Comments for Society of Metabolic Health Practitioners https://thesmhp.org/ One Voice For Metabolic Health Tue, 05 Mar 2024 14:14:03 +0000 hourly 1 https://wordpress.org/?v=6.4.3 Comment on Ethnic/demographic propensities to different manifestations of metabolic disease. by Sybil Cooper, PhD https://thesmhp.org/discussion-topics/ethnic-demographic-propensities-to-different-manifestations-of-metabolic-disease/#comment-218 Tue, 05 Mar 2024 14:14:03 +0000 https://thesmhp.org/?post_type=discussion-topics&p=58503#comment-218 Hi Steven. I’ve been trying to catalogue papers etc that I find. I know one MD in this space, can’t recall who, told me that in his experience, African Americans suffer the consequences of insulin resistance at lower A1C, lower fasting glucose, etc than whites and are more carbohydrate intolerant. For myself, I felt like I had diabetes symptoms at A1C of 6.1% which my doctor said was a perfectly fine A1c and not to worry about it. Certainly AA have greater issue with hypertension as well as I think response to blood pressure lowering medications.

Here are a few snippets I’ve jotted down but haven’t had time to fully process.

Lp(a) concentrations are elevated in Blacks compared to their White and East Asian counterparts; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087179/#:~:text=Lp(a)%20concentrations%20are%20elevated,%2D79%20nmol%2FL)%2C

https://www.jacc.org/doi/10.1016/j.jacc.2022.09.027 HDL not indicative of CVD in blacks.

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Comment on Elevated glucose and fasting insulin persist despite LCHF diet by Karla Lester, M.D. https://thesmhp.org/discussion-topics/elevated-glucose-and-fasting-insulin-persist-despite-lchf-diet/#comment-217 Sat, 06 Jan 2024 18:04:40 +0000 https://thesmhp.org/?post_type=discussion-topics&p=50973#comment-217 I agree with above that it takes longer than one month to become fat-adapted for many patients and for results to show both physically and via labs. After getting fat-adapted, you can look at intermittent fasting or eating windows to improve insulin sensitivity. I treat teens with IR, so don’t do IF, but have written an article published in KevinMD about when to use IF. IR is also very genetic. I also find the duration of the Insulin Resistance cycle is important and may require more than nutrition. Dialing in on all metabolic health strategies is helpful as mentioned above. If long-standing can be a tough cycle to crack. Are there other improvements physically? Waist circumference decreasing, less glycemic variability, less binging and craving, more energy? Noticing these improvements is so helpful for patients to believe they are getting traction. I consider medications too as part of the treatment. A little metformin can go a long way. Hope this helps! Karla Lester, M.D.

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Comment on Elevated glucose and fasting insulin persist despite LCHF diet by Lisa Parker https://thesmhp.org/discussion-topics/elevated-glucose-and-fasting-insulin-persist-despite-lchf-diet/#comment-216 Sat, 06 Jan 2024 16:46:04 +0000 https://thesmhp.org/?post_type=discussion-topics&p=50973#comment-216 In reply to Jarrett Hammer.

I have seen this as well. Are you checking fasting c-peptide as well – it represents about 24 hours of insulin production and is often more accurate than fasting insulin. Could they need more time? 1 mos is not long enough for some. Also, what about sugar addiction and eating disorders- these patients are not always forthcoming due to fear of shame. How old and what sex? Postmenopausal women who have dieted repeatedly and are now in a state of metabolic dysfunction require much less carbs and a much longer period to respond positively. Check a uric acid in all of these women – it is often elevated and can be tracked for progress in addition to the other biomarkers. What about stress, PTSD? – fixing diet, doesn’t fix these. Stress can sometimes be seen on CGM but not always, sometimes the BS elevation is just a little above baseline, and a constant state of fight or flight causes cortisol release and higher BS which defeat ketosis. Certain medications can do the same thing. And finally, consider gut heath/microbiome issues and circadian rhythm disturbances. Hope this helps!!!

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Comment on Elevated glucose and fasting insulin persist despite LCHF diet by Steven Lyon, M.D. https://thesmhp.org/discussion-topics/elevated-glucose-and-fasting-insulin-persist-despite-lchf-diet/#comment-215 Sat, 06 Jan 2024 02:37:00 +0000 https://thesmhp.org/?post_type=discussion-topics&p=50973#comment-215 In reply to Meghann Blankenship.

