[HN Gopher] How I keep myself alive using Golang
       ___________________________________________________________________
        
       How I keep myself alive using Golang
        
       Author : ingve
       Score  : 653 points
       Date   : 2024-03-04 22:42 UTC (1 days ago)
        
 (HTM) web link (www.bytesizego.com)
 (TXT) w3m dump (www.bytesizego.com)
        
       | lol768 wrote:
       | I went to Open Data Camp in the UK in 2023 and there was an
       | interesting talk from two attendees with Type 1 diabetes about
       | how locked down a lot of these devices are from a data
       | perspective, which seems like a real shame - particularly when
       | it's your own health data they're collecting!
       | 
       | CGM devices seems like the gold standard in terms of what they're
       | natively capable of (and you don't need something separate on top
       | of a flash sensor) and I think they're free on the NHS. Lots of
       | them have companion smartphone apps, so you'd assume that it's
       | possible to reverse engineer whatever API that these apps are
       | using in order to get at the raw data. Dexcom seemingly does have
       | an API, but it only works if you're located in the US.
        
         | secabeen wrote:
         | From what I've gathered, the community has largely given up on
         | trying to get at the raw data through Libre and Dexcom. That's
         | not going to work in the long run, as Dexcom or Libre could cut
         | it off at any time. The smarter solution is just to reverse-
         | engineer the software component of these systems and take
         | Dexcom/Libre out of the equation, or (even better) run a
         | parallel system that does the data exporting you want. There
         | are a number of open source solutions in this area. No
         | guarantee that your physician will accept these, but they are
         | pretty interesting, and very feature rich.
        
           | croemer wrote:
           | T1D here. Luckily not true, exporting works well at least for
           | Dexcom on Android with https://www.patreon.com/byod
           | 
           | It's a patched app that broadcasts values it receives to any
           | app that's listening, e.g. xdrip.
           | 
           | Libre 2 has also got patches floating around on the internet.
        
           | selimthegrim wrote:
           | I worked for a company that had licenses for Libre, Insulet
           | and Dexcom and we had their serial APIs - but you had to plug
           | it in to your computer, store the data at our colo and use a
           | Java applet to view it in the browser. In 2014.
           | Unsurprisingly mobile apps have had more uptake since.
        
       | chewxy wrote:
       | I talked to Matt about not owning our own data after GopherConSG
       | where he gave this talk. It was enlightening how complicated the
       | issue is - there's a lot of legal liabilities on the end of the
       | data provider (the company that monitors the glucose) so I can
       | understand why larger corps are a bit hesitant to open up.
       | 
       | On the other hand, it seems quite heinous that users don't have
       | access to data that is rightfully theirs that they can action on
       | it.
        
         | yndoendo wrote:
         | I never understood this. Would this be like buying a BIC pen
         | and they have a required license agreement where any entropy
         | made with the pen is owned not by the creator of the data but
         | by the creator of the tool used? With out the person the data
         | would not exists.
        
         | mattboyle wrote:
         | Hey Chewy! Good to see you here :)
        
       | secabeen wrote:
       | This is interesting, but is there a reason that you didn't
       | explore the open source software in this space (Nightscout,
       | xDrip, etc.)? These aren't new problems, and lots of people have
       | solved them already with much more feature-full solutions that
       | just work.
        
         | mattboyle wrote:
         | I did explore them; for what I wanted to do I could build it
         | faster from scratch and it was a fun learning experience
        
       | princevegeta89 wrote:
       | After messing around with Elixir, I decided on my own that the
       | Elixir ship wasn't worth it for me and I moved on to typescript.
       | 
       | Now I am debating between Rust and Go for backend development
       | (for a web service). Which one between these two would be
       | recommended for my needs? My priorities are to be able to learn
       | quickly and develop/iterate as fast as possible.
        
         | not-my-account wrote:
         | Go is probably your choice, it was stupid fast to pick up. It's
         | a fun language too
        
           | princevegeta89 wrote:
           | Is there a good batteries-included framework for Go, like
           | Ruby on Rails or Django?
        
             | ralfhn wrote:
             | The Go community is generally averse to frameworks.
        
               | princevegeta89 wrote:
               | Looks like it, however, wouldn't that decrease the speed
               | of development for new people that come onboard?
        
               | guessmyname wrote:
               | > _[...] wouldn 't that decrease the speed of development
               | for new people that come onboard?_
               | 
               | If that was the case, wouldn't people who love Go have
               | created one after more than a decade in existence?
               | 
               | The reason why Go developers don't like "frameworks" a-la
               | Ruby on Rails in the Ruby ecosystem is because the Go
               | community generally prefers libraries over frameworks
               | because Go's simplicity and flexibility allow developers
               | to compose their solutions using small, composable
               | packages rather than being constrained by a rigid
               | framework.
               | 
               | This approach often results in more efficient and
               | maintainable code. The Go philosophy emphasizes
               | minimalism and encourages developers to avoid unnecessary
               | abstractions.
        
