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This is a follow up post from “The Unreasonable Math of Type 1 Diabetes” (https://maori.geek.nz/the-unreasonable-math-of-type-1-diabetes-8c96bdf5b7fb https://ma

This is a follow up post from “The Unreasonable Math of Type 1 Diabetes” (https://maori.geek.nz/the-unreasonable-math-of-type-1-diabetes-8c96bdf5b7fb https://maori.geek.nz/the-unreasonable-math-of-type-1-diabet...). It is more about the long term complications of T1D and the way we have adapted our strategies to minimize them.

vertis 4y ago
It's an absolutely amazing read. Not really a useful comment, because I lack anything useful to say. ¯\_(ツ)_/¯
- grahar64 4y ago
  It’s better than the pro eugenics discussion above this comment. Cheers :)
agileAlligator 4y ago
- iLoveOncall 4y ago
  That's kinda the feeling I got from reading the post. Eugenics is a part of science deemed immoral and forever shunned because associated with the nazis, but maybe it would be good if we had made enough progress to avoid babies that come near death 4 times a day every day and require their two parents to be dedicated to their care 24/7.
  - consp 4y ago
    I've had this argument before: If you argue eugenics then you should really look into your family history and be 100% sure no-one has any "defects" anywhere. Most people who argue it have either needed some form of intervention somewhere in their lives to fix a "defect" and in other cases one of their predecessors and would they be unwanted in the eugenics-fanatics eyes. (Reflection usually works quite well with when someone is reasoning for eugenics)
    - iLoveOncall 4y ago
      Well that's a pretty week argument. Yeah sure if we killed every baby to be that had a defect I probably wouldn't exist. But I wouldn't care, because I wouldn't exist. Note I'm not saying to kill those unborn children, I'm saying that if this medical field had not been completely put to a stop following WW2, we wouldn't have to kill unborn children but we could do in utero interventions to prevent those conditions from developing. "Kill the babies" is the current state of eugenics because it has been at a full stop for more than half of a century. That's my point.
    - agileAlligator 4y ago
      Eugenics doesn't necessarily mean kill the baby. It meant that in the past only because science wasn't advanced enough. Techniques to modify the human genome exist; we could potentially "fix" the bad genes without killing the child.
  - borski 4y ago
    How many diabetic scientists and engineers have there been that have changed the world for the better?
    - iLoveOncall 4y ago
      Probably not as many as diabetic terrible people? I'm not saying to kill those unborn children, I'm saying that if this medical field had not been completely put to a stop following WW2, we wouldn't have to kill unborn children but we could do in utero interventions to prevent those conditions from developing.
      - valarauko 4y ago
        How, though? It's not like we've had the ability to diagnose the majority of these diseases in utero until fairly recently, nor have we the means to intervene, even now. CRISPR as a tool has existed for just over a decade, and we're still very far from the ability to reliably modify fetuses, even in lab animals, and it's been only possible for, what, 5 years now? Lab research did not stop after WW2, and even then we've barely gotten to this point. The ability to sequence the whole genome and find mutations for the major disorders is still a far off goal. The majority of disorders are now known to be polygenic, affected by hundreds of different gene variants, with each population group seemly affected by different groups of genes. Nor have we settled on a definitive group of gene variants that can reliably be identified to be deterministic of any widely distributed disorder, outside a small handful like CF and DMD.
    - agileAlligator 4y ago
