Interesting article in the Sydney Morning Herald on diabetes.  As you all know, I had gestational diabetes during pregnancy.  During my pregnancy that ended in miscarriage in 2019, my A1C was measured at 5.6.  (5.7 is considered prediabetic, and 6.5 diabetic.)  My A1C was measured a year after this most recent pregnancy again at 5.6.  Then, I had it measured again recently, roughly two years after pregnancy at 5.5.  Not terrible, but definitely not great.

I read pretty extensively about diabetes when I was pregnant, and the number one knob you can turn is to reduce the amount of fat you have, especially around your abdomen.  As far as I know, it’s not really possible to control where the fat on your body goes, so if you want to reduce fat around your middle, you need to reduce fat, period.  I have always stored a disproportionate amount of my body fat on my abdomen, and this trend has only increased with time.

The closest proxy for body fat is weight, or BMI.  (Given your height is constant, for an individual, there is no real difference.)  Reduce your weight, and your body fat will in general go down.  Obviously if you lift weights or engage in some other muscle building activity, you might be able to reduce body fat while maintaining your weight.  Studies have shown that more muscle reduces risk of diabetes.

You read a lot about how obesity causes diabetes.  This is true in some ways.  Given that for any individual, more body fat means for that person they will require more insulin to process sugar after eating, and will have higher glucose in their blood, if the body weight of a population is increased across the board, more people will get diabetes.  There is probably no other illness, not even heart disease, affected as profoundly by your weight (as a proxy for fat) as diabetes.

However, I do think this generalization obscures a very important fact.  Every individual has a body weight they can maintain (given a % fat) which will allow them to avoid diabetes.  Let’s assume we’re talking about people who are 5’6″ (my height).  For person A, that weight might be 130 pounds.  For person B it might be 150.  For person C it might be 200 pounds.  Person D might be able to maintain 280 pounds with no blood sugar issues.  Genetics is an incredibly powerful force.

Rather than harping at people about the dangers of obesity, I think it’s more important to tell people to get their A1C tested.  If you’re reading this, you’re probably over 40.  Get your A1C tested!  Figure out if your weight is acceptable for your body.  Believe me, you don’t want to get diabetes.   For me, the most important quote from the article was this:

Taylor said the results “demonstrate very clearly that diabetes is not caused by obesity but by being too heavy for your own body”.

Life is not fair.  Some of us need to be skinnier to avoid diabetes.  Some of us can be fatter but will have to work much, much harder all the same to maintain that non-diabetic weight.  But I’ve watched my relatives deal with the health problems that diabetes causes, including vision loss and amputations.  I also did not enjoy the finger-pricking, and I’m sure injecting insulin sucks as well, not to mention watching your diet all the time.

As for me, I’d let my weight creep up close to 140.  That’s technically a “normal” weight, but it’s just not healthy for me.  Based on my life experience, I believe my optimal weight is probably 120 to 125.  (That’s still more than I weighed in high school and college.)  So, I’ve been working on losing a few pounds over the last couple months, and I’m down to about 134.  It’s annoying.  I want to be able to eat whatever I want, especially since I’m exercising a lot, but that’s just not how it works for most people.  Hopefully, I can get to my goal weight and have my A1C tested again and see some improvement.

A friend of mine has Type 2 diabetes.  He was overweight, probably technically obese when diagnosed.  Maybe not.  You certainly wouldn’t have seen him on the street and thought him excessively fat.  He’s less than 5 years older than me.  He got diagnosed when he started losing his vision.  He started exercising and losing weight, and being a data nut, was able to chart the decrease in his fasting glucose and A1C as he dropped the pounds few years.  We are friends on Strava, and I know how hard he works to maintain his health, but it’s working.  His numbers are close to mine at this point.  (He also cut back his work hours drastically to no more than 40 per week, which I’m sure was critical.)