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    Giticus Nick386i's Avatar
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    Just diagnosed as type 2 diabetic

    Is this going to be a major issue for my cycling or does it not affect it? Thinking in terms of nutrition and keeping the energy going when doing races, and rides of 100-200k etc.

    Total numpty on diabetes so have lots of reading to do.......

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    Giticus Nick386i's Avatar
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    just did a search.... and found the thread doh!

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    50000 Guatts of power 127.0.0.1's Avatar
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    no matter what happens, for the rest of your life do all you can to get a 4.6-5.6 a1c do not go over.




    and no being diabetic doesn't really affect 'being an athlete' if you do hit the books
    and figure it all out. didn't stop me. I pulled 20,000 miles out of my butt last year.
    Last edited by 127.0.0.1; 01-07-09 at 09:15 AM.
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    Nick,

    As a certified internist in the U.S. and recreational cyclist, I'd say that type 2 diabetes would not threaten your ability to train or participate in races or long rides of 100-200k. You may need to regulate your nutritional intake more seriously during rides if you are insulin dependent (meaning that you need to inject insulin). However, most type 2 diabetics in their early stages are able to regulate using just oral medications, and their use of gels and electrolyte drinks would be the same as a non-diabetic. Type 2 diabetes also tends to respond well to weight loss and exercise strategies such as cycling.
    In the States, we have health professionals called Diabetes Educators (my wife is one) that help discuss issues like this. Your physician may also be able to assist you with other questions as they relate to medicines you are taking or more complex issues of disease management.

    Hope this helps.

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    A buddy of mine has quite a bit of info on type 2 and cycling. I will pm him with the link to this thread.

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    Senior Member ModoVincere's Avatar
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    Quote Originally Posted by 127.0.0.1 View Post
    no matter what happens, for the rest of your life do all you can to get a 4.6-5.6 a1c do not go over.

    and if you really want optimum results, skip any and all meds and go straight to insulin if you
    can't maintain a1c with diet and exercise alone. the meds will ruin you, insulin is 100% clean to the
    body. meds will make you feel blah sometimes, screw with digestive system, long term affects are
    not all known, some have been recalled for liver damage...all that...whatever....it is
    a lot for the body to deal with. insulin is simple clean and pure way to control blood sugar

    yes needles are involved but they do not hurt...you gotta trust that
    Metformin before insulin.....trust me on this.
    As a type 2, your body is already producing lots of insulin (unless you are very advanced in the disease) and adding extra insulin is not a good idea. Exercise to help reduce insulin resistance, diet to control carb intake (note I did not say eliminate it), and if needed, medication such as metformin to help control the liver's dumping of glucose which is a primary issue for type 2's.

    I was Dx'd type 2 in Sept 2000. I've had no issues related to cycling and diabetes. Feel free to PM me if you wish.
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    Quote Originally Posted by ModoVincere View Post
    Metformin before insulin.....trust me on this.
    As a type 2, your body is already producing lots of insulin (unless you are very advanced in the disease) and adding extra insulin is not a good idea. Exercise to help reduce insulin resistance, diet to control carb intake (note I did not say eliminate it), and if needed, medication such as metformin to help control the liver's dumping of glucose which is a primary issue for type 2's.

    I was Dx'd type 2 in Sept 2000. I've had no issues related to cycling and diabetes. Feel free to PM me if you wish.
    Recent studies have shown that putting type 2's on insulin right away can put type 2 into remission for up to a year and in some diabetes clinics they are putting people on insulin right away. The insulin induces a beta cell rest and allows functioning beta cells to repair and regenerate, while many oral antidiabetics further strain the beta cells, exogenous insulin keeps them from having to work allowing a beta cell rest.

    Chen, HS., Wu, T.E., Jap, T.S., Hsaio, L.C., Lee, S.H. & Lin, H.D. (2008), Beneficial effects on glycemic control and -cell function in newly diagnosed type 2 diabetes with severe hyperglycemia after short-term intensive insulin therapy. Diabetes Care 31(10), 1927- 1932.

