risk factor than saturated fat
kslusherplantman t1_j1eqw34 wrote
Did you miss where I say “yes, avoid bad fats”
nancyapple t1_j1eqtss wrote
There might be some controversy. My personal opinion is without the amount of sugar people consume, fat(natural saturated fat/unsaturated fat with a good Omega 3: Omega 6 ratio) is healthy. At least the most obvious problem of American diet is hyper-processed food/additive sugar, and in general too much fast calories to me. The equation has too many variables and you can't just blame American people don't follow the saturated fat part of the guidelines.
strizzl t1_j1e2zl5 wrote
Diet is definitely worse. Every corner is laden with carbohydrate fueled artificial garbage we call food. If we want to see health improve we need to shift our incentive structure to favor vegetables and lean meats or other natural protein sources institutionally.
VergesOfSin t1_j1efi86 wrote
saturated fat does not make you fat
JackHoffenstein t1_j1grl6r wrote
Uh it sure will if you consume enough.
VergesOfSin t1_j1h43mv wrote
that goes for food in general
JackHoffenstein t1_j1h5cbb wrote
Yeah but saying saturated fat won't make you fat is wrong. The only thing that determines whether or not you get fat is whether or not you're in a caloric surplus.
strizzl t1_j1hkad8 wrote
I remember asking a bariatric surgeon one time “how often do you see metabolic problems being the sole reason for someone to be morbidly obese?” He paused a moment then said “I have never met a patient that eats less than me [in 30 years of experience].”
VergesOfSin t1_j1iitkj wrote
nope, the calories in calories out argument is archaic and false. we are not simple machines, we are very complex. 3000 calories of fat vs 3000 calories of carbs will have VAST differences on how much, and what type, of fat is made and stored.
[deleted] t1_j1ik364 wrote
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Dolphintorpedo t1_j1emw22 wrote
No it just kills you faster
VergesOfSin t1_j1fe7cr wrote
No, it doesn't, that's a lie. 50 or so years ago, heart disease and heart attacks were almost unheard of. When Eisenhower had a heart attack in office, they blamed fat. Not the 3 packs of cigarettes he was smoking a day.
Look up ancel keyes, and see how he was paid by the sugar industry to fake results, and shift blame to animal fats.
We evolved to eat fat. Animal fat is the only reason we were able to evolve bigger, more complex brains. Well, cooking had a big role in it too.
Delet3r t1_j1gbzkw wrote
This subreddit baffles me. People are meat for thousands of years, now suddenly meat is bad.
AtheismTooStronk t1_j1gh4es wrote
In the quantities that people eat it, yes. Compare it to the days of being a hunter and actually having to work for your food and needing to make it last. You can’t eat meat all day every day and have the activity level of the average American and come out okay.
Reep1611 t1_j1h32sn wrote
Which in part comes down to the American way of selling fresh, healthy food as a premium „luxury“ product.
lol_alex t1_j1hj4we wrote
In particular, the highly processed junk with loads of high fructose corn syrup. It’s cheap and it adds volume.
Secondly, the junk food and takeout / ordering food trend.
KevlarUnicorn t1_j1ekojt wrote
It must certainly be related to wealth disparity, in that the more efficient formulations, and therefore more expensive formulations, are unavailable for people in lower income groups. In essence, poor people don't get the best advancements in insulin formulation and delivery.
I'd wager there's also a connection between non-white groups, as well as women, who experience discrimination bias, where doctors simply don't believe their patients. This is an ongoing problem in medicine: https://www.health.harvard.edu/blog/racism-discrimination-health-care-providers-patients-2017011611015
So the US faces the results of its capitalist and supremacist roots. It's likely yet one more reason why our quality of life and life expectancy have been dropping: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20220831.htm, https://pubmed.ncbi.nlm.nih.gov/29338955/
cdiddy19 t1_j1e8hon wrote
Which is why we need universal healthcare like all first world developed countries have except the US.
Other countries are also more strict with the types of food that are allowed
CryoAurora t1_j1e4wij wrote
Yet they charge ever more for it. Despite no improvements.
Pharmaceutical companies are as bad as landlords who jack up the rent despite doing nothing to provide more for that money.
sal_moe_nella t1_j1kpbbm wrote
You are wrong that there are no improvements and that was not the point of the study. Thank you for your useless knee jerk conspiratorial nonsense.
Champagne_of_piss t1_j1gk41b wrote
Can we do an experiment that establishes;
Diabetes control has not improved among US adults BECAUSE disparities for minority and uninsured adults worsens
Several_Emphasis_434 t1_j1g595c wrote
The cost of insulin is probably a huge part of the disparities
shashinqua t1_j1ir4ig wrote
Not really. I go through one vial every about three and a half weeks. That’s $25 each. A neighbor that is a heroin addict gets me my syringes for free since my local Safeway won’t sell them to me.
