The Dragon's Bookshelf

Pre-diabetes was rejected as a diagnosis by the World Health Organization (although it is used by the US and UK) - the correct term for the condition is impaired glucose tolerance. Approximately 2% of people with "pre-diabetes" go on to develop diabetes per year. You heard that right - TWO PERCENT. Most diabetics actually skip the pre-diabetic phase.

There are currently no treatments for pre-diabetes besides intentional weight loss. (Hmm, that's convenient, right?) There has yet to be evidence that losing weight prevents progression from pre-diabetes to T2DM beyond a year. Interestingly, drug companies are trying to persuade the medical world to start treating patients earlier and earlier. They are using the term “pre-diabetes” to sell their drugs (including Wegovy, a weight-loss drug). Surgeons are using it to sell weight loss surgery. Everyone’s a winner, right? Not patients. Especially fat patients.

Check out these articles:

Prediabetes: The epidemic that never was, and shouldn’t be

The war on ‘prediabetes' could be a boon for pharma—but is it good medicine?

Also - I love what Dr. Asher Larmie @fatdoctorUK has to say about T2DM and insulin resistance, so here's one of their threads I pulled from Twitter:

1️⃣ You can't prevent insulin resistance. It's coded in your DNA. It may be impacted by your environment. Studies have shown it has nothing to do with your BMI.

2️⃣ The term "pre-diabetes" is a PR stunt. The correct term is impaired glucose tolerance (or impaired fasting glucose) which is sometimes referred to as intermittent hyperglycemia. It does not predict T2DM. It is best ignored and tested for every 3-5yrs.

3️⃣ there is no evidence that losing weight prevents diabetes. That's because you can't reverse insulin resistance. You can possibly postpone it by 2yrs? Furthermore there is evidence that those who are fat at the time of diagnosis fair much better than those who are thin.

4️⃣ Weight loss does not reverse diabetes in the VAST majority of people. Those that do reverse it are usually thinner with recent onset T2DM and a low A1c. Only a tiny minority can sustain that over 2yrs. Weight loss does not improve A1c levels beyond 2 yrs either.

5️⃣ Weight loss in T2DM does not improve macrovascular or microvascular health outcomes beyond 2 years. In fact, weight loss in diabetics is associated with increased mortality and morbidity (although it is not clear why). Weight cycling is known to impacts A1c levels.

6️⃣ Weight GAIN does NOT increase the risk of cardiovascular OR all causes mortality in diabetics. In fact, one might even go so far as to say that it's better to be fat and diabetic than to be thin and diabetic.

Dr. Larmie cites 18 peer reviewed journal articles (most from the last decade) that are included in their webinar on the subject, linked below.

Here's some answers

1. Bodily Autonomy

When you have a chronic illness or a disability that limits your control of or connection with your body, it can feel like you're alienated from or disassociated from the very flesh you live in. Making changes can make you feel more in control than you otherwise would.

Why be limited by other people's expectations of what normality is, or what your body "should" look like? Especially because

2. People already stare or make comments

I have had kids follow me down the street shouting abuse at me because I walk with a cane. I get stares and weird comments.

People don't have any manners when it comes to disabled people. They want to tell you about crystals or protein powders or meditation or a church that they're certain will cure you. And God, GOD, do they stare, and look, and peer, and examine

Adding mods and quirks makes that easier to bear.

When I'm walking around just with my cane, I don't know what weird comment a starer is going to make, but that it'll probably be weird.

When I'm dressed alternatively and with an anchor on my cheek, there's a chance it might be positive, or that I can redirect the negative attention.

3. Uniform expectations

A lot of the anger and frustration people express towards unnatural hair colours, piercings, tattoos, and even alt clothing styles seems to come from a frustration with what they perceive as a resistance to adhere to dress codes or uniform demands in schools and offices

The thing is, schools and offices already go out of their way to exclude us. Many places of education and business don't maintain accessiblity basics - ramps are too steep, lifts don't work if they're even there, allergens are everywhere, etc, and many places won't hire a person who looks disabled

They'll discriminate against people who use mobility aids or with visible differences because they don't like how we look, or because they don't want the expense that making a workplace accessible to us will incur

They don't want to deal with extra sick days or inconsistency from chronic illness

In short, many places that demand a dress code already actively exclude us; ergo, even those of us who are ABLE to work are forced to rely on disability aid, be self-employed, or work in alternative industries

Why would we make ourselves look office-ready when many offices don't want us anyway?

4. Different Tolerances

Many chronically ill and disabled people just have a very different tolerance for pain or discomfort to our abled, healthy counterparts. Not only do I tend to giggle when receiving a tattoo (artists have told me this is creepy), it actually gives me RELIEF from chronic pain

Many of us won't even baulk at the pain promised by piercings or tattoos or other body mods - needles and various devices inserted under the skin are already a matter of course, and as for the time and discomfort that it takes to maintain a good dye job, well, what else have we got but time?

And finally...