      I am not saying we should let diabetic babies die at birth. I am simply reflecting upon the fact that their genes would have been removed from circulation in the past; this is no longer the case. If we disallow nature from taking its course, it will have consequences on "genetic quality". Following that train of thought and assuming we don't want to kill genetically malformed babies, an alternate route must be chosen. Better in-utero screening, CRISPR to fix the deformed genes, etc.
      - 4y ago
- datapolitical 4y ago
  Except type one diabetes is only partially affected by genetics. A woman with type one diabetes has less than a 4% chance of passing it to her child. The biggest risk right now to our genetic success is overwhelmingly the fact that the people most likely to reproduce are the ones with the least amount of education.
  - mschuster91 4y ago
    > The biggest risk right now to our genetic success is overwhelmingly the fact that the people most likely to reproduce are the ones with the least amount of education. Idiocracy wasn't a dystopia, it is a documentary... Sarcasm aside: A low amount of education is not really related to genetics (some forms of inheritable mental health issues aside). There are, however, extremely strong correlations with poverty: - poor families tend to live in areas with underfunded and thus lower-quality public schools, whereas rich people have better schools and can afford after-school private education - poor families tend to have issues with food security, which was brutally shown by covid as schools had to stay open simply so that the children could have at least one warm, somewhat healthy meal a day - poor families often tend to send their children off to work as soon as they can and are legally allowed to, simply to help make ends meet. That leaves them less time for homework and learning (leading to lower grades), and not being able to pursue higher education at all because having a job to survive is more important, which in turn locks them out of higher-paying careers and sets them up for being poor for life
    - mlyle 4y ago
      > A low amount of education is not really related to genetics Intelligence in adulthood is overwhelmingly heritable. Environmental and upbringing effects are small. Twin studies, unrelated sibling studies, etc, demonstrate very large effects. (Oddly enough, intelligence in childhood does seem to be very influenced by environment, but by adulthood your genetic destiny takes hold). Intelligence is also the biggest single predictor of your child's educational attainment-- even bigger than SES. Of course, it's not really clear what one can do with this information that is both ethical and useful. A confound: severe neglect and abuse is known to permanently reduce intelligence, and this is much less represented in adoption studies because of parental screening and social worker follow-up.
- whostolemyhat 4y ago
  What a stupid thing to say
- grahar64 4y ago
  Pro Eugenics comment to a post about keeping my kid alive. Wow!
  - sunmag 4y ago
    These comments and thoughts will come at you. You will quickly find reasons to dismiss them as noise. - father of T1D son.
  - agileAlligator 4y ago
- piokoch 4y ago
  I think we no longer aim at purely physical strength. In the old days person who was not able to work on the field, in the garden, have 10 kids, hunt, fight was useless. This is no longer the case, maybe those kids when they grow up will be scientists or artists, maybe they will make our lives much better.
robocat 4y ago
Perhaps add “article author” or something similar, as it is not obvious on some of your comments. Thank you for your write up about such a personal topic.
shagie 4y ago
(hmm, visited link)... ahh. For other people passing through the comments, that post was on HN several months ago https://news.ycombinator.com/item?id=30376777 https://news.ycombinator.com/item?id=30376777 with 673 points and 304 comments. There is a lot of interesting material in there to read too.

