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Friday, July, 25, 2008

Setting Slack Standards

by  David Mendosa
Sunday, March 09, 2008
David Mendosa
David Mendosa
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Medical journalist living with diabetes

After earning a B.A. with honors from the University of California,...

David Mendosa

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"We live in a culture of low targets," writes Hana, one of my regular correspondents in England who has diabetes. For example, her nurse told her that that walking...

  1. Slack Standards
    metaour
    Tuesday, March 11, 2008 at 12:33 PM
    I have often thought about many of the articles points. The standards just didn't make sense to me. Yet I am just coming out of a several year denial. I know that if I was hit with everything I wouldn't have made it. I still wish I could deny the diabetes but it is here and I am learning to live with it everyday!
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  2. Untitled Comment
    Rob
    Tuesday, March 11, 2008 at 02:39 PM
    David - there is an alternate workout philosphy which has a lot of support on the fitness blog I use. A couple years ago NYT (I believe) reviewed and recommended New Rules of Lifting. It recommends far less exercise time that I previously had used. Three or four workouts a week are enough. But you trade intensity for duration. Essentially 3 40-50 minute intense free weight lifting sessions, and 3-5 HIIT, High Intensity Interval Training sessions. These include very intense fast times of 15 to 60 seconds, and that or twice as much slow time. Total fast times are not to exceed 6 minutes total. I have had really good luck with all of this. An endearing part of the book, however, were rules 1 and 2. Do something and Do something you like. They are NOT against the long endurance sorts of exercise you like. They just offer another system that also works.
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  3. Biology is not exact
    Mark Benjes
    Tuesday, March 11, 2008 at 07:53 PM

    I'm not sure if lax standards is exactly the case, or if it is more that there are a lot of variables. I think it is also the case that people respond differently, depending on how long they may have been having problems before they were diagnosed.

     

    Having a farm and livestock background, maybe I can relate to more of the differences even though we think they should be the same. The difference in pigs born in the same litter can be amazing, yet they would have most of the same genes with same parents. 


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  4. exercising difficulties
    harderm_21
    Friday, March 21, 2008 at 08:02 PM
    I have difficulty exercising enough due to charcot in my right foot.  Of course walking, running, aerobics, etc.. are out for me.  The only thing I do basically is ride a stationary bike every day.  It works to do this type of exercise, but I'm wondering if it also is affecting my foot, it doesn't feel like it, but who knows? 
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  5. Untitled Comment
    myjoy2go
    Saturday, March 22, 2008 at 10:06 AM

    David, I have been a fan of your for years. Why you may ask? Because we are Diabetics and can relate and you have had a love to research as I do.  I am so glad to hear of your success with Byetta. Are you still using Byetta?  You are looking great Big Smileand for your height please tell me you are not looking to loose more weight. 

     

    So before taking Byetta were you as regimented with exercise as you are today?


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    re: Untitled Comment
    David Mendosa
    Saturday, March 22, 2008 at 11:19 AM

    Thank you! Yes, I surely do love to research diabetes.

     

    About Byetta: It helped me immensely to lose weight. I thought that I would never be able to stop it out of fear that when I did I would gain weight back. But now on a very low-carb diet I am not hungry and have been able to stabilize my weight just below 160 pounds, which is a body mass index of 20.0 and where I want to be.

     

    Best regards,

     

    David 


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  6. Slack Standards
    Neal Gallagher
    Wednesday, April 02, 2008 at 12:40 PM

    David

     

    The wide range in HbA1Cs is definetly discerning. I tend to favor the Bernstein approach as well and I think most other physicians would fall into line were it not for the increased hypoglycemias. Im not too worried about hypos, it seems to me that all the longterm complication result form hyperglycemia, but physicians dont have the time and perhaps dont feel that patients want normal blood sugars as Dr Bernstein puts it. I suspect also a great deal of biochemical/genetic indivdiaulity in terms of some people thriving at 7.0% while others have complications with normal ranges.

     

    Im a type 1 diabetic and get the majprity of my calories from fat probably int he range of 60-75%. Have maintained a HbA1c in the 4.3-4.5 range for the last year. Most of the fat is from nuts, seeds, etc. The polyunsaturates in these fats seem to increase insulin sensitivity at the receptor/cell membrane from all the reasearh Ive read. The only problem one might have with fat is the variabil,ity it has on carbohydrate digestion as well as its own digestion. If one wants to maintain  83mg/dl like Dr Bernstein advises its harder to work these fats in, but if one wants to be a little more lax great way to keep the numbers within acceptable limits.

     

    Hypoglycemic symptoms may be avoided by a high fat diet. As the body transitions away from a dependancy on glucose and the brain shifts towards fat/ketones for energy supplies. Ive forwarded an interesting email to you from a NIH researcher with a paper he wrote on the subject a few years back.


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  7. Untitled Comment
    Aggie
    Thursday, April 03, 2008 at 10:13 PM
    Correct me if I'm wrong, but it seems that it was the Byetta that caused your dramatic weight loss and not the exercise. Were you exercising that much before and still weighed over 300 pounds? If so, that is very discouraging. It doesn't seem that exercise provided much benefit in the way of weight loss. Am I missing something?
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    re: Untitled Comment
    David Mendosa
    Thursday, April 03, 2008 at 11:34 PM

    Dear Angie,

     

    Since you asked, I will. Byetta alone leads to about 6 pounds of weight loss in 32 weeks, according to the clinical trials. I lost a lot more than that because I started to take care of my body -- with both better nutrition and a hell of a lot of exercise.

     

    David 


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  8. lax standards
    laura clerici
    Saturday, May 03, 2008 at 02:07 PM

    I agree that it is appropriate to criticize the ADA for its lax standards.  I have my diabetes treated by an endocrinologist, who knows better, but I wonder about those of us who go to GPs.  They usually quote the standards of care set by ADA, so those standards really should give the doctors and diabetics information which will protect us.  

    I wonder whether they ever had this debate when the American Heart Association was considering appropriate diet, exercise and medication to prevent heart disease or to deal with cardiac care?  I doubt it somehow.


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