More than 100M Americans have diabetes or prediabetes (2017)
cdc.gov
cdc.gov
You can quickly get a good idea about how different foods and exercises affect your blood glucose. For me it was fun and motivating. It's helped a lot to put my diabetes into complete remission. The improvement in my daily quality of life is not subtle.
Since an improvement in your insulin levels can easily add healthy years to your life, it's worth doing even if you have no diagnosis of (pre)diabetes.
In the European Union, the Freestyle Libre 3 is available and is far better technology than the Freestyle Libre 2, for a variety of reasons. This also does not require a prescription in Europe. Because I cannot get a Freestyle Libre 3 in Croatia, I order the Freestyle Libre 3 from Abbott Diabetes Care in Germany, without a prescription using a German mail forwarding service (I personally use myGermany). You can ship to the USA using this method. The pricing is also regulated by the German government, so the price of the sensor is reasonable.
I actually use 2 glucose sensors in tandem: a Freestyle Libre 3 and a Dexcom G6. The Freestyle Libre technology is better than the Dexcom. It is also, way, way, cheaper.
While these articles were for older iterations of the Dexcom and Freestyle Libre, they are still very applicable. [1] [2] [3]
I use the Dexcom because it connects to my Tandem t:slim x2 insulin pump and it creates an “artificial pancreas”. It automatically manages my blood glucose, with very little effort. I can get a 6.2 or 6.3 A1c with almost no effort, using only the Dexcom G6 sensor (no Freestyle Libre 2|3 sensor use), and I have an profoundly messed up digestive tract, that really should profoundly mess up my blood glucose values.
Anyways, the Freestyle Libre updates more frequently (1 minute versus 5 minutes) and responds to changes in blood glucose faster than the Dexcom, so I can take action and dose insulin much faster.
With the Freestyle Libre 3, used in tandem with my Tandem t:slim x2 insulin pump using artificial pancreas technology via the Dexcom, my A1c hovers around a 4.9 or 4.8.
[1] https://type1tennis.blogspot.com/2014/12/how-much-faster-is-...
[2] https://type1tennis.blogspot.com/2014/12/14-days-with-dexcom...
[3] https://type1tennis.blogspot.com/2015/02/another-view-of-fre...
Freestyle Libre has the additional feature of continuity, which IMO, is likely to be more inaccurate (generally portable models take a blood drop and give one reading, i.e., are not continuous monitors).
Any thoughts on this?
The continuous glucose monitors tend to be pretty accurate. The Mean Absolute Relative Difference (MARD) for the ascribed devices:
Freestyle Libre 3: 9.2% (in adults)
Freestyle Libre 2: 9.2% (in adults)
Dexcom G6: 9.0% (in adults)
Also, I regularly test my blood glucose using finger sticks whenever I need to take a fairly large insulin dose and there is a large amount uncertainty of where I may possibly be (such as when my two sensors have a big discrepancy, and especially when my blood glucose is fluctuating). For that, I use Freestyle Lite blood glucose test strips.
About 1 in 25 to 1 in 30 Freestyle Lite test strips I use is about 50 mg/dL off, despite me using proper testing technique, which is quite significant, since my blood glucose values are very tightly managed. It is obvious when it happens, looking at the Freestyle Libre 3 graph, and the Freestyle Libre 3 in this case keeps me from overdosing and causing a serious low.
In Australia we only have access to the Libre 1. Which is both frustrating as I’d like my girlfriend to have the ease of the Libre 2/3 (bluetooth etc) but it’s tolerable given the more open nature of the first iteration where we double the function life - essentially halving the high cost.
I’m looking at grabbing a Bubble glucose monitor (https://www.bubblan.org/) that adds bluetooth functionality to the Libre 1 amongst other monitoring etc.
Have you looked into OpenAPS / AndroidAPS to move away from the Dexcom? Still learning so this may be an overly simplistic question.
Can you call on the phone and order? Also how does it work about shipping internationally? Do they ship to Croatia or do you need to ship to a DE address first, then FWD to Croatia. Contact info in profile. If you can send me any info or tips, I would greatly appreciate.
Proof that healthy people benefit from caring about something that isn't broken?
I've used Levels, but at $400/mo, not very sustainable.
I'd have access to health insurance, I'd be happy to nag my primary care doctor for a prescription.
I’m curious as to what you mean by “remission.” Aren’t you simply making better decisions now which is reflected in your A1C and blood glucose numbers?