5. Those mods might be helping

In the immediate aftermath of healing, the sting of the tattoo actually distracts me from my usual bone and muscle aches

Wearing tight waistcoats supports my lower back and helps my posture; corsets and bustiers can do the same thing.

Jewellery might serve as a stim toy or a distraction, but many decorative pieces may actually be bracing or supporting a weak joint or muscle

Heavy boots might help an uneven gait or balance issue, and keep us stable, and so on and so forth

To you, it might just look cool or different or sexy

Victory.

I wouldn't call everything"put away", because I need to build specific storage for a lot of this stuff (particularly the garden tools and power tools), but at least everything is consolidated by type and I have surfaces again.

I got the idea from cowcatchers old locomotives used to have.

Anyways, yesterday I uploaded the model to Thingiverse, and just hours after uploading it, the Community Relationship Manager of the whole website left a comment suggesting I enter the model into a competition that's currently being held on the site.

So I did... and now it's in third place not even a day later. First place is $500, but the competition still has a month to go.

Then the Community Manager contacted me again, telling me they want to feature my model in an upcoming design promotion.

Just, what is happening? I mostly made this thing for myself in, like, an hour, and now it's suddenly super popular? This is all a little bit overwhelming 😵‍💫

Other models I worked on for weeks didn't get nearly as popular. I swear, it's impossible to predict what people will like.

Anyways, if you want to print the wheel guards yourself, you can get the model here or here.

I also made a quiet version you can stick furniture felt pads on.

The avoidance of the puddle would be precisely the kind of superb detail that, say, Tolstoy might flourish; War and Peace has an execution scene very close in spirit to Orwell’s essay, and it may well be that Orwell basically cribbed the detail from Tolstoy. In War and Peace, Pierre witnesses a man being executed by the French, and notices that, just before death, the man adjusts the blindfold at the back of his head, because it is uncomfortably tight. The avoidance of the puddle, the fiddling with the blindfold—these are what might be called irrelevant or superfluous details. They are not explicable; in fiction, they exist to denote precisely the inexplicable. This is one of the “effects” of realism, of “realistic” style. 

But Orwell’s essay, assuming it records an actual occurrence, shows us that such fictional effects are not merely conventionally irrelevant, or formally arbitrary, but have something to tell us about the irrelevance of reality itself (…) There was no logical reason for the condemned man to avoid the puddle. It was pure remembered habit. Life, then, will always contain an inevitable surplus, a margin of the gratuitous, a realm in which there is always more than we need: more things, more impressions, more memories, more habits, more words, more happiness, more unhappiness. 

O-okay, let’s get into this, shall we?

*grumbling* Would you rather work for Lex Luthor or the Joker- *shouting* Lex Luthor, by like, a fucking mile!

Yes, yes, working for Lex Luthor is basically like being an Amazon employee that makes weapons of mass destruction, which is bad. Lex is like Donald Trump mixed with Mark Zuckerberg mixed with Jeffrey fucking Bezos, it’s not a great mix. He does not treat his henchmen well. Their lives still suck, and they are probably monitored on how long they take piss breaks for.

But let’s analyze what working for Lex Luthor is like versus the fucking Joker. With Lex you probably get a dental plan, a health plan, a paycheck, and the guy that you’re fighting really cares about human life. Superman will hit you just long enough to knock you out, so you’re not a treat, so he can stop the problem.

If you work for the Joker, your payment is you’re not fucking dead. You say one wrong thing? Bang. You don’t laugh at his jokes? Bang! You do laugh at his jokes? Bang! You think Joker gives a fuck about a henchman?

Who’s Lex Luthor’s right-hand-man? It’s a woman, you sexist, her name is Mercy, she’s awesome. Who’s Joker’s right-hand-man? Bob? Nah, he’s dead. Harley? Tried to kill her multiple times. Slappy? Who the fuck is Slappy?

The best case scenario of working for the Joker is that you fight the fucking Batman! And that presents its own fucking list of problems. If you stop Superman as a Lex Luthor henchman, Lex’ll be pissed, but he’ll be at least happy that Superman was caught. If you stop Batman as a Joker henchman, you better have a fucking coffin picked out yesterday.

This isn’t a fun hypothetical question, this is a screening technique that the doctors at Arkham use to determine your mental health! There is a right and a wrong answer to this question, and the correct one is Lex fucking Luthor. Thank you for coming to my fucking Ted Talk, have a nice day.

"Us? Oh, of *course* our Dachshund sleeps inside- we just let him out in the morning and make sure he comes back for dinner. He just does his own thing, no worries."

"Um, you know it's not humane to keep a chihuahua confined to an apartment? They're dogs, they're natural predators. They need to experience hunting behaviors or they get depressed. No we don't leash ours, he absolutely hates it, we just let him come and go whenever."

Yall get how fucking stupid that sounds, right? So stop letting your goddamn cats get eaten and attacked and infected and hit by cars

A toddler would probably love full unattended access to the neighborhood too, but we don't do that either, do we