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

[Mark Allums]

Marilyn Traber wrote:
> Mark Allums wrote: some stuff

> 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. 

Caveat: while it is generally true that losing fat nearly always helps 
type 2 diabetics, Your Mileage May Vary.


> Actually, the BMI is currently taking some heat.

The BMI is better that the things that went before.  Undoubtedly, there 
could be room for further improvement.  For the Average/Typical/Normal 
person, the BMI is a decent figure *to start from*.


> 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.

This is why the BMI is divided into *ranges*.  I put my own goal for BMI 
at the very top end of the Normal range.  I am a bit on the 
broad-shouldered side, and was fairly muscular, back in the day.  190 
was a reasonable weight for me then.  Now, 165 might be closer to 
reality, with the loss of muscle mass/tone I've had over the past 25 
years.  Then my BMI wouldn't have been in line with the guidelines.  I 
was an athlete.


> And per my endocrinologist - yes if you are heavy losing weight *may* 
> help the diabetes, 

Usually.


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,

Yes it does.  In lots of people.  The insulin resistance is due to the 
abundance of fat cells.


  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... ' 

It is frequently true for lots of people.  Your Mileage May Vary.


> 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. 

Certainly.  Good.


I was specifically using myself as an example.  I was beyond "morbid" 
obesity.  I had life-threatening obesity.  I found that, just like the 
study stated, losing 7-8% of my body mass resulted in a drop in blood 
sugar.  This is now the standard recommendation for nearly all Type 2 
diabetics.  I was agreeing with Louann that Peter had the types mixed 
up, then I went on to state what nearly any internal medicine doc or 
G.P. will tell you.  A little on the high side of normal is probably a 
good thing, but very far above that has consequences.  Not usually in 
the "*being* fat" (except for insulin resistance) but in the "*getting* 
fat".  There is a good chance that the "average" person who is gaining 
weight is leading an unhealthy lifestyle, beginning with eating either 
the wrong foods, or too much of the good ones. It's that behavior that 
is unhealthy.  And while not true for everyone, it is true for lots of 
people, including me.

--Mark Allums