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Re: ‘Fat but Fit’? The Controversy Continues

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It is common for people that don't care about their health just to lie about their health.  Even 6.4 may be OK. 

 

What you can do is look at the bottoms of the foot of the diabetic.  If they are at 6.0 their feet will be normI have al.  Of couse you can't say anything.  Smoking is worse for you than poorly controlled T2D.  That is REALL BAD.

 

You can feel good you married the smart one in that family and he will live a normal life span.  I am old enough that if I was to die from T2D complications, I would know what will kill me by now.  I still have nothing.  The sad thing is once you learn you lost the gambol it is too late to do anything but die.  Typically, your arteries are destroyed long before you get any outward signs something is wrong.  Even my PCP Dr thinks I am nuts and have gone over board.  My endo and her boss think I am smart and follow guidelines.  Not over board but prudent.  It is sad she mu PCP is so poorly informed.  She is a great doc but I know a lot more about T2D than she does.  My PCP did note I don't have diabetic feet which always shows up within 5 years.  This is the only sign we can see without cutting us open.  The eye Dr can also see your arteries in your eye. Mine are non diabetic.  Often they go bad before you become a diabetic.   

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Re: ‘Fat but Fit’? The Controversy Continues

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@RonMesnard  One sister refused metformin and has said she's fine with her 5.9 A1C. Two close relatives died of diabetes complications; another is on the way out, also from diabetes complications; and one other close relative recently died from a heart attack, though this relative also had Alzheimer's (which you may have read is now considered another form of type two diabetes). But she's fine, she says.

 

As for my sister, she smokes, she's morbidly obese, eats like a true southerner (fried water, if you can manage it), has multiple health concerns including two bouts of cancer and of course, diabetes. Both our parents had diabetes. She's on metformin and says her A1C is 5.0. But she recently blacked out and had a fall, then, said, oh yeah, I could feel my BS drop. I have had conversations with her about the damage that diabetes wages to one's organs, and have used the recent examples of same from DH's family to try to get through to her that she is not in fact living with this disease, but slowly dying with this disease.

 

Here's the rub: you can lead a horse to water, and you can splash it all over them, but you cannot make them drink.  Sadly, neither of these two 'horses' are sufficiently thirsty. We have shared, extolled, reported, proclaimed, hollered about and touted our success. The data has been presented and results proven. I'm thinking that's about all we can do.

 

So here's how I make peace: I tell myself that each person has the right to define the constructs of their life in the manner they see fit. These sisters can choose to live a shorter life with sweets and carbs if that makes them happy. As for me, I choose to live a more highly functioning life by eating lots of veggies and working out to a sweat a number of times per week, no matter how many years this behavior may or may not end up adding to my lifespan. That makes me happy. So be it.

 

 

 

 

"The key to success is to keep growing in all areas of life - mental, emotional, spiritual, as well as physical." Julius Erving
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Congrats!  Like with a war it doesn't matter much how you won but did you win.  What are DH's sisters doing?  Maybe we can help them. 

 

What meds do they take and how is their diet and excersise?  It doesn't matter how you skin the cat as long as you do.  Maybe we can find so more palatable options for them.  The benefits to maintaining a non diabetic A1c are large.  By maintaining an A1c below 6.5 I have no physical symptoms of T2D.  My eyes and feet are still normal.  Your eyes and feet show diabetic wear and tear after 5 years of less than 7.0.  That is a very slow progression if you maintain below 7.0.  Still, the end result is you going blind and your feet being amputated.  Why would you want that? 

 

The experts the endocronologests made the goal of less than 6.5 last century and the results are great for those that follow that guideline.  You don't even die 10 years early! 

 

For the medical to work you need at least an OK diet and excersise.  Drugs can't make up for a bad life style.  What meds are they taking and do they test their BG and when? 

