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	<title>Comments on: Juicy &#8220;Daily Apple&#8221; Shakes the Tree</title>
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	<link>http://www.diabetesmine.com/2007/02/juicy_daily_app.html</link>
	<description>A gold mine of straight talk and encouragement for people living with diabetes</description>
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		<title>By: wschaf</title>
		<link>http://www.diabetesmine.com/2007/02/juicy_daily_app.html/comment-page-1#comment-37070</link>
		<dc:creator>wschaf</dc:creator>
		<pubDate>Fri, 23 Feb 2007 23:54:33 +0000</pubDate>
		<guid isPermaLink="false">http://diabetesmine.dreamhosters.com/2007/02/21/juicy-daily-apple-shakes-the-tree/#comment-37070</guid>
		<description>Mark Sisson is probably more right than wrong - but only if you can follow the correct diet and exercise a lot.  I would like to point you to a study in Diabetes Care 29:1777-1783, 2006 by Neal Barnard et al [website: &lt;a target=&quot;_blank&quot; href=&quot;http://care.diabetesjournals.org/cgi/content/full/29/8/1777]&quot; rel=&quot;nofollow&quot;&gt;http://care.diabetesjournals.org/cgi/content/full/29/8/1777]&lt;/a&gt; that showed that a very substantial improvement in Type 2 diabetics can be acheived with a low-fat vegan diet alone.  In 22 weeks 43% reduced meds, some to none; 6+ kg weight loss; and 1.2% decrease in A1c.  Much less improvement was seen with the ADA diet.  Note that there was no additional exercise part of the design - with increased exercise levels the results should be even better [since there are several anecdotal cases of substantial improvement with exercise-induced weight loss].

That being said, Sisson does go overboard with the implication that Type 2&#039;s can be cured.  Even with the vegan diet with exercise, the situation will, at best, be analogous to what non-drinking alcoholics consider themselves - recovering.  Type 2&#039;s won&#039;t be cured, they will only be holding off the disease with their behavior.   There are going to be many who cannot make the requisite changes due to age or advanced infirmities or living situations.  There are also going to be those who have become insulinopenic and will need extra insulin.  And there will be those with more severe genetic predispositions who simply cannot overcome that barrier.  A lot of the problem is behavioral, but not nearly as much as Sisson thinks.
</description>
		<content:encoded><![CDATA[<p>Mark Sisson is probably more right than wrong &#8211; but only if you can follow the correct diet and exercise a lot.  I would like to point you to a study in Diabetes Care 29:1777-1783, 2006 by Neal Barnard et al [website: <a target="_blank" href="http://care.diabetesjournals.org/cgi/content/full/29/8/1777]&#8221; rel=&#8221;nofollow&#8221;>http://care.diabetesjournals.org/cgi/content/full/29/8/1777</a> that showed that a very substantial improvement in Type 2 diabetics can be acheived with a low-fat vegan diet alone.  In 22 weeks 43% reduced meds, some to none; 6+ kg weight loss; and 1.2% decrease in A1c.  Much less improvement was seen with the ADA diet.  Note that there was no additional exercise part of the design &#8211; with increased exercise levels the results should be even better [since there are several anecdotal cases of substantial improvement with exercise-induced weight loss].</p>
<p>That being said, Sisson does go overboard with the implication that Type 2&#8242;s can be cured.  Even with the vegan diet with exercise, the situation will, at best, be analogous to what non-drinking alcoholics consider themselves &#8211; recovering.  Type 2&#8242;s won&#8217;t be cured, they will only be holding off the disease with their behavior.   There are going to be many who cannot make the requisite changes due to age or advanced infirmities or living situations.  There are also going to be those who have become insulinopenic and will need extra insulin.  And there will be those with more severe genetic predispositions who simply cannot overcome that barrier.  A lot of the problem is behavioral, but not nearly as much as Sisson thinks.</p>
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		<title>By: Steve</title>
		<link>http://www.diabetesmine.com/2007/02/juicy_daily_app.html/comment-page-1#comment-37069</link>
		<dc:creator>Steve</dc:creator>
		<pubDate>Thu, 22 Feb 2007 02:59:04 +0000</pubDate>
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		<description>Someone who doesn&#039;t have it simply cannot understand.
