[LMB] Type 1 diabetes, was Rise of the Medications was OT: if civilization fell

[Marilyn Traber]

Mark Allums wrote:
> Yes, and simplified a bit.  Type 2 probably means you need to lose 
> weight, at least 8% of your current weight, and probably quite a bit 
> more.  For example, I got up to about 440 lbs.  One scale read 436; 
> another read 443.  I took an average.  Right now, I weigh about 391, 
> nearly 50 lbs. lighter, or a loss of about 11%.  This is from a BMI* of 
> well over 60, to a BMI currently of 56.1, or so.
>
>
>   
Um, no. I was solidly into type 2 and weighed between 92 and 130 lbs. 
Well, I started out at 135, my kidneys shut down on me and the 
gestational diabetes decided to stick around from the time I dropped 
down to auschwiz-chic and regained my weight back to 130ish. I stayed at 
130 - 140 for the next decade. I shot up to over 300 in the 3 years 
between 1990 and 1993. No I didnt change my diet, and no the Navy 
seemed  to not want to be arsed into actually diagnosing me [it was 
easier to tell me to stop sitting on my bum and eating bon-bons.] My 
glucose readings stayed pretty much the same the entire time between 
1981 and when they put me on byetta last summer.


Actually, the BMI is currently taking some heat.

 From wiki -

The medical establishment has generally acknowledged some shortcomings 
of BMI.^[11] <http://en.wikipedia.org/wiki/Body_mass_index#_note-10> 
Because the BMI is dependent only upon net weight and height, it makes 
simplistic assumptions about distribution of muscle and bone mass, and 
thus may overestimate adiposity on those with more lean body mass (e.g. 
athletes) while underestimating adiposity on those with less lean body 
mass (e.g. the elderly).

In fact, some argue that the error in the BMI is significant and so 
pervasive that it is not generally useful in evaluation of health.^[12] 
<http://en.wikipedia.org/wiki/Body_mass_index#_note-11> Due to these 
limitations, body composition for athletes is often better calculated 
using measures of body fat 
<http://en.wikipedia.org/wiki/Body_fat_percentage>, as determined by 
such techniques as skinfold measurements or underwater weighing. 
However, recent studies of American football 
<http://en.wikipedia.org/wiki/American_football> linemen 
<http://en.wikipedia.org/wiki/Lineman_%28American_football%29>, who 
undergo intensive weight training to make their muscles 
<http://en.wikipedia.org/wiki/Muscle> extremely large, show that they 
frequently suffer many of the same problems as people ordinarily 
considered obese, notably sleep apnea 
<http://en.wikipedia.org/wiki/Sleep_apnea>^[13] 
<http://en.wikipedia.org/wiki/Body_mass_index#_note-12> ^[14] 
<http://en.wikipedia.org/wiki/Body_mass_index#_note-13> .

In an analysis of 40 studies involving 250,000 people, heart patients 
with normal BMIs were at higher risk of death from cardiovascular 
disease than people whose BMIs put them in the "overweight" range (BMI 
25-29.9).^[15] <http://en.wikipedia.org/wiki/Body_mass_index#_note-14> 
Patients who were underweight or severely overweight had an increased 
risk of death from cardiovascular disease. The implications of this 
finding can be confounded by the fact that many chronic diseases, such 
as diabetes, can cause weight loss before the eventual death. In light 
of this, higher death rates among thinner people would be the expected 
result

I leave it up to you to go there and play with links... For what it is 
worth, LobSang spent much of the past 10 years being considered 
borderline obese by the BMI, so the Navy did the water float test that 
is way more accurate and decided he wasnt right for the pudge club...

And per my endocrinologist - yes if you are heavy losing weight *may* 
help the diabetes, but it *will* help you feel better, relieve joint 
stress, make it easier to boost your metabolism because it will make it 
easier to exercise. *No* being fat does *not* CAUSE diabetes, but 
frequently people who are overweight *can* develop it - but not 
everybody who is overweight becomes diabetic. Not all diabetics improve 
when they lose weight. There are way too many factors to simplify it 
down to 'You are fat and diabetic [type 2] lose weight and you will 
improve... ' there is no generic 'you'. If my brother became diabetic, 
his body would not react like mine, if I had a daughter, she would not 
react like me. My mother would not react like me.

Doc Vargas is very much into working with patents and their family to 
manage diabetes. She knows there is no magic bullet, and not everything 
will work with everybody. As she pointed out that is why there are about 
15 different meds she can use, and she may work her way through all of 
them in combinations before she finds what works best. I work best with 
metformin and byetta. Next year I may be on insulin, and if so I change 
from shooting up with lizard spit and change to insulin. No big deal=) I 
have been steadily losing weight since this time last year, and other 
than when my meds get tweaked, my glucose stays pretty much the same 
[except for right after the operation on my throat.]