The fat thing mentioned in the post: fat seems to slow down absorption in my experience, though not to the extreme that some self-described “body hackers” (who don’t have DM) seem to think.
I basically consider my malfunctioning pancreas to have been replaced/augmented by my brain, assisted by a cgm. My diet is rather boring but keeps me alive and keeps the BG in a pretty tight range.
My biggest problems are hypo (usually due to being in “flow” for long periods…bliss) and DKA (when I’m backpacking or on long bike rides, which my doctor recommends I not do, but I do anyway).
I've never had DKA in 12 years. How does it happen? I've been on CGM (Libre/Dexcom) and it's impossible to get high enough values unnoticed to end up with ketoacidosis for me. Even before with sticks, I just measured often enough.
Would be really curious to know more how DKA happens to you!
Just living my life in an urban setting it’s never been a problem.
Had a serious episode about a month ago (ketones at 9 mmol/L). I was on a short backpacking trip with some friends: four 15 mile days. I don’t carry a lot of carbs. My pen became hot despite my best efforts.
Had another episode earlier in the year in a similar trip backpacking in the snow — shorter distance, harder work; my meter froze and stopped working so I don’t know BG level. On the second day my pen got “slushy” even though I carried it next to my body/in sleeping bag.
My understanding is that in these cases your liver starts out dumping glycogen into the bloodstream but reserves are exhausted and so you start going into ketosis. I don’t understand the mechanism under which my glucose then hikes — some stress reaction?
This is generally scary for my companions but not for me as I am a bit confused, falling over etc. The only feasible way out was to hike. Fortunately on the first trip we had adequate water access so I drank (and pissed out) about a litre a mile.
Thanks that's great context! I don't think I've been out as long in similarly harsh conditions.
I always carry plenty of backups, usually duplicates, because CGM sensors can fall off and it happens that I screw up the insertion, so having at least one is good. Also I always carry some old-style sticks with me as backup.
To prevent freezing/overheating of insulin, I'd probably pop some vials into a small thermos filled with room temperature water. Just dropping into a bottle of water is also better than leaving exposed to air.
See, that's the thing. I've had T1D for 26 years now and I have stubbornly refused to accept that it's not a smart idea to eat anything I want. I am not going to give up hash browns until I lose a leg.
Interesting; as a non-diabetic, there are lots of (nice) things I don't eat regularly (pretty rarely in reality) for general health reasons. Hash browns aren't a particular thing for me, but they'd definitely be on my 'not regularly' list (deep fried, comparatively simple carbs, lots of salt, etc.)
Genuine question, not trying to 'gotcha': do you think your stubbornness in this regard was somehow accentuated by having T1D? Is this perhaps a recognised phenomenon amongst diabetics? (An old friend with T1D was similarly [maybe even more extremely] stubborn, being perhaps the most badly-behaved and impulsive of our friend group at that time.)
It's just a response to the constant frustration of feeling limited, especially by something arbitrary. If I got told randomly that now every single family gathering, social event, date, drink with the boys, exercise routine, and road trip must circle around a chronic health condition that I must make conscious decisions around every day all day for the rest of my life, it makes total sense for me to occasionally go "fuck it".
I understand (as much as I can) that it must be very frustrating, as you outline. However, the post I was asking the question of sounded a step or two beyond occasionally saying "fuck it" (which we all do, I suspect, whatever out motivation for health conscious behavior):
> I have stubbornly refused to accept that it's not a smart idea to eat anything I want. I am not going to give up hash browns until I lose a leg.
Maybe I'm over-interpreting a single line of text on an internet forum, but this sounds like more of a policy than an occasional lapse.
As long as you measure often and inject control amounts liberally eating pretty much everything is fine. I think the diet restrictions were very much necessary before frequent testing and fast acting insulins were available.
I basically consider my malfunctioning pancreas to have been replaced/augmented by my brain, assisted by a cgm. My diet is rather boring but keeps me alive and keeps the BG in a pretty tight range.
My biggest problems are hypo (usually due to being in “flow” for long periods…bliss) and DKA (when I’m backpacking or on long bike rides, which my doctor recommends I not do, but I do anyway).