February 26, 2021

"Should older people with slightly above-normal blood sugar readings — a frequent occurrence since the pancreas produces less insulin in later life — be taking action..."

"... as the American Diabetes Association has urged? Or does labeling people prediabetic merely 'medicalize' a normal part of aging, creating needless anxiety for those already coping with multiple health problems?... Defenders of the emphasis on treating prediabetes, which is said to afflict one-third of the United States population, point out that first-line treatment involves learning healthy behaviors that more Americans should adopt anyway: weight loss, smoking cessation, exercise and healthy eating. 'I’ve had a number of patients diagnosed with prediabetes, and it’s what motivates them to change... They know what they should be doing, but they need something to kick them into gear.' Geriatricians tend to disagree. 'It’s unprofessional to mislead people, to motivate them by fear of something that’s not actually true.... We’re all tired of having things to be afraid of.'"

From "How Meaningful Is Prediabetes for Older Adults?/A new study indicates that the condition might be less of a worry than once believed" (NYT).

84 comments:

Tom T. said...

It's hard not to be mistrustful when I hear someone urging me to use less medical care.

TickTock said...

Very interesting & thanks for posting. Over the past several years I've slipped into the pre diabetes range a couple of times and then returned to normal.

mikee said...

I am over 60 and am still obese, but I've lost 50+ pounds since the beginning of COVID last year precisely because obesity is a comorbidity factor for the virus, and I figure every pound less helps me. I've avoided getting the virus, can't yet get the vaccine (Thanks, Biden!) and will take it asap. I'm still losing a pound or two per week, and by this Christmas hope to be able to do a handstand, to impress my daughter.

It isn't fear-mongering to tell the truth. Carrying around extra lard on yourself damages your body over time, and as you age your pancreas doesn't work like it did when you were younger. Combine those two facts, and the effects are worse. Lose the weight, fatso.

Let me say it again, because I need the motivation as much as anyone else:
Lose the weight, fatso!

Ann Althouse said...

When I slipped over the line into the "pre-diabetic" zone, it motivated me to lose 22 pounds in the next 6 months and get retested to see that I'd gotten below that line. I knew there was nothing magical about where they drew the line, but it was a big motivator for me. I really didn't think I could lose weight at my age, but I started my running routine, ate low carb, and stopped eating in the evening, and it was enough.

tim maguire said...

A lot of this seems to be to come down to our ability to properly assess risk and live with unknowns. "Prediabetes" may in some sense be medicalizing the normal process of aging, but I can also see it being useful for who to watch, who is most at risk.

But unfortunately, that's all too often not how it works out. Some people will respond positively by cleaning up their health habits, others will respond neutrally by doing nothing differently, while still others will have health anxiety over it and pursue unnecessary or ineffective treatments and their quality of life will suffer. And then there is the always-present danger of insurance companies and other organizations misusing the information.

There's a COVID tie in here. Our sense of risk tolerance developed in a time where we had rudimentary ability to detect risk. If we saw it, it's probably serious enough to alter our behavior to deal with it. But today, when we can detect such miniscule amounts of risk that they don't present any realistic risk at all, we are still using the "if you know about it, you should protect against it" standard. See, for instance, extreme COVID lockdowns.

Lucid-Ideas said...

Just don't tell Southern black people. Keep yourself healthy, but you don't need that kind of trouble.

TreeJoe said...

The term "prediabetes" is a scare term to simplify the fact that your blood sugar is elevated, close to the level defined as diabetic, but not there yet.

It's a scary way to say the following: Your body is not processing glucose efficiently and it's building up in your blood. This could be normal or it could be you are heading to diabetes. With your history, you should do X, Y, and Z for three months and let's check back. Nothing to be scared of here; 1/3 of americans fall into this zone at some point.

As a related point: The types of accuracy of these tests is always in question at macro scale. How many people are properly fasting? What was the last meal before that? etc.

Now a real tangent: There is not a broad public knowledge of how inaccurate current COVID remains and how as the positive infection rate decreases the resulting numbers become LESS accurate, whereas at higher positivity rates the numbers are more reliable. To wit: Reading Hospital in PA has lots of covid patients but they haven't had a single flu patient this season.

Mr Wibble said...

I lost about 30 pounds during 2020 due to dieting and working out, and then promptly gained it back in September when I spent 6 weeks on the road visiting family while waiting to start a new job and move to VA.