             | foldr wrote:
             | There's a good list of frameworks here:
             | 
             | https://github.com/mingrammer/go-web-framework-
             | stars?tab=rea...
             | 
             | But you won't find anything that's anywhere near as
             | comprehensive and batteries-included as Rails or Django.
        
             | kreek wrote:
             | While not quite as batteries-included as Rails, Fiber made
             | the most sense to my Ruby/Rack brain.
        
               | princevegeta89 wrote:
               | Thank you!
        
             | machekb wrote:
             | The OP is using Encore
             | (https://github.com/encoredev/encore) for the project
             | described, it's pretty much what you are asking for.
        
         | srameshc wrote:
         | Go is "amazing" . I am using Go since the very early days, and
         | I absolutely love it. I have built services using Go and manage
         | it all by myself. The community is so awesome and there is
         | likeyly an opensource project that supports your need when you
         | want it to do something exceptional.
        
         | aleksiy123 wrote:
         | If your goal is iteration and development and not performance,
         | why not just stick with a typescript backend?
        
           | princevegeta89 wrote:
           | Just wanted to use something new this time since I feel like
           | I'm bored with TS now.
        
         | petesergeant wrote:
         | Unless your goal is learning the new language for the sake of
         | it, Node should already be plenty performant for most needs
        
           | princevegeta89 wrote:
           | Yes, I am really looking at using something new since I did
           | get bored with the JS/TS world.
        
         | blandflakes wrote:
         | I'd love to hear why Elixir wasn't for you - not from a
         | judgemental place, I just like hearing others' experience
         | reports for languages that stuck or didn't.
         | 
         | For a web service with fast iteration times, I'd probably pick
         | Go of those two. While I'm not personally a giant fan, I think
         | it is a much simpler stack that lets developers be pretty
         | productive especially in the domain of web services.
        
           | princevegeta89 wrote:
           | Iteration was easier but the main complaint from my team was
           | it was hard for junior engineers to pick up and understand.
           | Along with that, IDE support still seems poor (we use
           | Jetbrains and the Elixir plugin doesn't work reliably for us)
        
       | ping00 wrote:
       | I just wanted to add that your writing style is wonderful and
       | that this was a pleasure to read.
       | 
       | Incidentally, I work in pentesting, and one of my colleagues has
       | Type 1 Diabetes; your overview of it and its resultant
       | complexities really made me empathize with what challenges he has
       | to surmount daily while still being one of the nicest, most
       | approachable people in our team.
        
         | mattboyle wrote:
         | Thanks so much for the kind words :)
        
         | begueradj wrote:
         | Your employer must be good then. Lots of companies don't hire
         | and fire sick employees. Actually it's generally advised not to
         | share one's medeical information at workplace.
         | 
         | I even read recently about the case of a worker who wasn't
         | promoted despite everyone else expected him to be promoted. His
         | sin ? He told briefly one of his colleagues that his car got
         | stuck and he was tired of fixing it every now and then.
         | 
         | The promotion involves commuting for a certain distance. His
         | manager told him he would have promoted him but he heard his
         | car was not fit.
        
           | dgellow wrote:
           | Difficult to hide your diabetes when you wear a sensor on
           | your arm and have to inject insulin throughout the day
        
             | yurishimo wrote:
             | Actually, the sensor is super easy to hide (especially with
             | long sleeves) and injecting is also quite discreet these
             | days. I've seen injectors that are about the size of a
             | marker or a wireless earbuds case. It's easy enough to go
             | to the bathroom right before lunch or when you get an
             | notification on your phone.
        
               | nuancebydefault wrote:
               | I'm not diabetic but I'm pretty sure what you describe
               | would cause a lot of stress, especially if you don't want
               | anybody in the office to find out... "hey you have a
               | small bladder maybe?" Stress has an impact on sugar
               | levels, making it harder to regulate. If you think
               | knowing of the medical condition is bad for your career
               | at your current employer, maybe it is better to switch
               | employers.
        
           | rob74 wrote:
           | In Germany, depending on the type and seriousness of your
           | diabetes, you can get officially recognized as handicapped,
           | and companies above a certain size (20 employees) are
           | obligated to have a certain number of handicapped employees -
           | so an employee who is handicapped, but can work (more or
           | less) the same as a normal employee is actually a win-win
           | situation.
        
         | froh wrote:
         | also incidentally, pentesting as in testing diabetes pens may
         | partially be done with pentesting as in testing with pen and
         | paper. is it, though?
         | 
         | and then there is penetration testing as in trying to break
         | into things. is that what you do?
         | 
         | sigh
        
         | rob74 wrote:
         | Yes... you _can_ lead a normal life with diabetes (you can even
         | be a top level tennis player -
         | https://en.wikipedia.org/wiki/Alexander_Zverev#Personal_life),
         | but this article really made me appreciate the level of self-
         | discipline it takes to do that.
        
           | gullywhumper wrote:
           | There's also an all-diabetic pro-cycling team:
           | https://www.teamnovonordisk.com/
        
           | jrh3 wrote:
           | Several NFL players play/have played with Type 1.
        