    By the time someone is DX'd with diabetes 50-80% of beta cells are dead and the liver is producing abnormally high amounts of glucose which will further strain the pancreas.

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    Zin
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    Nick,
    The best advice I can give from my own experience is simply this...

    1. Educate yourself about Type 2 Diabetes and the associated meds. Diabetes is a highly personal disease. As are the meds. What works for one person may not work for another. Do your own research so you can participate in your care with intelligence. Which leads to #2 below...
    2. Build yourself a medical team that you trust to "help" manage the diabetes. Your medical team and you must become partners in your care. You need to have a team in which you can feel comfortable in challenging the information you are given, or at least know what they are telling you.

    The advice above to go directly on insulin without knowing your C-peptide level is misguided. If you do not know what the C-peptide is, or indicates, then you have your first home work assignment.

    You can cycle just fine as stated above. However, you should keep an eye on your glucose and carb intake. Before. During. And after. You will need to fine tune your individual balance of effort vs. intake which will keep your glucose levels in check.

    It is not the end of your cycling by any means. In fact, cycling is a major tool I use to control by glucose levels.
    Last edited by Zin; 01-07-09 at 09:31 AM.

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    Quote Originally Posted by 127.0.0.1 View Post
    no matter what happens, for the rest of your life do all you can to get a 4.6-5.6 a1c do not go over.
    This is an extremely bad piece of advice. While you need to have a suitable HbA1c you must take care of how you get there. Doing all you can will cause you a lot of harm. You need to reach suitable HbA1c levels without hypoglycemia. You are better to have slightly higher levels if the only way you can reach lower levels is by going hypo.

    Hypoglycemia is something that should be avoided at all costs. Of course you need to temper that with the need to avoid hyper glycemia.

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    50000 Guatts of power 127.0.0.1's Avatar
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    Quote Originally Posted by Someday_RN View Post
    This is an extremely bad piece of advice. While you need to have a suitable HbA1c you must take care of how you get there. Doing all you can will cause you a lot of harm. You need to reach suitable HbA1c levels without hypoglycemia. You are better to have slightly higher levels if the only way you can reach lower levels is by going hypo.

    Hypoglycemia is something that should be avoided at all costs. Of course you need to temper that with the need to avoid hyper glycemia.

    no it is not bad advice for someone who has a brain and uses it

    umm, I am running at 4.4 right now and I figured out how not to go hypo. so yes don't go hypo
    but 4.2 4.6 5.6 is totally doable....

    and long term damage from diabetes is from running high. the part where you lose a foot
    or need dialysis....long term damage from frying your system with glucose laden blood

    hey to each his own...I prefer to keep my kidneys and nerve endings and brain function
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    50000 Guatts of power 127.0.0.1's Avatar
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    Quote Originally Posted by Someday_RN View Post
    Recent studies have shown that putting type 2's on insulin right away can put type 2 into remission for up to a year and in some diabetes clinics they are putting people on insulin right away. The insulin induces a beta cell rest and allows functioning beta cells to repair and regenerate, while many oral antidiabetics further strain the beta cells, exogenous insulin keeps them from having to work allowing a beta cell rest.

    Chen, HS., Wu, T.E., Jap, T.S., Hsaio, L.C., Lee, S.H. & Lin, H.D. (2008), Beneficial effects on glycemic control and -cell function in newly diagnosed type 2 diabetes with severe hyperglycemia after short-term intensive insulin therapy. Diabetes Care 31(10), 1927- 1932.