Achilles said...

I am going to switch to the carnivore diet.

I think almost everything our medical and science establishments have put forward for the last several decades is highly suspect with our overall health given less importance than the profits of Pfizer and nabisco.

Ann Althouse said...

There's the problem of medicalizing old age, but also the problem of de-medicalizing old age.

I can see in that article the creeping belief that it's not worth treating older people for slow-developing conditions because they're likely to die before the problem fully manifests itself.

Michael K said...

The most important thing to do is weight loss. Metabolic Syndrome can cause high serum insulin levels. Most of the time weight loss corrects it.

greg said...

Just got tested, Hemoglobin A1c 5.7%. Prediabetic range 5.7-6.4% I have had a weakness for Coca-Cola...Until the B.S. with coke and white racism involving employee behavior training. I drank Coke for the last time about 2 weeks ago. It's war now. Coke is trying to kill me. Good tasting, slow working Poison.

Ann Althouse said...

"Just don't tell Southern black people. Keep yourself healthy, but you don't need that kind of trouble."

Did the NYT even touch on the racial angle in this problem? So much race seen in so many problems these days, but this is one where the difference is very clear! If the idea is to back off on treating diabetes, the impact on black people is much greater than on white people.

Ice Nine said...

My A1C went high normal last year. So I went on a low carb diet for three months. No bread, pasta, rice, ice cream, cake, cookies, OJ...all the things I love. What an absolutely miserable way to live! And it only dropped my A1C by 0.1. Told my doc that I wasn't going to live my last 10-15 yrs on the planet like that. And if that meant it was going to be only 8-13 yrs or some such, so be it. If/when the A1C goes into slightly abnormal range, I will start taking Metformin or whatever and keep on living an enjoyable life.

tim in vermont said...

I don’t trust any ‘science’ that looks for all the world like a rationalization for rationing. It’s like the ideas that we should ignore prostate cancer and not test for it. Like one urologist said, ‘Yes they have a lot of fancy and intricate math that says they are right, but I don’t miss the wards full of men dying of prostate cancer I used to have to deal with."

Levi Starks said...

You have to be very careful with the “healthy eating” Toit the modern food pyramid that’s gotten us to where we are.
The original creator of the food pyramid did not envision it’s current form.
You simply need to learn to be satisfied with far less carbohydrates. And learn not to fear fat.

Assistant Village Idiot said...

When a doctor says "I've had a number of patients..." it means she hasn't done the homework and is following confirmation bias.

farmgirl said...

Micheal K
Yay! Nice to see u.
Miler- Word. &Great job!

Mark said...

There is a LOT of "labeling people [X, which] merely 'medicalizes' a normal part of aging, creating needless anxiety." And the older someone is, the more they do it.

John henry said...

I'm pre-dead, myself.

John Henry

Howard said...

Eat less processed foods, eliminate added table sugar, eat fewer calories, move more, skip some meals, fast every day, don't snack. Everything else is just vanity. Vegans and Carnivores are virtual signaling: Human beans evolved as Omni vores.

joshbraid said...

My wife is a wound-care nurse and her patient load is mostly people with diabetes, Types I and II. Here stories of amputations of toes, feet, and legs, and never healing wounds is enough motivation for me.

Dave Begley said...

mikee:

How did you lose all that weight?

I've started rowing. So far, 87,000 meters in about one month. I hope to hit 100k this weekend.

Mark said...

And when they label one level which is actually normal and natural as "abnormal," and consequently give some drug to address it, the drug will invariably throw something else out of whack.

From the NYT -

A few years ago, routine lab tests showed that Susan Glickman Weinberg, then a 65-year-old clinical social worker in Los Angeles, had a hemoglobin A1C reading of 5.8 percent, barely above normal. “This is considered prediabetes,” her internist told her. A1C measures how much sugar has been circulating in the bloodstream over time....

She was already taking two blood pressure medications, a statin for cholesterol and an osteoporosis drug....


Well, there you go. Mystery solved. Statins raise blood sugar. So, after the doctor being the cause of this new condition, now he/she wants to give her yet another med which will cause who knows what other problems.

Lucid-Ideas said...

"Did the NYT even touch on the racial angle in this problem? So much race seen in so many problems these days, but this is one where the difference is very clear! If the idea is to back off on treating diabetes, the impact on black people is much greater than on white people."

