They never said don’t worry much.
You need to read clear statements when they are made.
Absolutely! What was your statement again? Your doctors “never worried much” about a fasting blood glucose of 128? How did they convey this not worrying much? Semaphore? Morse code? Or was it you that mistakenly inferred a lack of concern.
My fasting glucose has never been as high as 90 or A1c north of 5.4 (what it is now on statins) and I was concerned enough to suggest a circulating insulin along with the advanced lipid testing and CAC scan when I finally decided I wanted to feel as reassured as my previous doctors about my healthy lifestyle and that “mildly elevated” LDL-C of 135 mg/dL or so. That was just about 2 years ago.
Fortunately, my intervention cardiologist is as proactive as I. Certainly not a fear monger but no false reassurances from him regarding potential Red Flags.
@iampops5 …that 11% with T2D is probably an underestimate, given that it’s a diagnosis that’s generally based on a A1c that’s reached a magic number and having gone through a period of “pre-diabetes” and all the metabolic disturbances on the way there from healthy homeostasis
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My post should have read, “since 1958”. Typo.
Not just care! It’s also often a barrier to getting good transportation services (think airplane seats, etc). And it’s often also a barrier to getting good clothing (hard to find nice stuff in very large sizes). And it’s also a barrier to vacationing (have to move a round a lot, and cruise cabins are tiny with small showers). And it’s also a barrier to fitness (bicycling, running, all forms of exercise are much more difficult for heavy people). It’s also a huge barrier to keeping body joints in good shape, all that extra weight is damaging to knees, etc. Even touchscreens pose a barrier to those with extra large fingers (very hard to tap that little ‘x’ to close the advertisement). Stairs are a barrier, can’t choose to live in a walk-up apartment. And you could probably think of tens or even hundreds of other barriers posed!
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Which is why I carry a stylus and don’t use my fingers to dial or select on my phone. Keeps the screen far cleaner AND I can choose the soft or hard end of the stylus, depending upon what is needed.
That is daft. You have never dealt with Type 2 Diabetes as a patient.
Once t2d a reading of 128 is not high. If asked is 128 high in my circumstances, “No it is not very high”.
The bigger issue was fish oil. The reason given very early on was it can mask your LDL and triglyceride numbers but I needed to lose weight. Easily said but hard to do. I was asked not to mask my numbers with fish oil.
Now 12 years later with good numbers I have started to take krill oil for the benefits.
But I have dealt with patients with T2D…and those who were on their way there. As a consequence, I’ve made a very definite effort to understand the physiology of metabolic dysfunction…and the negative effects of the same on the body before ever the pancreas starts to fail and that blood glucose begin to rise.
“Not very high” is a relative term. In relation to some folk, I don’t doubt it. But “not very high” is still a lot higher than healthy.
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Of course. You are on target. It is unhealthy.
Most people with t2d have higher sugar levels. Mine was very briefly at 128. It rode around 118 or lower.
You say this as if this is anywhere close to a healthy range. For a fasting blood glucose it’s not…it’s a warning sign that the pancreas is starting to fail after an extended period of overwork.
Realistically, the human body (for most people) is not able to survive to what is now “old age” without significant assistance. It can only do so today because of major advances in a wide variety of areas: Health care, food, water, governance, and much more. Thus, it is no surprise some body parts will fail–some sooner than others. T1 diabetes is ONE body part failure that is not yet cured–but is generally treatable for a considerable lifetime–for those who would have died young.
For sure. Stick around for long enough and the passage of time guarantees that body parts inevitably and eventually fail. Biological senescence, it’s called…or eugeric aging. Hence the phrase “we grow up until our 20s…and then we grow old”. Let’s be honest, though…we’re not talking about that. Well, you might be but I certainly wasn’t.
T2D/metabolic syndrome secondary to an obesogenic sedentary lifestyle is a form of pathogeric aging and, as mentioned in this thread and many others on the topic, is happening to younger and younger individuals at an earlier age. Most definitely not what should realistically be expected to happen to the human body in the teens or earlier.
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You can not help mischaracterizing anything I say. Are you having a personal problem with language?
My grammar and spelling are poor. That said I have some training in engineering technical writing. What is said most of the time if not slang is more exacting.