</description>
		<content:encoded><![CDATA[<p>Someone who doesn&#8217;t have it simply cannot understand.</p>
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		<title>By: Lili</title>
		<link>http://www.diabetesmine.com/2007/02/juicy_daily_app.html/comment-page-1#comment-37068</link>
		<dc:creator>Lili</dc:creator>
		<pubDate>Thu, 22 Feb 2007 00:52:55 +0000</pubDate>
		<guid isPermaLink="false">http://diabetesmine.dreamhosters.com/2007/02/21/juicy-daily-apple-shakes-the-tree/#comment-37068</guid>
		<description>The thing that always got me about people saying Type 2 is preventable is that in a sense it really is losing the genetic lottery. Many times the people I observe saying this or negative things about fat people are eating THE SAME DIET they&#039;re lambasting, but because they did better in the genetic lottery, they&#039;re not overweight or diabetic. How is that fair? I think everyone who says Type 2 is preventable should have to follow the same healthy diet all the time. Put their food where their mouth is! Heh.

I am a Type 1, btw.
</description>
		<content:encoded><![CDATA[<p>The thing that always got me about people saying Type 2 is preventable is that in a sense it really is losing the genetic lottery. Many times the people I observe saying this or negative things about fat people are eating THE SAME DIET they&#8217;re lambasting, but because they did better in the genetic lottery, they&#8217;re not overweight or diabetic. How is that fair? I think everyone who says Type 2 is preventable should have to follow the same healthy diet all the time. Put their food where their mouth is! Heh.</p>
<p>I am a Type 1, btw.</p>
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		<title>By: Maureen</title>
		<link>http://www.diabetesmine.com/2007/02/juicy_daily_app.html/comment-page-1#comment-37067</link>
		<dc:creator>Maureen</dc:creator>
		<pubDate>Wed, 21 Feb 2007 23:49:16 +0000</pubDate>
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		<description>I second Jennifer &amp; Amy.  BUT...I&#039;d like him to have to walk a mile in my 11 year old(type1) son&#039;s shoes..He doesn&#039;t remember what things were like before he &quot;had&quot; diabetes.  On second thought, he couldn&#039;t, Casey&#039;s shoes would be too big for him to fill.
</description>
		<content:encoded><![CDATA[<p>I second Jennifer &#038; Amy.  BUT&#8230;I&#8217;d like him to have to walk a mile in my 11 year old(type1) son&#8217;s shoes..He doesn&#8217;t remember what things were like before he &#8220;had&#8221; diabetes.  On second thought, he couldn&#8217;t, Casey&#8217;s shoes would be too big for him to fill.</p>
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		<title>By: AmyT</title>
		<link>http://www.diabetesmine.com/2007/02/juicy_daily_app.html/comment-page-1#comment-37066</link>
		<dc:creator>AmyT</dc:creator>
		<pubDate>Wed, 21 Feb 2007 21:18:21 +0000</pubDate>
		<guid isPermaLink="false">http://diabetesmine.dreamhosters.com/2007/02/21/juicy-daily-apple-shakes-the-tree/#comment-37066</guid>
		<description>I agree with Jennifer. People like Mark need to walk a mile in our shoes...