Like I said, don't tell them. Injecting race into the conversation is ok, it's 2021. But body-shaming? Very much a taboo subject still. Black bodies should - as we all know - "be celebrated".

tim in vermont said...

Howard’s right. Except I still use table sugar on my bran and banana in the morning. It’s the pre-sweetened stuff that is poison.

Oh yeah, in defense of the banana. There are three low-preparation sources of potassium: dried apricots, bananas, and avocados. Potassium is an electrolyte critical to good heart rhythm and is also key in controlling the excretion of salt and maintaining good blood pressure. Since I got religion on potassium and started preparing almost all of my own meals, which sounds daunting, but after it becomes habit, you start to enjoy it, and since I make sure to get a solid dose of potassium with every meal, which bananas make easy, though a baked potato is good too, or a sweet potato or acorn squash, etc, for my cooked meal, I have managed to ditch a lot of my blood pressure medications and my blood pressure is lower now than it was when I was taking three times as much and couldn’t take any more because of how it would make me feel.

The thing about bananas for me is that I have to stick to the medium ones, and remember that they have as many calories as a slice of bread, and you can’t just eat them as if they were cherries or small apples or something.

rhhardin said...

How much of older age do you want to spend being a patient. Letting things run a natural course frees up a lot of your mental space. Also you avoid iatrogenic sickness.

tim in vermont said...

I also lost 25 pounds to drop my blood pressure, so it wasn’t just the potassium, but I lost a lot of that weigh prior to getting religion on cooking my own meals by carefully adding up the calories heplfully provided on the MacDonalds menu. If I am on the road now driving, a MacDonalds cheeseburger (300 calories) and a banana with water is a perfectly fine road meal. The key to losing weigh on the road is to avoid the heaping fat laden portions at most sit down restaurants. In other words, stick to fast food, which is ironically healthier, as long as you stay away from the fries and the poison fountain, I mean soda fountain.

Howard said...

Being a sedimentary fat fuck senior is a free e-ticket ride to a plethora of medical whack a mole inducing iatrogenic sickness.

MadisonMan said...

One thing I'm particularly good at, after a lifetime working with computer code, is Feature Creep. This is what the American Diabetes Association is doing. Not merely content with fighting Diabetes (and the fund-raising necessary for that fight), they much now also fund-raise (and then fight against) something more prosaic.

Leland said...

This is something quite personal to me. I've been diagnosed pre-diabetic. Like most Americans, I'm also over weight. But then we go through the actual data from my labs. Yes, my blood sugar levels are elevated, but are below the threshold for diagnosis as diabetic. All my other scores are in the clearly healthy areas.

For me, the bottom line is a limit to assessing people using broad categories. Statistics suggests there are outliers, and those not willing to accept the existence of outliers are displaying a sort of bigotry regardless of the topic.

As for staying below the diabetic diagnosis; I agree with others that cutting sweetened drinks of any variety helps. I can always lower my scores by going to a no carb diet for about a week or two, which also can shed about 10 lbs over 2 weeks. It is fairly recent that I'm no longer told that a low carb diet is bad.

-XC said...

Some years ago I lost 80 lbs (280->200lbs) and got within spitting distance of my high school athlete weight. I was running 100+ miles/week and lifting weights - I was dangerously near having a six pack. Or a four pack.

I got diagnosed by a sloppy PA as "slightly obese." I asked her if she'd looked at me and she said - at six feet you shouldn't weigh 200lbs. I asked her to find some fat to pinch and, give her credit, she tried and it wasn't there. "Huh, you're a big guy."

That was the day I lost all respect for the way that the medical profession measures stuff. My post-heart-condition experience hasn't been any better, TBH.

-XC

PS - I am back up to 240 and starting to (again) get back on the calorie counting necessary to lose the weight. Again.

Geoff Matthews said...

"Being a sedimentary fat fuck senior is a free e-ticket ride to a plethora of medical whack a mole inducing iatrogenic sickness."

this should be a mantra in the medical community. Howard, you need to run with this.

Chennaul said...

I can see in that article the creeping belief that it's not worth treating older people for slow-developing conditions because they're likely to die before the problem fully manifests itself.

***********

A long time ago in Canada a doctor was wondering if he should treat a lady in her 60s for hypothyroidism. A lot of her complaints fell in line with that but he decided she was old and it would not be worth all the follow ups. Now that I am older I am more horrified by that.

