Archive for July, 2011

The Diet Soda Debate

July 29th, 2011

It was not unusual for me to go through a six-pack of Diet Cokes in my years in high school and college.  I used to call Diet Coke the “nectar of the gods” I drank it so much.

It’s embarrassing and a little frightening to think about it now!

What made me give it up?

When I went on Weight Watchers and really started to try and lose my excess weight, I started drinking a heck of a lot of water.  What a difference that made in my life!  So in part I gave up so much soda because my bladder just isn’t that big.

And then a few years later I started to really get into being fit.  And I started thinking about how what I put into my body really was making my body what it is.  I’m not all the way there yet, at all, but I realized just how many chemicals, particularly aspartame, that scared me.

When I see news reports linking diet soda consumption to higher weight and risky waist to hip ratios I wonder even more.

Sure, I am at zero risk of developing diabetes as a result of diet soda consumption.  But that doesn’t mean I want to taunt unknown other effects of those chemicals!  (And no, I never had diet soda or aspartame or anything close before I was diagnosed with type one diabetes.)

One group studied the body measurements of people who drank diet soda and those who did not.  After nine and a half years:

Diet soft drink users, as a group, experienced 70 percent greater increases in waist circumference compared with non-users. Frequent users, who said they consumed two or more diet sodas a day, experienced waist circumference increases that were 500 percent greater than those of non-users.

Why does waist circumference matter?  It signals the amount of abdominal fat, a major risk factor for a whole host of chronic conditions that include cardiovascular disease and cancer.

The other study reported was conducted on mice: they gave half the diabetes-prone mice (how did they know that?) food with added corn oil, and the other half received food with added corn oil and added aspartame.

After three months on this high-fat diet, the mice in the aspartame group showed elevated fasting glucose levels but equal or diminished insulin levels, consistent with early declines in pancreatic beta-cell function. 

Oh dear.  When someone starts discussing beta-cell function it’s already too close for comfort in my world.  (Pancreatic beta cells, responsible for insulin production, are what my body attacked to cause my type one diabetes and why type one is an autoimmune disease.)

As someone already living with a chronic condition, I want to avoid any other reasons to be under a doctor’s care.  So for me, the choice to avoid artificial sweeteners is a good one.  Now I drink a lot of water, a lot of tea, and soda water.  It works, and I don’t feel deprived.  It feels like a great healthy and simple choice to have made for myself and my body.

We’re all doing the best we can, after all.

Here’s to you and the healthy choices you make for you and your body!

A New Idea for Me About Evolution: Body Weight, Insulin Resistance, and Fructose

July 28th, 2011

This paper is fascinating me right now despite being sidetracked yesterday. Dr. Richard Johnson of Denver Colorado is the presenter and researcher; he presented at the World Congress on Insulin Resistance, Diabetes, and Cardiovascular Disease in November 2010.

(This is one of what seems like an infinite number of instances wherein “diabetes” means type two diabetes, by my figuring.)

Full disclosure here: I’m not a scientist.  One of the reasons I’m not a scientist is that I have to read science terms very slowly and I’m not patient enough to do so.  So please remember I’m pointing to words, terms, and phrases in the online work itself rather than paraphrasing in large part because I’m not familiar enough with what I’m writing about.  (Not that that stops me from writing about it.) 

Johnson believes that “fructose may not be simply an energy source, but may have specific metabolic effects that may aid in increasing fat stores.”

He goes on to say that islet injury from fructose is in part mediated by urate, and uricase deficiency is a genetic mutation that may just have saved our ancestor’s lives. (I can’t fully explain how the islet injury occurs to begin with, or why.)

So, in a world where fruit and fruit sugar is a main source of energy, those with a uricase deficiency would have had a tough time of insulin management, which would today appear as insulin resistance (one of the hallmarks of type two diabetes).

Until  you consider Survival of the Fittest: those best able to survive periods of famine were those who had the genetic propensity to insulin resistance.


Because a body resistant to insulin makes more insulin to manage glucose in the blood.    It also in turn increases fat storage since that’s one of the functions insulin serves in our bodies.  More body weight (fat) means more insulin required, which means more insulin made, which starts the cycle all over again.

So those who carried extra body fat and body weight due to a uricase deficiency would have been those best equipped to survive a famine.

Wacky, isn’t it?

Our ancestor’s propensity to increase fructose consumption without proper genetic tools to manage that consumption helped them survive, and here we are in the twenty first century with insulin resistance and type two diabetes as one of the world’s most alarming health crises.