       | martsa1 wrote:
       | Nice write up! I stumbled across the Open Pancreas project a
       | while back, may be of interest to techies with T1:
       | https://openaps.org/
        
         | brandonp0 wrote:
         | There's also Loop on the iOS side:
         | https://github.com/LoopKit/Loop. I've been using it for 7 or 8
         | years. There's also several pumps that have closed loop
         | capabilities built-in, but I've found that they try so hard to
         | play it safe that they are less capable than running your own.
        
           | Benjamin_Dobell wrote:
           | Agreed. My daughter (5) is using a G6 + TSlim X2 closed loop.
           | The target blood glucose is 6.0 mmol/L and you can't decrease
           | it. However, I haven't tried (and likely won't try) anything
           | DIY since it's my daughter and not myself.
           | 
           | Despite this, it is nice whilst my daughter is at school,
           | since some automated corrections (even if overly
           | conservative) are certainly better than none -- teachers
           | generally won't administer corrections (but will bolus for
           | food).
        
             | user_7832 wrote:
             | As someone who's planning to start a TSlim, this is a bit
             | worrying. Admittedly even an average value of 7mmol would
             | be an improvement over where I am, but I've certainly heard
             | the lack of aggressiveness as an issue with the controlIQ
             | system (if that's what your daughter is using).
        
               | Benjamin_Dobell wrote:
               | Yeah, ControlIQ.
               | 
               | I do imagine it's different for everyone though, and
               | would also depend on what your alternatives are. In our
               | circumstances, it's a huge improvement over manual
               | injections. But by no means the closed loop silver bullet
               | we're all hoping for.
               | 
               | We ran the TSlim on BasalIQ (precursor to ControlIQ) for
               | a couple of years. Haven't done her HbA1C since we
               | swapped, so I don't have any hard data. Well, and with
               | the constant changing lifestyle of kids, _all data_ needs
               | to be taken with a grain of salt. I think we 're being
               | woken by high alarms less often, but she just seems to be
               | _fairly_ high (just under 10 mmol /L) much more often.
               | There are of course still run away highs much worse than
               | that (don't want to misrepresent the situation!) and I
               | guess they're somewhat mitigated by ControlIQ, but it
               | definitely doesn't stop them outright, and manual
               | corrections are still required if you want the high
               | resolved in under 2 hours.
        
       | giantg2 wrote:
       | I suspect that type 1 has an environmental cause/trigger in many
       | cases. As an anecdote, I knew many kids from military families or
       | live in close proximity to specific bases where some chemical
       | contamination may exist who have endocrine system issues without
       | any family history of them. I knew very few from other areas and
       | backgrounds with similar issues.
       | 
       | Edit: I'm curious if the people disagreeing with my musings have
       | some studies investigating the topic, or some other interesting
       | point.
        
         | giantg2 wrote:
         | Wow, ok, disagree with me even more without contributing to the
         | conversation. I'll leave additional reading for you to disagree
         | with this comment as well.
         | 
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518604/
        
         | user_7832 wrote:
         | I don't know why you're being downvoted, environmental triggers
         | eg from pollution are linked to autoimmune conditions. Any kind
         | of excessive (oxidative) stress would increase the chances of
         | it for that matter.
        
       | zy0n911 wrote:
       | Incidentally, I created something related to this yesterday. A
       | tmux plugin to display your glucose data as a status icon in your
       | terminal.
       | 
       | As a T1 myself, I use a Dexcom as my CGM and have it working
       | around that specifically, but I'd love to open it up to other
       | devices too, and offer more. Feel free to check it out!
       | https://github.com/Cian911/tmux-xdrip
        
         | wferrell wrote:
         | Wow. This is really impressive. thanks for sharing.
        
         | jrh3 wrote:
         | I wish Dexcom could sync directly with a watch. I've been
         | waiting on that for years but I guess it would drain the watch
         | battery.
        
       | tonymet wrote:
       | I love this post. there's a lot of potential for a personal
       | monitoring platform like this. great work and keep staying alive
        
         | mattboyle wrote:
         | Thanks so much for the kind words!
        
       | bluesounddirect wrote:
       | Sorry 1/2 into the article all that kept popping into my head is
       | someone tell this man about a cgm like a dexcom . It all of this
       | out of the box . My wife has been a t1d for 30 years the dexcom
       | cgm makes all of this a lot better
        
         | ShakataGaNai wrote:
         | He has that. The problem is not the CGM, it's everything around
         | that (and the fact that both Freestyle Libre, and Dexcom, don't
         | readily expose the data for the DIY types to do anything with).
         | 
         | While the Dexcom is "better" (than Freestyle Libre) in my
         | opinion because the recent revision can talk directly to your
         | phone continuously (the Libre only sends alerts, getting data
         | requires you tapping phone to arm)... your insurance may cover
         | only one or other. Either is way way better than nothing, but
         | both are still a long way from automation.
        
           | natdempk wrote:
           | Not sure exactly what you mean by "getting data" but recent
           | versions of both Libre and Dexcom have apps where you can
           | view graphs of data on your phone with no tapping step.
        