LH in Montana said...

The healthcare industry loves the ever-expanding list of chronic conditions (like pre-diabetes, allergies, etc.) because treating ongoing conditions is a lot more lucrative than treating those that are quickly resolvable.

Curious George said...

Intermittent fasting is a great way to lose weight, and lower blood sugar. You consume all calories in an eight hour period...for me that's noon-8. So basically skip breakfast. I also use the LoseIt! app to keep track of calorie intake for a progressive weight loss. Right now that still allows about 1800/day. The nice thing is that consuming those 1800 calories in 8 hours still allows a lot of eating. The first few days to a week when you start you're hungry in the morning, but then it gets normalized and you don't even notice it. I just drink tea and/or water.

Achilles said...

So Omega-6 fatty acids seem to be at the root of inflammatory issues.

Processed vegetable oils made a lot of money and caused massive health issues that are impossible to trace back linearly.

Ignorance is Bliss said...

I take dexamethasone (among other things) once a week for multiple myeloma. It tends to spike my blood sugar. I've discussed this on an MM forum, and the common experience is that everyone's oncologist tells them not to worry about it, and everyone's primary care doc tells them to do what they can to minimize it.

I eat low carb the day of and day after dex, and that largely avoids the spike.

Ignorance is Bliss said...
This comment has been removed by the author.
320Busdriver said...

To see just how jacked up our nations food systems are, including the food pyramid and its genesis you have to watch “Fat, a documentary”

Ignorance is Bliss said...

Being a sedimentary fat fuck...

Are sedimentary fat fucks deposited on the couch slowly, accumulating over many years?

Greg The Class Traitor said...

Defenders of the emphasis on treating prediabetes, which is said to afflict one-third of the United States population, point out that first-line treatment involves learning healthy behaviors that more Americans should adopt anyway: weight loss, smoking cessation

smoking cessation leads to weight gain. Which leads to diabetes.

So they've established up front that they are dishonest hacks who can't be trusted.

Which makes the rest of what they say rather pointless

Daniel Jackson said...

"I can see in that article the creeping belief that it's not worth treating older people for slow-developing conditions because they're likely to die before the problem fully manifests itself."

I agree. This trend has been coming for a long time. I seem to recall Obama saying something similar when he was running for election in 2008. Something about perhaps "we" should reconsider if granny really needs a bypass in her eighties. The issue was about nationalizing healthcare.

So, here we are again facing similar issues of a national healthcare policy that devalues old age relative to "increased health costs." This has also been an underlying issue with the treatment of the elderly with COVID as noted in the emerging scandal in NY state placing older COVID patients in overcrowded nursing homes to let them all die off (or so cynics say).

I experienced similar issues in 2019 regarding my own healthcare in the France versus the US. In the US, I was diagnosed with prediabetes although not medicated (but given a blood meter). In France, with the same readings (from a lab blood test battery), I was told it was not prediabetes and I should just eat less sugar. A year later, in Morocco, I was hospitalized with out of control blood sugars, put on insulin therapy, and after leaving the hospital prescribed glucophage, which I take religiously after eating.

I continue my three times a day blood readings, medications, and have lost nearly 15 kilos. Blood readings are normal. I would say, however, that I am NOW a Type II diabetic medically and diet controlled. I discussed this with my doctor who confessed that the French tend to let the unfit elderly go untreated in order to reduce the national costs of their Excellent healthcare system.

In the US, this is what we all have to expect in the years to come. Too many old people living longer are not simply increased costs to national healthcare, they also cost more in Social Security (since the fertility rate of successive generations is low). It is important for individuals to be take control of their own healthcare, eat less (or better), and lose weight. Ageism is real all over the world now. Pay attention.

wild chicken said...

Yeah they did this to me too. But they put it in my chart without taking to me about it.

Doesn't it affect insurance underwriting?

I complained and the doctor backed right down and too it out. Wtf

Achilles said...

Do plants like to be eaten?

Do you think they have just been sitting around for millions of years figuring out how to make humans or any animal that eats them healthier when eating them?

What happened to general human health and size about 12000 years ago when we domesticated plants?

If you actually think about these things in a systematic way it is pretty obvious that eating plants is generally bad for you. Fruits and vegetables are just unhealthy.

wild chicken said...

I mean if I am at risk I want to talk with the doctor about it, not just garner rando notes in my chart.