10113r114m4 t1_j1f2nn9 wrote
Honestly, diabetic technology hasnt improved all that much in the last 30 years. Yea, we have CGM and the pump, which is nice, but honestly I would have thought some automated pancreas would have been invented by now. Like technology flew off to space and diabetic technology seemed to slowly invent new stuff. Comparing the first introduction of the pump to now, it hasnt even changed all that much. There's now a new pod pump with no tubes but that literally just got FDA approved last year. It's ridiculous how slow these innovations come out. As an engineer with diabetes, it just blows my mind how slow innovation is for this disease.
uraniumEmpire t1_j1fvlea wrote
Gonna be a lot harder to sell premium insulin if you give your patients a single-payment pancreas.
KevlarUnicorn t1_j1glzod wrote
Don't worry, I'm sure our healthcare system would just install the pancreas, and you'd pay a monthly fee to keep using it. I guarantee this has come up as an option in at least one board meeting.
Scary-Owl2365 t1_j1hc0wi wrote
A subscription service for your pancreas. I wouldn't even be surprised at this point.
DarkestDusk t1_j1g64ue wrote
Which is literally the only reason that the medical industry does not fund the research and pay for the proponents necessary to make such things a possibility. The Love Of Money Is The Root of All Kinds of Evil.
FourDimensionalTaco t1_j1hrvf7 wrote
No. Diabetes is just extremely complicated to fix. Type 1 diabetes is an autoimmune disease and requires fixing the immune response (which is several Nobel prizes away) and restoring the destroyed beta cells. Type 2 diabetes is more of an umbrella term for various types of insulin resistance and associated metabolic problems, and thus also extremely complex. A cure for either type would be immediately be sought after by health care insurance companies, since for them, this would be far more economical than the ongoing expenses for insulin and anticipated diabetic medication.
DarkestDusk t1_j1hvvpv wrote
>A cure for either type would be immediately be sought after by health care insurance companies, since for them, this would be far more economical than the ongoing expenses for insulin and anticipated diabetic medication.
Which do you think a business would rather have? A subscription model of making money, or a One Time Payment? As someone who went and studied business at University, I know they almost ALL would prefer subscription, unless the One Time Payment Option was enough to keep them afloat by itself, because as soon as everyone has made their One Time Payment, they no longer require your services, and will no longer have a need to pay for it.
FourDimensionalTaco t1_j1jhhii wrote
All it takes is for one business to come up with a cure to disrupt the market. If there's a cure, why opt for the ongoing treatment? Such a company will sell the cure for a very high price. Insurers still go for that cure. Maybe not in all cases, but at least the more problematic patients will get it. That company then has a big ace up their sleeve with that cure, and of course patents the hell out of it. Other companies try to come up with their cures so they get picked by insurers. In the meantime, the first company has its monopoly. Once that has run its course, and competitors are coming up with their cures, the first company drops their price massively to undercut the competition.
Diabetes treatment is very expensive for health insurance providers. A cure would be cheaper for them even if it costs 500k once.
And yes, cures are being made for diseases. See this for example. Another example is the ongoing research into growing islets out of stem cells and transplanting said islets. See the Vertex VX-880 trial for example.
DarkestDusk t1_j1jzdm9 wrote
Thank you for your dissertation, and I will agree it has Some Merit, though I can only speculate when I do not have all the information available to determine whether or not it is all truth. Have an amazing Day, and Merry Christmas Four Dimensional Taco.
FourDimensionalTaco t1_j1hrjcx wrote
Disagree. I myself have type 1 diabetes, and CGMs are total game changers. Maybe they are not as useful for many type 2 diabetics, but for type 1, CGMs are essential. Also, I would never trade my pump and ultra rapid Lyumjev insulin for syringes and R. And what closed loop systems can already do is amazing.
10113r114m4 t1_j1iqnf8 wrote
I wasnt saying CGM was a huge improvement to diabetic life, it is. However, to engineer something like a CGM, especially in the mid 2000s wasnt difficult. Im an engineer not related to this field, but I feel like in 2 years, I could make a CGM machine, and that's me being generous with the time. All Im saying is there should be more innovation in this field, but yet, things crawl at a snails pace.
