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    • 13 hours, 31 minutes ago
      KCR likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      None of the specialists I’ve seen have suggested, recommended or prescribed methods for doing this in the lovely 40 years I’ve been T1D. My 80th birthday is the summer. It will officially be half of my life.
    • 15 hours, 29 minutes ago
      Derek West likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      I test when I have unexpected, or stubbornly high blood glucose that just won't go down. I also test when I feel sick. Testing, for me, involves putting urine on a strip, either by peeing directly or dipping the strip into urine. I may use about 2 or 3 strips in a year. When I test positive, I increase my insulin dosage to a "sick day" level, which can be anywhere from 125% dosage to 400%. I usually start with small increases in dosage, and work my way up until my blood glucose levels even out.
    • 20 hours, 3 minutes ago
      Marty likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      I test when I have unexpected, or stubbornly high blood glucose that just won't go down. I also test when I feel sick. Testing, for me, involves putting urine on a strip, either by peeing directly or dipping the strip into urine. I may use about 2 or 3 strips in a year. When I test positive, I increase my insulin dosage to a "sick day" level, which can be anywhere from 125% dosage to 400%. I usually start with small increases in dosage, and work my way up until my blood glucose levels even out.
    • 20 hours, 4 minutes ago
      Marty likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      I have a blood ketone monitor. It works just like a glucometer.
    • 21 hours, 53 minutes ago
      Kathy Hanavan likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      Perhaps only the poets who love alliteration could love the phrase, “killer ketones.” The ungodly pain experienced is your body eating and devouring itself. 🥵 Ketones are relentless killers. Do not give the bad guys a chance.
    • 21 hours, 59 minutes ago
      atr likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      I test when I have unexpected, or stubbornly high blood glucose that just won't go down. I also test when I feel sick. Testing, for me, involves putting urine on a strip, either by peeing directly or dipping the strip into urine. I may use about 2 or 3 strips in a year. When I test positive, I increase my insulin dosage to a "sick day" level, which can be anywhere from 125% dosage to 400%. I usually start with small increases in dosage, and work my way up until my blood glucose levels even out.
    • 22 hours, 35 minutes ago
      Judith Halterman likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      Perhaps only the poets who love alliteration could love the phrase, “killer ketones.” The ungodly pain experienced is your body eating and devouring itself. 🥵 Ketones are relentless killers. Do not give the bad guys a chance.
    • 1 day, 16 hours ago
      Anthony Harder likes your comment at
      Do you have ketone testing strips?
      Hi, Marty. Does your specialist have a source for that claim? It makes little sense that ketones would rise faster than BG since the metabolic pathway is much slower. If there's a source, however, I'd look further into the claim. FWIW, I've been a Type 1 for over 50 years; I can't remember the last time I tested for ketones. I possess no ketone testing strips.
    • 2 days, 19 hours ago
      Marty likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      Covers it with co pay
    • 2 days, 20 hours ago
      atr likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      It covers both. I prefer to have the the nasal version as I think it would be easier for someone else to administer.
    • 2 days, 22 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      I’ve been T1D for 60 years. As a child my mother didn’t like needles or injections so she just fed me when low. In college, explained use to dorm mates and classmates would’ve been a waste of time. Now married, my wife assumed the role of my mother and doesn’t like using needles on me either. I don’t have glucagon.
    • 2 days, 22 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      Yes, always have one or two nasal glucagon kits (Baqsimi) at home in easy to reach locations (ie at bedside and special container in living area) and always keep one with me when I go out ( along with glucose tabs or other simple carbs for treating LBS.). I apparently required injectable glucagon several times as a child and needed injectable glucagon only twice as an adult, both more than 15 years ago . More recently I needed my husband to give me Baqsimi after eating a difficult to dose for, high fat meal. The experience was terrifying so I don’t go anywhere without it now.
    • 2 days, 22 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      I actually have 2 non-expired prescriptions. One for Baqsimi and one for Gvoke. I have not filled either of them because they’re $500-600 each.
    • 2 days, 22 hours ago
      Lawrence S. likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      My Medicare Part D essentially doesn't cover glucagon when any form is nearly $500!
    • 3 days, 13 hours ago
      Amanda Barras likes your comment at
      Do you have a non-expired glucagon prescription?
      Same here. Been as low as 19 (struggling with a vacuum cleaner bag and refused to let it win) but was still able to swallow food. I did used the “red needle” as my husband refers to it once when I went low but was scheduled for surgery and couldn’t eat or drink anything. Only once in 26 years. Fortunate.
    • 4 days, 8 hours ago
      Karen Newe likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 4 days, 20 hours ago
      Natalie Daley likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 4 days, 21 hours ago
      atr likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 4 days, 22 hours ago
      Lawrence S. likes your comment at
      Share some of your favorite T1D-related podcasts in the comments:
      I don't do T1 podcasts.
    • 4 days, 22 hours ago
      Lawrence S. likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 4 days, 22 hours ago
      Gary Taylor likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 5 days, 9 hours ago
      Amanda Barras likes your comment at
      Which T1D influencers do you enjoy following?
      Currently it’s the Diabetech, Justin Easter.
    • 5 days, 19 hours ago
      ChrisW likes your comment at
      Share some of your favorite T1D-related podcasts in the comments:
      I don't do T1 podcasts.
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      Share some of your favorite T1D-related podcasts in the comments:
      TCOYD Diabetes Nerd Your Best T1D Year Think Like a Pancreas
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    Several companies are investigating islet cell replacement therapies for people with T1D, some of which would require patients to be on immunosuppression therapies. Out of the following options, which of these outcomes would be the most meaningful and desirable for you?