 

There are several drugs they can take.  Metformin is the cheapest and the rest are expensive to very expensive.  To afford the most expensive you need to be on a good medication plan.  That means a bigger premium. When the drugs you take cost over a grand  a month, the premium isn't the biggest issue.  There is even more than one form of metformin.  Some are more powerful than others.  The once a day tablets are the way to go and the cost is about the same.

 

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@RonMesnard So has it really been since February that we started DH with the continuous glucose monitor? I'm sorry that I dropped this thread.

 

We have been focused on cycling training, then racing at the senior games, then on resting from the months of frenetic activity and I am happy now to report that at this point DH is 100% out of pre-diabetes.  We did, of course, continue to closely monitor his nutrition and exercise program, employing things we learned about his body while using the monitoring system. But I'll spare you the blow by blow.

 

Anyway, today is day 10 for this 10-day sensor and I am happy to state that with one exception --that being a 6 hour lapse between meals, then a good sized helping of coconut panang curry over rice-- his blood glucose remained within the 70-140 range and averaged 93. So that's the BG numbers. What also contributed to this success was that we got a second mini-trampoline and began regularly doing high impact interval training together and also lifting hand weights. We both lost weight this summer, but most importantly, we each gained muscle and dropped our BMIs by 1.5%. (We both now wear smaller clothes than we did in high school.)

 

So I guess the rub is that diet and exercise really can pull a person away from the pre-diabetes cliff. Even a super fit member of a diabetes-rich family can tweak habits to fend off what seems inevitable due to DNA, given exacting data.

 

We're super glad to have been able to use the continuous glucose monitoring system to help us win this battle. The ability to monitor the impact of certain behaviors has been of immense value, because his was never a textbook case. (His weight was never out of the 'healthy' range, and most people would have called him thin before he lost weight this summer) It has been enormously helpful to see the effects of chocolate and pasta, for instance, on his blood sugar levels. How marvelous it is to know his particular limits and to have learned to live well within those.

 

To make good use of the continuous monitoring system, one must be willing to be neo-OCD about it. Charting intake. Taking measurements every 15 minutes. Scheduling meals according to needs rather than wants. But if that's what it takes, then that's what it takes, am I right? Smiley Happy

 

Meanwhile, we both have older sisters who are unwilling to use the continuous monitoring system and who are fighting this disease the traditional way. Neither of them are winning.

 

Epster, relieved about DH, still concerned for the sibs

 

 

 

 

 

"The key to success is to keep growing in all areas of life - mental, emotional, spiritual, as well as physical." Julius Erving
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@RonMesnard  just touching bases, now that DH has had the CGM device hooked up for a few days:

 

So far 1/2 cup of oatmeal (of the savory variety, so made with diced tomatoes & onions, a wee bit of salsa and topped with half a small avocado) served with one piece of dry whole wheat toast is a no-no. That spiked his BG to 180. Next we'll try the oatmeal w/o the toast. Sheesh. Smiley Happy

 

But an apple, later, was free in terms of BG. Not even a ripple. (Yes, yes, I am planning to make sure we have apples onhand at all times.)

 

Yesterday, a green salad for dinner took his BG down to 80, whereas a before dinner snack of 25 corn chips plus 2 ounces of queso took it up to 167. It didn't return to 99 for over an hour, after which we ate dinner, and the monitor reported the drop to 80.

 

Too early to draw conclusions, of course, however this CGM system is already the best show in town and we are hooked. Smiley Happy 

 

Epster, hoping this is a good crazy Smiley Happy

 