FourDimensionalTaco t1_j1jgc9z wrote
Hell no. You completely miss the physiological aspect of this. The sensor filament that has all kinds of special coating to ward off filament degradation and to deal with other phenomena like what happens in the insertion site immediately post-insertion (which is a micro trauma, and the body reacts accordingly). You also miss how electronics in the mid 2000s was far less sophisticated. Creating a CGM transmitter that filters out sensor errors, performs extrapolations, temperature compensation (since the glucose-oxidase enzyme in sensor filaments is highly temperature sensitive), regularly communicates over radio the last N data points, AND can run off a small coin battery for over 90 days was just not doable. I also highly doubt that your makeshift CGM would have anywhere near the same MARD that a G6 has. And with bad MARD your CGM is near useless.
The one area where I agree is the combination of CGM and pump. That's why the WeAreNotWaiting movement exists. That is why projects like AndroidAPS and iOS loop exist. But your own CGM? Not going to happen. No way.
Illusive_Man t1_j1i0jyc wrote
closed loop systems, where the pump communicates with a CGM to automatically adjust your insulin, are very now.
ViaCyte is doing human trials with stem cell research
Crankyclam t1_j1f50d2 wrote
Healthy people aren’t profitable
AtheismTooStronk t1_j1ghdlf wrote
Insurance companies do not make nearly as much money off of overweight and obese people as they do healthy people who normally only get regular check-ups.
Illusive_Man t1_j1i0nlq wrote
they lose money on them
pharmaceutical companies on the other hand
Pool_Party_Ziggs t1_j1g1pc1 wrote
I can't afford any of the new tech...
Reep1611 t1_j1h2pc6 wrote
Welcome to late stage Capitalism, where everything improves but only for the fewer and fewer people who can afford it.
SexyOldHobo t1_j1ht12c wrote
We’ve done nothing and we’re all out of ideas!
The “formulation” is probably one of the least important aspects of improving this issue on a national scale. Diet and consumer access to healthy food options is the most important, that’s what hits certain communities who aren’t well served. Next is the cost of insulin, which has sky-rocketed, that hits poor and uninsured people the hardest. When people start rationing their insulin, all your optimization and catered treatments go out the window.
We need green spaces with gardens, quality markets, places to exercise, affordable access to cheap medicine. Things everyone wants, but becoming less and less accessible
I’d argue stop subsidizing corn and find an alternative national beverage to soda, that’s not diet soda.
Until we pull ourselves out of our cultural tailspin and establish an improving baseline, any benefits of further drug developments will disappear into the statistical background of deeper social problems
fredmull1973 t1_j1huwyt wrote
Unsurprising if people eat the same foods that triggered diabetes in the first place. Thanks Food Pyramid
Technical_Sir_9588 t1_j1g936k wrote
Healthcare management is profitable; prevention, not as much.
Barrows91 t1_j1guxny wrote
Far too many people in this thread blaming individual choices rather than interrogate the more useful question; which is, why is “bad food” allowed onto grocery shelves in the first place?
Illusive_Man t1_j1i0lnp wrote
because adults can make their own decisions?
Barrows91 t1_j1i1u1q wrote
You’ve completely missed the point.
If there is nothing but “cheap, bad food” on grocery shelves then you can’t possibly expect every diabetic to get the “expensive, good food” to manage their condition.
You’re thinking to small. This is not an individual choice problem. The problem is that the government/grocery corporations have financial incentives from Big Agriculture and Big Sugar to continue stocking our shelves with “bad foods.”
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Dont_know_nothin0 t1_j1eoftv wrote
Maybe they should look into having more farmers markets with natural produce. Or have gas stations have more natural food produce. Or maybe look into educating the mass with Jim healthy 30 day diabetes cure. Or maybe have a Finland type free education system so we don’t stress out so much and look into comfort food. Or maybe tell the banks to quit raping the people with high interest rates on homes. Or tell the car companies to lower the prices on the vehicles while maintaining low interest rates. The list can go on with the stress and fear mongering. In the meantime I shall eat my sugary candy not made out of truvia.
p3canj0y363 t1_j1f92y7 wrote
Until people stop putting into their mouths the things that make/ keep our bodies sick, people will be sick. Fresh, healthy, appropriate foods need to be affordable and readily available. People need to be better educated on what is healthy for their unique selves, and on how to prepare it. Folks that can't prepare the food for themselves need affordable, easy access to healthy, fresh, prepared meals. And we all need to have the self control to put into our mouths what our bodies NEED, vs what we WANT. Not holding my breath on any of that.
Illusive_Man t1_j1i0qxi wrote
I have type 1 diabetes tho
SummerMcFoster t1_j1g4rou wrote
I really think it's what's in our food.
unskilledplay t1_j1gz23m wrote
The scope of the diabetes epidemic in the US is far worse than people seem to realize. It's truly frightening. 38% of Americans over 18 are pre-diabetic. Almost all of them will develop type 2 diabetes.