</description>
		<content:encoded><![CDATA[<p>I agree with Jennifer. People like Mark need to walk a mile in our shoes&#8230;</p>
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		<title>By: Rachel</title>
		<link>http://www.diabetesmine.com/2007/02/juicy_daily_app.html/comment-page-1#comment-37065</link>
		<dc:creator>Rachel</dc:creator>
		<pubDate>Wed, 21 Feb 2007 21:12:56 +0000</pubDate>
		<guid isPermaLink="false">http://diabetesmine.dreamhosters.com/2007/02/21/juicy-daily-apple-shakes-the-tree/#comment-37065</guid>
		<description>I think it is dangerous to put the word &quot;cure&quot; next to &quot;type 2&quot; until there really is one.  There are many ways to be IN CONTROL, but not cured.  As soon as someone stops taking care of their diabetes, it will go out of control (no matter what type).  Even if diet &amp; exercise are the prescription, one needs to keep up with the prescription in order to stay IN CONTROL.  No, there&#039;s no cure.

And I agree with your above commenters, there&#039;s no need for more people blaming type 2 patients for past bad habits.  The emphasis has to be on the idea that those habits can be changed for the better, not making them feel worse than they already do.
</description>
		<content:encoded><![CDATA[<p>I think it is dangerous to put the word &#8220;cure&#8221; next to &#8220;type 2&#8243; until there really is one.  There are many ways to be IN CONTROL, but not cured.  As soon as someone stops taking care of their diabetes, it will go out of control (no matter what type).  Even if diet &#038; exercise are the prescription, one needs to keep up with the prescription in order to stay IN CONTROL.  No, there&#8217;s no cure.</p>
<p>And I agree with your above commenters, there&#8217;s no need for more people blaming type 2 patients for past bad habits.  The emphasis has to be on the idea that those habits can be changed for the better, not making them feel worse than they already do.</p>
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		<title>By: Melitta</title>
		<link>http://www.diabetesmine.com/2007/02/juicy_daily_app.html/comment-page-1#comment-37064</link>
		<dc:creator>Melitta</dc:creator>
		<pubDate>Wed, 21 Feb 2007 20:57:20 +0000</pubDate>
		<guid isPermaLink="false">http://diabetesmine.dreamhosters.com/2007/02/21/juicy-daily-apple-shakes-the-tree/#comment-37064</guid>
		<description>I get really tired of people like Mark who fail two distinguish between two vastly different diseases (Type 1 and Type 2) and who use &quot;diabetes&quot; as an umbrella term while actually only referring to Type 2.  Yes, Type 2 is almost always a preventable disease. And if you have been diagnosed with Type 2 but don&#039;t have any of the classic attributes of Type 2 (post from Hamish, above), you should find a qualified endo who knows about Type 1 in adults and get a correct diagnosis (c-peptide and antibody testing). Misdiagnosis is ugly.
</description>
		<content:encoded><![CDATA[<p>I get really tired of people like Mark who fail two distinguish between two vastly different diseases (Type 1 and Type 2) and who use &#8220;diabetes&#8221; as an umbrella term while actually only referring to Type 2.  Yes, Type 2 is almost always a preventable disease. And if you have been diagnosed with Type 2 but don&#8217;t have any of the classic attributes of Type 2 (post from Hamish, above), you should find a qualified endo who knows about Type 1 in adults and get a correct diagnosis (c-peptide and antibody testing). Misdiagnosis is ugly.</p>
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		<title>By: Jennifer</title>
		<link>http://www.diabetesmine.com/2007/02/juicy_daily_app.html/comment-page-1#comment-37063</link>
		<dc:creator>Jennifer</dc:creator>
		<pubDate>Wed, 21 Feb 2007 19:36:18 +0000</pubDate>
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		<description>Oh well.  I guess it&#039;s all my fault I have diabetes.  I&#039;m a terrible person made to feel worse because insensitive losers like this &quot;peach&quot;  think I should just stop supersizing my combo meals.

How about instead of making broad, insane comments we take a step back and help people.  All people with type 2 can be helped, they can be taught to monitor their sugars and take insulin (T1&#039;s already know these things) and make positive lifestyle changes.  Slowly.

Let&#039;s not push newly diagnosed T2&#039;s and the &quot;socioeconomically disadvantaged&quot; down and beat them with words like &quot;it&#039;s all your fault for being fat&quot; and &quot;you&#039;re stupid because you&#039;re poor&quot;  That&#039;s just plain insulting.

