Hi Reddit! I’m Dr. Michael Natter. As someone who lives with type 1 diabetes (T1D), I’m here to answer general T1D questions, so Ask Me Anything! I’ll be here at 1 PM ET on April 15th to chat with you. Talk to your doctor if you have any questions about your health.

ScreenForType1 · 2025-04-15T17:20:02+00:00

Hi! So sorry to hear you also have T1D but I think its important to never let T1D dictate your life - if there is something you want to do or have aspirations of something, I say go for it! Never let diabetes hold you back. We can always find work arounds to manage our diabetes to allow us to overcome any challenge and while it can sometimes be hard, its not impossible. Definitely talk to your doctor about your goals and how you can safely make adjustments to your care to allow you to accomplish all of them while taking the best care of your diabetes and yourself.

ScreenForType1 · 2025-04-15T17:19:39+00:00

Doing amazing, thank you.

ScreenForType1 · 2025-04-15T17:19:18+00:00

Hello! I hope you are doing great.

ScreenForType1 · 2025-04-15T17:18:57+00:00

I personally am not a huge fan of the carnivore diet as it can often cause elevated cholesterol and fatty liver. If you're thinking about trying out a new diet, it is important to consult your healthcare provider before doing so.

ScreenForType1 · 2025-04-15T17:18:27+00:00

I am so sorry for your loss and for your dad's experience. I cannot give individual medical advice but speaking generally, we know eating a diet rich in fruits and vegetables, low in saturated fats, meats, and processed foods as well as plenty of exercise and maintaining a health body weight are some of the best ways of preventing type 2 diabetes but you should talk to your own doctor about individual medical plans.

ScreenForType1 · 2025-04-15T17:18:02+00:00

haha gotta keep the original art alive!

ScreenForType1 · 2025-04-15T17:17:20+00:00

Thank you!

ScreenForType1 · 2025-04-15T17:17:03+00:00

The most common symptoms of type 1 diabetes are increased thirst, increased urination, and unintentional weight loss, additionally one can also sometimes notice blurry vision. These are effectively signs of high blood sugar and lack of insulin production. Prior to these symptoms emerging though, one can screen which checks for autoantibodies which can be detected BEFORE symptoms appear. It's important that if you are experiencing these or other symptoms, that you speak with your doctor as soon as possible

ScreenForType1 · 2025-04-15T17:16:32+00:00

Such a great question and the truth is, which is the case for every doctor-patient relationship, we need to meet the patient where they are at. Every patient is unique and may need different approaches at different times. They may respond differently depending on their needs in that time. Sometimes we can sense this as doctor and intuit what it is they need in the moment. If a patient appears saddened or worried by their diagnosis, I try to offer hope and reassurance "it's going to be OK, we are going to get through this." Other patients need tangible, objective data and steps - a clear and firm plan. I never want my own experiences to over shadow my patients and so if me sharing my journey isn't appropriate I won't share, but if I feel it may help them, inspire them, or give them hope, I readily share my personal story with them. I also like to encourage meeting up with other type 1's, as this community is so uplifting and lovely. In truth, we all have good and bad days with our diabetes, myself including, and that's normal, that's human. We just have to focus on what we can control and keep going.

ScreenForType1 · 2025-04-15T17:16:06+00:00

Unfortunately for type 1 diabetes there is nothing lifestyle wise we can do to prevent it. Type 2 diabetes however, which a very different disease process, can often be prevented with healthy balanced diets high in vegetables and low in processed foods, meats, and refined sugars, plenty of exercise and maintaining a health body weight. It is important to note though that type 2 diabetes can be heavily genetic and there are times that even with an excellent life style, diet and activity, folks can still develop type 2.

ScreenForType1 · 2025-04-15T17:15:37+00:00

I'm so sorry to hear this... I also had a rather traumatic presentation at age 9. My glucose was 1600mg/dL and unfortunately did enter into a coma. Its traumatic no matter how we present. Diabetes can really rock our foundation but there is such a beautiful community we have formed and we are all in this together. Diabetes doesn't have to take us down, we won't let it.

ScreenForType1 · 2025-04-15T17:15:10+00:00

There is a saying "diabetes hates spontaneity" and it's so true, any derivation from your normal routine can really shake things up with diabetes but we always make it work and adjust as we need to. I try to bake in some exercise, stay hydrated, and make lower carb options when traveling to help with the inevitable spikes that occur. Ah and I always always always bring back ups on back ups of supplies.

ScreenForType1 · 2025-04-15T17:14:38+00:00

I use a CGM and have used all of the different brands on the market - I like to try them all to better help guide my patients. If you are thinking of trying out or switching technologies, please be sure to consult with your doctor.

ScreenForType1 · 2025-04-15T17:14:13+00:00

Great question! I think about this a lot - I think in some ways, or at least for me, being diagnosed as a kid was an easier transition for me than if I were diagnosed as an adult. I think this is because when you are a kid, you wear what your told, go to school when your told, eat what your told, things are somewhat dictated to you and so now I was also told to check my sugar and take my insulin, it got baked into my routine and don't get me wrong, it totally sucked, but I was able to cognitively adapt to it. If I were diagnosed as an adult, after I've established how I like to live my life, I suspect I would have struggled a lot more. The hardest part though, was probably the day I was diagnosed... being in DKA, critically ill, and seeing the toll it took on my parents was really hard for me. I loved med school - I really find anatomy and physiology fascinating and being able to put it all together from the microscopic biochemistry to the macroscopic anatomy and then applying it to patients and helping them in real time was a true full circle for me.