Richard Dolan said...

Sounds like fake-but-accurate has finally found its place in medicine: you're not really about to suffer from the effects of diabetes, but scaring you into thinking so is good for you anyway.

Lovely. Coming soon to a clinic near you.

Alan said...

My family doctor told me that the invention of pre-diabetes and the change in the definition of diabetes from a fasting glucose level of over 140 to over 125 were done in 2009 (I think) to make diabetes look like a more-serious problem than it is, which helps diabetes researchers get more funding. Interesting if true, and he's not a diabetes expert. But a sudden change in the OK glucose standard and the invention of pre-diabetes did occur at about that time.

tcrosse said...

I took my diagnosis as reminder of time’s wingèd chariot hurrying near, of which I was in denial. Cutting out the Scotch and the Eskimo Pies has given me a bit of a reprieve.

mikee said...

Dave Begley: I lost 20, regained it, lost it again, lost 20 more, regained 10, lost 20 more....and here I am, only 150 pounds from my goal weight. Trying to achive stability of dieting so that I lose 30 or 50 before regaining 10.

Andrew said...

This is good news. I don't feel guilty for eating a whole box of Russel Stovers assorted dark chocolates at my desk yesterday.

Freeman Hunt said...

Prediabetes seems like a useful diagnosis if used as the stage before needing medication for diabetes. A wake up call stage and a chance to avoid future medical treatment.

tim maguire said...

Achilles said...Do plants like to be eaten?

Their seeds often do.

Howard said...

Who doesn't like their seeds eaten?

walter said...

Eskimo Pies are high in blubber..and frowned upon in civilized society.

Tina Trent said...

I come from a type 1 diabetes family. It was sheer hell on my immediate family members with it, and they did nothing to cause it, and every minute of every day of their lives required self-control few people could do and many didn’t survive into middle age. This was before the insulin pumps.

Type II is mostly behavioral. And it is crazy to start pumping people full of expensive and dangerous drugs when weight loss can usually completely cure or manage it. Low carb is the cure, period. With this disease you don’t want the drugs or the complications. Stand outside a dialysis clinic for an hour and see if you can face that human misery. I’m a serious cook, and I have managed to find carb-free substitutes for pasta made of Japanese yam. I know that sounds unlikely, but it’s really great stuff — and as long as I have pasta, I can hang in there. 20 calories for a big plate, too. Yam pasta, cauliflower mash with lots of fats, deli, cheese, chicken brats, nitrate-free bacon and eggs: it doesn’t suck, and the pounds fall off. I think it works especially well for older women and men of any age.

It’s not depriving people of medical care to tell them they can either lose some weight or start taking five medications a day and check their blood sugar and go on insulin.

Alan, I remember in the Seventies “the cure” was always just around the corner for the genetic diabetes, Type I. It never came. Now all the focus, and research — and yes, profits — are in medicating vast numbers of Type II people who could prevent a serious and costly disease just by losing weight. That’s deeply irrational. It also strains exceedingly limited resources such as kidney transplants for people who have the genetic type of the disease or other genetic kidney failure. I’d be happy to see more resources put into pushing weight loss harder. Save a lot of lives and miseries — and eventually money too.

Richard Fagin said...

"It’s unprofessional to mislead people, to motivate them by fear of something that’s not actually true.... " Did anyone tell Dr. Anthony Fauci?

Achilles said...

tim maguire said...

Achilles said...Do plants like to be eaten?

Their seeds often do.

Is it necessary for me to differentiate between how broccoli and oranges are treated by our appetites?

I would also question how long our species has had to adapt to year round fruit availability?

I think you are just poking fun.

Howard said...

Let's see. Humans evolved in the tropics. Tropical fruits are popular. Ergo ipso facto quad erat demonstrantium.

farmgirl said...

Mikee, it was to u I expressed Word.
It is not fear mongering to tell the truth.
So honest. Keep up the great work!
Autocorrect turned your name to miler.

Achilles said...

Howard said...

Let's see. Humans evolved in the tropics. Tropical fruits are popular. Ergo ipso facto quad erat demonstrantium.

We evolved in the tropics...

Do you just try to be as stupid as possible at times?

Unknown said...

There are good reasons not to be obese, like being able to climb stairs or jump out of the way of a car or play with your grandkids. It isn't fat shaming. If you can't hop up onto the curb maybe you are too heavy. Maybe it will keep you from doing things.

bagoh20 said...