I&#039;m sorry for the rant but people like that make me want to scream.  He doesn&#039;t want to help T2&#039;s, he wants to be rich and famous.  Were it up to me, he&#039;d have diabetes so he would know what it feels like.
</description>
		<content:encoded><![CDATA[<p>Oh well.  I guess it&#8217;s all my fault I have diabetes.  I&#8217;m a terrible person made to feel worse because insensitive losers like this &#8220;peach&#8221;  think I should just stop supersizing my combo meals.</p>
<p>How about instead of making broad, insane comments we take a step back and help people.  All people with type 2 can be helped, they can be taught to monitor their sugars and take insulin (T1&#8242;s already know these things) and make positive lifestyle changes.  Slowly.</p>
<p>Let&#8217;s not push newly diagnosed T2&#8242;s and the &#8220;socioeconomically disadvantaged&#8221; down and beat them with words like &#8220;it&#8217;s all your fault for being fat&#8221; and &#8220;you&#8217;re stupid because you&#8217;re poor&#8221;  That&#8217;s just plain insulting.</p>
<p>I&#8217;m sorry for the rant but people like that make me want to scream.  He doesn&#8217;t want to help T2&#8242;s, he wants to be rich and famous.  Were it up to me, he&#8217;d have diabetes so he would know what it feels like.</p>
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		<title>By: Hamish</title>
		<link>http://www.diabetesmine.com/2007/02/juicy_daily_app.html/comment-page-1#comment-37062</link>
		<dc:creator>Hamish</dc:creator>
		<pubDate>Wed, 21 Feb 2007 19:30:46 +0000</pubDate>
		<guid isPermaLink="false">http://diabetesmine.dreamhosters.com/2007/02/21/juicy-daily-apple-shakes-the-tree/#comment-37062</guid>
		<description>Oh great, another ignorant, high profile &quot;it&#039;s all your own fault, you fat, lazy person&quot; mouthpiece.  Just what the world needs.  My first diabetologist focussed on sports people with diabetes - amongst them an olympic gold medallist in rowing - an endurance sport calling for extreme levels of activity.  He is not a type 1, but he didn&#039;t present with the typical type 2 attributes that Mark ascribes to all of us who aren&#039;t type 1 i.e. he wasn&#039;t overweight, sedentary and living on junk food.  When I was first diagnosed, neither was I - 38 years old, 6&#039; 1&quot;, 180 pounds, regular vigorous exercise and healthy diet but with fasting blood sugar of well over 300.  What exactly was I supposed to change to &quot;cure&quot; myself?  Diabetes cases range on a sliding scale from the extremes of type 1 to type 2 - more than one doctor has scratched their heads looking at my case and proclaimed &quot;type 1.5&quot;   Where does that fit in Mark&#039;s narrow view of diabetes?
</description>
		<content:encoded><![CDATA[<p>Oh great, another ignorant, high profile &#8220;it&#8217;s all your own fault, you fat, lazy person&#8221; mouthpiece.  Just what the world needs.  My first diabetologist focussed on sports people with diabetes &#8211; amongst them an olympic gold medallist in rowing &#8211; an endurance sport calling for extreme levels of activity.  He is not a type 1, but he didn&#8217;t present with the typical type 2 attributes that Mark ascribes to all of us who aren&#8217;t type 1 i.e. he wasn&#8217;t overweight, sedentary and living on junk food.  When I was first diagnosed, neither was I &#8211; 38 years old, 6&#8242; 1&#8243;, 180 pounds, regular vigorous exercise and healthy diet but with fasting blood sugar of well over 300.  What exactly was I supposed to change to &#8220;cure&#8221; myself?  Diabetes cases range on a sliding scale from the extremes of type 1 to type 2 &#8211; more than one doctor has scratched their heads looking at my case and proclaimed &#8220;type 1.5&#8243;   Where does that fit in Mark&#8217;s narrow view of diabetes?</p>
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