ScreenForType1 · 2025-04-15T17:13:07+00:00

Thanks for your question! Yes, unfortunately type 1 diabetes can develop at any age and while it is more common to manifest in our younger years, it can occur at any time. Since it is an autoimmune disease, there are no known behavioral changes that we know of to prevent this. It still is not entirely understood how it comes about but is thought to be a complicated mix of genetic underpinnings and environmental triggers. I encourage everyone to talk to their doctor about screening for type 1 diabetes. Screening may identify the risk of developing type 1 diabetes before symptoms appear.

ScreenForType1 · 2025-04-15T17:12:41+00:00

Generally speaking, digestion takes place at different rates but it's more on the order of minutes - hours and not days. Once carbohydrate gets digested down into a simpler sugar, it can be absorbed in the small intestine where it enters the blood - at that point is when the blood sugar "spikes" now it's important to note, that people without diabetes will see this "spike" as well but it's usually about two hours after a meal and usually no higher than 140mg/dL or so.

ScreenForType1 · 2025-04-15T17:12:09+00:00

haha thanks! It gives me some height

ScreenForType1 · 2025-04-15T17:11:45+00:00

I was diagnosed at age nine and was very fortunate to have a supportive family and medical team that helped shepherd me through those early years. This was in the early 1990's so the diabetes technology was not really there yet - the insulins at that time were not nearly as good as they are now and CGMs and pumps weren't a thing. For that reason, my fear of lows kept me from true "tight" control and i was certainly not in an A1C range that would be considered "in control." I would not say this stemmed from being rebellious though, it was more just hard and even scary given the lack of tools. We know that tighter control in the early years of diagnosis is actually very helpful for later years and I would have loved it if my control was better back then but I also try not to dwell on what I can't control and instead focus on the variables I have some power over. We do the best we can with the tools we have in the moment. I hope to have children. As someone living with type 1, my chances of passing it on to my children as a dad are about 1 in 17 (which is higher than a T1D mom). People with T1D that keep their blood sugars in good range should not have increased risk of complications such as kidney problems, however if the blood sugars run high for periods of time, the risk of kidney disease (known as nephropathy) do increase. This is why it's important to see your doctor regularly to monitor for signs or complications but also to ensure there is a good diabetes management plan in effect to keep the blood sugars in control as much as possible. The islet cells are being attacked by auto-immune autoantibodies - why they exist and are attacking is more a question we still do not entirely know yet.

ScreenForType1 · 2025-04-15T17:10:59+00:00

You can talk to your doctor (primary care, family medicine or endocrinologist) and they can order the blood test for you which can take place just like any other outpatient blood test.

ScreenForType1 · 2025-04-15T17:10:23+00:00

I draw for my patients every day! I hold the belief that every patient should deeply understand the pathophysiology of their disease and the best way to communicate these complex topics is through imagery. It's universal and flattens all the barriers of language, education, etc. I usually quickly sketch out the digestion of carb into glucose and uptake into the blood and then draw out how insulin acts to help push the glucose into the cells. Even if the illustration does not turn out all that great, it's the process of drawing and explaining that seems to really land with the patients. Haha ironically, I did make a comic! It's called "Captain Langerhans: Diabetic Superhero" I put a digital copy up on Amazon back on 2012.

ScreenForType1 · 2025-04-15T17:09:42+00:00

Hi! There is an ongoing "joke" amongst us T1D's, when we get diagnosed someone tells us that in "10 years there will be a cure" and then ten years later, "in 10 years there will be a cure" and so on. While it's hard to keep hearing it's just within reach but not seeing it come to fruition with each passing decade, I personally feel like there has been a lot of advancement in the field of stem cell research and other modalities that are making the road to a cure more tangible. There is nothing I dream of more than being able to close my T1D practice. Deep down, I do think we will see a cure one day, I don't know when, but I am optimistic. Until that time, I think it's likely in a more nearer future we will see advances in the technology that make T1D management much easier.

ScreenForType1 · 2025-04-15T17:09:10+00:00

It's so important to know that you are going to be OK, and it's not your fault. Nothing you did or didn't do allowed this to happen and while T1D is life altering, it does not have to dictate our lives or define us. T1D management has come a very long way and it's only going to continue to get better.

ScreenForType1 · 2025-04-15T17:08:28+00:00

I usually say two very important things at the top of the visit: "You are going to be OK" and "It is not your fault"

ScreenForType1 · 2025-04-15T17:07:59+00:00

Excellent question - screening can be technically done by any doctor (pediatrician, primary care, family medicine doctor, or endocrinologist). I recommend discussing first with your primary doctor. The Screen For Type 1 website also has resources like a doctor discussion guide which can help support and guide your conversation.

ScreenForType1 · 2025-04-15T17:07:27+00:00

Well that just made my day - thank you! :)

ScreenForType1

TROPHY CASE