"A new study says": The number of suckers born everyday has increased 1227% since 1964, and has accelerated dramatically in the last decade. Some see this as a helpful development, while others find reason for concern. Political leaders promise extensive funding for further study.

Iman said...

Losing weight is good for most folks in so many different ways. At 6’2”, I’d been at 265 lbs and holding for 6 years. Then came the COVID, and I lost 35 lbs. But I’ve been at 230 now for too long and need to focus attention in this area again. The difference in how I feel, e.g., much lighter on my feet, more energetic - I hadn’t been below 240 lbs. for 25 years - made me think of Dr. Dean Edell’s old radio show and his consistent advice to lose weight, saying how much better you’d look and feel. He’d say think about lugging a 30 lb frozen turkey around all day and how different you feel after putting it down.

And now my goal is to lose 20 more by end of this Summer.

Unknown said...

Diabetes is a growing problem throughout the world including the developing world. The growing sedentary lifestyles comparative to the usual subsistence living/working has growing numbers of people developing Type II diabetes. It is much more difficult to control Type II diabetes when your foundation dietary food source is some form of starchy carb from rice, wheat, and/or corn. Think rice, beans, & some form of corn tortilla or wheat bread as the classic combo in most Latin American countries, white rice and/or naan in India, rice in East Asia. Unlike the US the developing world citizenry has less wealth to invest in alternate food options. The availability of cheap sugary snacks/drinks is a huge driver in this trend.

Francisco D said...

Ann Althouse said...
There's the problem of medicalizing old age, but also the problem of de-medicalizing old age.

I was fit and healthy in reaching Medicare age. I shopped around for primary care providers. My sense was that they did not want to address some of my (relatively unexciting) complaints. They really did not want to deal with me at all. Luckily I found one who was really good at referring me to specialists.

My complaints have been resolved to my satisfaction, but I still get the sense that I am an annoyance because of my age and insurance. I remain healthy and quite active, but wonder what it will be like as I start to fall apart.

tim in vermont said...

If you actually think about these things in a systematic way it is pretty obvious that eating plants is generally bad for you. Fruits and vegetables are just unhealthy.

Humans evolved in regions based on what food was available. Generalizations are bound to fail, but yeah, we are still adapting to the superabundance of agricultural produce, and evolution is a messy business with winners and losers and it is wise to opt out of a game if it’s not gonna pay off for you. For me? Eating a lot of plants and not a lot of meat makes me feel better and keeps my weight down.

Balfegor said...

Re: Althouse:

When I slipped over the line into the "pre-diabetic" zone, it motivated me to lose 22 pounds in the next 6 months and get retested to see that I'd gotten below that line.

I didn't get a pre-diabetic warning . . . went from a fasting blood sugar of 86 to a fasting blood of 386 in two years, and in retrospect (based on symptoms) I am pretty sure I had developed full blown diabetes by the beginning of 2020, just a little over a year after my previous checkup. I wouldn't even have known except that I decided to have a full checkup done in Tokyo just before returning to the US back in September. I'm still in my 30's, though, so while diabetes was on my radar given family history, I wasn't going in for regular checkups. Lost about 10 lbs since I received my test results in October, and I think another 10 is realistic. I've become much more sedentary since coronavirus, but "eat less" has always been my primary strategy for weight loss, and it still works.

Re: Unknown:

It is much more difficult to control Type II diabetes when your foundation dietary food source is some form of starchy carb from rice, wheat, and/or corn. Think rice, beans, & some form of corn tortilla or wheat bread as the classic combo in most Latin American countries, white rice and/or naan in India, rice in East Asia.

I'm pretty sure the 自粛要請/stay at home request period supercharged my blood sugar because there were days in April and May when I ate nothing but sweet fruits and rice, with a little furikake seasoning on top of the rice, or an egg mixed in. That said, it's not that hard to control blood sugar while eating rice, if you're trying. I can't snack on a whole pot all afternoon, but after a normal meal portion of rice (or noodles), a brief 15-20 minute stroll is generally enough to keep my blood sugar in the normal range (<140 post meal), and usually pushes me down around 100.

Achilles said...

tim in vermont said...

