Good work. Very well written. It’s a life that requires consistency, attention to detail, and discipline, with a sprinkling of curiosity, trial and error, and self-compassion.
Thank you. This is the best diabetes article I have read in my 20 years with T1 diabetes. Thank you for framing it in a way that feels possible and livable.
I was about to say the same thing. Thank you indeed. Language really matters and this thoughtful article does that very well, from the very outset. Atomic habits applied to T1D is a great match. Thank you 🙌🏼
I loved all the talk about the atomic habits and that is all so true, but I was so surprised by the talk about HgA1c levels of 7 and 8 etc. I am new to your writings and I just don't get it. I was a patient of Dr. Bernstein and I have eaten carnivore for years and run an A1c of about 4.8, exercise regularly, use small amounts of insulin, make adjustments for exercise and have stable weight. I am not stating this to challenge your writings or traditional treatment, but just saying that full ketosis adaptation is easily achievable and a valid and healthy alternative. I am enjoying some of your writings.
my comments (citations?) about A1c levels of 7s and 8s are not in this article (four healthy habits), so you're likely referring some other article(s). Possibly the one on longevity? That one cites research showing that the risk of all cause mortality (from any number of comorbidities) is most profoundly reduced by having very healthy metabolic health, as that can help the body recover from all sorts of risks -- mostly, cardiovascular -- that come from elevated glucose levels, lipids, excess insulin, and so on. This is by no means suggesting that one can just throw caution into the wind and let glucose levels rise, so long as they exercise a lot. But it does put things into perspective on the outsized benefits that metabolic health has, relative to the damage of other factors.
The fact that you are able to achieve your balances is absolutely wonderful. People also marvel how well I and others are able to achieve them too, all while having little in common with one another. At the end of the day, genetics plays a big role (perhaps more than we appreciate and that can be easily analyzed, given how much interplay there is between different genes and the environment). Indeed, about 10% of the population are "metabolically healthy obese" -- they are highly overweight, but something in their genetics shows no signs of metabolic dysfunction, no dislipidemia, no cardiovascular risk--nothing. They are surprisingly healthy. and do no exercise.
The main message is, there are many ways to get to health, and if good genes are part of that, so be it. But since you don't really know, do the best you can with what's in your control. Chasing lower glucose levels is good, but it should be balanced with the side effects that can come with it: excess insulin, metabolic health, cholesterol, just to name a few. People place glucose at the top of the list at the expense of the other factors, and that more often leads to poor health outcomes that taking in the whole.
You've described my approach to T1D to a T. This is my 60th year and will be my 10th Joslin Medalist celebration. You've thoroughly captured everything I've been doing (even though I didn't know exactly how to describe what I was doing, having pieced the approach together on my own without real guidance until I came upon the work of Dr. Richard K. Bernstein and the brilliant writing of Gary Taubes.) After reading Bernstein's The Diabetes Solution and Taubes' Good Fat, Bad Fat, I adopted solid (atomic) habits, as you describe in this piece, got truly serious, and turned things around. Beautifully constructed article. I've shared it and raved about it. Thank you. I truly appreciate your work.
Good work. Very well written. It’s a life that requires consistency, attention to detail, and discipline, with a sprinkling of curiosity, trial and error, and self-compassion.
Thank you. This is the best diabetes article I have read in my 20 years with T1 diabetes. Thank you for framing it in a way that feels possible and livable.
I was about to say the same thing. Thank you indeed. Language really matters and this thoughtful article does that very well, from the very outset. Atomic habits applied to T1D is a great match. Thank you 🙌🏼
I loved all the talk about the atomic habits and that is all so true, but I was so surprised by the talk about HgA1c levels of 7 and 8 etc. I am new to your writings and I just don't get it. I was a patient of Dr. Bernstein and I have eaten carnivore for years and run an A1c of about 4.8, exercise regularly, use small amounts of insulin, make adjustments for exercise and have stable weight. I am not stating this to challenge your writings or traditional treatment, but just saying that full ketosis adaptation is easily achievable and a valid and healthy alternative. I am enjoying some of your writings.
my comments (citations?) about A1c levels of 7s and 8s are not in this article (four healthy habits), so you're likely referring some other article(s). Possibly the one on longevity? That one cites research showing that the risk of all cause mortality (from any number of comorbidities) is most profoundly reduced by having very healthy metabolic health, as that can help the body recover from all sorts of risks -- mostly, cardiovascular -- that come from elevated glucose levels, lipids, excess insulin, and so on. This is by no means suggesting that one can just throw caution into the wind and let glucose levels rise, so long as they exercise a lot. But it does put things into perspective on the outsized benefits that metabolic health has, relative to the damage of other factors.
The fact that you are able to achieve your balances is absolutely wonderful. People also marvel how well I and others are able to achieve them too, all while having little in common with one another. At the end of the day, genetics plays a big role (perhaps more than we appreciate and that can be easily analyzed, given how much interplay there is between different genes and the environment). Indeed, about 10% of the population are "metabolically healthy obese" -- they are highly overweight, but something in their genetics shows no signs of metabolic dysfunction, no dislipidemia, no cardiovascular risk--nothing. They are surprisingly healthy. and do no exercise.
The main message is, there are many ways to get to health, and if good genes are part of that, so be it. But since you don't really know, do the best you can with what's in your control. Chasing lower glucose levels is good, but it should be balanced with the side effects that can come with it: excess insulin, metabolic health, cholesterol, just to name a few. People place glucose at the top of the list at the expense of the other factors, and that more often leads to poor health outcomes that taking in the whole.
Nice thoughtful answer. :)
You've described my approach to T1D to a T. This is my 60th year and will be my 10th Joslin Medalist celebration. You've thoroughly captured everything I've been doing (even though I didn't know exactly how to describe what I was doing, having pieced the approach together on my own without real guidance until I came upon the work of Dr. Richard K. Bernstein and the brilliant writing of Gary Taubes.) After reading Bernstein's The Diabetes Solution and Taubes' Good Fat, Bad Fat, I adopted solid (atomic) habits, as you describe in this piece, got truly serious, and turned things around. Beautifully constructed article. I've shared it and raved about it. Thank you. I truly appreciate your work.
I appreciate your warm words. And wish your fish good tidings! All six. I think.