    Home > LC Polls > Several companies are investigating islet cell replacement therapies for people with T1D, some of which would require patients to be on immunosuppression therapies. Out of the following options, which of these outcomes would be the most meaningful and desirable for you?
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    Were you experiencing DKA (diabetes-related ketoacidosis) when you were diagnosed with T1D?

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    Do you ever feel pressure or anxiety to eat “low carb” in public around people who know you have diabetes? (Share in the comments experiences that you’ve had.)

    Sarah Howard

    Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.

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    " At T1D Exchange, we’re proud to announce our Medical and Research Advisory Team — an accomplished group of leaders in endocrinology, research, and quality improvement. Together, they are redefining what’s possible in type 1 diabetes (T1D) care through rigorous data analysis, innovative research approaches, and real-world implementation. Their collective expertise is central to our mission of improving outcomes for all people living with T1D.  “We’re excited to be working with our advisors given their deep expertise across a broad range of areas in T1D,” said Dave Walton, CEO of T1D Exchange. “Their involvement magnifies our reach, knowledge, and impact. These advisors are shaping the future of diabetes care — driving innovation across research, clinical practice, and quality improvement.”    Meet the Medical & Research Advisory Team  The T1D Exchange Medical and Research Advisory Team brings together four leading endocrinologists, each offering a unique perspective and shared commitment to advancing T1D care:    Jenise Wong, MD, PhD Pediatric endocrinologist at UCSF Benioff Children’s Hospital and Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco Focus areas: Diabetes technology adoption and usability; health equity and access to care and technology; community-based and peer-support interventions; culturally responsive care          Jennifer Sherr, MD, PhD Pediatric endocrinologist at Yale Medicine and Professor of Pediatrics in the Division of Endocrinology at Yale School of Medicine in New Haven, Connecticut Focus areas: Clinical trials in diabetes technology (CGM and AID systems), disease-modifying treatments and immunotherapies, and emerging technologies and medications, including continuous ketone monitoring and nasal glucagon     Viral Shah, MD Adult endocrinologist at Indiana University Health and Professor of Medicine in the Division of Endocrinology and Metabolism at Indiana University School of Medicine in Indianapolis, Indiana Focus areas: Diabetes technology and adjunctive therapy trials; translational and data-driven research; T1D complications and bone health         Nestoras Mathioudakis, MD, MHS Adult endocrinologist at Johns Hopkins Medicine and Associate Professor of Medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland Focus areas: AI-driven clinical support tools; EMR-based data analytics for clinical decision making; data-driven quality improvement; health equity in T1D care        This accomplished team’s expertise spans adult and pediatric endocrinology, research, and quality improvement affiliated with leading institutions nationwide. Collectively, they have authored over 500 diabetes publications and secured research funding from organizations such as the National Institutes of Health, Helmsley Charitable Trust, the American Diabetes Association, and Breakthrough T1D — while remaining actively engaged in both clinical care and research.  “These individuals represent an impressive body of work while remaining deeply involved in the day-to-day realities of diabetes care,” said Walton. Their expertise covers the full spectrum of T1D care — from AI and predictive analytics to complication prevention, automated insulin delivery, continuous glucose and ketone monitoring, GLP-1 treatments, health equity, mental health, autoantibody screening, and disease prevention.    Turning insight into impact  The team’s work goes beyond research, focusing on translating insights into real-world practice. By leveraging data to scale best practices, the goal is to drive meaningful, measurable change across clinics and communities.  “Our advisors will help to extend our impact — whether through QI strategy, research innovation, funding opportunities, or new data-driven solutions,” said Walton. “We want to take what’s working at individual centers and spread that as broadly as possible.”   