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Friend, you’re diabetic. Your survival is ultimately your own responsibility. Prepare yourself for a few hard truths. No one — including nurses and doctors wh

Friend, you’re diabetic. Your survival is ultimately your own responsibility. Prepare yourself for a few hard truths. No one — including nurses and doctors who are not specifically trained in diabetes management — truly knows your situation. I had a TIA. I was barely functioning, hospitalized, semi-conscious. Not a single person in the ER, nor during the entire week I was admitted, stopped to think that maybe I wasn’t mentally fit to manage my own CGM. Always be prepared. I once found myself in what my company had sold to me as a “hotel” in Germany. It was really more of a shack. I was having a severe hypo, glucose at 70 and dropping fast. There was no lobby, everything was closed, emergency services didn’t speak English, and I couldn’t even find a taxi willing to come out there. I ended up licking sugar crumbs and biscuit dust that had accumulated over the years in the pocket of my suitcase. Your CGM can fail. In fact, it will almost certainly fail while you’re on vacation on some Greek island with no signal. You must know how to manage your blood sugar with insulin pens. Even with different insulin types. You need conversion charts. You need the phone number of your diabetes center so you can get proper instructions. You must be able to change an infusion set in the dark, slightly drunk, like Rambo — except this isn’t a movie. You need to remember your insulin-to-carb ratio and be able to estimate the carbohydrates in a dish you’ve never seen before. I’m lucky enough to be able to “feel” my blood sugar. More importantly, I can sense when I’m heading toward a hypo, and I do everything I can to preserve that personal superpower. As we say in Italy, being diabetic is serious business. My colleagues and friends see only the outside. They see a well-managed condition, an HbA1c of 6. They laugh when I tell some of the more extreme stories. But they have no idea — absolutely no idea — how difficult our lives are. Ours, and our families’.

UomoNeroNero 4mo ago
Oh, and one more thing. I always keep a blood glucose meter in my backpack. You know, that medieval-age stuff with the finger-pricker and test strips. (You can buy one for about €10 in pretty much any pharmacy in Europe, but it’s better to already have one with you.) And pen needles, too.
- UomoNeroNero 4mo ago
  P.S. As a European, I genuinely struggle to understand how you cope with your healthcare situation. In France, in a small mountain village, I walked into a pharmacy and, through a combination of gestures and sketches, managed to buy a box of rapid-acting insulin at full price (around €30–40). The insulin was clearly available. The issue was purely bureaucratic — technically I needed a prescription from a French doctor. But the urgency of the situation, and the fact that I was obviously diabetic, were equally obvious. We certainly have our own problems over here, don't get me wrong. But I don't envy yours.
  - georgemcbay 4mo ago
    > As a European, I genuinely struggle to understand how you cope with your healthcare situation. As an American, most Americans don't realize how bad it is because everything seems fine when you are insured and only need basic care. The huge problems aren't immediately apparent until you suddenly get diagnosed with something serious and become a cost center for your private insurer instead of pure profit for them. At that point they realize how fucked they are and how much the insurance company will fight tooth and nail to deny care. Everyone else tries to ignore how fucked those people are out of superstitious belief that maybe they too will fall into the Unfortunate Situation group if they think about it too much.
  - s5300 4mo ago
    [dead]
  - cm2012 4mo ago
    In the US every CVS had rapid acting insulin for $35 for one month supply. This is not special to europe.
    - gusgus01 4mo ago
      Are you talking about the Lilly Insulin Value Program? If you're uninsured, you do need to get the savings card but it's mostly a matter of filling out the form. And that's only since they started the program in 2020.
deleted 4mo ago
[deleted]
Neywiny 4mo ago
You didn't bring glucose tabs or glucagon with you or get more when you ran out? Was it an overconfidence in your ability to feel low?
- chopete3 4mo ago
  Exactly my question. Something is missing in this story. We carry a bag of sugar, juice mix, biscuits and candy
  - Rapzid 4mo ago
    Until you don't. Then you'll have a story with something missing.
  - kotaKat 4mo ago
    DR doesn't just stand for 'disaster recovery', it's 'didn't realize'. It'll always be the one day you didn't realize you forgot the kit...
    - UomoNeroNero 4mo ago
      Yes. Really
- ninjin 4mo ago
  As a type-1 diabetic, in my experience it is perfectly possible to end up in a situation like this even if you are responsible. Remember, type-1 diabetes is a condition that requires your attention tens if not a hundred times per day. This is not just on good days, but also on your very worst days when you are juggling everything else that life throws at you and you may not have slept properly for days. So, maybe you had noticed that your emergency glucose was low, but in this instance out of a hundred you forgot to replace it when you came home because you were exhausted and then overslept and had to rush out in the morning. What makes type-1 diabetes challenging is not that you can not technically manage every single one of the decisions and actions that it demands out of you, it is that you must carry them out under all conditions and largely without fail for every day in your life or you will suffer both short-term and long-term consequences. Everyone I know has had a nightmare episode. Just a final recent anecdote to illustrate some of the complexity. It may look like maths on the surface, but even something like "carbohydrate ratio" is a fluid concept. Yesterday for example I was out and about in the sun and had the very same bottle of sweet tea that I have had for months. Given that I knew I was physically active and it was hot, I reduced the usual dosage for this specific drink by 80% to be on the safe side. To my surprise, on this particular day for whatever reason this was still far too much and I pushed myself into hypoglycemia in little over an hour. We humans are highly dynamic and complex systems and this is me failing with the very best technology we have available: Insulin pump and continuous glucose monitor.
mettamage 4mo ago
> while you’re on vacation on some Greek island with no signal. Not diabetic but my car was stuck on a mountain on a Greek island with no signal. In hindsight it was fun, but when it happened I initially feared for my health. We were at the highest road stuck in the snow with a car that had no business being in snow. Luckily my wife is a born and raised Michigander and she showed my Dutch ass how to handle real snow. She started digging in the mountain side to grab as much small rocks as possible since every Michigander has cat litter so that wheels can get traction. Without it, we would still be stuck.
DennisL123 4mo ago
> Friend, you’re diabetic. Your survival is ultimately your own responsibility. Prepare yourself for a few hard truths. This.
jeffwask 4mo ago
The thing that struck me most was that for 25 of 27 years, they have relied entirely on machines and computers to manage the condition which means every hard-earned lesson you have experienced they did not and the author likely has very little person knowledge and experience on how to do anything off the pump. It's the AI argument in a nutshell. We are handing things off to machines and losing the knowledge to do it ourselves. Imagine if this were a systemic catastrophic failure, that lasted months... how many people would perish just because they weren't taught or never learned how to manage without the machine.