    By the time someone is DX'd with diabetes 50-80% of beta cells are dead and the liver is producing abnormally high amounts of glucose which will further strain the pancreas.

    this. 3 endos I consult with agree.
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    50000 Guatts of power 127.0.0.1's Avatar
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    hey the best advice

    is finding an endo who specialzes in 'sports and diabetes' because really
    they can help. finding a good endo may be problematic depending on where you live. there
    are not a lot of endos. fewer still who specialize in athletics and endocrine problems
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    Quote Originally Posted by 127.0.0.1 View Post
    no it is not bad advice for someone who has a brain and uses it

    umm, I am running at 4.4 right now and I figured out how not to go hypo. so yes don't go hypo
    but 4.2 4.6 5.6 is totally doable....

    and long term damage from diabetes is from running high.

    hey to each his own...I prefer to keep my kidneys and nerve endings and brain function
    Congrats on the excellent results your efforts are commendable.

    Low HbA1c is good don't get me wrong, but doing at any cost is the issue. I have seen many people with excellent HbA1c and some of them get there by going hypo, which is just as bad as running high if not worse.

    A big part of the problem is that people will get used to a low BG, that when it goes too low they will not be aware until it is too late. Hypo-unawareness is a extremely dangerous way to live life, true, there is no worry about long term symptoms because chances are life will be cut much shorter.

    Again if you are reaching HbA1c of 4-6 without going hypo you are doing an excellent job and are reducing chances of peripheral neuropathy and renal disease. I know that your diabetes educators are always happy to see you take control and live healthy.

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    50000 Guatts of power 127.0.0.1's Avatar
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    Quote Originally Posted by Someday_RN View Post
    Congrats on the excellent results your efforts are commendable.

    Low HbA1c is good don't get me wrong, but doing at any cost is the issue. I have seen many people with excellent HbA1c and some of them get there by going hypo, which is just as bad as running high if not worse.

    A big part of the problem is that people will get used to a low BG, that when it goes too low they will not be aware until it is too late. Hypo-unawareness is a extremely dangerous way to live life, true, there is no worry about long term symptoms because chances are life will be cut much shorter.

    Again if you are reaching HbA1c of 4-6 without going hypo you are doing an excellent job and are reducing chances of peripheral neuropathy and renal disease. I know that your diabetes educators are always happy to see you take control and live healthy.

    I do not consult with any diabetes educators. they can't tell me anything. I have no need.
    I am on top of my problem. All I do is check in with my endo 2 or 3 times a year and he says great job, keep it up, you are in the top .1% of people in control....you need any prescriptions refilled ?

    never been told or suggested to consult with anyone. no need. now if everyone with dx took it as seriously
    as I do then there wouldn't be many problems....too bad the majority have a lazzi faire attitude.

    I certainly don't. I test glucose constantly. and have piles of glucose tabs stashed everywhere I will be at all times.
    [but I barely touch them anymore.]


    talking about 'teh D' is a rant with me because I have zero tolerance for anyone whining about it...'Oh my
    a1c is gonna be high my endo is gonna give me a talking to'....no tolerance for someone who doesn't take
    care of themselves. the tools are there. use them. you'll live to be 100. end of story.

    now if someone has multiple endocrine issues, or brittle d, and it is extremely hard to control then
    I am not gonna rag on those people. I am talking about the face-stuffers and whiners....
    Last edited by 127.0.0.1; 01-07-09 at 10:34 AM.
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    Senior Member ModoVincere's Avatar
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    Quote Originally Posted by Someday_RN View Post
    Recent studies have shown that putting type 2's on insulin right away can put type 2 into remission for up to a year and in some diabetes clinics they are putting people on insulin right away. The insulin induces a beta cell rest and allows functioning beta cells to repair and regenerate, while many oral antidiabetics further strain the beta cells, exogenous insulin keeps them from having to work allowing a beta cell rest.

    Chen, HS., Wu, T.E., Jap, T.S., Hsaio, L.C., Lee, S.H. & Lin, H.D. (2008), Beneficial effects on glycemic control and -cell function in newly diagnosed type 2 diabetes with severe hyperglycemia after short-term intensive insulin therapy. Diabetes Care 31(10), 1927- 1932.