It’s important to keep in mind that the amount of fructose our ancestors consumed is NOWHERE NEAR the amount we consume today.  Johnson points out that in our lifetimes we have seen an incredible increase in the amount of sugar we consume compared to just three hundred years ago:
“…from a mean of 4 pounds of sugar intake per year in 1700 in the United Kingdom and United States, to greater than 150 pounds per year today….we found that 25% of the population was ingesting over 130 g of fructose per day, which equates to over 200 pounds of sugar per year …some individuals are ingesting more than 50 times the mean amount of sugar than was being ingested just 300 years ago.”

So while we owe our ancestors a debt of gratitude for surviving as well as they did, we need to make some changes in our own lives and in our own world so that our children and grandchildren and 10-times-great-grandchildren can thank us, too.

Sidetracked By An Op/Ed Column

July 27th, 2011

I sat down this afternoon at my computer with my highlighted article in my hand, ready to write about a concept new to me about evolution
and body weight and insulin resistance.

But then I opened Facebook, and the JDRF Bay Area had a link to an Op/Ed article written by a former JDRF advocate and published in the San Francisco Chronicle, and I got sidetracked.

It was the headline that hit me wrong.

“Lives Wasted as FDA Stalls on Artificial Pancreas Technology”

Let me say first off that I understand that this author is advocating for funding for research on type one diabetes.  I understand that advocacy before Congress requires highly charged vehement pleas, essentially, for money.  For that, people have to care about the goal
you have and have to want to help.

But here’s the thing that’s hitting me wrong about the entire article, and a lot of the pleas some of these research and other groups are required to adopt in order to wrestle sufficient funds out of others’ hands.  It’s not only the MESSAGE; it’s the tone.  They are discussing my disease, you know.

MY life isn’t being wasted.  MY diabetes isn’t the “constant, frightening, deceptive and malicious” one this author discusses her daughter lives with every day.

My friends with diabetes aren’t wasting their lives, either: they are nurses, teachers, mothers, scientists, engineers, dieticians, social workers, authors, attorneys, students, photographers, volunteers, artists, and more.  They are amazing and normal people who are busy improving their worlds as they live with their diabetes.

If I were waiting around on the latest “breathe into a tube instead of prick your finger” machine, or hoping for a pancreas transplant, or if I spent any time at all hoping for a cure; those things would make me feel like I were wasting my life.

Not one of us will get out of this alive, you knowWe don’t get guarantees.  We only get the here and the immediate right now today.
Sure, we need to plan and learn and dream and work and play and appreciate and share and do our very best as often as we can—but I for one think we have no time available for wasting.

(I also think that any death due to low blood glucose levels is horrible and think the only thing possibly more terrible is the thought that
someone might say that it was a “wasted” life.)

I’m clearly not the best Drama Queen when it comes to what it takes to live well with diabetes.  The author says “every hour of every day, individuals with type 1 diabetes have to balance insulin, food and activity to try to prevent low and high blood sugars, and the devastating and costly complications: seizures, comas, kidney failure, heart disease, blindness and amputations.”

Balance: yes.

Prevent: yes.

Devastating: really?!

Costly: alright; I’ll give her that.

Seizures: haven’t had one.

Comas: haven’t experienced one.

Kidney failure: haven’t had any.

Heart disease: not planning on it.

Blindness: none I can see in my future.

Amputations: ticklish as a schoolgirl.

So who is this lady talking about in her article?  What is she telling Congress?  Who do the SF Chronicle readers now think I, as a type one diabetic, am?  How many of them have I already met?

How many will I run past during Sunday’s marathon through San Francisco?

Will they see me as devastated, tragic, or doomed?

I can’t help but think of Bill Polonsky’s speech starter: Well-[managed] Diabetes is the Leading Cause of… Nothing!

If you’re waiting for the Big Bad Diabetes Wolf to come and get you, you may very well have a very long time to wait.  Don’t waste that time.

Go out and get living.

A Funny Thing Happened

July 26th, 2011

It isn’t a “ha-ha” kind of funny thing.  It’s an “odd” kind of funny thing.

One of my diabetes doctors, Dr. Joe, has several cats. (I can understand how they seem to grow; I’ve lately been trying to get my neighbor’s kitten Jerry to live with us instead of them!  We are much more fun and he’s here all the time anyway.)

And the funny thing is, one of my diabetes doctor’s cats was just diagnosed with diabetes.