             | croemer wrote:
             | NHS likely doesn't pay for Dexcom. Someone has figured out
             | how to make the Dexcom app broadcast values it's received,
             | it works great: https://www.patreon.com/byod
        
             | muwtyhg wrote:
             | It seems like you and the GP didn't read even the first 20%
             | of the article. The author shows their CGM in the first 2
             | page lengths. They mentioned they did all of this because
             | the official Libre app was constantly losing connection
             | with their CGM. He bought a "hat" device called a "Miao
             | Miao" and then siphoned off the data to his own CGM service
             | that won't cut out if it receives, as the author puts it,
             | "anomalous readings"
             | 
             | It has a side benefit of allowing them to show it on their
             | Apple Watch using Google Calendar only.
        
               | natdempk wrote:
               | Actually I did read the whole thing before posting...
               | There are different CGM models where some require
               | scanning and some report continuously. My reading was
               | that the author's model seemed to only support scanning
               | thus the need for the hat, rather than periodic updates
               | to an app that newer models provide, but it doesn't seem
               | 100% definitive from the article as I don't know if on
               | newer models data export might require scanning? The
               | point of my comment was that rather than all this work,
               | getting a different device could more-or-less enable the
               | desired functionality without so many workarounds and the
               | bulky hat device by eliminating the whole
               | scanning/inconsistency aspect. Though if you want to pull
               | the raw datapoints etc. and export them elsewhere, then
               | there are still more complications. The non-scanning ones
               | might still be a bit unreliable as well, not sure where
               | that aspect is coming from.
        
             | jstanley wrote:
             | "Getting data" would mean automated exports into a format
             | that you can actually do some processing on. Not just
             | viewing graphs on a screen.
        
         | mattboyle wrote:
         | I wrote the article- I'm very aware of Dexcom and it doesn't
         | have all this out the box
        
           | user_7832 wrote:
           | Have you looked into third party apps? I'm very personally
           | used the app diabox (on android), I've heard suggah (if I
           | spelt it correct) also supports a nightscout link like
           | diabox. However I'm not sure how these work with dexcoms.
        
           | rubymancer wrote:
           | You probably know all this as well, but for future googlers:
           | 
           | I used to use Libre + MiaoMiao + Nightscout, but these days I
           | much prefer Dexcom G6 + xDrip + Nightscout.
           | 
           | Pros for the G6:
           | 
           | - No 3rd party transmitter (e.g. the MiaoMiao)
           | 
           | - It's smaller and can go on the stomach so it's less likely
           | to get ripped off
           | 
           | - 1 less app involved -- xDrip integrates directly to
           | Nightscout and there is no need for the Dexcom app
           | 
           | - Supposedly the glucose readings are a bit more accurate
           | than the Libre
           | 
           | Cons:
           | 
           | - Sensors are more expensive than the Libre
           | 
           | - The transmitter is not rechargeable so you need to keep
           | buying them every 90 days
        
       | hk1337 wrote:
       | I could be mistaken but I believe both types of diabetes has no
       | cure; however type 2 is MUCH MORE manageable with a proper diet?
        
         | renatolb wrote:
         | There's no cure, but 'remission' is possible in type 2 diabetes
         | with lifestyle changes. Remission is defined as maintaining
         | normal blood sugar levels without medication. This is not
         | possible in type 1 diabetes
        
           | Projectiboga wrote:
           | Type 1 here, there is a simple hack for both 1 & 2 and it's
           | take melatonin at night. That upregulates the actual insulin
           | receptors to do more with less insulin. I've been using that
           | for 28 years now. My insulin requirements dropped 40% over my
           | first 6 months and have stayed there ever since. I know two
           | Type 2 who went into remission with diet, melatonin and who
           | tapered off pills after initial use.
        
           | mnw21cam wrote:
           | "There's no cure" for type 2 diabetes is true only on a
           | technicality. Type 2 diabetes is defined as a progressive
           | disease, which means that if you actually practically cure
           | it, it is still technically defined as "in remission". It's
           | just words.
        
         | croemer wrote:
         | Type 1 and 2 are quite different beasts - they both have in
         | common that you pee sugar when it's not managed (diabetes means
         | sweet urine in Greek).
         | 
         | Type 1 is when your immune system erroneously kills the cells
         | producing insulin in your pancreas. Treatable by injecting
         | insulin manually - but as any substitute, there are caveats,
         | it's not perfect. Type 1 is pretty binary, you either have it
         | or you don't, it appears rather rapidly, usually at young age,
         | up to around 20. There's no way to avoid injections through
         | diet.
         | 
         | Type 2 is when the cells that are _reacting_ to insulin are no
         | longer doing so very well. Lots of reasons: genetics, body
         | weight, physical activity. It's much less binary, with gradual
         | onset over years. Can initially be managed by change of diet,
         | activity, pills - later it also requires injections like type
         | 1.
        
         | tibbydudeza wrote:
         | Type 2 is called Insulin Resistance - basically your pancreas
         | works fine but the cells in your body stops responding to the
         | hormone that tells it to remove glucose from your blood leading
         | to a dangerous build up.
         | 
         | I use a drug called Metformin daily which slows down my
         | digestive tract (you feel fuller after a meal longer like
         | Ozempic), lowers the uptake of glucose in your gut and lowers
         | glucose production in your liver.
         | 
         | That and a low carb diet is essential.
        