    By the time someone is DX'd with diabetes 50-80% of beta cells are dead and the liver is producing abnormally high amounts of glucose which will further strain the pancreas.
    Type 2 is rather complicated and involves more than just blood sugar control.


    http://www.naturalnews.com/005465.html
    I know its not a medical journal, but its worth reading.

    http://www.thediabetesblog.com/2007/...heart-disease/

    http://www.heartzine.com/546-Insulin...t-Disease.html
    "Researchers at the University of Alberta have found the reason behind the link between diabetes and heart disease; their research has shown that there is a defined link between defective lipid metabolism and high levels of insulin. "

    And all this leads back to what I suggested...metformin before insulin if the patient can handle it. Metformin has its own set of risks including lactic acidosis (you do not want this, trust me), but it does not promote insulin production and it does address insulin resistance, both hepatic and muscular.
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    Pat
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    I have two cycling friends who came down with type II. Both of them worked with a nutrionist to help get their blood sugar under control. It seems that what will spike one persons blood sugar will not spike another's. Both people thought the nutrionist was very helpful in managing their diabetes.

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    Thank you for the links Modo.

    I noticed that they said that high insulin levels are very bad but they ignore the fact that insulin levels have been high in someone with type 2 diabetes because of elevated blood glucose levels. The effect of having high levels of blood glucose, which are ameliorated by exogenous insulin, causes glucotoxicity through oxidative stress of lowering blood glucose levels quickly.

    The supposed studies also looked at the elderly and not younger active people. They also did not mention the type of insulin and how good their glucose control is. If they took something like NPH or mixed once or twice a day then they would probably have horrendous unpredictable control.

    The idea is to use the new insulins in multi-dose therapy. A background dose is taken to keep a stable level of insulin all day long, while carbs are counted and a rapid acting like aspart is taken before eating. This is the best way to have tight glucose control without using a pump and an interstitial monitor.

    This is the method that is indicated. Obviously there is a lot of teaching needed and the individual must have a supreme commitment to tight control. Many people think that taking a needle is worse than taking a pill. So if they can take a few pills in the morning and a few pills at night they will usually opt for metformin because of the lack of commitment needed. So if insulin is to be the best choice there is a huge commitment that must be made if they take MDI.

    The idea behind taking insulin is to take it so you keep your glucose levels within a certain range all the time. This also requires lifestyle changes, such as diet and exercise to increase insulin sensitivity so there is not the dilemma of taking buckets of insulin to bring down massive spikes. A big part of how diabetics are injured through their disease is through large blood glucose excursions. The oxidative stress, caused by reducing glucose levels quickly, is detrimental.

    So using massive amounts of insulin and not modifying food and lifestyle habits is detrimental. Anyone can bring their glucose down from whatever it may be by adding more insulin. In the end this adds weight (fat).

    Like you said type 2 is a complicated disease that affects individuals and addressing must be done tailored to the individuals. Many concepts are the same, to successfully stay healthy the concepts must be framed within the individual's context to be successful.


    I see you may be set against insulin, but the knowledge of type 2 diabetes has progressed, and is progressing very fast; it is now known that insulin near the time of diagnosis has showed better results than traditional therapies used along with lifestyle intervention.

    I know that metformin is the oldest and safest oral anti-diabetic, which has many more benefits than people know about. I know it is easy on the pancreas because unlike sulfonylureas, biguanides do not cause the pancreas to secrete insulin they work by increasing sensitivity and on the liver.

    So although in theory insulin is the best choice there is too much variability when dealing with individuals whether they have the commitment to deal with the disease.

    In relation to the OP. He needs to discuss with his diabetes team what is the best choice for him and what he is willing to do. Metformin may be his best choice, or maybe an intensive insulin regimen. Maybe his diet is crap and the guidance of the dietitian may solve all his problems. The fact that he bikes will help him have that much more control over diabetes.

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    Senior Member ModoVincere's Avatar
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    agree with that.
    I'm not against insulin therapy. It is lifesaving for many. However CAD is the primary killer for T2s.

