You don’t need a gym membership. You *need *to exercise.
Jumping jacks, burpees, jumping rope. Fill up some old plastic gallon milk bottles with water and do squats holding them, or thrusters (that’s just holding the bottles by the handles against your chest, squating down and in one motion explode up and thrust the bottles over your head, squat repeat.) You don’t need to spend lots of money; just a fairly small amount of time.
It took a bit but I think I understand what confused me about your question. The fit/not fit that you initially refer to is about weight and how the normal weight individuals with a new diagnosis have a worse prognosis than those who are overweight or obese at diagnosis! I didn’t get that because to me those who are normal weight are not necessarily fit and those who are fat may be fit.
Yes, thanks for both your interest, and for your explanation, which adds another fact against ignorance.
To be even simpler, my thought was even before that, pre-diagnosis: “aah, you’re fat and forty, you’re gonna get diabetes.” That epidemiological kettle of fish.
To add to what’s already been said, I’ll offer two (more) ‘explanations’:
(as background, please note that when people use the term “fat”, they are actually referring to triglycerides)
Fat (triglycerides) around the belly is inherently more metabolically active than fat around the hips (e.g. although tough to do, you can lose fat around your belly by “lifestyle measures” whereas once fat is deposited around the hips, it is almost impossible to lose).
By “metabolically active”, I am referring specifically to the equilibrium that exists between fat (i.e. triglyceride) and its breakdown components called fatty acids and glycerol (here is a clear picture).
So, fat (triglyceride) around the belly is constantly breaking down into its core constituents of fatty acids and glycerol, but fat (triglyceride) around the hips tends not to breakdown nearly as much and thus doesn’t produce as much fatty acids and glycerol.
But here’s the thing: fatty acids released from fat, as occurs from fat in the belly, leads to insulin resistance and also signals the liver to start making sugar. In other words, it’s a double whammy - insulin is made less effective by fatty acids and fatty acids also signal the liver to produce sugar. The net effect is a tendency to high blood sugar. (Fatty acids also have other effects which, as you guessed, also lead to high blood sugar).
Not only is belly fat more likely to generate the sugar-elevating fatty acids than hip fat, but any fatty acids so released tend to go directly to the liver, with the liver being a central player is sugar metabolism. Phrased differently, even if hip fat did break down into fatty acids to the same extent as belly fat, any fatty acids so released would not go directly to the liver and thus have a more modest impact on sugar metabolism - i.e. belly fat ‘drains’ into the liver but hip fat drains away from it. (For those with a physiological background, belly fat drains into the portal system, but hip fat goes systemically).
Sounds like she may have had polycystic ovary syndrome. The disease process with that involves the pancreas dumping too much insulin, until eventually it burns itself out. It’s incidental that insulin is so similar to an ovulation-inducing hormone that it binds to the same receptors and interferes with ovulation, though that’s usually the symptom that gets women diagnosed.
By the way, if anyone wants to learn more about the relationship between fatty acids and (rising) blood glucose levels, it’s described by the Randle Cycle.
First off the discussion here was asking about the cause of diabetes and preventing it. That study was designed to analyze preventing the complications of in people who already have it.
What is buriedin the actual data is what was hinted in the NYT article. Odds are the exercise and improved diet group needed much less medicine to achieve the same results (Insulin, other injectable hypoglycemics, statins, BP meds, etc.).
Concluding that it “did not help” is not accurate. It reduced the need for medications, reduced some signficant complications, and improved quality of life. Compared to intensive medication management coupled with standard exhortations to eat right and exercise (which resulted n some gradual weight loss in the control group as well) it was no better in reduction of cardiovascular complications. People are disappointed by that. Go figure.
[quote] I have type II, aka the “fat and forty” one)
[quote]
So my comments are completely relevant here.
But the details of the Look AHEAD study you presented are duly noted. I suspect, however, that most diabetics would rather simply take more meds than make the effort to restrict calories and exercise regularly.
Surreal on review the conversation had certainly moved into what to do about it now that he has it and the importance of exercise. Still I do think clarifying that that article was talking about prevention of complications, not prevention of diabetes, was im[portant to make.
As far as taking more of more expensive meds (so long as they are covered) rather than serious diet and exercise, possibly. Increased risk of kidney failure, of going blind, of depression, of decreased mobility … yeah probably willing to live with those in many cases than actually eat well and exercise regularly. But erectile dysfunction! That might get a few to work at it some!
Hmm, as far as I’m aware though she doesn’t have any of the other symptoms of that. I would assume a gynecologist or the doctor she went to when she was pregnant with me would have noticed if she had it.