           | AnonHP wrote:
           | > That and a low carb diet is essential.
           | 
           | Not essential. There are people who manage it or even get
           | into remission with high carb diets (high carb low fat) too.
           | One common thread across all these diets is avoiding
           | processed foods.
        
             | tibbydudeza wrote:
             | I miss my pasta and rice :).
        
           | glp1guide wrote:
           | Also note that drugs like Ozempic (GLP1 Receptor Agonists)
           | work in at least the following ways:
           | 
           | - slow down stomach emptying (which was noted)
           | 
           | - improving glucose disposal
           | 
           | - reduce appetite by affecting brain chemistry
           | 
           | GLP1 RAs are really really interesting compounds (I'm a bit
           | biased of course)
        
             | tibbydudeza wrote:
             | I must note my gut has some interesting moments with it -
             | some days - also I used to love mince (think US calls it a
             | sloppy joe) - now I can't stand the sight and smell of it.
        
       | mholt wrote:
       | A family friend of ours just had a child -- 6 years old --
       | diagnosed with diabetes, and has to wear one of these monitors,
       | with that same app and everything.
       | 
       | Neat idea.
        
       | keithnz wrote:
       | Scott Hanselman has blogged and youtubed about having type 1
       | diabetes over the years with various tech hacks. A while back he
       | hacked it so his blood sugar showed up in his terminal prompt...
       | https://www.youtube.com/watch?v=_meKUIm9NwA
        
       | Sxubas wrote:
       | Mildly related, I was diagnosed with obstructive sleep (OSA)
       | apnea 6 months ago, and when sleeping I have to use a machine
       | that blows air with a set pressure so it 'counters' the
       | obstruction (a CPAP machine). Not mission critical like type 1
       | diabetes, but those machines log a lot more than I expected.
       | 
       | While reading this I wondered if someone has geeked something for
       | similar for OSA, maybe for monitoring purposes or more severe
       | cases.
       | 
       | I already know (and am incredible grateful for) OSCAR[1], but I'm
       | really curious to see what else is out there.
       | 
       | 1: https://www.sleepfiles.com/OSCAR/
        
         | tibbydudeza wrote:
         | Rather mission critical I reckon. A CPAP machine was a life
         | changer for me - long term untreated sleep apnea causes heart
         | and other life issues.
         | 
         | During my sleep study I logged about at the worst 48 incidents
         | per minute of stopping to breath (kind of difficult to do that
         | when you tongue rolls back into your airway)
        
           | sbstp wrote:
           | My sleep study revealed 90.7 events per hour (30 is
           | considered severe) and 55% blood oxygen level. I've been
           | using a CPAP machine for about 2 months now, but still
           | feeling pretty tired in general. Still waiting for the life
           | changing effects.
        
             | cpuguy83 wrote:
             | Have you analyzed the data from your cpap to see if it's
             | doing what it needs to do? It has the data for your apnea
             | events, sleep time, all kinds of interesting things.
             | 
             | Check for leaks. Make sure your mask is actually
             | comfortable, I'd recommend trying multiple if you haven't
             | already.
        
             | manmal wrote:
             | Maybe you need a BIPAP.
        
             | hnlmorg wrote:
             | I was around 79 events and my CPAP was also life changing.
             | But they're not easy to get right.
             | 
             | First you need a mask that fits the profile of your face
             | and the severity of your condition. There are a lot of
             | different shapes and designs. Having tried a few, some were
             | completely useless for me. Only one actually worked.
             | 
             | Facial hair also affects the performance of the mask too. I
             | don't know if this is something you need to be concerned
             | about or not, but if you have a beard and wear a full mouth
             | and nose mask, then you might want to consider a change of
             | appearance.
             | 
             | Then you have the configuration of the CPAP machine itself:
             | 
             | + how much pressure to apply?
             | 
             | + what, if any, ramp up period to use before deep sleep
             | pressure is applied?
             | 
             | Those two metrics took a bit of tuning before I found
             | something I was comfortable with.
             | 
             | I was lucky that I had (and still have) an excellent doctor
             | to guide me through all of this. Free from the UK NHS too.
             | I can't imagine having to navigate all of these caveats on
             | my own.
             | 
             | Good luck with the CPAP machine. Not getting enough quality
             | sleep can be debilitating. I've been in the same situation
             | as you so understand how horrible life was before my CPAP
             | machine.
        
               | tibbydudeza wrote:
               | I unlocked the machine by pressing two buttons and
               | rebooting it and changed the ramping algorithm to less
               | aggressive and increased the start pressure as it felt I
               | was breathing from a straw when I tried to sleep.
               | 
               | I use a nasal mask (not the pillows) since I am not a
               | mouth breather - for me the Fisher & Paykel Eson 2 (L)
               | was just the right fit - took about two different masks
               | before I settled on it.
        
         | cpuguy83 wrote:
         | https://home.sleephq.com/ does a good job of processing this
         | data if they support your machine.
        
