People can’t afford yet another monthly bill.

It’s like walking in Trador Joes for snacks. Oh, hey, this is only $3! And look, this is only $5! Get to checkout: $130 please.

Seriously, that’s how this nickel and dime subscription crap works.

Doctors have been saying “you need to lose weight” for a very long time, decades at least. Aside from a small sliver of patients this advice is typically ignored. People want a pill for this, not to have to give up that bucket of KFC or the supersized McDonald’s French fries.

Recently, patients raise hell with healthcare workers’ bosses if weight loss is advised because it’s “mean” or is “impacting my mental health” regarding body image. So the suggestion is not made as much in general in the last 5 years.

The problem on this one isn’t often the doctors.

Now, if a patient needs surgery and is too obese for it to happen then there’s a path forward to advise weight loss without repercussions. If cholesterol is high there’s also a path forward for advising diet change, again, without repercussions. Diabetes, again, diet recommendations so you don’t fall into a coma and die, and so you can potentially keep both your feet.

All of that said, you hit diabetes phase you do have it forever, but with type 2 you can manage it by diet if you behave well, reduce weight, and maintain healthy eating. This is great, but it doesn’t mean the type 2 diabetes is gone just that it’s well managed, or “diet managed”. Another way to think of it is that it’s in remission by virtue of your good behavior but not cured. Go on a month long food bender and things can change back again.

To reverse, you need to lose weight and adjust your diet, per your doctors instructions, as soon as your doctor tells you you are pre-diabetic.

Nutrition consults typically come with the diagnosis, but people are notorious for not following up with the next specialist. Diabetic educator is a position as well. Your doctor is booked like an airport by his/her bosses and probably can’t cram that into the 15-20min time slot allowed. Referrals are made for a reason.

Two things that commonly happen to thinking on this topic. Oh, I’m prediabetic, whatever, it’s something we watch, nothing to do here, I’m safe because no insulin required. Or, I no longer need Metformin or insulin or whatever, so I must no longer be diabetic. Both are typically wrong.

Another thing that happens is hardcore denial of even having type 2 diabetes because “I don’t take insulin.”

This isn’t all people, this is simply a piece of the mess involved with diet and exercise advice in health care alongside type 2.

In keeping with the probabilities game that is the human body, here’s a fun fact. There are morbidly obese people in the 500-700lb zone who are not diabetic and still guzzling sugar like none other. Someone has to exist on the tails of the bell curve.

As always, bring your health questions to your doctors, don’t take some random dipshit on the internet seriously.

There’s an odd mentality that you just need to dose more insulin, no big deal, when eating poorly with diabetes. Understanding is sometimes the problem.

Here’s a better way to think about it in terms of body damage over time.

Think of sugar as fuel, because it is. When you have diabetes you lack the capacity to regulate the concentration and intensity of that fuel once you ingest it. You can add other things to the mix that can and will help (insulin and various oral agents) but the efficiency and immediacy of the inherent system simply isn’t there when you have diabetes.

Think of excess sugar in the blood as a caustic fuel that slowly (speed varies by individual as well as food consumed) burns out the vasculature (blood vessels) over time.

This burn out due to excess fuel is why nerves in the feet die. Neuropathy is the official name for the numbness and tingling in toes and feet that diabetics generally, eventually, experience. The burnout is also why toe tissue dies and toes need to be amputated, along with a foot or even an entire lower leg with knee, depending. Eye tissue is another location hit particularly hard by this burn out effect from sugars.

So there’s impact over time based on how much caustic sugar fuel you pour into your own bloodstream.

Also, sugar is addictive. Like meth or heroin, people struggle with letting it go.

Oh yes. One of my Family members was obsessed with that bit of history and still believes Cheney might be the antichrist.

Love or hate it’s still a power vacuum.

You’re backing my point. I’m not saying it’s all positive. Remember what happened in the Middle East when Saddam was removed.

Threat and diplomacy both, yeah. Leader of the free world is a title we used to wear, for good or ill. On a side note, Israel is what we raised them to be. The most colonial of the colonialists backed them and still are. Britain just sent them more weapons. Tempered by Abrahamic religion and modern tech, ofc Israel is even more violent.

It’s complex, but the base element is there’s a hole where the USA once stood. And the example of leadership is now no longer normal, but an impulsive fuck with two middle fingers in the air saying “I do what I want.” Not FDR, or Kennedy, or even Obama, but the impulsive fuck who can’t even ring the stock exchange bell outside the paradigm of a 7 year old. There’s permissiveness in that.

We’re not in charge of the world stage any more.

USA was a world stabilizer. 1 trump term and a quiet Biden follow up and we have Russia and Israel losing their damn minds. Even N Korea is marching.

And why not? Who will stop them? China amassing around Thailand per a couple articles.

Impulsive. With a “I do what I want.” slogan is the new USA example. The world will follow. The USA guardrails were only broken the first Trump term and only the boldest broke through. Now they’re completely off. Anything could happen.

Between this and our internal rage regarding healthcare and money, I’m not feeling optimistic about the next few years.

Bill Burr isn’t really my humor but I listened to him talk about it as a New Yorker. That was enlightening.

Two thoughts here:

1. How do they find an impartial jury? Is it possible to find an impartial jury?

2. Will we ever learn if the McDonalds employee who turned him in received a payout?

To the latter. I was into OSINT to a lesser degree for several years. There are people who engage with it for the sole purpose of trying to find criminal people in order to collect reward money. However, the deal is, the amount posted is typically “up to” the amount posted, and, worse, can be contingent on conviction in a court of law. So, yes, I want to know if the McD Employee was paid as of yet.

Is that how all dominos of ww3 go down? Netanyahu?

Really though, one senator can’t do anything.

President is immune now.

National Review isn’t a reliable “news” source. It’s more like a version of the old supermarket crap like the The Enquirer, only with a politics lean instead of People Magazine lean.

Is this Wes Anderson’s dog?

Also a bit how working in the office instead of from home looks like.