Blog

Short blog posts, journal entries, and random thoughts. Topics include a mix of personal and the world at large. 

Continuous glucose monitoring

Last week I wrote that I scored a 5.7 on the HbA1c test during my annual checkup. That number is just into the range of pre-diabetic, which is rather alarming. With no other levers to pull - my sleep and exercise regiment is on point, the only lifestyle choice I am making is to limit carbohydrates. More so than I’ve already been doing for over a decade. It’s kind of difficult to cut carbs when I hardly eat any sugary products to begin with. I would be cutting into the staple carbs I eat with meals: rice, bread, noodles, fruits, et cetera.

Ideally, I want to be able to see which of those carbs are spiking my blood glucose level. It’s not prudent to cut out carbs completely, because I need some of it for sustenance, especially after workouts. Therefore it would be helpful to see if white rice spikes blood glucose, but a slices of wheat bread does not (or vice versa, I don’t really care). I will then only eat the carbs that do not elevate blood glucose.

Turns out there are devices called continuous glucose monitors (CGM). Exactly as the name suggests, it constantly measures a person’s blood glucose level (every five minutes). An app on a smartphone collates the data, and users can see in real time if it’s normal, elevated, or too low. Originally developed for type one diabetics - they need to check their blood glucose constantly, CGM devices are now broadly used by people (diabetic or otherwise) wanting a clear picture of their glucose profile.

I asked my doctor to prescribe one to me, and she agreed. But there’s a problem: because I am not a type one diabetic - or any form of diabetic, Kaiser Permanente insurance does not cover the CGM. I will have to pay out of pocket (in the American healthcare system, there is no money in prevention). The primary cost driver are the patches that sticks to the skin (for measuring). Those need to be replaced every 10 - 14 days (depending on the brand).

It’s a necessary expense. I need to see if my blood glucose level is indeed higher than what is considered normal. No better method than measuring (kind of) at the source. Sometimes HbA1c results can skew higher by other factors, so I want to check if that 5.7 might be a false positive (if you will). More to come!

From the window…

Sugar how you get so high

Yesterday was the first time in my life I got the flu vaccine. And let me tell you, I am feeling like crap today. Make sense, right? The vaccine is effectively introducing a small strain of the influenza into my body. Of course it is going to react as if I actually got flu. At least the symptoms aren’t truly on the levels of a real one. The last time I got it - more than a decade ago - I was bed-ridden for two days.

It was a smart decision to not get the latest COVID vaccine at the same time. Despite what the Travis Kelce commercial says, asking your body to fight two invading viruses concurrently might not be the best idea. My coworker got both the flu and COVID vaccine at the same time, and he was down in the energy dumps for two days. I’ve a history of symptomatic reaction to the COVID vaccine (the second Pfizer shot was killer), so I am delaying what would be the fifth shot to a later date.

I also got the annual blood test yesterday: the usual cholesterol and glucose measurements. Turns out I am pre-diabetic? My HbA1c is 5.7, which is barely into the pre-diabetic range. I am kind of dumbfounded at this. I’m rather religious with proper diet, sleep, and exercise - and have been since my early 20s. I don’t drink or smoke, and I avoid added sugar whenever possible. My weight is completely normal for my height. How the French am I pre-diabetic?

Since I already get eight hours of sleep per night consistently, and exercise multiple times per week, any adjustments to be made will not be in those two areas. It will have to be diet. Moving forward I will cut back on carbs as much as possible, and eat more vegetables and fibrous foods. Let’s check back in six months when I get the next blood test.

The green tree of Ethnic Studies and Psychology building.

That's not what you want

A coworker of mine is dangerously close to being diabetic. The doctor has him on three medications already to try to stem the tide. Yesterday I regrettably informed him that being diabetic does indeed increases the risk of Alzheimer’s and dementia. Just as smoking increases the risk of lung cancer. Maybe that will finally be the impetus for my coworker to change his lifestyle. Because losing the mind - our consciousness - is a horror no one wants.

Obviously, type two diabetes is overall bad news for practically every facet of the human body. My late maternal grandfather lived with it for the latter part of his life. It was a never-ending cycle of dialysis. It’s a surprise that he lived to 93, because he did not adhere to the strict diet and exercise advice typically prescribed to diabetic patients (you know, the part that doesn’t involve drugs). Maybe there’s hope yet for my coworker, because he’s failing massively to change his diet, and let’s not even talk about working out.

The easiest on paper prescription is the toughest to follow. I’ve another friend who got told by her doctor that if she doesn't change her diet and exercise habits, she won’t live pass 40 to see her kids graduate. That should be a sufficient wake-up call, right? The friend has changed her diet somewhat, but flat-out refuses to do any sort of exercising. It’s sad to see, honestly. My coworker also has a young daughter to live for. How much stronger do incentive need to get for people to change?

And to think the impetus that got me to change my diet and exercise - way back in college - was a mere borderline hypertensive blood pressure result during a routine checkup. I get it: most other people want an easy pill to swallow. Habits are difficult to build. Short term rewards are more salient than long-term thinking. All I’m saying is, the latter two decades of my grandfather’s life was no life at all. That’s cautionary tale enough for me.

That’s a penis!

For the sake of others

A coworker on mine recently got diagnosed as pre-diabetic. The condition is serious enough that he is now taking three separate medications for it. What he needs to avoid is the full type 2 diabetes: a lifetime of blood-glucose monitoring and kidney dialysis, if it gets bad enough.

Other than the meds, the prescription is simple, really. The coworker just have to eat right, exercise, and get enough sleep. Of course, what is easy on paper is really not when it comes time to move. It’s a drastic change for those who are used to a life of eating with impunity and not much exercising. The struggle is real when you’re trying to eat a salad while the people around you are eating cheeseburgers. Whichever pharmaceutical company figures out how to compress diet/sleep/exercise into a one singular pill is going to make all the money in the world.

Until then, my coworker is going to have to do the hard slog. So far, not so good. Just last week he went to the campus dinning hall to eat lunch, which is buffet style. Naturally then he stuffed himself to the gills, ruining his afternoon of productivity. It’s kind of disappointing to see a diagnosis of pre-diabetic isn’t enough of a wake up call for him. Especially considering he has a young daughter (and a wife, in Borat voice). Surely he wants to be healthy and functional for her sake.

The answer is of course yes - on paper. Wanting to be healthy and actually doing the steps to get there can be mutually exclusive. You’d think having a daughter to live for would be enough of an impetus, but we’ve yet to see the consistent change with our coworker. Hopefully it won’t take crossing over to full diabetes for him to actually get on with it.

Hitting in the park.