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[personal profile] mattbell
There are already implantable glucose monitors.  Why not create one that causes harmless pain if blood glucose rises beyond a certain level, with the amount of pain increasing commensurate with the level?  People modify their behaviors quickly to avoid pain if there's a clear and rapid connection between the pain and a pain-causing stimulus.

Devices that intentionally cause pain might be difficult to get FDA-approved, but it seems like techniques like gastric bypass essentially accomplish the same thing, with far more side effects an irreversible changes. 

I feel like I have a natural version of this glucose-pain connection; when I eat many kinds of junk food, I start to feel sick within minutes.  It's trained me to not eat junk food, even if it once tasted good at the time of eating.

Date: 2011-01-12 11:33 pm (UTC)
From: [identity profile] tenacious-snail.livejournal.com
this assumes that blood sugar rises because of food intake, and not because of a failure to produce insulin.

Date: 2011-01-12 11:34 pm (UTC)
From: [identity profile] nasu-dengaku.livejournal.com
True. This wouldn't work for all forms of diabetes.

Date: 2011-01-12 11:39 pm (UTC)
From: [identity profile] tenacious-snail.livejournal.com
I know it wouldn't work for Type 1. I'm not sure how it would work for Type 2, in that it presumes that eating too much sugar is the cause of diabetes, not the result of having a pancreas that doesn'wt work as it should. And even if you were going to limit this to people who already have Type 2, I don't know who would go for it-- I note that I paying attention to how my body feels, and blood sugar spikes already feel plenty bad enough. As do blood sugar drops.

Date: 2011-01-12 11:53 pm (UTC)
From: [identity profile] nasu-dengaku.livejournal.com
You probably know way more about this than I do, but I had always heard that type 2 diabetes is caused by a mixture of genetic risk factors and diet. I know a couple of people who have avoided the "inevitable" diabetes that runs in their family by eating healthier foods.

Date: 2011-01-13 12:30 am (UTC)
From: [identity profile] tenacious-snail.livejournal.com
if you were looking at doing this for people who are at risk for diabetes due to genetic propensity, the problem with "healthy diet" is that some of what makes ones blood sugar levels lower (limiting intake of fresh fruits and grains, eating a fair amount of fat) isn't the same as what one would eat if one were trying to avoid cardiac problems. My stepfather was recently diagnosed as pre-diabetic, 20 years after his quadruple bypass and a few years after a double bypass. He's been eating low-fat and low-sodium for years; I have no idea how adding diabetes to the list of concerns may change his eating.

If you were looking at doing this for people who are prediabetic, it might help them to better learn what the blood sugar rises and falls feel like, before they develop full blown diabetes.

Date: 2011-01-13 12:50 am (UTC)
From: [identity profile] nasu-dengaku.livejournal.com
Presumably people can cover most of your fat intake with the "good" fats that lower bad cholesterol and are less likely to lead to arteriosclerosis? I know you need to do different things to avoid heart disease vs avoid diabetes, but it doesn't seem super hard to do both.

Date: 2011-01-13 03:45 am (UTC)
From: [identity profile] integreillumine.livejournal.com
Mm, you can 'exhaust' your pancreas even as Type 2, as far as I understand it.

Date: 2011-01-13 03:44 am (UTC)
From: [identity profile] integreillumine.livejournal.com
Also, blood sugar extremes can make it difficult for one to think straight; I know I can get woozy and headachey. (And I was once a 'pre-diabetic'... that has been since diagnosed normal.) Adding more active pain to the mix might make it even worse.

Date: 2011-01-13 06:32 am (UTC)
From: [identity profile] plymouth.livejournal.com
People modify their behaviors quickly to avoid pain if there's a clear and rapid connection between the pain and a pain-causing stimulus.

If only! I've been sitting in ways that cause me pain for YEARS. I know that is causes me pain, the pain develops within minutes but I KEEP DOING IT. Why? Because other than the part that hurts it's actually quite comfortable. So you really have to have not only pain but pain that is considered worse than the associated positive effect of the same behavior.

See also: masochists

Date: 2011-01-13 09:53 pm (UTC)
From: [identity profile] nasu-dengaku.livejournal.com
So I'd need an adjustable pain multiplier dial... including one with negative settings for masochists. :-)

Date: 2011-01-13 07:34 am (UTC)
From: [identity profile] sandrak.livejournal.com
Given that I currently have gestational diabetes... I think this would actually work for me. But it wouldn't even have to be pain. Just something that set off an unpleasant alarm would be helpful. As it is, I don't know if I've gone over until I check my blood level an hour after eating-and that's only if I remember! (I forget about 25% of the time).

Date: 2011-01-13 07:37 am (UTC)
From: [identity profile] sandrak.livejournal.com
And the gestational diabetes isn't due to my sugar/carb intake, or even my weight. It's a high risk factor due to pregnancy with twins and age. Just moderating my diet doesn't help-I have to remember to take the insulin shots _and_ watch what I eat.

