Health-related discussions

congratulations on accomplishing “remission”. Too many people think it is impossible.

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Your post gives me a glimmer of hope. I have eaten way too much all my life but I exercised 4 or 5 times a week so I never realized it. Then Covid closed my gym and I slowly gained 20-25 pounds from April of 2020 until October of 2022 and went into Afib pretty steadily for a year now. I had a really hard time in the higher altitudes of South America last year and had no idea what was wrong, but it started happening at lower altitudes too.
My doctor has put me on drugs for this and for that but it really has not addressed the problem. I eat poorly and need to exercise more to lose the weight I gained over the past couple years. Some people can handle gaining weight, I cannot.

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The pandemic brought a lot of health or health related problems right to our faces, literally. My weight remained pretty static because I couldn’t go out to eat and I couldn’t indulge myself with the kind of groceries I wanted. I couldn’t go out to exercise, either, so I walked a lot of circles around my apartment. 10,000 steps a day. I don’t do that any more. I can go out now. I hope your doc gets your afib under management. I have 2 afib cousins who have had successful ablations in the last year. I still go to cardiac rehab for exercise many years after a successful repair. Good luck!

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This is interesting. The debate about whether someone, once diabetic, can be no longer diabetic is frankly meaningless and obscures the fact that with careful management of diet and weight loss, the differences become essentially indistinguishable.

I’ve a friend, a long-time Army medic and lab tech who trended pretty damned heavy (about 220 when he should have been 175). Then he started having all the physical symptoms of type 2 DM, very rapid onset, and once he got back from a road trip and got tested, found his fasting glucose over 350.

Three weeks of fasting (48-72 hours, then eating 48-72 hrs, alternating) with moderately low carb diet - no pasta or bread but as much veggies as ever - and his glucose was around 110. Another 2 weeks of the same and it was around 85. Now, 6 months in he’s lost 50 pounds and around his “ideal” weight for his age/size, and his glucose is still normal, fasting or post prandial.

So I guess one would say that he’s “still diabetic, but in remission”.

I know 2 others who’ve done the same path, with the essentially the same results.

Yeah, I know, anecdotes and all that - ain’t data.

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I’ve never heard of someone being called a Type 2 diabetic in remission up here in Canada. If you can get your glucose down to healthy non-diabetic levels through lifestyle changes and weight loss, you’re no longer considered Type 2 diabetic.

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Thanks. Maybe it’s just a US-centric thing, but I’ve listened to several docs and nurses insist that as soon as you’ve been labeled T2, there’s no going back. My daughter in nursing school was just taught the same thing (a discussion of my Army bud brought this to light). So I started googling and the US medical position on it seems to be that you can’t come back from diabetes. But if functionally you’re essentially at that point, who really cares?

Anyway, I just reread my prior comment, though, and I should have been more moderate (a lesson I never seem to learn…). With amendments,

  • The debate about whether someone, once diabetic, can be no longer diabetic is frankly meaningless and obscures the fact that with careful management of diet and weight loss, the differences for a certain subset of people experiencing recent onset can become essentially indistinguishable.
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Another thing to consider, is that what blood glucose range is considered to be pre- Type 2 diabetes or full-blown Type 2 diabetes has changed over time.

Big Pharma would like to sell more drugs, so it’s better for business if more people are caught in the pre-diabetes and full-blown diabetes ranges.

In Canada, pre-diabetes captures A1Cs of 6.1-6.9. 7.0 and up is considered diabetic.

In the States (correct me if I’m wrong), pre-diabetes is currently 5.7-6.4, and Diabetes is 6.5 and up. These numbers, in terms of deciding where to draw the line, are results of policy decisions.

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I’ve been surprised at how the meanings of some lab markers are considered to have changed over time. I was a working lab technologist from 1983 to 1996 but have at least sort of kept track over the years with buddies who’d stayed on that path longer.

Back in the early 80s the lab’s chem director told me with no uncertainty that I must be pre-diabetic because my glucose never waivered from 80 g/dl from fasting to post-meal to post choking down 3 Snickers bars and two Cokes. Her reasoning (which was common at the time) was that such tight control meant my pancreas was working overtime and was eventually going to fail. 40 years later, my glucose is still rock steady (as of my last check, admittedly too long ago).

And I agree that pharma is pushing more interventions earlier than possibly needed. And my last 12 years before retiring were as an IP attorney at a subsidiary of a big (ca. $350 billion market cap) parent pharma company.

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I think whether you want to call something in remission or consider it reversed is as much a language issue influenced by culture as it is a scientific one. Here is a British article https://www.bmj.com/company/newsroom/losing-weight-can-reverse-type-2-diabetes-but-is-rarely-achieved-or-recorded/

Of course, losing weight is a bitch.