When I learned this, I had the following thoughts, in this order:

  1. Poor cat.
  2. Poor Dr. Joe.
  3. Lucky cat.
  4. Lucky patients.

First of all, let me make this clear: I’d love it if no one else ever got diabetes from this point on.  It isn’t something I’d wish on anyone for any reason.  The diabetes aspect of my life is never not a pain in the rear.  Why would I want someone else to have to deal with it?  I don’t.  So, for any and every newly diagnosed person or animal, I feel some sadness.

Secondly, I’m very sad for my doctor and his wife.  I think that anyone having to deal with someone else’s diabetes (kids or pets) who cannot communicate through what I consider “normal” channels (namely, speaking words) or who has to overcome difficult concepts for the diabetic to understand (you have to eat X amount of food because we just gave you Y amount of insulin) faces just an overwhelming task.

I know how complicated things can get when living with my own diabetes and I don’t face either of the above challenges in my own life (well, not so much that you’d notice) so my heart and thoughts go out to everyone who is caring for someone else’s diabetes.  What a job.

(My doctor was pretty emotional when he mentioned how he now needs to care for his cat.  He released a video, here, about what he was going to have to do.)

Back to Sunny. I think that cat probably had a pretty good life before he was diagnosed.  (I think most cats have a pretty good life, when it comes down to it.)  He gets to climb on bookshelves and countertops and hide inside places we humans don’t fit and probably can’t even see sometimes.  He has fun siblings and a relatively well-behaved D.O.G. niece and nephew (if a cat can consider a d.o.g. well behaved), not to mention doting parents.

And, if you have to be diagnosed with diabetes, wouldn’t you feel sort of lucky if your dad
lived and breathed all things diabetes for his career?
  Talk about well-educated; Sunny’s dad is the educator!!

The last thought I had when I first heard about my doctor’s cat being diagnosed with diabetes was how lucky my doctor’s patients are.  It highlighted for me just how much work we all do every day we live with diabetes, and it’s nice to know that one of my doctors now takes on an additional level of understanding.    I think we each are looking for that in all of the experts on our team: consideration of the challenges we face and some understanding in the ways we opt to deal with those challenges.

I, for one, am rooting for Sunny the Cat and his caretakers. They all have some learning to do and it’s very nice to know they will be learning together.

Go Team Sunny!!

Don’t Ignore Your Upper Body!

July 25th, 2011

I’m always talking about how to do a squat or a lunge or how to keep your core strong, not to mention discussing what it takes to get my legs to run, but don’t take my relative silence on the  upper body to mean it’s okay to ignore it!

Take my suggestions here with a grain of smart salt: if a certain move doesn’t work for you for whatever reason, don’t do it!

You may have been one of those people who adopted a new catch phrase for your upper body ‘round about 2008-09: Michelle Obama Arms. 

And you might recognize that a large part of Mrs. Obama’s sculpted arms is genetic, a large part of it is a result of her diet, and about 5-10% is related to her workouts.  (How do they look to you now, once you think about how well she must eat in the White House compared to how we eat when we feed ourselves?)

That said, we do owe it to ourselves to love our arms.  LOVE them.  Make them the best and strongest arms they can be.

Which does take some thought, and some knowledge.

Your upper body consists of five general muscle groups: back, chest, shoulders, biceps, and triceps.

Back and chest muscles support all motions of your arms as well as facilitate movement and stability of your spine as you move through your day.  Keep up your ab work and strengthen your lower back with moves like supermen and bird dogs, and always think about your posture!!

Your shoulder joint is the one joint in your body with the greatest range of motion and therefore can be injured if you don’t pay attention to your form! Keep your shoulders pulled back and down to combat the hunch and inward caving you experience from sitting at your desk or computer.  Always follow the Rule of Thumbs: be able to see your thumbs throughout any overhead moves to avoid nerve impingement and injury.

Biceps help you grasp and carry, and are those “flex” muscles.  Your biceps (“bi”= two) attach to your shoulder in two separate places and attach inside your elbow in one spot.  Doing hammer curls (thumbs up, palms face inward toward the midline of your body) and traditional bicep curls (palms face the ceiling as your hands move toward your shoulder) uses different portions of the muscle, so make sure you hit them both!

Your triceps (“tri” = three) extend your arm and have three separate attachment points along your upper arm but share a common tendon above your elbow.  To avoid that certain waddle, you want to use all three aspects of your triceps as you perform kickbacks, dips, overhead extensions, and triceps pushups.