On one hand, the extreme prevalence of diabetes in the next 10, 20 and 20 years alone will ensure availability of insulin and other medications. On the other, without steps to prevent type 2 diabetes with diet and exercise, diabetes will become a leading cause of death.
FourDimensionalTaco t1_j1hsd6i wrote
I see a common problem with reports like this one: they do not take the time in range (TIR) metric into account. Especially closed loop systems reduce both hypers and hypos, which is clearly a big improvement. But because the hba1c has the characteristic of an average value, reductions in both high and low blood sugars cancel each other out, and the hba1c remains largely unchanged. Admittedly, this is not relevant if the hba1c is something like 11%, because that is far too high no matter what. But someone with 7% can experience such an improvement in glycemic stability and still remain at 7% for example.
A_Evergreen t1_j1i9gpj wrote
Almost like the capitalist system of “just let the poor die for profit” is braindead and could never yield long term positive results.
deletedtothevoid t1_j1i9n3s wrote
These companies are so greedy and corrupt. And yet, we wonder why some people don't trust the vaccine. Hard to trust a company when they have been caught doing many things they should not have.
Vaccines are safe. Not saying they are not by any means.
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reb0014 t1_j1ee4ar wrote
Yes but think of all the profit created for pharmaceutical companies!
bsanchey t1_j1ekuim wrote
That’s not surprising. Cultural difference in what we eat and if you can see a doctor yearly and take a physical you don’t know if your trending in the wrong direction. A yearly physical can help prevent lots of diseases and conditions. But insurance CEOs need mega yachts.
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dceglar t1_j1g9nma wrote
Watch Jason Fung's YouTube videos.
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Ombliss22 t1_j1hnyj5 wrote
Good I just had a doughnut.
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Tribiny t1_j1hupz2 wrote
It would help if they didn't just occasionally check A1C and call it screening either. It took a decade to be diagnosed as insulin resistant even though I'm not currently even pre-diabetic. But making a lifestyle change now will at least postpone my genetic predisposition. Without having other issues I wouldn't have learned what was causing my random weight gain. I also learned of things like Inositol that work at least as well as metformin but without the side effects and is actually just a B vitamin (it is naturally occurring in small doses). But that isn't profitable for the pharmaceutical industry...
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Twisted_Cabbage t1_j1hz6iq wrote
That's because our food and healthcare systems are the antienvy of the world. All the US does well with anymore is war.
Haunting-Tale-817 t1_j1i4ozc wrote
While not for everyone, low/no carb and high fat/protein diets have been very helpful for a lot of people with diabetes and developing self discipline. Just remember to transform the diet into a lifestyle. Taking care to monitor oneself regularly to start to ensure you go into ketosis as opposed to ketoacidosis. Food is a huge factor. Ground beef and egg prices aren’t what they used to be, but…
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JohnnnyOnTheSpot t1_j1gkm70 wrote
The best therapy is prevention
PrometheusOnLoud t1_j1gky2x wrote
Advancements in science and healthcare are meaningless if people still partake in the things that cause diabetes. The diet that lends itself to becoming diabetic is more affordable and more likely consumed by those in poverty, and the education around diet choice is less common in those in poverty as well.
Concordflyer t1_j1guzah wrote
Stop drinking sodas and juice. Also don't eat chocolate or other satisfied fats.
Alternative-Flan2869 t1_j1feo0x wrote
Better regulation on fast food ingredients would help.
Trifle_Old t1_j1fnjua wrote
All good has become sugar rich and should be regulated. Add to that the cost of insulin is insane.
grewapair t1_j1f6txg wrote
Just so that people know, the average diabetic takes 3 vials of insulin per month and Walmart charges $25 per vial.
DarkestDusk t1_j1g6dlu wrote
Yes, but those are literally the basic formula that the patent was sold for $1 so that way people's lives could be saved, and they are still charging people equivalently 25x as much as what they paid for the formula for each person who is doing what you said per vial.
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DollyPartWithOn t1_j1enpo6 wrote
You need added sugar and junk food taxes so people consume less of these things. Even pure sugar and white flour should get taxed. Meanwhile, healthy snacks like veggies, fruit, popcorn, diet soda, and carbonated water can all receive subsidies along with whole grain bread and artificial sweeteners.
-Stahl t1_j1esvnd wrote
Because Americans are too fat and have no regard for their health.
Source: I’m and American.
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VergesOfSin t1_j1eff9c wrote
lets not forget that type 2 diabetes is 100 percent reversible.
lame-borghini t1_j1e1l63 wrote
Advancements in science, technology, and medicine are meaningless when the barriers are too high for the average person to access them, color me shocked!