UomoNeroNero 4mo ago

Oh, and one more thing. I always keep a blood glucose meter in my backpack. You know, that medieval-age stuff with the finger-pricker and test strips. (You can buy one for about €10 in pretty much any pharmacy in Europe, but it’s better to already have one with you.) And pen needles, too.

UomoNeroNero 4mo ago
P.S. As a European, I genuinely struggle to understand how you cope with your healthcare situation. In France, in a small mountain village, I walked into a pharmacy and, through a combination of gestures and sketches, managed to buy a box of rapid-acting insulin at full price (around €30–40). The insulin was clearly available. The issue was purely bureaucratic — technically I needed a prescription from a French doctor. But the urgency of the situation, and the fact that I was obviously diabetic, were equally obvious. We certainly have our own problems over here, don't get me wrong. But I don't envy yours.
- georgemcbay 4mo ago
  > As a European, I genuinely struggle to understand how you cope with your healthcare situation. As an American, most Americans don't realize how bad it is because everything seems fine when you are insured and only need basic care. The huge problems aren't immediately apparent until you suddenly get diagnosed with something serious and become a cost center for your private insurer instead of pure profit for them. At that point they realize how fucked they are and how much the insurance company will fight tooth and nail to deny care. Everyone else tries to ignore how fucked those people are out of superstitious belief that maybe they too will fall into the Unfortunate Situation group if they think about it too much.
- s5300 4mo ago
  [dead]
- cm2012 4mo ago
  In the US every CVS had rapid acting insulin for $35 for one month supply. This is not special to europe.
  - gusgus01 4mo ago
    Are you talking about the Lilly Insulin Value Program? If you're uninsured, you do need to get the savings card but it's mostly a matter of filling out the form. And that's only since they started the program in 2020.

deleted 4mo ago

[deleted]

Neywiny 4mo ago

You didn't bring glucose tabs or glucagon with you or get more when you ran out? Was it an overconfidence in your ability to feel low?

chopete3 4mo ago
Exactly my question. Something is missing in this story. We carry a bag of sugar, juice mix, biscuits and candy
- Rapzid 4mo ago
  Until you don't. Then you'll have a story with something missing.
- kotaKat 4mo ago
  DR doesn't just stand for 'disaster recovery', it's 'didn't realize'. It'll always be the one day you didn't realize you forgot the kit...
  - UomoNeroNero 4mo ago
    Yes. Really
ninjin 4mo ago
As a type-1 diabetic, in my experience it is perfectly possible to end up in a situation like this even if you are responsible. Remember, type-1 diabetes is a condition that requires your attention tens if not a hundred times per day. This is not just on good days, but also on your very worst days when you are juggling everything else that life throws at you and you may not have slept properly for days. So, maybe you had noticed that your emergency glucose was low, but in this instance out of a hundred you forgot to replace it when you came home because you were exhausted and then overslept and had to rush out in the morning. What makes type-1 diabetes challenging is not that you can not technically manage every single one of the decisions and actions that it demands out of you, it is that you must carry them out under all conditions and largely without fail for every day in your life or you will suffer both short-term and long-term consequences. Everyone I know has had a nightmare episode. Just a final recent anecdote to illustrate some of the complexity. It may look like maths on the surface, but even something like "carbohydrate ratio" is a fluid concept. Yesterday for example I was out and about in the sun and had the very same bottle of sweet tea that I have had for months. Given that I knew I was physically active and it was hot, I reduced the usual dosage for this specific drink by 80% to be on the safe side. To my surprise, on this particular day for whatever reason this was still far too much and I pushed myself into hypoglycemia in little over an hour. We humans are highly dynamic and complex systems and this is me failing with the very best technology we have available: Insulin pump and continuous glucose monitor.

mettamage 4mo ago

> while you’re on vacation on some Greek island with no signal. Not diabetic but my car was stuck on a mountain on a Greek island with no signal. In hindsight it was fun, but when it happened I initially feared for my health. We were at the highest road stuck in the snow with a car that had no business being in snow. Luckily my wife is a born and raised Michigander and she showed my Dutch ass how to handle real snow. She started digging in the mountain side to grab as much small rocks as possible since every Michigander has cat litter so that wheels can get traction. Without it, we would still be stuck.

DennisL123 4mo ago

> Friend, you’re diabetic. Your survival is ultimately your own responsibility. Prepare yourself for a few hard truths. This.

jeffwask 4mo ago

The thing that struck me most was that for 25 of 27 years, they have relied entirely on machines and computers to manage the condition which means every hard-earned lesson you have experienced they did not and the author likely has very little person knowledge and experience on how to do anything off the pump. It's the AI argument in a nutshell. We are handing things off to machines and losing the knowledge to do it ourselves. Imagine if this were a systemic catastrophic failure, that lasted months... how many people would perish just because they weren't taught or never learned how to manage without the machine.