Nice comment. Individualizing care with finesse is very rewarding

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Comment on Society of Metabolic Health Practitioners Addresses Concerns Over American Diabetes Association’s Alleged Ties to Processed Food Industry by Roshani Sanghani https://thesmhp.org/ada-and-processed-food-industry/#comment-214 Sat, 18 Nov 2023 03:03:58 +0000 https://thesmhp.org/?p=58477#comment-214 Glad to support the stand against biased information, organisations and guidelines. We are stronger together.

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Comment on Elevated glucose and fasting insulin persist despite LCHF diet by Dr. Leandro Pucci https://thesmhp.org/discussion-topics/elevated-glucose-and-fasting-insulin-persist-despite-lchf-diet/#comment-213 Sun, 05 Nov 2023 21:29:50 +0000 https://thesmhp.org/?post_type=discussion-topics&p=50973#comment-213 Hope this was resolved, but it looks like this is a case that needs a deep dive beyond just diet. Hormones test may be a good start…

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Comment on Elevated glucose and fasting insulin persist despite LCHF diet by Don Dyer https://thesmhp.org/discussion-topics/elevated-glucose-and-fasting-insulin-persist-despite-lchf-diet/#comment-212 Sat, 04 Nov 2023 20:47:52 +0000 https://thesmhp.org/?post_type=discussion-topics&p=50973#comment-212 In reply to Meghann Blankenship.

Meghann I am not amMD.. My degree is Kinesiology.. The study human performance – physical/mental/ as well as metabolic. I applaud you. I have been studying this info since 2017. I too have a theory that 1/3 of the population will be react positively to many diets. But 1/3 will have some results and stall.. 1/3 will not improve at all. It is related to our familial DNA Inherited from our ancestors before us.

I myself have a fasting insulin of 13.. The system says 5 to 25 is normal.. They is a thought it should be 4 or 5.. Which I subscribe too. For some 13 may be ok. However because of my familial genes 13 makes me store fat.
My a1C is 5.7.. Trig/HDL RATIO .6 (6/10).. Less than 2 good. Cardiac Calcuim score 20 less 100 is good.

I would love to be part of this space, would love to speak to you? 805-279-7760

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Comment on Ben Bikman, PhD, to Deliver Grand Rounds Presentation: “The Role of Insulin Resistance in Chronic Disease” by Liz Alexander https://thesmhp.org/discussion-topics/ben-bikman-phd-to-deliver-grand-rounds-presentation-the-role-of-insulin-resistance-in-chronic-disease/#comment-211 Sat, 02 Sep 2023 23:29:48 +0000 https://thesmhp.org/?post_type=discussion-topics&p=52206#comment-211 Thanks.

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Comment on Elevated glucose and fasting insulin persist despite LCHF diet by Pam Devine https://thesmhp.org/discussion-topics/elevated-glucose-and-fasting-insulin-persist-despite-lchf-diet/#comment-210 Sat, 02 Sep 2023 03:56:53 +0000 https://thesmhp.org/?post_type=discussion-topics&p=50973#comment-210 Any Updates @Jarrett Hammer?! We would love to hear what’s been happening with your patient’s over the last year! The question made me think to ask whether your patients do any resistance training? Dr Ben’s Slow Maximum Resistance Training SMaRT , can be done at any age, at any level, adjusted to anyone’s current state and ability, and built on. Building muscle mass/base can help empty the liver of glucose and fatty acids when working the muscles to failure. Dr Ben describes failure at any age or level, as working each muscle group as hard as the individual can (that could be getting out of a chair 10 times, or heavy leg press depending on age and strength!) building back insulin sensitivity .

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Comment on Ben Bikman, PhD, to Deliver Grand Rounds Presentation: “The Role of Insulin Resistance in Chronic Disease” by Pam Devine https://thesmhp.org/discussion-topics/ben-bikman-phd-to-deliver-grand-rounds-presentation-the-role-of-insulin-resistance-in-chronic-disease/#comment-209 Sat, 02 Sep 2023 01:51:08 +0000 https://thesmhp.org/?post_type=discussion-topics&p=52206#comment-209 In reply to Liz Alexander.

Hi Liz!

All Grand Rounds are recorded, and the replays are available on the Education & Events Tab, under Grand Rounds , you have to be logged in, but you can access all of them there! And once you do a whole module, you can apply for CME/CMHE 🙂 Enjoy!

and hope you can be on the newest one live tomorrow, if possible, with Endocrinologist Roshani Sanghani ‘The role of motivational interviewing in a metabolic health practice’

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