Humans evolved in regions based on what food was available. Generalizations are bound to fail, but yeah, we are still adapting to the superabundance of agricultural produce, and evolution is a messy business with winners and losers and it is wise to opt out of a game if it’s not gonna pay off for you. For me? Eating a lot of plants and not a lot of meat makes me feel better and keeps my weight down.

It depends on how you think evolution works. I think there are some things like gut biome that change fast. Other things change more slowly.

Everything is a theory at this point.

Scientists think we almost went extinct 70,000 years ago after a volcanic eruption with varying estimates of breeding pairs as low as 4000. Some studies say double digits. There are a bunch of anomalies like breeding male counts dropping to 1 male for every 17 females 5-7000 years ago.

Brains are massively calorie intensive. As a family our brains began to grow about 1.5 million years ago with the advent of fire and cooking and a decrease in the size of our gastrointestinal system. The thing that allowed for this to happen was the change in our diet from chimp diets of plants/seeds/minuscule amounts of meat etc. to large game hunters. We moved out of the trees and forests onto the plains and started killing big things.

The caloric-dense diet allowed our guts to shrink and brains to grow. This reversed with the advent of domesticated agriculture. Over the last 40 years human gastrointestinal system size has exploded.

One thing I find interesting is the absolute rage saying a carnivore diet is healthy induces.

Howard said...

Yeah, I hear the carnivore diet is great option for short guys. It'll make a Viking out of you yet. Tell us about the sludge constipation feature. That sounds natural and healthy.

Josephbleau said...

So Howard, you are an oil geologist? Where have you sifted the sand?

Howard said...

My only E&P experience was in the steam patch. Geysers, Imperial valley, Coso, Dixie Valley, Roosevelt Hot Springs. It was all hard rock except Imperial.

Hercules, not that one though said...

Here now, is the first Hercules Roundup:

Mikee-"I am over 60 and am still obese, but I've lost 50+"

Hercules -Phenomenal! God bless you brother.


Ann Althouse- "I started my running routine, ate low carb, and stopped eating in the evening"

Hercules - Walk. Walk. Walk. All the rest is extra. A human being needs to walk. Ann gets that.

Mr Wibble -"I lost about 30 pounds during 2020 due to dieting and working out, and then promptly gained it back in September"

Hercules- What happenned? Walk.

Ann Althouse - There's the problem of medicalizing old age, but also the problem of de-medicalizing old age."

Hercules- I don't even know about medicalizing and de-medicalizing. I got a 'physical' when I went in the US Army in 1971. Didn't want to do that again. Haven't.

Michael K - "The most important thing to do is weight loss. Metabolic Syndrome can cause high serum insulin levels."

Hercules- I'm going with this guy's advice.

Ann Althouse - "Did the NYT even touch on the racial angle in this problem? So much race seen in so many problems these days, but this is one where the difference is very clear! If the idea is to back off on treating diabetes, the impact on black people is much greater than on white people."

Hercules- We live our lives, white and black. We take our pleasures where we find them. Longevity is not the goal. Longevity is NOT the goal.

John Henry - "I'm pre-dead, myself."

Hercules- How can anyone not love this guy?

Tim in Vermont - "The thing about bananas for me is that I have to stick to the medium ones, and remember that they have as many calories as a slice of bread, and you can’t just eat them as if they were cherries or small apples or something."

Hercules-I reluctantly buy the smallest bananas I can find, because I think they are somehow important.

Howard - "Eat less processed foods, eliminate added table sugar, eat fewer calories."
Don't use sugar.

Hercules- Makes sense to me.

also Howard -"Being a sedimentary fat fuck senior is a free e-ticket ride to a plethora of medical whack a mole inducing iatrogenic sickness."

Hercules- I don't know what iatrogenic means and I'm too lazy to look it up. I will agree that being a fat fuck senior is not a good thing.

XC - "That was the day I lost all respect for the way that the medical profession measures stuff."

Finally! Do you wear a mask. Baby steps.

Greg the Class Traitor - "smoking cessation leads to weight gain. Which leads to diabetes."

Hercules - Schmokin for 50 f'n years. Haven't gained weight, as you suggested.
Don't go to see a Doctor unless something's broke.

What a marvelous vessel my Mom allowed to be created...in her...in her body...for me to jump into this world. Mom died when she was 54. She launched me into this world.

Thanks Mom.

I'm Not Sure said...

Hercules- I don't even know about medicalizing and de-medicalizing. I got a 'physical' when I went in the US Army in 1971. Didn't want to do that again. Haven't.