Date: 2011-01-13 09:54 pm (UTC)
From: [identity profile] nasu-dengaku.livejournal.com
Hmm... you could use your phone to set a 1-hour alarm after each meal.

Date: 2011-01-13 09:35 am (UTC)
From: [identity profile] sacra-imbri.livejournal.com
The short of it:
A pain-stimulus implantable device for out-of-range serum glucose is not going to exist any time soon, if ever.

The long of it:
1) There are many factors other than diet that influence serum glucose. Diet, yes, also exercise, genetics, stress, illness, injury and various medications. Linking a pain stimulus to spike at a high serum glucose would increase the stress of someone who has the high CBG due to stress, just compounding the initial problem.

2) The body adapts to pain, especially constant pain. Basically, if your patient with the pain stimulus device doesn't treat the fluctuation right away for a prolonged period, it will become less effective as the mind releases endorphins to calm the pain sensation, and then begins to interpret the constant pain signal as background static.

3) Excepting masochists, people don't buy devices designed specifically to cause themselves pain.

4)People that might seek to use such a device are the ones who already pay attention to the signals their bodies give for blood glucose imbalance. If you don't notice the shakes or the rages from being too low, nor the headaches and need to pee from being too high, who is to say a pain probe will do any better?

Date: 2011-01-13 10:03 pm (UTC)
From: [identity profile] nasu-dengaku.livejournal.com
Good points. Some thoughts.

(1) I didn't realize that stress induced increased blood glucose in some people.
(2) The pain could be made to ome on at periodic or random intervals, or otherwise be made impossible to begin ignoring.
(3) As far as I can tell, while it's not explicitly stated, pain upon overeating is the primary purpose of gastric bypass surgery
(4) I've found that at least I respond to direct pain much more readily than other negative stimuli.

Upon more reflection, perhaps the right solution would involve a more immediate feedback so that the stimulus-response is very clear. For example, the sensor could be in the stomach or intestines instead of the bloodstream so that high glucose intake is immediately detected. Alternatively, perhaps something could be done to the taste receptors on the tongue to make them more sensitive to sweet things, thus making many things too sweet to consume.

Date: 2011-01-21 07:55 am (UTC)
From: [identity profile] sacra-imbri.livejournal.com
(1) For the life of me, I can't remember why it happens, but I observe the phenomenon regularly at work.

(2) Which intermittent pain is harder for the body and brain to simply filter out...

(3) The primary purpose as stated for gastric bypass is enforcing portion control by reducing the amount the stomach can expand, thus giving the distended and therefore sated feeling before any more than a reasonable amount is consumed.

(4) Well yes, but just think bout how much more readily you take to positive stimuli. In general, you buy things that make you feel good, or protect you from pain. How willing are you to shell out hard-earned cash for something that blatantly states "This device will cause the user pain"?

Part of the issue on that taste issue is our diet. We eat too much sweet and filter it unless it's near overwhelming... Of course, bad carb comes in lots of flavors. The Siren-call for me is the salty crunch of the corn chip...

Date: 2011-01-13 09:38 pm (UTC)
From: [identity profile] peristaltor.livejournal.com
Go the other way. Develop a monitor that releases dopamine or another happy-goo when the person eats almost no processed sugar. The more disgusting the vegetable the bigger the short shot.

Asparagus? Brocolli? Any steamed green shyte? Mainline heroin. That's the only way to condition against the Evil.

Date: 2011-01-13 09:56 pm (UTC)
From: [identity profile] nasu-dengaku.livejournal.com
Haha. I think a simpler trick would just be to tech people to stir-fry their veggies in walnut oil or some other healthy oil. :-)

Date: 2011-01-13 10:38 pm (UTC)
From: [identity profile] peristaltor.livejournal.com
Healthy oils can do nothing to stop the Horrible Taste of Evil, that which Invokes the Gag. Those who fail to recognize that The Evil Exists, who insist "Oh, c'mon, they're delicious!" are working for The Devil -- the Dark Lord of the (stir) Flies -- in Spreading His Vile Lies.

Calling putrescent substances by cutesy names (like the hateful moniker "veggies") is insufficient in overcoming our body's natural rejection based on taste. This will take hard drugs. ;-)

Date: 2011-01-13 10:52 pm (UTC)
From: [identity profile] nasu-dengaku.livejournal.com
You must not be stir-frying them right. Or perhaps your taste buds are genetically different from mine, in which case carry on with the heroin-injected vegetables. :-)

Date: 2011-01-21 07:30 am (UTC)
From: [identity profile] sacra-imbri.livejournal.com
Actually, rather a good idea from the marketing standpoint, though difficult on implementation...

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