I am trying to quit sugar, again, today.

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Thank you, very interesting. My friend mentioned is the sort who is very motivated (once something jumps up and bites him on the butt, as happened here).

The article mentions “… generally perceived as … incurable, but for many … it can be reversed … say experts in The BMJ today”. The full text of whatever it was that “experts in The BMJ today” said is for subscribers only, but the article seems to capture the gist of what the experts did say well enough.

I can see a brief stub of the main “expert” piece and the Altmetric scoring indicates only 30 news organizations have reported on it in the 6 years since publication. Too bad.

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Every person is different, so what may work for one person may not work for another. Sometimes a medical issue is brought on by lifestyle; other times there may be a family history or some deep seated genetic piece that doesn’t respond to lifestyle changes.

I get frustrated with doctors who immediately, particularly in “pre-” stages of something, want to jump to medication before considering diet or exercise changes (assuming the patient is willing to do them). Sure, there are some cases where a more extreme measure may be needed (ex. a biopsy that showed cells that looked precancerous led to my hysterectomy. Not going to argue with my docs about that!). But, I’ve had success with lifestyle changes that have brought my (ridiculously high) blood pressure and other biometrics down to “normal”. I still had to tell my PCP that I didn’t want to hear any discussion about Ozempic and weight loss. Some docs just get fixated on Big Pharma solutions. I try to remind myself that they are mostly likely just doing their due diligence to discuss options. Probably T2 (in the US) is considered “incurable” because more patients than not can’t commit to lifestyle changes, for whatever reasons. It’s not always an option for some.

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Agree on all points. The lifestyle/drug thing has become a popular meme. Speaking of which, I gotta get mine back in order.

image



And you may have dodged a bullet regarding Ozempic.

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More on Ozempic

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I find it deeply worrying that the manufacturer has plans to test this drug on young children now:
https://www.bloomberg.com/news/articles/2023-10-20/ozempic-maker-is-testing-weight-loss-drugs-for-kids?embedded-checkout=true&utm_source=pocket_saves&leadSource=uverify%20wall&utm_medium=email#xj4y7vzkg

https://www.reuters.com/business/healthcare-pharmaceuticals/eli-lilly-plans-diabetes-drug-trial-kids-young-6-years-bloomberg-2023-10-20/?utm_source=substack&utm_medium=email#:~:text=Lilly’s%20Danish%20rival%20Novo%20Nordisk,treatment%20of%20diabetes%20and%20obesity.

Anyway, to bring this back to food - I am looking forward to my lunch of chickpeas, rice, and yogurt! And there is salmon in my future this evening for dinner!

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I cut out sugar years ago. Now I don’t miss it a bit. I only eat small portions of desserts when we are invited to someone’s home and I have to be polite.

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I managed to cut out refined sugar and most white refined carbs for about 4 months in 2014, then I had some Life happen and fell off the wagon.

Since 2014, I have kept an eye on my sugar, and have sometimes gone quite a while without dessert or candy.

I need to be more careful.

I’m dealing with some Life-type stuff right now, and after losing weight from the spring until September, my weight has started creeping up over the past month and I need to get on top of that.

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“Remission” means A1C under 6.5 (long term), and no medication needed to control the situation. You can call it want you want but my take is it means no medication to control the condition. Don’t really wish to argue since it’s medical and personal, and yes, everyone is different.

That said, my medical records say I’m a diabetic and MD treats me as one when treating me…minus medication. My take is this is a safe place and medications often lead to other, stronger meds, so you want to delay using.

Beyond that, I think anyone/everyone can do this, and encourage everyone to try. The complication is everyone is different and what works for one person, might not work for another. It’s like the asking the meaning of life…everyone’s answer will be different…and searching with dead ends but also surprises.

Lots of factors, like some food that might be “good” for diabetes, you might in fact dislike or hate…so you have to try a bunch of different things. Or what’s your glutton trigger to unneeded eating. (food porn for me)

That said, I didn’t give up white rice or potatoes. I just eat less and found out a “hack” (hate that term) about cooking either and refrigerating either overnight creates resistant fiber, unlike the hot, right from the pot variety. It reduces the glycemic index/load significantly. Still can’t gorge, but not eliminated.

Any way, off the soapbox. Thanks.

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This. I reject the “take a pill” solution. I probably qualify for Ozempic, although don’t need it currently…but that stuff scares me. Just listen to the possible side effects, or a parody.

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https://www.washingtonpost.com/style/of-interest/2023/10/18/jardiance-commercial-actress-trolls/

I wish the folks dancing in the Jardiance ad were the recipients of a small scale nuke.
A surgical strike!
:wink:

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Me, too!!!

Sing and dancing about a serious medical condition. ….no. Just no.

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