It has taken 3 months to get through the videos but that is a wrap on #ATTD2025. I'll likely write a blog or two on it. At this stage I'm leaning towards what is normal blood sugar and how to achieve your goals with T1D. Thank you @dedocORG for making it all possible.

I was unaware of Roosevelt's "man in the arena" quote but it applies so well to living with T1D. Unless you are actually living it (not caring for it, not studying it, not working in it) your experience is valid, but it is inherently different, removed. #ATTD2025 #dedoc

The speaker made a really important point. Not only are goals different between PWDs but they also change over our lives. Whether we're newly diagnosed, trying to be pregnant, looking after a newborn, or trying to live as long as possible, priorities will change #ATTD2025 #dedoc

Here is how tricksy T1D can be. Two consecutive days, same walk, same food. Wildly different BGL response. #ATTD2025 #dedoc

A word of warning; if you set your target in the hypoglycemic range you can impair your hypo awareness. In the UK that means you cannot hold a driver's license. The speaker suggested it also means you impair your glucagon response to low BGLs. #ATTD2025 #dedoc

Speaking at the psychological aspect, whatever target we pursue, we should aim to maintain a reasonable level of Time in Happiness (thinking of you @nerdabetic ) or, as I prefer, Time in Contentment #ATTD2025 #dedoc

If you're unaware of how diabetes could be tougher on women, there was a slide for that. #ATTD2025 #dedoc

These were the specific concerns with TITR that came out in the survey. Any management plan seeking to use TITR as its measure needs to address these. #ATTD2025 #dedoc

Many T1Ds have concerns about TITR. They are doing their best and even TIR can be tricky. The speaker said in her survey women overall were more concerned than men. Why? Because it is consistently shown T1D is tougher on women. #ATTD2025 #dedoc

For those freaking out at this new lofty standard, the medical consensus suggests the goal for TITR (70-140, 3.9-7.8) would be 50%. If you are close to 70% TIR (70-180) you are likely already at 50% TITR. #ATTD2025 #dedoc

We see the 'hypo's in muggles in this graph. To have truly normal blood sugar you're looking at 98% TIR, 96% TITR/TING, TBR of 2%.
By all means set this as your north star but don't burn yourself out trying. #ATTD2025 #dedoc

I'm pretty sure I tweeted this while at #ATTD2025 but it is worth repeating. HbA1cs are coming down for T1Ds as time goes on. However, the goal is the dotted red line at the bottom (7%) so there is still more to be done. #dedoc

Interesting result. With a ketone sensor on its shown T1Ds have spontaneous spikes in ketones. On an SGLT2 the incidence of spikes increases but the study showed no increased incidence of DKA. #ATTD2025 #dedoc

Weekly basal insulins are now being Stage 3 trialed in T1Ds. The result is not worse than daily basal insulin from an HbA1c perspective but they did see higher rates of hypos, possibly because they are still figuring out how to use it properly in T1Ds. #ATTD2025 #dedoc

A bit of trivia, NPH works as a basal insulin because a protein from trout semen is added which delays the insulin action. #ATTD2025 #dedoc

A little over half of T1D adults have obstructive sleep apnea. Get a sleep study done my friends ;) #ATTD2025 #dedoc

The growth of CGM and AID use over the last 15 years. #ATTD2025 #dedoc

Some handy tips for managing GI issues on GLP-1s (NUSHs) such as Ozempic #ATTD2025 #dedoc

High Fat, High Protein dinners shown to lead to poorer outcomes for overnight glucose levels which, to me, suggests a good reason to consider AID/Looping if going for a low carb regimen. #ATTD2025 #dedoc

Some more tips for carb counting and 'spike hacking' #ATTD2025 #dedoc

While T1Ds tend to focus on carb amounts, GI can influence the glucose response, with lower GI showing smaller rises. #ATTD2025 #dedoc

Really interesting study showing an insulin dose covers a range of carbohydrate values, not just a precise amount of grams. In other words, carb counting does not have to be super precise to be effective. #ATTD2025 #dedoc

Interesting case study of a 12yo T1D girl on a low carb diet. Great glucose control but gaining weight and insulin resistance due to low carb snacking. A cautionary tale of focusing on one measure but ignoring others to the detriment of overall health. #ATTD2025 #dedoc

AID (Loop) plus Semaglutide (Ozempic) in T1Ds with an average BMI of 32 get improved results than AID alone and meet TIR and TITR targets. TDD dropped and carb intake also dropped. #ATTD2025 #dedoc

@sugarydoc compares commercial to open source and concludes the open source can get closer to a fully closed loop system and like me concludes that for now, adjunct meds may help close the gap #ATTD2025 #dedoc

Amylin is another hormone made by beta cells when they make insulin so T1Ds are missing both. When Amylin (Pramlintide) is mixed with insulin for injection, you get better results than insulin alone. #ATTD2025 #dedoc

A simple roadmap for a fully closed loop system. The speaker contends we are at Stage 3/4. I contend with medications it is possible to reach at least Stage 5 but, ideally, we need to get to a point where the system doesn't need meds to supplement it. #ATTD2025 #dedoc

The amazing Linxi Mytkolli speaks about the 4 L's of diabetes experience. #ATTD2025 #dedoc

Even #dedoc gets a mention and the presenter set the challenge for HCPs to attend the PWD-centered sessions at conferences such as #ATTD2025 to hear the lived experience voice.

Type 2 diabetes gives women a much higher risk of heart disease than it does for men. In fact, women have a much harder time with diabetes types 1 and 2 compared to men on most measures from what I'm hearing at #ATTD2025 #dedoc