Part 4: Wearing a Continuous Glucose Monitor as a non-diabetic Physician: Unexpected use – CGM to eliminate fatphobia and homophobia (it’s not what you preach, it’s what you tolerate)

2018.05 Low Carb and Low Carbon - Ted Eytan MD-548
2018.05 Low Carb and Low Carbon – Ted Eytan MD-548 (View on Flickr.com)

As I mentioned in part 1 of this series, a significant reason for me wearing a continuous glucose monitor (CGM) was to understand (a very small portion) what it might be like to have diabetes. I will never fully understand what it is like to have diabetes, and I know that.

I do understand what it’s like to be a fat person in society, as I have been one previously.

I also understand what it is like to be a minority in society and the different ways bias creeps into our lives, which is why this comment, added to my part 2 post impressed and surprised me:

Many gay men seem obsessed about their weight vs their health. You don’t need a glucose monitor if you aren’t diabetic. BTW Didn’t Dr Atikins die over-weight and from heart diseas (sic) ?“BrianAH”

CGM as a revealer of fatphobia and even homophobia

Because it’s not what you preach, it’s what you tolerate, and I don’t tolerate homophobia, I responded with the following:

Brian,

Thanks for stopping by and for the dialogue. I’ll take these one by one:

1. Many gay men also happen to be physicians (or I should say, many physicians also happen to be gay) interested in the health of the people they serve. Your statement doesn’t have evidence to back it up and is a little judgement and bias-tinged, don’t you think?

2. Did you read my “Why” post prior to this one? Here it is . If 55% of the population of California is insulin resistant, and the overwhelming majority don’t know it, 50% of them will progress to fulminant diabetes, what we think is needed may change. Hence this work. See this study for more information about CGM insights

3. No. He died from an intracranial hemorrhage from a fall.

Hope this adds clarity thanks for stopping by, happy to entertain other questions,

TedSource

Fatphobia and Homophobia/Transphobia are the only remaining prejudices accepted in medicine

This is fascinating to me because it parallels exactly what research has found in the explicit (endorsed) values of surveyed medical students

Explicit attitudes among medical students 54441
Explicit attitudes among medical students 54441 (View on Flickr.com)

How CGM could be a part of the solution of eliminating bias

I often hear physicians and professionals in the diabetes space talk about losing weight as the primary goal in management, almost to the exception of overall metabolic health.

The problem this creates in our patients are extreme feelings of disempowerment and labels that feed into the explicit biases above. I happen to know several people who would be considered overweight and have reversed their diabetes, from HbA1c’s in the 11’s to the 5’s. Are we to tell them that their primary goal is to lose weight, or is it to eliminate insulin and glucose toxicity?

Would we be happier if they were thin, hyperinsulinemic and glycotoxic? I don’t think so.

View this post on Instagram

#DataOverDogma #EmbraceCuriosity #MetabolicHealth #FMRevolution #Ketofest @2KetoDudes if someone knows something I don’t, I want to learn (HbA1c’s from 11.2 -> 5.2) ✌️🌎🕊

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For an incredible example of what this philosophy (“lose weight, eat less, exercise more”) may have done to a generation of girls, boys, men, and women, listen to this podcast hosted by @Daisy_Ketowoman featuring dietician @TurtonJessica, it may burn a hole in your sole when listen to the story of eating disorders created by the health system that promotes this approach so vigorously:

With the data (finally) to understand both the status of metabolic health and its determinants (“eat this, not that”), it’s possible we can get away from things like fat shaming based on appearance only.

With regard to the homophobic nature of the comment above, I’m glad it came to this space; I never would have made the connection between the anti-human things that some people think and how something that gives us knowledge about how our bodies work makes such comments meaningless.

More validation that my generation of physicians came to health care to change everything. I love this century 🙂 .

Disclaimer and this is not a promotion of CGM-for-all

I’ve been asked directly or indirectly recently if I am advocating CGM-for-all. I am not, and definitely not with the current profile of devices available. This could change dramatically if CGM is more universally available (see blog posts above).

Reminder of my statement of independence and no conflict-of-interest:

2018.05.29 Low Carbohydrate Meetup Washington, DC Presentation  453
2018.05.29 Low Carbohydrate Meetup Washington, DC Presentation 453 (View on Flickr.com)

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