Umm... glucose tablets do in fact spoil. I've never seen an unopened bottle spoil, but once they are opened they can spoil over time mostly from the humidity. I found this out the hard way.
Between this and your "humble-brag" on your other post, what I'm led to believe is that you're pretty ignorant on how variable insulin sensitivity and blood sugar management is from individual to individual.
I've maintained an A1C of less than 6.5 for more than a decade so I'm the picture of "perfect" control and I can tell you that physical activity is a pain in the ass. I'm hypersensitive to insulin during physical activity. When I go to the gym I want zero insulin on board because just 10 minutes on the treadmill could drop me from 160+ to 30. Just walking is enough to cause me to have low blood sugars, so I have to reduce or skip insulin with food accordingly. I'm required to elevate my blood sugar to 200 before I can scuba dive and then I can still only dive for a maximum of an hour because there is too much risk I will pass out and drown.
And then you say, "I am dealing with an issue where I think some of my preferred injection sites are becoming less effective". Preferred injection site? WTF dude? Of course it is becoming less effective, that is why they tell you to constantly change the location. Preferred injection sites are a huge no-no.
Soon the insurance replaces my pump to a Dana RS, which supports closed looping with AndroidAPS. Then it's just setting a temporary glucose target to a higher value and the system takes care of the basal rates to keep the glucose from dropping.
The article here is kind of weird. How am I supposed to dose e.g. 0.3 units or 0.75 units of insulin with the pills? The ability for a very fine granularity and the possibility to automate my medication are much more interesting compared to the pills mentioned in the article.
The temporary reduction or even suspension of insulin depending on my activity are key in preventing lows for me.
The closed loop pumps are the biggest improvement I've seen for living with T1. There's always lots of promises, but this is one of the few things that really improves my life on a day to day basis and it just keeps getting better.
Only the open source AndroidAPS for Android and Loop for iOS do this. And then you have a very limited set of pumps you can use.
The Tandem t slim x2 only has support for hypo prevention today, but it supports at home firmware/software updates and they are pretty far along with the FDA on getting approvals for their auto dosing for highs. They anticipate a release this summer.
I wish that OmniPod was further along on this front. I would love to have a tubeless solution and the convenience of not needing to disconnect every time I'm going to get in the water, but the trade-off just isn't worth it IMHO.
https://androidaps.readthedocs.io/en/latest/EN/Getting-Start...
I would be seriously interested in a closed loop Omnipod, but it will be awhile before I’m eligible for a new pump under insurance.
I rotate injection spots but have favorites based on convenience, sensation, etc. like anyone else. The variation in effectiveness I’m seeing is small enough that I’m not sure what’s happening yet. It’s not really a big deal because my numbers are fine.
It’s not a disease that varies so much from individual to individual that lessons can’t be learned and shared, and it’s a disservice to misrepresent the mental effort to new diabetics and people potentially lapsing into poor control.
^^ Sorry, this makes no sense at all. Maintaining a routine is one way to express a preoccupation with diabetes management!
I know this because I know diabetics who have lapsed out of control, or retreated into a rather small life, because they felt the excessive personal rules they’d either self-imposed or been taught by others were burdensome. When possible, teaching them a lighter set of principles to follow has had a positive effect.
Secondly, I think your description of diabetes is overblown. If you’re checking BGL frequently with a CGM, then you have a good understanding of what will happen in routine situations. If you’re not, you aren’t going to sweat 30 minutes in the car or the delta between the carbs from dinner plus toast and physical activity (I do like the humble-brag here, though!) because you don’t know what’s going on anyway. Hypoglycemia has the advantage of being treated with glucose tablets, which don’t spoil and can be stashed everywhere. Moderate activity and water intake are important but not going to swing your BGL wildly like a bottle of soda or an intense workout.
This disease can be a hypochondriac’s dream and I think that teaching other diabetics to be so preoccupied is dangerous to them because it increases the temptation to give up on the daily routines that actually make a difference.