Are you concerned about other health parameters with your low carb diet? Like high IGF-1 or blood vessel and digestive health?
Something similar happened to me with a low carb paleo diet years later. I've had to become more extreme to succeed. But I think that's because of the damage I've done to my own metabolism with a fork and spoon, and isn't true for most people.
Most people, I think, would benefit greatly from changing to a complex carb diet from a Standard American Diet.
Things seemed to really go downhill after I tried intermittent fasting(16/8).
Can I get a prescription at Walmart? Asking because I'm in one of the several states where the cost of healthcare exceeds total earnings.
I suppose it's off to the black market to see what's available - same as everyone else around here.
You can improve your health/diabetic markers by experimenting with any or all of the following things:
1) Intermittent fasting: reduce your daily period of eating to a 6 or 8 hour window. 16/8 or 18/6. The number of hours without food or sugar or cream or diet pop versus the window of hours that you're allowed to eat during.
2) Water Fasting: Skipping food altogether. For example, a 32 hour fast. Eat dinner, then go the entire next day without food, and then eat breakfast. Regularly doing a 32 hour fast once a week can be incredibly effective. Or do a longer fast once every few months.
3) Low carb (< 20 grams), medium protein, high fat diet. Keto diet.
Why do these things help? Adult onset diabetes generally traces back to insulin sensitivity, and too much insulin in the body. Reducing the amount of insulin in your veins, reducing the insulin spikes, etc all help the body recover back to health.
Highly recommend checking Dr Jason Fung's youtube videos or book.
Curious - do you pay for your blood glucose and A1c checks out of pocket?
Fructose intake (making up at least half the sugars in most sugar sweeteners) isn't metabolized like glucose, with a delicate and specialized load response and processing. It's metabolized like alcohol in the liver and then directly converted to fat, then shoved into the blood stream. Fructose is the reason why you increasingly see non-alcoholics with "alcoholic" fatty liver.
Now, when you eat an apple, the fructose content doesn't hurt you (unless your digestive system gets issues with it), because it's processed slowly, has to be broken out of the fiber matrix and is partially broken down by bacteria. However, blending the same apple, the fructose will overload your system all the same as drinking fructose water. Btw. many "healthy sugars" actually have a worse fru:glu ratio than table sugar, e.g. agave syrup or honey.
In Canada, our CGM's are over the counter, which is pretty cool...you can get the Freestyle Libre or Dexcom CGMs right from the pharmacy without a prescription
I am offended with the intentionally slow roll when it comes to artificial pancreas solution development... moreso, the regulatory hurdles these products are being held up in.
That said, there is a willing hacker community around CGM solutions that can be dove into that yields pretty awesome results in function and hip pocket savings.
T1 is a different story.
Though I think the science on what drives hunger cravings and "willpower" and fat storage this leading to obesity is still in its infancy.
There are so many reports coming out now that diet (mostly a whole foods plant based diet) can reverse diabetes and that too in a short time. People heal faster when they remove the root cause of the problem. (bad diet)
https://nutritionfacts.org/2019/10/08/how-not-to-die-from-di...
Hard to believe not a single comment about diet (whole food plant based) from hacker news community.
The problem is that vegan or vegetarian diets will scare away many people for no good reason.
Anyway, if you want something that actually works, look at the AIP diet: https://www.thepaleomom.com/
But yeah in general I agree. It's pretty amusing how the HN crowd talks about measuring and temporary fixes like "intermittent fasting" but not at all about actually ending the poisoning by food... Yeah sure, you can do all sorts of stuff to prolong your life while stuffing yourself with poison. However the most effective way is still not to eat the god damn poison in the first place. But hey, then there would also be no engineering problem to solve and no products to sell, right?
Personally my preferences involve eating meat, and Keto was exception good at reducing my blood sugar, and many other medical issues such as hypertension. I did think about going vegetarian, but it just doesn't suit my situation.
https://www.amazon.com/Diabetes-Code-Prevent-Reverse-Natural...
Limit your fasting coffee intake as well or part of it could be caffeine/sleep crash.
And yet my friends, with more reasonable diets, tend toward diabetes or near it. I'm rather afraid for my friends.
https://www.health.harvard.edu/blog/intermittent-fasting-sur...
Type 2 is the one that can be prevented (in most cases) by diet and exercise. This article is warning that we're failing at that, by very large amounts.
Type 1 is still a large problem, but a small fraction of this problem, about 1%. You could exclude them from this number without substantially altering it.
Don’t know much about this though. Anybody think there’s something to it?