Remember: muscle tissue does not know age—it knows use and it knows disuse.  USE IT or lose it!

Am I Simply Jaded?

July 22nd, 2011

I think it’s probably way past time for me to admit that I’m jaded when it comes to “the latest and greatest thing” for checking blood glucose levels.

Maybe it’s the companies trying to rekindle an excitement in me that never existed.

Maybe it’s my frustration at how much money must be pumped into research and development that I would rather see invested in people and families or even in tools that don’t exist for issues that I think do exist.

This one, in the July issue of Diabetes Forecast, discusses essentially a breathalyzer blood glucose glucometer thingamajig.  (Wow; I guess I must have added “thingamajig” to my computer’s dictionary since it flagged “glucometer” but not “thingamajig.” Awesome.) 

Scientists are trying to “develop a portable, lightweight, and inexpensive breath-testing device that could replace traditional blood glucose meters—and finger sticks.” (Forecast credits the April 2011 edition of the American Journal of Physicology-Endocrinology and Metabolism but I can’t find it in the Table of Contents over there.)

Just like the gluco watch I’ve never seen.

Or the iphone app that reads something like fluorocarbons injected under the skin.  (Shiver.)

Of particular interest in this one, they only tested normal and high blood glucose levels.  If only we had to concern ourselves with those, right?

Seriously: is checking blood glucose with a meter that much work for us that we need to invest millions in finding other solutions to accomplish the same thing?  I’m not saying my CGM isn’t fantastic, and I’m not saying that my meter isn’t a huge step up from urine checking.

I’m saying that people are working so hard to eliminate something that isn’t that big of a deal when it comes to my life with diabetes.

Don’t get me wrong: I think there is work to be done.  I think we need more and better tools when it comes to insulin and insulin delivery and our bodies’ metabolism.  I love the work people are doing on making low blood glucose levels a thing of the past through the use of service dogs.

What I can’t understand is why those people working with service dogs are doing so in nonprofit organizations and these scientists are probably making far more than minimum wage.

It gets to me.

Anyway, I’m not trying to complain.  But I am, and for that I apologize.  I’d love to leave you with a better thing to think about over the weekend.

So here you go, inspired by a Geico commercial I heard on the radio this morning (that I can no longer remember it was so long ago):

When cheese gets its picture taken, what does it say?

What hair color do they put on the drivers licenses of bald men?

Why are a wise man and a wise guy opposites?

If you’ve got any answers, I’d love to hear them!!

Which For You Requires More Strength?

July 21st, 2011

How do you define strength?  Is it in your ability to be disciplined and rigid?  Is it being flexible in the face of change?

Many of us find solace in the routines daily management of diabetes encourages.  Any change can throw our blood glucose levels for a loop and we therefore we learn to resent those unpredictable moments.

Does clinging to that routine cost us more than the routine provides?  Sometimes I think it does.

In the yesteryear of diabetes management, NPH and R shots required constant vigilance and attention to the clock.  Rigidity was mandated by the working life of the insulin we injected.

Dinner had to be served at 6:00 and snack had to be at 8:30.  Shots had to be injected between 5:30 and 6:00; it’s just how things were.

I think a lot of us have learned that eating the same amount of carbohydrates (not to mention the same exact food) at the same time of the day tends to give us what we all crave when it comes to managing our blood glucose levels: predictability.

Yet even with that predictable routine and rigid schedule, things change.  We can do the exact same thing at the exact same time every day for five weeks and achieve the same result only about 60%
of the time.

It’s maddening to say the least.

My personality doesn’t lend itself well to this kind of rigid schedule.  I would love it if I could, in a lot of
ways.  It might make things “easier” if I went to sleep at the same time every night and had dinner at the same time each day.

But that isn’t where I find myself.  My days aren’t routine and they haven’t been ever since I graduated high school and started taking classes held at different times on different days.  (For those mathematicians out there, half of my life.)

I had to learn how to be flexible when it came to my diabetes PDQ!  Thankfully, I started with my insulin pump around the same time as I graduated high school, so the Insulin Clock could eventually disappear from my brain.

I don’t miss that clock; don’t miss it at all.

Yet I see people on pumps still following those routines.  I see it in other people, too, who don’t live with diabetes.

It makes me wonder sometimes which one is more difficult: following a routine or being thrown a curveball and having to be flexible in dealing with the unexpected change.