"The key to success is to keep growing in all areas of life - mental, emotional, spiritual, as well as physical." Julius Erving
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@Epster, you are preaching to the choir.  3 of my grandparents died from diabetes the other died in a car crash before he got old enough to get diabetes.  I am the only one who became diabetic in my family and I needed to gain a great deal of weight to become T2D.  Back then my Dr blaimed a good bit on my condition on my weight gain so I was angry and lost 30 lbs.  That is the only reason I am not on insulin today.  They gave terrible diatary advice of which some still survives.  Sugar is not any more of the beast than any high carb food.  DH's relitives were likely diagnosed then if they are dying now.  It takes at least 20 years of being stupid, to die from this and it is a terrible way to go.  His relitives didn't know they were acting stupid back them but they know much more today.  When I lost my weight my BP meds were not dropped so I was high 120s - low 130s.  Not good but far from dangerous and lower than targets at that time.  That and my weitght loss is why I am healthier than the general population today.  Few become diabetics today unless their Drs are dinosaurs.  Now they catch you at pre-D and keep you there if you follow Drs advice.  Taking certain BP meds at night, staying trim and taking Metformin ASAP are the best way to slow or stop diabetes progression.  Unless you are eating too much food so you are gaining weight diet has little or no effect on diabetic progression. The same for excersise.  That is why going to a continous BP measuring is a bit bothersome.  Maybe the Dr is looking at your fasting numbers.  That could be meaningful. Far more meaningful than a glucose tollarance test. 

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Hey Ron, @RonMesnard. Yeah, DH isn't, at this point, dying of diabetes. His mom and a sister did. One sibling is dying of diabetes complications and another is diabetic. The thing is that for 3 of these relatives, diabetes went undetected for years. And then they died. The family history is what has us on alert. We're, shall we say, proactive. Smiley Happy  I wanna be climbing mountains and winning bike races with this man for decades to come. Diabetes does not factor in. If we can help it. We're hoping we can. Smiley Happy

 

None of these people were obese, btw. Most all of them --DH excepted-- were or are overweight, and none of them --again, save DH-- were given to regular heart-pumping exercise, though none of them are couch potatoes. All eat from-scratch meals and are health conscious. But still, their DNA (and lifestyle?) opened the door to this disease. We hope to slam shut that door, install a deadbolt and nail it shut for good measure. Then we plan to pull a heavy bookcase in front of it to seal the deal. Smiley Happy

 

More when we get data.

 

 

 

 

 

 

 

 

"The key to success is to keep growing in all areas of life - mental, emotional, spiritual, as well as physical." Julius Erving
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@Epster, I would be curious what a normal person 'looks like'.  I will expect very normal while he wakes.  Even if he becomes pre-D they still react near normally after eating.  What will be the most telling is what happens while he sleeps.  Fully normal persons have a fairly tight BG control when they sleep.  If it dips too low the liver dumps sugar and it is quicly shut off.  The worse your diabetes the longer the dump.  I was dumping like crazy last year until they finally upped my meds. 

 

Your hubby has a s-BP of 120.  He isn't 'dying of diabetes'. The first warning sign will be the raising of his s-BP. A rising of LDL or tri-s would be the next red flag.  If his s-BP rises BP meds will be more effective than diet at both keeping him healthy and slowing down the progression.  Both ACE and ARBs both reduce diabetic progression if taken before bed more than 70% one is a tiny bit better than the other but both reduce progression in the 70s%.  Diet has not been statistically proven to reduce diabetic progression unless you eat like a pig.  Diet has more to do with controlling weight.  I am sure he is in the group like me that will only get diabetes if they are over weight.  

 

You will get real, true, actual, usable data. 

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@RonMesnard  OK. So. Here's where we are: DH's PCP appt was yesterday. He was given a prescription for the continuous glucose monitoring system because of the family history with death-by-diabetes, even though he's now on the 'healthy' side of the pre-diabetic border. The premise is that DNA gave him a less-than-optimal and otherwise punky pancreas. The idea is to see what influences his BG. 

 

So off we go, into the wild blue yonder. Smiley Happy  I'll let you know what, if anything, we learn from the initial 10-day monitoring. 

 

Fingers crossed for real, true, actual, usable data,

Epster 

 

"The key to success is to keep growing in all areas of life - mental, emotional, spiritual, as well as physical." Julius Erving
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