    I'd like to add....from my discussions with my own dr. so I have nothing to link to for you.
    Even though beta cell destruction is usually in the range of 50-80% before BG's run up to the point of dx in most T2's, the remaining 20-50% can still produce adequate amounts of insulin to maintain BG homeostasis in non insulin resistant individuals. In individuals with IR, the fasting insulin levels are usually still way above normal. This is not always true, but is often true, especially in overweight and obese individuals (OP...I have no idea what your weight is and am not trying to say either way about you).
    Last edited by ModoVincere; 01-07-09 at 03:36 PM.
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    50000 Guatts of power 127.0.0.1's Avatar
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    Quote Originally Posted by Someday_RN View Post
    Thank you for the links Modo.

    I noticed that they said that high insulin levels are very bad but they ignore the fact that insulin levels have been high in someone with type 2 diabetes because of elevated blood glucose levels. The effect of having high levels of blood glucose, which are ameliorated by exogenous insulin, causes glucotoxicity through oxidative stress of lowering blood glucose levels quickly.

    The supposed studies also looked at the elderly and not younger active people. They also did not mention the type of insulin and how good their glucose control is. If they took something like NPH or mixed once or twice a day then they would probably have horrendous unpredictable control.

    The idea is to use the new insulins in multi-dose therapy. A background dose is taken to keep a stable level of insulin all day long, while carbs are counted and a rapid acting like aspart is taken before eating. This is the best way to have tight glucose control without using a pump and an interstitial monitor.

    This is the method that is indicated. Obviously there is a lot of teaching needed and the individual must have a supreme commitment to tight control. Many people think that taking a needle is worse than taking a pill. So if they can take a few pills in the morning and a few pills at night they will usually opt for metformin because of the lack of commitment needed. So if insulin is to be the best choice there is a huge commitment that must be made if they take MDI.

    The idea behind taking insulin is to take it so you keep your glucose levels within a certain range all the time. This also requires lifestyle changes, such as diet and exercise to increase insulin sensitivity so there is not the dilemma of taking buckets of insulin to bring down massive spikes. A big part of how diabetics are injured through their disease is through large blood glucose excursions. The oxidative stress, caused by reducing glucose levels quickly, is detrimental.

    So using massive amounts of insulin and not modifying food and lifestyle habits is detrimental. Anyone can bring their glucose down from whatever it may be by adding more insulin. In the end this adds weight (fat).

    Like you said type 2 is a complicated disease that affects individuals and addressing must be done tailored to the individuals. Many concepts are the same, to successfully stay healthy the concepts must be framed within the individual's context to be successful.


    I see you may be set against insulin, but the knowledge of type 2 diabetes has progressed, and is progressing very fast; it is now known that insulin near the time of diagnosis has showed better results than traditional therapies used along with lifestyle intervention.

    I know that metformin is the oldest and safest oral anti-diabetic, which has many more benefits than people know about. I know it is easy on the pancreas because unlike sulfonylureas, biguanides do not cause the pancreas to secrete insulin they work by increasing sensitivity and on the liver.

    So although in theory insulin is the best choice there is too much variability when dealing with individuals whether they have the commitment to deal with the disease.

    In relation to the OP. He needs to discuss with his diabetes team what is the best choice for him and what he is willing to do. Metformin may be his best choice, or maybe an intensive insulin regimen. Maybe his diet is crap and the guidance of the dietitian may solve all his problems. The fact that he bikes will help him have that much more control over diabetes.



    this is why if you get books on the subject, OP, you may get stale info. the newest insulins

    basically 2 types.