He added, “As a Collaborative, we’re also focused on advanced population health strategies such as exploring predictive data models to identify risks earlier and intervene before complications even begin to happen.”    The power of the T1D Exchange Quality Improvement Collaborative  Central to this work is the T1D Exchange Quality Improvement Collaborative (T1DX-QI) — a nationwide network of clinics working together to improve care through shared data, benchmarking, and evidence-based practices.  “I’m thrilled to serve as a Medical Advisor for T1D Exchange, because I’ve seen firsthand the impact this network can have on patient care,” said Dr. Nestoras Mathioudakis. “T1D Exchange is the premier organization for quality improvement in type 1 diabetes, with unparalleled assets like a large EHR database and robust patient registry.”  He added that he is excited to apply his expertise in EHR research and big data analytics to generate real-world evidence across diagnosis, management, and outcomes.  Dr. Viral Shah echoed that perspective, reflecting on T1DX-QI's evolution: “I have been involved with T1D Exchange since its early days and have had the privilege of witnessing how it has transformed the quality of diabetes care across the United States. I’m delighted to return as a Medical Advisor.”  He emphasized the importance of accelerating impact. “I look forward to working closely with the team to accelerate the evidence generation and to help translate these insights to improve patient care.”   Dr. Jenise Wong highlighted the visible impact of T1DX-QI on the delivery of care. "I’m truly honored and grateful to be working with T1D Exchange as a Medical Advisor. T1DX-QI is a remarkable resource for centers that are using continuous process improvement to improve the quality of care for people living with diabetes.”  “Diabetes centers working with T1DX –QI have done amazing work using QI methodology to make care accessible and equitable for all people with diabetes,” she said. “It’s inspiring to be a part of a collaborative in which centers have been creative and thoughtful with initiatives to address individual and systemic challenges to care, improving clinical outcomes as well as the patient experience."  Looking ahead, Dr. Sherr highlighted the opportunity to build on the existing strong foundation. “I’m very excited to be working as a Medical Advisor for T1D Exchange,” she said. “It’s a privilege to help shape what comes next for a group that’s already doing such impactful work.”  “Sharing what’s happening in clinical practice, benchmarking across centers, and understanding outcomes is how we figure out what’s working, what’s not, and where we go next,” she said.      The future of T1D care   With this team’s vision and expertise, T1D Exchange is positioned to accelerate progress in T1D care — bridging research and real-world practice to drive meaningful, measurable impact.  Together, we look forward to advancing innovation and improving outcomes for everyone affected by type 1 diabetes.   "

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    37 Comments

    1. PamK

      I chose “not having to plan insulin dosing,” because I have a hard time getting the timing right. I either go low before my meal is ready, or I go high after eating. It just never seems to be right other than on rare occasions.
      I would also have liked to answer “>90% time in range or HbA1C <6%," as this is also very important to me. Unfortunately, I could only choose one answer and not having to plan insulin dosing seemed to me to be a solution to both.

      2
      5 years ago Log in to Reply
    2. Jordan Mooty

      I would choose a greatly improved A1c and time-in-range, but I’m also not willing to do immunosuppression therapy unless I had absolutely no other choice.

      3
      5 years ago Log in to Reply
    3. Patricia Dalrymple

      I chose none of these. If I am trading what I do for T1D with immunosuppressive therapies, whatever that entails, I’ll stick with what I know. I have an A1C of 5.7 and I know what I should and shouldn’t do to avoid highs and lows. I don’t like drugs and all if their side effects. I’ll stick with insulin.

      12
      5 years ago Log in to Reply
      1. William Bennett

        Same selection and same reasoning for me. 5.8 A1C, and I’m doing fine with a pump and CGM. None of the listed options sounds attractive enough to go on immunosuppressants for the rest of my life, even if we weren’t living in the age of the COVID pandemic.