I got a physical three years ago, hadn't had one for about forty years. Doctor says "Hmmmm... I'm sending you for an echocardiogram." Turns out, I had a birth defect- an aortic valve with two flaps instead of three, and severely restricted. Had open heart surgery a month later. If I hadn't gone for that physical, I'd probably be close to dying right about now. So there's that.

Just sayin'.

Hercules, not that one though said...

I'm Not So Sure - "I'd probably be close to dying right about now. So there's that."

Here's the thing. You didn't know you didn't have enough flaps. A Doctor said you didn't have enough flaps. Before your physical, did you have enough flaps? I don't know how many flaps I have. Probably not enough. I've never had enough of anything. Heh.

I've decided to be in the 'control group'. I'm running this body I walk around in to the ground, until it gasps for air, and gives up the Ghost. Could be tonight or tomorrow, or a decade from now. Who knows?

We are here for a short time. Be right with God. It's important.



I'm Not Sure said...

You didn't know you didn't have enough flaps.

Correct.

A Doctor said you didn't have enough flaps.

Correct.

Before your physical, did you have enough flaps?

No.

I've decided to be in the 'control group'.

Fair enough. At this point, I'm glad I'm not in it. YMMV.

Hercules, not that one though said...

Tim in Vermont- "..but I don’t miss the wards full of men dying of prostate cancer I used to have to deal with."

A Doctor told you that. Would that be the same Doctor that wanted to sell you on getting a tube shoved up your butt? Was it that Doctor?

Are you wearing 2 masks now? Will you wear 3?

*******

I'm Not Sure -"Before your physical, did you have enough flaps? No."

I'd like to try this question again in a different way.

Before your physical, did you know you had flaps, and how many you should have?

I don't need an answer, you don't owe me one, I'm just try to point out how strong the 'appeal to authority' is.
A Doctor says....

Here's an example. I mentioned this in a post weeks ago. China said they had a new Covid test. It was an anal swab.

I noted that China was trolling us and there were some stupid enough to bend over for it.

It turns out that China subjected US Diplomats to the anal swab. Our US Diplomats 'bent over for it.' Creme de la creme.

Awais said...

Nice Post!
Sir can you post a guide about syllabus of pms on your site it will be nice of you….

Jeff Brokaw said...

Very interesting thread—nothing to get old people talking like asking about their health, LOL!

The complaint in the article about not wanting to hear bad news about declining health ... I don’t get that attitude. If you think the whole concept of “pre-diabetes” is a scam, or not worth the sacrifices for you personally, then here’s what you do: be an adult with agency, and ignore the advice. You’re free to do that. Be frank and transparent with the doctor: “Thank you doctor but I’ve done my own research and feel the trade-off is not worth it for me in my 60s/70s/whatever”. Done. Your doctor is an advisor, not your boss.

This sounds like more of the “triggered snowflake” attitude that we hear about, a toxic attitude where you use your emotional responses to perfectly reasonable input from others — including when it’s their job and perhaps even their legal duty to inform you — to shame and guilt them into being accountable for your emotions. Your emotions are yours, it’s not up to others to manage them for you.

dreams said...
This comment has been removed by the author.
dreams said...

I love my Metformin. I can't say it has helped my A1C very much but I'm nice and slim, not overweight and hungry all the time.

I'm Not Sure said...

"Before your physical, did you know you had flaps, and how many you should have?"

I knew there were flaps but had no idea what number was normal.

"I don't need an answer, you don't owe me one, I'm just try to point out how strong the 'appeal to authority' is.
A Doctor says...."


Well actually, two cardiologists and a surgeon, all who saw the echocardiogram, said. And then, there was the first doctor who noticed something out of the ordinary, but did not offer an opinion on what that was.

Regarding 'appeal to authority' and using this definition:

Insisting that a claim is true simply because a valid authority or expert on the issue said it was true, without any other supporting evidence offered.

I would make the point that there was supporting evidence (the echocardiogram).

Hercules, not that one though said...

Fair enough.

Caligula said...

""Should older people with slightly above-normal blood sugar readings — a frequent occurrence since the pancreas produces less insulin in later life — be taking action..."
"... as the American Diabetes Association has urged?"

That would depend on the "action," wouldn't it?


If "taking action" means dropping a few pounds and eating less junk, why not?