    1) fast acting bolus, you take for a meal. this is also what is used in a pump. example: novolog


    2) and long acting basal rate, example levemir (acts long duration by binding to blood albumin and unbinding over 17-24 hours) or lantus (acts long duration by forming micro crystals in a deposit which dissolve over 24 hours)

    usually type 1 diabetics are more worried about long acting basal rates.


    these may not be described in many books you find on the shelf because these are
    recent developments. you really no longer have to use mixed insulins and funky meal planning
    curves. a lot of books will tell you how things were done 10-15 years ago....may not apply to you
    at all




    ---get a gram scale so you can weigh food things like dry rice, pasta, apples....you measure carbs.

    diabetes control
    is all about measuring carbs in, and blood glucose levels in the morning, and 2 hours after eating. early on though, you
    want to test a lot more often. and test when you ride, every 30 minutes until you get the hang of what exercise
    is doing to you. bring your blood test kit and hammer. test. hammer. test. figure it out. you only have to do this
    until you 'get used to your body' so to speak



    anyway, no worries you can still ride with the 'd' it really will be a few months of learning about your body
    and dialing it in. the key is get your doctor to prescribe 6-8 blood test strips per day (so you insurance will cover the cost) and testing blood sugar 6 times a day or even more, so you have a total handle on
    your glucose levels. all you have to worry about is glucose levels and keeping an eye on it and adjust
    accordingly. many diabetics are healthier than a normal person because you are more in control of yourself. (if done correctly and taken seriously enough)


    and gee whiz what is your fasting glucose anyway ? you might just get away with riding more and eating low glycemic index carbs. no drugs no insulin. could be just that easy.



    here is a pretty good site for the newly diagnosed and long term I suggest
    reading the whole site and following all links. [skip the amlin byetta part, that drug is no good]

    http://www.mendosa.com/diabetes.htm
    Last edited by 127.0.0.1; 01-07-09 at 03:53 PM.
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    Senior Member AnthonyG's Avatar
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    My two bobs worth. If your in early stages of type 2 diabetes stay completely away from any drug regime. You SOO don't want to go there.

    Commit your self to controlling and healing through diet alone.

    See, http://www.mercola.com/ Sign up for the free e-mail newsletter and search his site for diabetes and Metabolic Type.

    Anthony

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    Quote Originally Posted by AnthonyG View Post
    My two bobs worth. If your in early stages of type 2 diabetes stay completely away from any drug regime. You SOO don't want to go there.

    C
    Anthony
    Too bad most people diagnosed with type 2 diabetes are only diagnosed after they have had the disease 10-15 years.

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    Senior Member ModoVincere's Avatar
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    Quote Originally Posted by Someday_RN View Post
    Too bad most people diagnosed with type 2 diabetes are only diagnosed after they have had the disease 10-15 years.
    Sadly, many aren't diagnosed until they are in the cardiac ward after having an MI.
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    I knew a guy through the forums once that was Diagnosed with it. He was always a Dick but I liked him anyhow even tho he was cocky and thought he knew it all. Who knows, maybe hes back and using a different name. *wink*

    Heres his thread on how awesome having this desease is. I wouldnt wish it on anyone, not even his rude ass.


    WooooHoooo I am diagnosed DX...awesome actually
    Quote Originally Posted by rousseau View Post
    I don't like any other exercise or sports, really.
    ....

    http://www.xxcycle.com/logo_w150h100/bmc.jpg

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    Thanks for all the replies, dont really want to involve drugs in this, fasting level was 7.5, I am overweight I would say by about 20lbs, currently 180lbs for 5'8" but that said I am of a musclar build trying to lose upper muscle as my previous sports were swimming and rowing. Age is just turned 36, some birthday present that result turned out to be !


    What is IR? quote from above "In individuals with IR"

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    Senior Member AnthonyG's Avatar
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    Quote Originally Posted by Nick386i View Post


    What is IR? quote from above "In individuals with IR"
    IR is Insulin Resistance. That means that your body is producing all the insulin it needs but your body cant see it and kind of acts like its not there.

    Here's some articles from Dr Mercola's site on insulin resistance.

    http://search.mercola.com/Results.as...n%20resistance

    You may need to sign up for his newletter to see them which is free. These days Dr Mercola does advertise certain products which I don't buy. The newsletter is worth receiving.

    Anthony

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