        1
        5 years ago Log in to Reply
    4. Lawrence Stearns

      I chose eliminating hypoglycemic events.

      However, I would not participate in a therapy that makes me take immunosuppression therapies. Could you imagine having a suppressed immune response if you catch Covid 19 or the flu? No, thank you.

      1
      5 years ago Log in to Reply
    5. Ahh Life

      Emphasizing “outcome most desirable for you,” I must state “eliminating severe hypoglycemic events.” The time in range and Hba1c parameters, while all desirable in the long run, are not immediately lethal. The immediacy and certainty of death rather gets my attention.

      5 years ago Log in to Reply
    6. Patricia Kilwein

      What exactly is islet cell replacement therapy? How can a person make a choice when we do not know what that choice is?

      5 years ago Log in to Reply
    7. marmcs@yahoo.com

      Being able to eat without insulin calculation/dosing is a close 2nd to a1c.

      5 years ago Log in to Reply
    8. cynthia jaworski

      What I would most like is freedom from complications. My time in range and other measurements are good, probably because managing my dosages has become 2nd nature to me after 60 years. However, I would not be surprised to find that other components of a functioning pancreas may be important in overall health (C-peptide, amylin?)

      2
      5 years ago Log in to Reply
    9. LizB

      If I still have to take insulin at all I would not opt for any therapy that requires immunosupressants. Taking those brings on their own problems so unless the trade off it freedom from taking any external insulin it’s not worth it.

      3
      5 years ago Log in to Reply
    10. Mig Vascos

      None of the above if it involves using immune suppression drugs. I’m fortunate enough that I can maintain an average of 85% TIR with a Dexcom sensor and a tandem pump. I’d rather put up with a few lows than with the immunosuppressive drugs.

      3
      5 years ago Log in to Reply
    11. Eve Rabbiner

      COVID has shown just how vulnerable you are on immune suppressing therapy.

      5 years ago Log in to Reply
    12. Clearblueskynm

      I would only want the immune suppressant drugs with the islet cell transplant if there was no, and I mean no, diabetes at all. Otherwise, researchers are wasting their time. And since our own auto bodies are continually attacking our islet cells (I assume that also means transplanted cells), immune suppressive treatment should in theory just allow the new islet cells produced by our own bodies to work. Figure out a protected islet cell transplant that will not allow our own bodies to kill it, that’s really where the future treatment will be.

      4
      5 years ago Log in to Reply
    13. Carol Meares

      I need a lot more information to answer this. Plus during a pandemic, which may not end soon, being on immunosuppressant drugs could be hazardous.

      1
      5 years ago Log in to Reply
    14. Henry Renn

      Already have multiple issues with autoimmune system. Would not want to take meds to suppress it.

      2
      5 years ago Log in to Reply
    15. Thomas Cline

      Managing Type I diabetes simply isn’t difficult enough to make me willing to accept living on immunosuppressants. I would think Covid-19 would have made more people share this view.

      5 years ago Log in to Reply
    16. connie ker

      I would check all of the above because they all sound GOOD. However taking immunosuppressant drugs is BAD. How about taking your own islet cells in the therapy?????

      5 years ago Log in to Reply
      1. Sue Herflicker

        I totally agree with you, I like all the above except for taking the immunosuppression drugs. No thank you!

        5 years ago Log in to Reply
      2. Lynn Smith

        Connie, our islet cells have been killed and no longer work, so there aren’t any to use from our own bodies. 😬

        1
        5 years ago Log in to Reply
    17. Mary Dexter

      I wish more were known about LADA, how it differs from T1 and T2, what it means to still produce random amounts of insulin at random times. I would like to not suddenly go low while grocery shopping, or sweeping, or vacuuming. I would like to sleep without having to get up and fix a low or a high that randomly appears unrelated to how much insulin I took, what I ate or did. I would not like if the transplant made things harder to manage.

      5 years ago Log in to Reply
    18. Kim Murphy

      I would not choose any of the options if it meant I had to be on immunosuppressive drugs.

      4
      5 years ago Log in to Reply
    19. GLORIA MILLER

      Any transplant requires (at this time) immunosuppression therapy, as I understand it. I have a friend who had the islet cell transplant several years ago. She was off insulin for a length of time and then needed another transplant. Due to other problems she had to stop the treatment to stop her body from rejecting the transplant and returned to multiple injections per day. I applied to the same program in 2010 but I had antibodies that prevented me from getting the transplant.

