Sunday, August 5, 2012

Something A Bit Different

It has been a busy weekend here at Castle Graybeard, all of it centered on things not related to our usual discussion fodder.  I wanted to pass on some interesting health-related items I've been reading about. 

Diabetes is becoming a very common and very serious problem in the developed world today. As a threat to overall health and well-being, I think it's pretty widely underestimated, yet virtually all of the scheduled (that is, non-traumatic) amputations in the US are caused by "complications of diabetes".   Likewise, it's a leading cause of blindness, kidney disease, tendon injuries and a strong contributor to heart disease.  In a study of cancer, researchers found the strongest predictor of heart disease was not cholesterol or blood lipids, but a measure called A1c.  A1c is a measurement of the amount of hemoglobin in the blood that has had glucose bonded to it.  A1c is often considered an indication of how well diabetics control their blood sugar, more like a long term average than the instant value obtained with a blood sugar meter (glucometer). 

I don't have diabetes, but my mother and brother do.  Because of the way my genetic dice are loaded, I do, however, qualify as pre-diabetic in a lot of the studies that are being done.  Added to that, I have an elevated fasting blood sugar, although my response to meals remains within good limits.  The elevated fasting blood sugar is probably the result of insulin resistance, a precursor condition of diabetes. 

In an effort to ensure I don't go the rest of the way to full diabetes, I've been reading the excellent, "Blood Sugar 101" by Jenny Ruhl.  While the book is a compilation of information available for free at her website by the same name, and you don't "need" to buy it, putting the data in book form makes it more readable, and easier to ensure readers get a logical progression of the thoughts that go into understanding the subject.  Jenny is a type 1 diabetic, and has been researching that condition and the various types of the disease for years.  Most adults have heard the term "type 2 diabetes"; it turns out there's more than just the two types.  Although she isn't a physician, I've run across more than a couple who say they've learned more from her than from med. school. 

As a side note, you'll often hear that obesity leads to type 2 diabetes.  Research is showing the opposite case to be the truth: the conditions that eventually lead to diabetes cause obesity first.  There are several things that cause this series of problems, from "bad genetics" to environmental toxins that disrupt insulin production in the body.

The big take away message from the book and web site is that the slide into these complications can be stopped.  If you've been told you're diabetic, odds are that your physician is willing to accept numbers for fasting sugar and especially postprandial sugar (i.e., after meals) that have been shown to be dangerous.  The same warning applies to your A1c number.  You should not let your blood sugar go above 140 mg/dl after meals, and there's no reason you shouldn't be able to keep your A1c below 5%.  In a very thoroughly documented case, Jenny shows why the numbers being advised by the American Diabetic Association are too high to maintain your health. 

If you, or a loved one, has diabetes, I can't recommend this book highly enough.  It is the most interesting thing I've read in a year, since Gary Taubes book "Why We Get Fat". 


  1. My Dad and his Dad were both diabetics, and I am, too.
    I try and watch what I eat and get enough exercise, but I still take Metformin and a time-release Glipizide.
    My A1c runs around 5.7, which makes my Doctor very happy.
    If I could lose this extra 30 pounds I seem to keep lugging around, I'm sure my A1c would drop even further. The funny thing is that before I came back to this job, I was only lugging around about 10 extra pounds. I keep telling my wife that I was actually getting better quality exercise doing all the yard work, tree trimming, and landscaping I was doing, vs lugging heavy equipment around like I do now.
    And my knees didn't bother me one bit! Now, with all the stairs I have to climb, carrying 20~30 pound pieces of test gear, my knees are killing me, and I've put the weight back on!

    1. When I tell my doctor that it used to be much easier for me to lose weight, he says, "your metabolism has changed". To me, that's a meaningless statement. It's like saying, "you're fat because you're fat". I want to know what changed and why. More importantly, what to do about it.

      I gained a lot of excess weight while cycling 100 miles a week or so (except for the days I did 100 miles a day). So thinking I'm going to lose it by any reasonable amount of exercise doesn't strike me as realistic.

  2. Well, as a general rule, your metabolism slows down as you get older, which makes it harder to lose weight.
    I noticed the biggest difference when I got to be about 50.
    "Gaining weight" isn't necessarily a bad thing. Muscle weighs more than fat, so if your pants aren't getting tight, and your waistline stays the same, you're probably converting fat to muscle mass. When I was off work, and doing all the manual labor around the house, my pants were getting loose, and my wife made the comment that it was easier for her to put her arms around me, and yet my weight stayed the same. My Doctor said that was a good thing, as it meant I was exchanging fat for muscle.
    And my A1c was way down back then, too. I wasn't really considered "diabetic" anymore, but as soon as I went back to work, and my eating and exercise changed, the weight came back up, along with mildly elevated A1c levels.

  3. I was headed down the diabetes highway myself. As an RN, I know what that means... a slow death. I finally hrew out all processed food, vegitable oils and sugar and artificial sweeteners. I started eating just vegitables, wild caught fish, eggs, raw unpasturized goat and cow milk, and grass fed beef, with a few nuts and berries to keep it interesting. Started growing some of my own stuff too. I do my best to eat a lot of saturated fats. Yes, conventional medical wisdom is wrong on that one too.
    It's been 6 years and my blood sugar is better than normal. I take no meds, My HA1c is 5.0. I dropped 30 lbs in 4 months. At the gym (Crossfit) I've outdone people 30 years younger than myself who are in the military (I'm 52).
    You can cure yourself. You just have to want to bad enough.It's been 6 years now!

    1. Excellent story, Dave.

      Readers - Dave's success at treating diabetes with "diet and lifestyle" is not that unusual. If I may lump his approach to treating himself into a name, this is the "paleo diet". If you read some of the blogs for any length of time, you will come across many success stories like this.