128 for a t2d is not high. Usually, it was 118 or lower. Now it is under 90. It has been under 90 for three years.
When it was 128 the response from my PCP was that is not high for t2d.
Again it is not high for t2d. Can you appreciate that without making up your own garbage?
They needed the competitive advantage of weight loss to counter the rapid loss of pricing power in core insulins due to me-too competition, and they’ve now started discontinuing the ones most affected:
’ Levemir® FlexPen® and vial will be discontinued on December 31, 2024
Our top priority is always the health and safety of the patients that use our products. After careful consideration, we made this decision because of global manufacturing issues, decreasing patient coverage, and because we are confident that patients in the U.S. will be able to find alternative treatments.’
Here’s how traditional insulins are losing pricing power:
‘Novo Nordisk Inc. today announced it is lowering the U.S. list prices of several insulin products by up to 75% for people living with type 1 and type 2 diabetes. Products include both pre-filled pens and vials of basal (long-acting), bolus (short-acting) and pre-mix insulins, specifically Levemir®, Novolin®, NovoLog® and NovoLog® Mix 70/30. Novo Nordisk is also reducing the list price of unbranded biologics to match the lowered price of each respective branded insulin. These changes will go into effect on January 1, 2024.’
Oh, my apologies. I didn’t realize you were talking about poorly controlled blood glucose in T2D. I’m sure it’s not high in comparison to really poorly controlled T2D, but still, your PCP must’ve been pretty jaded to be looking at that sort of metabolic profile and not encouraging/working for something better.
See, this is what I’m talking about. There are so many sick phenotypes in PCPs’ offices these days that the Good Custodian outliers such as myself (and the young guy who lived across the road from me years ago who had LADA misdiagnosed for years because he was a runner and fit and his slowly rising blood glucose “wasn’t that bad”) get shortchanged.
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Very true. But Type 1 diabetes is only 5% of diabetes victims, the other 95% (i.e. Type 2) is largely self-inflicted.
intercst
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Both Type1 and Type 2 have a significant genetic / hereditary contribution:
’ Type 1 Diabetes
In most cases of type 1 diabetes, people need to inherit risk factors from both parents. We think these factors must be more common in white people because white people have the highest rate of type 1 diabetes.
Type 2 Diabetes
Type 2 diabetes has a stronger link to family history and lineage than type 1, and studies of twins have shown that genetics play a very strong role in the development of type 2 diabetes. Race can also play a role.
Yet it also depends on environmental factors. Lifestyle also influences the development of type 2 diabetes. Obesity tends to run in families, and families often have similar eating and exercise habits.’
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Well, yes. But again, my comments have been in the context of insulin dependent diabetes (because INSULIN is the topic of this thread) For all that full blown T2D… and those on the trajectory towards it…is so prevalent, I seriously doubt that the numbers of T2D patients requiring insulin is as high as 95%
I did not know you were in the office with me for the entire group of conversations. Good for you. You know it all.
A bit of a change from “you don’t know what you’re talking about”…but just as petulant.
Regardless of how accurately you’re conveying your PCP’s conversations on metabolic status, as written they were a very poor representation of the potential severity of your disease state. Quite possibly accurate representations of conversations going on in many offices, though. It’s a bit disappointing to think that so many primary care physician have become so jaded and immune that they don’t respond with alarm and a bit of intellectual curiosity to such Red Flags in the way that a general practitioner would’ve done a couple of generations ago, say. When, ironically, ability to test for and manage the “pre” stages wasn’t as easy as it is today.
Whilst a fasting blood glucose of 128 mg/dL is probably considered to be the lower end of the range for T2D it’s still T2D. It seems to me that T2D is not a condition that should be trifled with at any stage, just because it’s so common.
For but one take on that statement…
How deadly is type 2 diabetes? - Peter Attia.
P.S…although this article discusses the official diagnosis of T2D, a good many of Attia’s newsletters, blog posts, podcasts and relevant sections in his book emphasize the somewhat arbitrary designation as determined by an A1c and fasting blood glucose. More importantly he/his podcast guests discuss the pathology caused by the metabolic dysfunction in the run up period to the diagnosis…that might be as much as decades of insulin resistance/hyperinsulinemia.
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