      5 years ago Log in to Reply
    20. Janis Senungetuk

      None of the above, thank you. My TIR is already 90% or better with Tandem’s Control IQ. I’m not interested adding immunosuppression drugs to the list of prescriptions I already take.

      1
      5 years ago Log in to Reply
    21. Lynn Smith

      First let me say that I would never ever be interested in a method of controlling my diabetes that required taking immunosuppressant drugs. My A1c is currently 5.8. I’m on a pump and I’m not that concerned about low blood sugar, other than my CHM waking me up at night. But, I absolutely would rather not have to figure out how much insulin to bolus every single time I put something in my mouth to eat. 😬

      5 years ago Log in to Reply
    22. M C

      I’d rather wait for the science that will allow the creation of replacement islet cells from my own cells, and never take immunosuppression therapies. After what we have all just been living through over the past year and a half as a great example, where those who are immunosuppressed were at much greater risk of severe illness, I wouldn’t voluntarily put myself in that position. (I’d love to never have to manage insulin, or my BG levels, for the rest of my life, but I wouldn’t want to live with the additional risk of being immunosuppressed.)

      2
      5 years ago Log in to Reply
    23. Ceolmhor

      I answered A1c < 6, but I agree with all those who said they wouldn't take immunosuppresive drugs to accomplish it.

      5 years ago Log in to Reply
      1. RobbyLee

        Me too. I misread the question! I don’t feel immunosuppression is the answer when technology is presently good, but can become great!

        5 years ago Log in to Reply
    24. Kevin McCue

      Immunosuppression therapy isn’t a plus for if I’m getting islet cell therapy. Feels like your dancing with the devil for a few benefits without getting meaningful relief

      1
      5 years ago Log in to Reply
      1. sweetcharlie

        I agree with Kevin !! I have lived with T1D for 68 years since age 21 years and no really problems, so why risk other troubles !!!

        5 years ago Log in to Reply
    25. Molly Jones

      I chose Eliminating severe hypoglycemic events as I am concerned with my cognitive functions as I age.
      Thinking about it harder, I should have chosen being able to eat my meals without planning dosing because if this were possible I assume all the others would fall into place.
      I have hope for T1D, especially those newly diagnosed, as I watch clinical trials and pubmed!

      5 years ago Log in to Reply
    26. Amanda Barras

      My biggest struggle is food. I take so much insulin it really is hard to get it right and not over do it. As well, slow digesting food makes for unexpected highs later. Best solution is low carb to help manage. But, to not have to worry about omitting carbs all the time would be wonderful.

      5 years ago Log in to Reply
    27. Sahran Holiday

      None of these is worth immunosuppression.

      5 years ago Log in to Reply
      1. Britni

        Agreed. I’m not interested in trading one problem for another.

        5 years ago Log in to Reply
    28. David Smith

      I agree with so many others – becoming immunosuppressed would, in my view, not offset any advantages that could be offered. With CGM and pump therapy, T1D has been very manageable for me, at least.

      5 years ago Log in to Reply
    29. Donna Young

      If reducing insulin to one injection a day with smart insulin, it would also accomplish the other items. The best treatment is glucose responsive insulin since it would greatly reduce/eliminate the effort of constant monitoring and adjusting insulin while preventing lows and highs. While some people are successful with pump/cgm combinations, who wants to have these things hooked to their body for life? Also, these devices are expensive and unreliable and require frequent monitoring/maintenance.

      5 years ago Log in to Reply
    30. Robert Brooks

      I think we would need to see elimination of the side effects of diabetes to endure immunosuppression. Cardiovascular disease, nephrotoxicity, neurotoxicity, retinopathy and blindness would all have to go away.

      5 years ago Log in to Reply
    31. Tb-well

      If it involves immune suppression, it isn’t a solution. I wouldn’t use it. I have seen far too many people I cared about die from minor infections while on immune suppressants.

      5 years ago Log in to Reply

    Several companies are investigating islet cell replacement therapies for people with T1D, some of which would require patients to be on immunosuppression therapies. Out of the following options, which of these outcomes would be the most meaningful and desirable for you? Cancel reply

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    [searchandfilter slug="sort-filter-post"]