> he is obviously brilliant, so controlling diabetics via insulin shots should not be hard

Being brilliant and the ease someone has controlling diabetes aren’t necessarily related.

The higher you are for a long time, the less you’ll notice the highs. When I was diagnosed, my A1C was over 13, so I’d likely been averaging 300+ for weeks. I felt like shit but it came on slowly over a period of months. It had been so long that I didn’t know what it felt like to feel normal.

But I’m also quite stupid, so take this with a grain of salt.

I can understand not knowing the very 1st time (prior diagnosis), or a denial as there is no cure. Most Type 1 diabetes takes weeks/months to be diagnosed, indeed. However, his case was years long - I'd expect he'd have had a glucometer and at least a test a day (it takes less than 10sec). That's the controlling part. It's much easier to die from hypoglycemia than hyper one with insulin treated diabetes, with the former taking mere minutes and switching the brain entirely off.

Avoid trying to guess/predict how someone who's not you deals w/ a lifelong chronic illness. In a perfect world every person with diabetes would be rigorously testing and in total control of their blood sugars. This isn't always possible and isn't always what the person wants.

Personally, as a person with Type 1 Diabetes who has relatively good control, I am much more worried about DKA than an unexpected low. Modern insulin analogs are very predictable and I eat a very structured diet. I wear a CGM and am very aware of my #s. It's much more likely that illness or some other factor will send me into DKA than an unexpected low will kill me.

This isn't true for all people with diabetes though.

"But I’m also quite stupid, so take this with a grain of salt" <-- this sounds like genuine humility, thanks for this, we only see this rarely.

His tweets have referenced insulin in the past, so there must have been other complications.