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The CDC says 34% of US adults have pre-diabetes, and of those, 88% are undiagnosed[1]. Yes, about 29% of US adults have un-diagnosed pre-diabetes, or about 74 m

• goodells 9y ago
  This sounds very interesting as another metric (like weight on a scale, as you put it) for someone trying to be conscious about their health. Is this something that a person could do cheaply at home with over-the-counter diabetic testing supplies? Could you be more specific or link to something about a protocol for e.g. measuring the effect of a meal on blood glucose and how to interpret those results?
  • troydavis 9y ago
    Disclaimer: This is not medical advice and I'm not very knowledgeable, I'm just a data and public health geek. If you believe you may have diabetes or pre-diabetes, contact a doctor. Yes, it's doable with over-the-counter products. You need a meter and lancet device, and then for each test, a single-use lancet insert (tiny needle) and test strip. These are usually bundled together in a pharmacy for $25-$75. However, if you look or ask the pharmacist, there's often a 100% money back refund right in the store. Additional test strips are $0.75-$1.75/strip in packs of 25, 50, or 100. While that sounds expensive (and for diabetics, is), for the purposes we're talking about, one could probably only test after high-carb meals and a few days of fasting readings. The included 25-50 test strips may yield enough data to act on, and if not, one more 25-50 pack probably would. https://www.diabetesselfmanagement.com/blog/what-is-a-normal-blood-sugar-level/ https://www.diabetesselfmanagement.com/blog/what-is-a-normal... has more about when to test (basically, 1 and 2 hours after the start of a meal) and what results to expect. Feel free to ask the pharmacist to show you how to use it and interpret the results. Important note: this feels nothing like a blood draw. It's barely noticeable at all and not anything I'd call painful. There's a depth adjustment on the lancet, so it's the tiniest imaginable prick on the side of a finger. It yields less than a drop of blood, then immediately closes, ie, no bandage or bleeding. I did this myself as an extension of quantified self in 2012 (https://twitter.com/troyd/status/281931325471068161 https://twitter.com/troyd/status/281931325471068161), just because I wanted to see the readings and the process. I did it again this year to see whether the testing process had improved (no) or my results had changed (no). Other than some puzzled pharmacists who aren't used to people buying a meter for cash, there's really nothing to it. It'll also give a tiny peek at a process that millions of people do all the time. It's fascinating to see how one's body responds, particularly to meals that aren't obviously unhealthy (and depending on the person, may not be). Some examples: sandwiches (especially on big hoagie/grinder-style refined bread), burritos (tortilla+rice+beans), any meals with 2 significant sources of carbs (sandwich with fries or potato, breakfast with toast and hash browns, etc), and pasta. These aren't inherently unhealthy, but they all significantly raise blood glucose, and the only way to see how much is to test. More on "glycemic load": https://www.google.com/search?q=glycemic+load https://www.google.com/search?q=glycemic+load
    • 9y ago
• jklinger410 9y ago
  Hey Troy, I'm Director of Marketing for an early stage startup focused on this exact issue. Our founder's grandmother was diagnosed type 2 and he was aggravated with the pain points in the experience, along with the lack of information and tools. Then after doing research and running a health coach practice he realized the scope of the diabetes epidemic. We're taking top notch educators and putting their knowledge in an app. We have many features to add along the way in our product map, but we're already starting to form partnerships and see value. Company is called KingFit (https://kingfit.io https://kingfit.io). Drop me a line and I'd love to introduce you to the founders.
• iamt2 9y ago
  For most newly-diagnosed Type 2's, the disease management information out there, especially on the ADA, is terrible. Meter and strip accuracy is more off-kilter than many realize; calibrate against a venous draw-based blood glucose test. To calibrate my meter on a fine scale, I manipulated my glucose into multiple ranges, and went in for a venous draw each time on my own out-of-pocket money: 120+, 70-120, 60-69, 50-59, 40-49, 20-39. The last four required a water fast at one, two, three and four weeks, respectively. My meter and strips have to be adjusted +20 for 70 and up readings, but only +10 for 60-69 readings. If you're just curious, buy a starter meter kit over the Net (cheaper than what you can usually find in the pharmacies), and whatever reading you get, fudge it by about 10-15 points; you really want to see the trend, not an individual specific number at a single point in time. Most doctors won't know about various antibody tests that can help refine a diagnosis, and avoid a mis-diagnosis of Type 2 when you really have adult-onset Type 1. If you test pre-diabetic, search on diabetes antibody tests. Fastest results back to "normal" for most (not all) Type 2 and pre-diabetics come from cutting out net carbohydrates (far below what the ADA recommends), combined with strength training (weightlifting) and supplementing with HIIT cardio. It takes a serious time commitment to do that: 90-120 minutes a day, 3-5 days a week. While I'm diagnosed Type 2 for over three years, for the past two I've not been on any medications, my post-meal ("post-prandial" in medical lingo) glucose stays below 90 at one and two hours after the meal, A1c is 5.3, and cholesterol numbers are in the normal range; I keep my net carbohydrates below 20g per day, roughly half a single, unadorned bagel (my diet is mostly animal protein and green leafy vegetables). Intermittent Fasting helps, as does outright water fasting for 24 hours or longer, for many (again, not all) people. My personal big revelation was learning the difference from limbic and true hunger, and my personal satiation patterns. Calories In Calories Out is true, but a vast over-simplification because it doesn't address the satiation issue. For me personally, I've settled on hitting at least 200g of animal protein per day, and as much Romaine hearts as I want, with 28g of grated Parmesan and a tablespoon of Caesar dressing on the side, mixed together and used a dip for the Romaine hearts. After that, I can manage the satiation issue with ancillary food. YMMV. There isn't one single treatment path for everyone, though there are lots of commonalities; I suspect diabetes is a catch-all for a class of a multitude of metabolic disorders, either that or our individual body metabolisms are more wildly different than medical science admits so far. The key to getting back into the normal ranges is apply the scientific method to your body, try one change at a time, measure, repeat.
• bcoates 9y ago
  You can do an a1c test at home or in the doctor to identify chronically elevated glucose (prediabetes). It's insensitive to time of day or fasting status you can just take it every few years or so at your convenience. Continuous blood sugar monitoring is probably overkill given how easy and cheap a1c tests are now. Blood pressure, on the other hand, is still a nightmare. A good way of reliably and simply measuring resting blood pressure would be a game-changer.
  • electriclove 9y ago
    A1c test at home? I had no idea, thanks for sharing this!
  • troydavis 9y ago
    Any location of the AnyLabTestNow nationwide lab network will also do an A1c test for about $50. They don’t require ID or a real name, just bring the receipt to pick up your results.
    • occultist_throw 9y ago
      Kind of pricy, to be honest. Walmart has an A1C test for $30. Although if they offer other tests, it could be useful.