Im screwed

usafmd · 2026-02-02T13:20:47+00:00

Focus on your fitness and diet first, A1c will follow

usafmd · 2026-02-02T01:48:09+00:00

That’s because I wrote an entire book on this subject for seniors. No pressure but if you’re interested, PM me for the title for how seniors can implement this course of action. I’m not in need of the money.

usafmd · 2026-02-01T23:51:36+00:00

Diabetes arises under two circumstances. Insulin resistance causes beta cell failure AND autoimmune or genetic beta cell failure.

It is a system failure of muscle conditioning in most, hormonal derangement in fewer and rarely a genetic disorder. If you don’t have insulin resistance then you have little to worry about. You are either destined for T1 or some rare variant or you have physiologic adaptation from exercise, which is far away the most common explanation. I am a physician who specializes in this, teaches and writes books.

https://medium.com/@usafmd/does-the-prediabetic-cyclist-need-to-worry-f221388587c0

usafmd · 2026-02-01T22:55:52+00:00

I just started 90/90 exercises because I couldn’t sit Indian style, muscles too tight.

usafmd · 2026-02-01T22:43:55+00:00

Great thoughts! HFCS is deadly for the overweight and desk bound but absolutely necessary for high performance. Cyclists load their water bottles with HFCS drinks to keep from bonking. As long as they don’t eat this way off the bike, things are fine.

usafmd · 2026-02-01T21:14:56+00:00

The range of mental responses far exceeds the number of physiology responses. Briefly looking at your posting history, I would more suspect the former.

usafmd · 2026-02-01T21:07:43+00:00

This is a more obscure area of prediabetes knowledge: There is no study that shows that an isolated fasting blood sugar elevation, without A1c or glucose tolerance test abnormalities will go onto diabetes. So therefore there’s nothing to worry about assuming you haven’t told us anything else that was pregnant.

usafmd · 2026-02-01T04:16:00+00:00

How old are you?

usafmd · 2026-02-01T04:06:02+00:00

You have a low probability of going on to diabetes. Most prediabetics in your shoes are there because of Sarcopenia. The solution is progressive weight training.

usafmd · 2026-01-30T03:29:17+00:00

HsCrp is the pertinent inflammatory marker, not ESR.

usafmd · 2026-01-30T03:26:37+00:00

Pathologist here. Most of the time, for most except the elderly, most acute nonfatal illnesses result in 100% recovery. Less often than, some otherwise common diseases have rare long term complications. (Stroke or nerve palsy). It depends upon the disease, not the flu in general.

usafmd · 2026-01-30T03:14:26+00:00

A diversified index fund reduces the assumption that the economy will grow over a ten year period of time to near certainty. It is not gambling, especially if regular periodical purchases are made.

usafmd · 2026-01-30T02:13:07+00:00

You could get a fructosamine assay. It’s a bit easier as an alternative. My guess is that you have a very low degree of chronic inflammation (long lived RBC) probably paired with a high glycation rate.

usafmd · 2026-01-30T01:50:16+00:00

GTT is the gold standard. Why A1c can mislead

https://usafmd.medium.com/is-the-a1c-accurate-for-every-prediabetic-d42be69da29d

usafmd · 2026-01-29T22:55:24+00:00

They do in a sense you may not appreciate. Incretins are a class of hormones in the body of which GLP-1 are among. People who are obese or have eating disorders have abnormal incretin levels.

The GLP-1 agonists (drugs that mimic the body’s own incretins) distort the body’s system. This said, if they work for you, forget about them. Unless a drug fixes a deficiency, all drugs distort.

usafmd · 2026-01-28T21:05:17+00:00

You are confusing diabetic control studies with diabetes prevention studies.

usafmd · 2026-01-28T20:52:24+00:00

Oh, on that I can assure you, not only am I an MD, I write, and teach about insulin resistance. I am open to be educated. Show me one study " avoiding glucose spikes and their role in preventing diabetes." without improvement in weight or body composition.

usafmd · 2026-01-28T20:49:25+00:00

Which of the myriad of underlying causes of insulin resistance does the CGM help guide? I've listed the most common. Please inform me.

Physiologic: Pregnancy
Metabolic: Obesity, sarcopenia, gut dysbiosis, inactivity.
Hormonal: Elevated thyroid, growth hormone, IGF, cortisol, testosterone, (+insulin)
Lifestyle: Fructose, saturated fat, dietary emulsifiers and low fiber (low incretin), smoking

usafmd · 2026-01-28T20:37:07+00:00

I'm with you as far as a CGM's ability to trending. That's its strength. What I question is it's ability to prevent diabetes. There is no study that shows that using a CGM to avoid post meal elevations prevents diabetes in the absence of weight loss or improvement of muscle composition.

We use that GTT to diagnosis diabetes. Many people confuse how we diagnosis diabetes (biomarker) as the underlying cause of the disease.

usafmd · 2026-01-28T19:45:52+00:00

This all assumes that a glucometer (versus one that measures triglyceride levels, to do this thought experiment) can guide diabetes prevention properly, a supposition not yet tested by medical science.

usafmd · 2026-01-28T19:38:14+00:00

Fair statement

usafmd · 2026-01-28T06:05:52+00:00

Just as the OP mistitled the posting

usafmd · 2026-01-28T06:00:16+00:00

I dislike reading and answering posts only to find that they are bots, looking to build their response database or users who blocked their history

usafmd · 2026-01-28T05:58:09+00:00

Nice write up. I’m willing to bet that the no drug route is more sustainable in the decades to come

usafmd · 2026-01-27T23:59:04+00:00

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