vertis 4y ago

It's an absolutely amazing read. Not really a useful comment, because I lack anything useful to say. ¯\_(ツ)_/¯

grahar64 4y ago
It’s better than the pro eugenics discussion above this comment. Cheers :)

agileAlligator 4y ago

iLoveOncall 4y ago
That's kinda the feeling I got from reading the post. Eugenics is a part of science deemed immoral and forever shunned because associated with the nazis, but maybe it would be good if we had made enough progress to avoid babies that come near death 4 times a day every day and require their two parents to be dedicated to their care 24/7.
- consp 4y ago
  I've had this argument before: If you argue eugenics then you should really look into your family history and be 100% sure no-one has any "defects" anywhere. Most people who argue it have either needed some form of intervention somewhere in their lives to fix a "defect" and in other cases one of their predecessors and would they be unwanted in the eugenics-fanatics eyes. (Reflection usually works quite well with when someone is reasoning for eugenics)
  - iLoveOncall 4y ago
    Well that's a pretty week argument. Yeah sure if we killed every baby to be that had a defect I probably wouldn't exist. But I wouldn't care, because I wouldn't exist. Note I'm not saying to kill those unborn children, I'm saying that if this medical field had not been completely put to a stop following WW2, we wouldn't have to kill unborn children but we could do in utero interventions to prevent those conditions from developing. "Kill the babies" is the current state of eugenics because it has been at a full stop for more than half of a century. That's my point.
  - agileAlligator 4y ago
    Eugenics doesn't necessarily mean kill the baby. It meant that in the past only because science wasn't advanced enough. Techniques to modify the human genome exist; we could potentially "fix" the bad genes without killing the child.
- borski 4y ago
  How many diabetic scientists and engineers have there been that have changed the world for the better?
  - iLoveOncall 4y ago
    Probably not as many as diabetic terrible people? I'm not saying to kill those unborn children, I'm saying that if this medical field had not been completely put to a stop following WW2, we wouldn't have to kill unborn children but we could do in utero interventions to prevent those conditions from developing.
    - valarauko 4y ago
      How, though? It's not like we've had the ability to diagnose the majority of these diseases in utero until fairly recently, nor have we the means to intervene, even now. CRISPR as a tool has existed for just over a decade, and we're still very far from the ability to reliably modify fetuses, even in lab animals, and it's been only possible for, what, 5 years now? Lab research did not stop after WW2, and even then we've barely gotten to this point. The ability to sequence the whole genome and find mutations for the major disorders is still a far off goal. The majority of disorders are now known to be polygenic, affected by hundreds of different gene variants, with each population group seemly affected by different groups of genes. Nor have we settled on a definitive group of gene variants that can reliably be identified to be deterministic of any widely distributed disorder, outside a small handful like CF and DMD.
  - agileAlligator 4y ago
    I am not saying we should let diabetic babies die at birth. I am simply reflecting upon the fact that their genes would have been removed from circulation in the past; this is no longer the case. If we disallow nature from taking its course, it will have consequences on "genetic quality". Following that train of thought and assuming we don't want to kill genetically malformed babies, an alternate route must be chosen. Better in-utero screening, CRISPR to fix the deformed genes, etc.
    - 4y ago
datapolitical 4y ago
Except type one diabetes is only partially affected by genetics. A woman with type one diabetes has less than a 4% chance of passing it to her child. The biggest risk right now to our genetic success is overwhelmingly the fact that the people most likely to reproduce are the ones with the least amount of education.
- mschuster91 4y ago
  > The biggest risk right now to our genetic success is overwhelmingly the fact that the people most likely to reproduce are the ones with the least amount of education. Idiocracy wasn't a dystopia, it is a documentary... Sarcasm aside: A low amount of education is not really related to genetics (some forms of inheritable mental health issues aside). There are, however, extremely strong correlations with poverty: - poor families tend to live in areas with underfunded and thus lower-quality public schools, whereas rich people have better schools and can afford after-school private education - poor families tend to have issues with food security, which was brutally shown by covid as schools had to stay open simply so that the children could have at least one warm, somewhat healthy meal a day - poor families often tend to send their children off to work as soon as they can and are legally allowed to, simply to help make ends meet. That leaves them less time for homework and learning (leading to lower grades), and not being able to pursue higher education at all because having a job to survive is more important, which in turn locks them out of higher-paying careers and sets them up for being poor for life
  - mlyle 4y ago
    > A low amount of education is not really related to genetics Intelligence in adulthood is overwhelmingly heritable. Environmental and upbringing effects are small. Twin studies, unrelated sibling studies, etc, demonstrate very large effects. (Oddly enough, intelligence in childhood does seem to be very influenced by environment, but by adulthood your genetic destiny takes hold). Intelligence is also the biggest single predictor of your child's educational attainment-- even bigger than SES. Of course, it's not really clear what one can do with this information that is both ethical and useful. A confound: severe neglect and abuse is known to permanently reduce intelligence, and this is much less represented in adoption studies because of parental screening and social worker follow-up.
whostolemyhat 4y ago
What a stupid thing to say
grahar64 4y ago
Pro Eugenics comment to a post about keeping my kid alive. Wow!
- sunmag 4y ago
  These comments and thoughts will come at you. You will quickly find reasons to dismiss them as noise. - father of T1D son.
- agileAlligator 4y ago
piokoch 4y ago
I think we no longer aim at purely physical strength. In the old days person who was not able to work on the field, in the garden, have 10 kids, hunt, fight was useless. This is no longer the case, maybe those kids when they grow up will be scientists or artists, maybe they will make our lives much better.

robocat 4y ago

Perhaps add “article author” or something similar, as it is not obvious on some of your comments. Thank you for your write up about such a personal topic.

shagie 4y ago

(hmm, visited link)... ahh. For other people passing through the comments, that post was on HN several months ago https://news.ycombinator.com/item?id=30376777 https://news.ycombinator.com/item?id=30376777 with 673 points and 304 comments. There is a lot of interesting material in there to read too.