via @NYTimes
nytimes.com/2022/08/09/hea…

I have not watched this documentary yet. As someone who lives w/ #Type1Diabetes I have a few immediate thoughts based on this article.
If I had a dollar for every “expert” in the field who told me it would be 5 years until there is a cure…

Some of you are reading this right now.

You were wrong & are still wrong. And as the article brings up it is psychologically exhausting & harmful. Stop.
T1 & T2 diabetes are very different diseases.

They can coexist.

Pathophysiology of both is complex.

I have lost close friends & family to complications of both types. Including my sister. I am now raising her kids.

T1 is far less common & many wish it had a different name.
Current diabetes technology is life changing.

I would never want to go back to life without a CGM.

This was the first big decrease in the psychological toll of having T1DM.

This technology has improved significantly. I trust it now but know when not to.
Looping is the next tremendous advancement.

Most of this work was done by the T1 community #doc themselves. Not industry.

Some in healthcare refused to see those who looped. Because as life changing as it was, it emerged through non-traditional pathways.
I was ambivalent about having a pump before #looping

Dramatic decrease in the cognitive burden with #Looping.

Industry is catching up & this is now mainstream. I may switch to a commercially available system.
It remains controversial but diet can make a difference w/ T1DM.

The strategies we published w/ @davidludwigmd are not for everyone. The low carb community often acts like they are. It can be hard. Cognitive load is cognitive load (diet or drugs).

pubmed.ncbi.nlm.nih.gov/29735574/
I was STRICT LC for a long time. I am much more flexible with my diet now with #CGM & #looping.

That “freedom” is remarkable.

No question BG is easier to manage w/ insulin w/ fewer carbs. Anecdotally hypos are less frequent too.

But it is nice to just “eat” sometimes.
I still use LC strategies at times myself & with patients. It can be very helpful for weight loss & with T2DM. There are other benefits. It is a tool. It is not the only tool. I am not getting into the weeds of that here.
It is important for people living with Type 1 to have options and choices in managment.

It is important for their healthcare team to support those choices & be knowledgeable.

It is infuriating that some Endo practices limit even pump choices to their patients.
Dealing with insurance companies is it’s own special exhausting hassle.

Pulling the insulin $35 price cap is unforgivable.
“Even with all the advances in care, only about 20 percent of adults with Type 1 are able to maintain healthy blood sugar levels, according to a 2019 study.”

This is a HUGE failure of our system. It doesn’t need to be this way. Period.
All of that said, I live an amazing life w/ T1DM. I have kids at risk for T1DM (my own & my sister’s) but it does not have to limit opportunity or joy. That doesn’t mean it is easy. But w/ the right support it is manageable. That needs to be accessible to all.
There may never be a cure in my lifetime. Accepting that there won’t was honestly freeing for me.

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