Learning to live with the routines and the curveballs in my diabetes management has been a rough road; it’s one of the hardest things to explain to a non-diabetic friend.  I have to learn to be both as
disciplined as possible AND not get too upset when the random wacky results show up and I have to wrestle a new basal rate or meal bolus or exercise routine into “submission”. (ha!)

I think that ability to simultaneously be both the proverbial tall oak tree and the bending reed is rather an amazing source of strength in itself.

We do learn to live amazing lives with our diabetes, don’t you think?

Some Reasons Your Basal Rates Are What They Are (It’s Your Metabolism)

July 20th, 2011

I read this and appreciated how cut and dried it seemed.  At the end of the day, we are who we are.  Olympians, models, Jane and Joe.  It’s nice to see some of the reasons behind our pump basal rate requirements, and to recognize how big a factor weight training is as we age.

Reading this, it would seem that the only way we can alter much of our predestined fate is THROUGH EXERCISE.

Go figure.

So, rather than paraphrasing a straightforward article and making comments here and there like one of the old guys from the Muppets, I’m just going to copy and paste a Cathe Friedrich article below.  (Factoid of the day: those guys are named Statler and Waldorf, after two NYC hotels.)

But back to the show.  Here, now, are SIX FACTORS THAT AFFECT YOUR METABOLIC RATE by Cathe Friedrich!!!!

Do you wish you had a faster metabolism so you could eat more without gaining weight? Many people are convinced their metabolism is too slow, and it makes it harder for them to lose weight. Each person has a metabolic rate that’s affected by a number of factors. Some of these factors can be altered, while others can’t be so easily changed. Have you ever wondered what makes your metabolic rate fast or slow?

First, a definition. Metabolic rate is simply the amount of energy expended over a given period of time. This energy is released as heat. You can measure your metabolic rate at a single point in time using different methods, but the rate will vary throughout the day based on a variety of factors including activity level. Here are some factors that affect metabolism.

Factors That Determine Your Metabolic Rate


According to a study published in Obesity Research, black women have a resting metabolic rate that’s about 5% slower than white women.


Men have a metabolic rate that’s 10 to 25% higher than women. This is at least partially due to greater muscle mass since muscle is more metabolically active than fat tissue. You can’t control your sex, but women can increase their lean body mass through exercise.


Resting metabolic rate drops by as much as 2% each year after the age of 20. Both men and women also lose muscle mass as they age, which accounts for some of this decline. You can’t control the aging process, but you can do strength training to increase how much muscle you have.


Larger people have higher metabolic rates because they have greater total mass. You can’t determine your height or the size of your frame, but you can alter your body composition and how much mass you carry to some degree through diet and exercise.


Genetics play a role in determining metabolic rate too. Most people know someone who can eat anything they want without gaining a pound. Unfortunately, it catches up with them as they age, and their metabolism starts to slow down. Some people aren’t able to adapt to their changing metabolism and gain significant amounts of weight as they grow older. You’ve probably heard formerly thin people say, “I was as skinny as you
when I was younger.” They probably were.


The primary hormone responsible for regulating metabolic rate is thyroid hormone, but sex hormones such as estrogen, progesterone and testosterone play a role too. This may be due to their effects on lean body mass. Most women experience a steeper decline in metabolic rate after menopause, but accelerated loss of muscle mass also contributes to this slow down. Growth hormone and other fat-burning hormones likely plays a role in regulating metabolism, and growth hormone levels decline with age.

Other Factors That Affect Your Metabolic Rate

Factors such as ambient temperature affect metabolic rate. Colder temperatures boost metabolic rate by causing shivering, which produces more heat. Turning down the temperature in your home can subtly boost your metabolism.

If you’re anxious or have a fever, you have a faster metabolic rate and produce more heat. Some medications can alter it too. Thyroid hormone, nicotine and caffeine raise it, and some medications such as anti-psychotic drugs lower metabolism.

High-intensity exercise that uses the anaerobic energy system such as heavy weight-lifting and sprinting boost metabolism for hours to days afterwards, and when you build lean body mass you burn more calories. Moderate-intensity endurance exercise has less of an effect on metabolic rate.

What and how you eat plays a role too. Restrict calories too much and your metabolism slows down to protect you against starvation.