           | TheCapeGreek wrote:
           | Interesting, first time I've had a website break on Firefox
           | like this. The CSS & JS are being blocked for tracking on
           | Unbounce.
        
       | broswell wrote:
       | Diabetes Alert Dogs - Not technology based
       | 
       | I have recently be learning about tremendous success with well
       | trained dogs alerting their owners as a complement to the
       | technology based monitoring and alerting systems.
        
       | __loam wrote:
       | The worst thing about ai art is having it inflicted on me at the
       | beginning of every medium article now.
        
         | wiseowise wrote:
         | It looks ugly and out of place.
        
           | __loam wrote:
           | The article is very good and involves several things I'm
           | passionate about including go and medical devices, I just
           | wish software engineers realized how bad the Dalle3 stuff
           | looks.
        
         | smallpipe wrote:
         | Yes! It's a great article, but why does anyone want a picture
         | where the sun somehow manages to melt the glazing bar to
         | illustrate an article about diabetes ? Or a big "Raise
         | incident" button with all the other buttons being meaningless
         | rubbish ?
        
       | mb7733 wrote:
       | Great article! While I haven't done anything as involved I have
       | found using technology to track health issues to be empowering
       | myself.
       | 
       | I'm curious about your thoughts on insulin pumps. I'm not very
       | familiar but I know a few people with T1 that use them and seem
       | happy with them. My understanding is that the idea is that they
       | both monitor glucose levels and supply insulin to keep things
       | stable. Have you considered them? Is there a limitation/downside
       | to them that isn't obvious to a non diabetic? Thanks!
        
         | mattboyle wrote:
         | Pumps work alongside something like a libre and you're correct
         | they can deliver insulin.
         | 
         | Unfortunatley I'm not eligible for an insulin pump on the NHS
         | so for now I'm sticking with injections. I do a good job of
         | managing them this way so it works for me for now.
        
         | OkayPhysicist wrote:
         | Pumps still require a fair amount of planning, experience, and
         | knowledge about one's T1D in order to use effectively. The pump
         | can only be reactive: sugar spikes, emit insulin. Sugar tanks,
         | sound an alarm. You're supposed to tell it in advance how much
         | sugar you're about to consume in order to keep things level,
         | and they can't anticipate you deciding to exercise.
        
       | sjwhitworth wrote:
       | incident.io CEO here! This is such a cool and unique usecase.
       | Love it.
        
         | manmal wrote:
         | I've seen your terms don't exclude liability for bodily harm -
         | IANAL, but wouldn't this be a possible issue?
        
       | captn3m0 wrote:
       | A good alternative to writing your own echo server and debugging
       | requests one route at a time is requestbin, which will gladly
       | take any requests you throw at it, log them, and optionally
       | return a response of your choice.
       | 
       | Lots of different implementations and hosts:
       | https://duckduckgo.com/?q=requestbin
        
       | grahar64 wrote:
       | My son was diagnosed in 2022 with T1D, I wrote this post about it
       | mostly out of determination to understand how to manage
       | https://maori.geek.nz/the-unreasonable-math-of-type-1-diabet...
       | 
       | He is now on Dexcom+Omnipod+AAPS and doing well.
       | 
       | Being familiar with PagerDuty and Datadog/ELK stack, all I want
       | is a similar set of services that can scale (cheaply) to manage
       | all people with T1D. Nightscout is a start but won't scale.
       | 
       | Awesome work and best of luck, T1D is shite.
        
         | mattboyle wrote:
         | Thanks Graham. We actually spoke a little on Twitter after you
         | posted that article here a year or so a go. I'm really happy to
         | hear your son is doing well
        
           | grahar64 wrote:
           | Oh true, those days seem like a lifetime ago. I am now
           | writing an app to make remote monitoring easier for Sams
           | preschool, but are planning on writing a scalable replacement
           | to Nightscout soon. Also digging into the various algorithms
           | would be fun.
           | 
           | There are so many ways that software can make T1D more
           | tolerable, I am glad you have found some solutions for
           | yourself too :)
        
       | je42 wrote:
       | Nice post ! I use a another set of tools to manage my type 1 and
       | the one of my son.
       | 
       | Monitoring glucose:
       | 
       | Sensor libre 2 and xdrip mobile app using the bluetooth option
       | where xdrip + oop2 reads values in 1min intervals. ( no miaomiao
       | needed ) Values are pushed to nightscout
       | 
       | I got 2 nightscout instances: one for my self one for my son
       | deployed to heroku.
       | 
       | Alarms are pushed to my phone for my sons low and high bloodsugar
       | using pushover.
       | 
       | Heroku alarms are configured if service goes down.
       | 
       | Database: mongo atlas highly available.
       | 
       | We both use omnipod dash with android aps app.
       | 
       | A) helps with carb to insulin calc and carb counting, insuline on
       | board.
       | 
       | B) closed loop, that auto corrects high glucose and stops insulin
       | when too low
       | 
       | C) different profiles for things like "recently done sports" vs
       | "didnt do much excerise in the last days"
       | 
       | D) aps app allows to track extra insuline injected by pen
        
       | lemper wrote:
       | bro, life saving stuff you've created there. also, for the "i
       | need help" part, i'd try my damnedest so things won't go south
       | like that (500 error). how about put it into a loop with backoff
       | or something?
        
       | jokethrowaway wrote:
       | That's an amazing blogpost for techies! Well written!
       | 
       | On the diet side, I'm living with almost no carbs for 2 years and
       | over time my ability to turn fat into energy changed
       | significantly, to the point I can do any activity I was doing
       | before as long as I keep in check my sodium and potassium intake.
       | 
       | You can find people doing well with Type 1 and carnivore and you
       | can find people telling you your insulin resistance will worsen.
       | 
       | I'd experiment regardless of what you find on the internet or the
       | doctor tells you.
       | 
       | I spent two years of hell (not diabetes though, frequent
       | diarrhea, stomach ulcers, blood in stool) following doctors
       | indications and ended up with non sensical prescriptions and a
       | low fat diet as a recommendation, when a high fat diet fixed all
       | the symptoms in a week.
        
       | sgt101 wrote:
       | Camdiab (https://camdiab.com/faq) is available in some places
       | (UK) to provide automated blood sugar level management.
       | 
       | I have dived into this a bit, and the thing that I grokked is the
       | challenge of proving that the algorithm/device loops really work
       | and are really safe. There has been a lot of painstaking work to
       | develop and certify a thing like Camdiab. Unfortunately it also
       | means that it's important to buy the right smartphone to make
       | sure that the right libraries are available and being used by the
       | app... Has been a bit expensive.
       | 
       | They have also walked the road of testing and proving the
       | devices/algorithm for use in small children and teenagers. Bear
       | in mind that this is all very complicated and there are a lot of
       | differences in the behaviour of different hormone systems in
       | different cohorts.
        
         | grahar64 wrote:
         | My son was on CamAPS for about 6 months with the Dana pump.
         | Systems like that are even harder to get out because it relies
         | on 3rd party hardware. Medtronic, Insulet's and a bunch of
         | other systems are rapidly becoming a walled garden where the
         | only way you can run the hardware and software you want is to
         | run open source like AAPS or iAPS.
        
       | UomoNeroNero wrote:
       | I have been diabetic for 16 years. I love your mood and I respect
       | you, when you are sad or angry with the illness, reread this post
       | and remember how sure you were that you could handle everything.
       | It's not easy (mentally and practically) and for me, for many
       | years, the situation has been "joyfully out of control" Just
       | yesterday I cried (really!) watching that for the first time in
       | my sick life I had a 36 hour streak on target. 100% green for 36
       | hours. I repeat, I cried. Maybe I understood. Maybe... The leap
       | in quality after years to 60% was due to: - microinfusor
       | connected to the CGM (a revolution compared to pens) - having had
       | the opportunity to share my experience as a diabetic with a group
       | of other diabetics. Something like Alcoholics Anonymous but much
       | more like Fightclub :-D - having installed a VM with NightScout
       | to always have an eye on blood sugar levels and trends
       | EVERYWHERE: phone, clock, desktop widget, alarm clock, fridge :-D
       | - count the CHO with German precision (and analyze the history
       | with respect to pre/post blood sugar levels) and do the boluses
       | STRICTLY 15 minutes before the meal. I hate hate hate living like
       | this but IT WORKS
       | 
       | Tieni duro. Non ti disunire
        
       | petepete wrote:
       | I'm intrigued by the idea of the Miao Miao.
       | 
       | I'm a T1 diabetic and while the Freestyle Libre is an _amazing_
       | device, truly life changing, the software is pretty bad. I
       | reported a bug more than a year ago and Abbott still haven't
       | acknowledged it as being a bug, despite there being loads of
       | reports online and in their app reviews on Google Play.
       | 
       | For anyone interested, or who might be able to add weight to my
       | case for them to acknowledge it, the bug is that adding LibreLink
       | to the list of apps that can override DND has no effect; entering
       | DND mode instantly shows a warning that 'alarms are not
       | available'. It's a pain in work settings where I can't enable DND
       | without disabling my glucose alarms too.
        
       | gog wrote:
       | Take a look at xdrip4ios[1]. If you are using Libre 2 sensors you
       | don't need MiaoMiao, Libre 2 has Bluetooth connectivity built in.
       | 
       | The other piece of the puzzle is Nighscout[2] that stores data in
       | Mongodb (last time I looked at it). You can also enter a custom
       | script to your Nightscout installation that can be your own
       | endpoint to accepting JSON data about BG.
       | 
       | 1) https://xdrip4ios.readthedocs.io/ 2)
       | http://www.nightscout.info/
        
         | ollysb wrote:
         | In many countries the official Libre app now supports bluetooth
         | continuous updates on Libre 2 and 3. That said I do much prefer
         | xdrip4ios.
        
       | scopeh wrote:
       | Coding is 100% a superpower. Great post and love how you
       | approached this. Hopefully it gives others similar ideas to help
       | them.
        
       | bmo-at wrote:
       | This is a great write-up. I will definitely implement a subset of
       | this for my father, who is a type 1 diabetic. While he has lived
       | with it for close to 25 years and has a lot of experience
       | managing it, occasional slip ups still happen. Just recently, he
       | had a small fracture from falling down during a hypoglycaemic
       | episode. This might help prevent that or at least lessen the
       | impact.
        
       | miobrien wrote:
       | Amazing stuff. My three year old son was diagnosed four weeks ago
       | so this really resonates with me.
        
         | massive wrote:
         | I'm in the same boat with you with my 3 year old daughter.
         | 
         | I'm grateful of the free health care that our country has.
        
       | wwilim wrote:
       | I wonder how the age at diagnosis affects your approach. I see
       | people like this guy or Scott Hanselman going "science the sh*t
       | out of this" and minmaxing their health, but AFAIK they were
       | diagnosed as adults. I was 4 when I was diagnosed and even though
       | I know I could do something to try to improve my results, my
       | approach ends up just being intuition, winging it and trying to
       | think about it as little as possible. I'm left wondering if I
       | have internalized powerlessness over this matter.
        
       | dangerwill wrote:
       | You've set up a torture loop for yourself instead of listening to
       | your body and the existing medical device. And you are now piping
       | medical biometric data through both Google Calendar and your
       | Apple watch.
        
         | UncleEntity wrote:
         | Ya know, people deal with life-changing events in their own
         | ways.
        
       | agao14 wrote:
       | Slightly related, but I've also been working on and off for a few
       | years on my own Type 1 Diabetes management solution
       | (https://github.com/algao1/iv3).
       | 
       | I haven't had time to work on it recently, but it uses ntfy and
       | Retool to send alerts and visualizations. Originally I did
       | everything over Discord, but found the UI to be not great
       | especially on mobile.
       | 
       | I was thinking of eventually incorporating some kind of automatic
       | remedial solution eventually to help keep my glucose in range,
       | but haven't had any time to look into it yet.
        
       | tomsmeding wrote:
       | > During this period, I am not able to take my blood glucose
       | levels using the device and I also would not receive alerts, if
       | my blood sugar was to reach dangerous levels. This error had the
       | habit of showing up at the most stressful times.
       | 
       | > [...]
       | 
       | > After playing around it seemed that the main app didn't like
       | sending data that it felt was anomalous due to a sudden change in
       | blood glucose level.
       | 
       | That sounds like a life-threatening bug.
        
       | Projectiboga wrote:
       | T1D here, I had to abandon the Dexcom as it had an unsilencible
       | alert for "your sensor will expire in 6 hours", that on top of
       | only 10 day sensor life pushed me over to the Libre 2. I now
       | realize I could've just started the sensor in the early evening
       | to have those alerts during the day, but I've survived 40 years
       | without alerts. To avoid alerts I use the Libre2 reader and then
       | use Juggluco app on my android, that was the one good thing about
       | the Dexcom was that it could pair more than one app or device,
       | where the Libre can't pair more than once per sensor life. Random
       | personal tips for better reducing the impact of low blood sugar.
       | Eat unsaturated fat as a condiment, especially olive oil. I feel
       | this gives me a non glucose energy source. I'm going to have to
       | dig deep and find an alternative as the world's olive harvests
       | are plummeting and prices are starting to spiral up. The other
       | thing I do is take a few puffs of THC around dinner time. I don't
       | want it affecting my daytime and it's neuroprotective effects
       | last 24 hours and don't require much. Finally learn to use
       | supplements and insure a good diet and supplement nutrient intake
       | to have the rest of your systems running as well as possible. I
       | have been taking Melatonin nearly every night since June of 1995.
       | Melatonin upregulates insulin receptors and allows for me to take
       | about 40% less than typical. It is a problem with the Lantis I
       | take as I need to take only 11.5 units and have to use a needle
       | and even then nudge my dose to a very specific spot that varies
       | sometimes with different needles.
        
       | jrh3 wrote:
       | I put the picture of the hamburger and fries in GPT-4 chat and
       | asked for the total carbs in it. With some caveats about double-
       | checking, it gave:
       | 
       | >Typically, a standard cheeseburger with a bun, beef patty,
       | cheese, lettuce, and tomato can contain around 30 to 40 grams of
       | carbohydrates, primarily from the bun. A standard serving of
       | fries could add an additional 30 to 50 grams, depending on the
       | serving size. Hence, the meal in the image could contain
       | somewhere between 60 to 90 grams of carbohydrates in total.
       | 
       | That is pretty good! Good luck with your T1D, my got his
       | diagnosis 5 years ago and it's pretty amazing technology we have
       | for it now.
        
       | dddiaz1 wrote:
       | Very Cool!
       | 
       | I also have T1D and its a natural source for cool software
       | engineering projects like this.
       | 
       | You might like these two posts: Using machine learning to predict
       | when I excercised: https://dddiaz.com/post/glucose-datascience/
       | 
       | Using Genomic Software to explore my auto-immune genes:
       | https://dddiaz.com/post/hla/
        
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       (page generated 2024-03-05 23:01 UTC)