What You Can Do to Boost Your Metabolism

Certain factors such as genetics, sex, race and age you can’t control. But you can boost your metabolism by doing high-intensity exercise and resistance training to increase lean body mass. If you restrict calories, never go below 1200 calories a day to avoid slowing down your metabolism. Focus on eating smaller meals more frequently that contain small amounts of lean protein. Drinking caffeinated beverages and green tea may also subtly increase metabolism.

Do You Experience Illness or Wellness?

July 19th, 2011

A therapist asked me a few years ago how it felt to me that I had been ill for the majority of my life.



I wasn’t sure how to answer her.

(You should know that I do a very bad job of hiding my emotions off of my face.  If I don’t understand something, I won’t fake it.  You’ll know just by looking at my face.  Same thing if I think something is great, or gross, or whatever.  It is not an aspect of myself I find very useful, despite the fact I’m sure it’s pretty entertaining for others sometimes.)

Anyway, I can’t tell you what my expression was, but I can tell you my eyes squinted and I got a crease in my forehead.

I couldn’t believe anyone would consider me “ill” because I have type one diabetes.  It isn’t a way I think of myself!

I’m more of a wellness and fitness kind of gal.

Which is why this article caught my attention in such a special way.  Of
course, I applied it immediately to my own life and saw how true the message

Illness versus Wellness.  I versus We.

When I tried to live with my diabetes all alone, I sucked at it.  I was in denial, I was terrified, I was simultaneously blatantly rebelling and hiding from my disease and my physical reality.  It was awful.  Truly awful.

When I got myself to a supportive environment at the Diabetic Youth Foundation, my diabetes immediately shrank.  I could be ME when I was singing goofy songs about having a blood glucose of 64 or when I was sitting quietly with a blood glucose of 378 and people knew how that felt.  I could be ME when I taught teens how to make figurines of clay and filled big vats of RIT dye for tie dying day with families.

I found myself in a group.  ALL of me, because my diabetes was what got
me into that group.

Insulin may be the key that unlocks the doors to our cells so that our bodies can use the glucose we eat, but my disease is what unlocked the door to a new world for me.

A world where I wasn’t alone.  I could be WELL and not ill.  Because that’s what I wanted, and what I think we all deserve.

A world where wellness can be my priority, and sharing that through Diabetes Outside is what I want to do all day, every day.

It is what I think it’s all about.  Life, Diabetes, and everything in
between.  Together.

Won’t you join me?

Monkey See, Monkey Do… Or Not (yes we’re the monkeys)

July 18th, 2011

I might have lost this bet.  I am rather surprised in some ways, but in other ways, it’s a no-brainer.

This study questioned general practitioners about their own activity levels and the activity levels they prescribe to their type 2 patients.

More confusingly, what they looked at was not the actual activity levels of the physicians, but rather the
physicians’ perceived barriers to physical activity.

I hope they didn’t word the questions in the same way. 

First off, they asked more than 600 physicians in France to complete the questionnaire; 574 declined to
participate.  Bummer for the researchers!  After all was said and done, 48 general physicians and 369 patients were included in the study.  So maybe this isn’t a great picture, but I think it does highlight on an important aspect of healthcare.  (This low return rate on the questionnaire is one of the things that surpised me.  It’s a shame because I’m pretty sure those physicians who do exercise returned their questionnaire.)

It matters to us patients how our healthcare professionals care for themselves.

The study found that the patients whose general physician didn’t think there were many hurdles with physical
activity in their own lives fared better when it came to the patient’s physical activity.

It makes sense: I think the average person would rather see a dentist who brushed their own teeth than one who didn’t.  We’d rather hire a plumber who had a toilet in their own house than one who used an outhouse.  (I could keep going but I won’t.  You’re welcome!)

So, it makes sense that if a general doctor tells a patient “exercise and be more active to help manage your diabetes” we at least on some levels will be more likely to follow that advice if the doctor exercises, too.

Maybe they can help their patients figure out how to beat some of the basic excuses when it comes to exercise
because they’ve had to figure out ways to make it work in their own lives.  Maybe it’s because a fit and active doctor
exudes good health
and we as patients want to learn from and copy that good example.

But I don’t think it’s unrelated.  I don’t think patients who see fit general doctors aren’t paying attention.  I don’t
think patients who do need to exercise look at their unfit doctor and don’t see it as a “get out of jail free” card.  (Which is a categorical shame.)

We are all looking for ways to make exercise work for us and our bodiesEspecially
those of us living with diabetes.

If your doctor, be they a general practitioner or an endocrinologist, isn’t speaking to you about exercise, NOW is the time to ask: