Just Desserts

(Note: since this blog serves to instruct, it should be noted that the correct English phrase is just deserts.)

Today was the annual bake sale at the church. In recent years, with an eye toward elevated blood sugar readings, I had simply given a ten-spot to the ladies (no, the men never brought anything) and went home empty handed. Today I gave in to temptation and filled a small brown bag with sweetmeats.

I also had a piece of pie and coffee and sat down with the aforementioned ladies to discuss the goings-on at the parish. Decades ago I disdained people who went to church for the gossip and food during coffee hour. Lo and behold, I have become them.

This time I paid twenty bucks. It was worth every penny.

Annual Check-up

I checked off a couple of items on last year's list, but the doctor added some to take their place.

The #1 goal, lose 10 pounds, is an old friend. I blame the post-COVID bounce in socializing and trips to Hawaii.

Monitoring blood pressure is a new addition. The readings have been climbing over the years, and weekly home measurements will help him decide whether to put me on medication when I come back in three months.

One health worry that's no longer on the list: last month's colonoscopy removed five non-cancerous polyps. I won't have to schedule another one until 2027.

It could have been worse, so I'll take it.

San Mateo County Fair: Giant Turkey Legs

Colorful signs made me buy it

At the San Mateo County Fair the dining offerings were nothing special (hamburgers, tacos, etc.) as well as overpriced.

A surfeit of sugary options--candied apples, cotton candy, sugar-covered fennel cakes, caramel popcorn--tempted, but they were verboten to those who have to watch their sugar intake.

Then I saw the signs for Giant Turkey Legs. They fit the bill: low carb, high protein, not commonly served in nearby restaurants, and, most importantly, I happen to like turkey.

I asked the heavy-set lady, How much is a turkey leg?

"Twenty dollars."

Does anything come with it? I thought it was a sensible question ($20 for just a drumstick?).

Surprised at such a ridiculous question, she answered with a stare. Hey, don't you know it's not polite to treat a customer this way?

I don't like getting ripped off, but I also have regrets about not trying something different when given the opportunity. I handed over two sawbucks, and she wrapped the drumstick in foil and inserted same into a paper bag.

Later that afternoon I unwrapped the turkey leg. There was a smoky flavor throughout. Although the surface layers were dry, the insides were moist. It was a pleasant surprise, but at that price I wouldn't go out of my way to buy it again.

Gimme Some of That Goat's Rue

I take one in the morning and one at night.

Nearly a year ago I commented on the off-label benefits of metformin:

Metformin, which I've been taking since August for type II diabetes,

affects a variety of age-associated cellular functions, including improving metabolism, tamping inflammation and boosting the mitochondria. It also has a long history of use in people, with a good safety profile.

In other words Metformin may extend my life, and not just because it treats diabetes.

Word has spread about Metformin's benefits, and it's become a popular new drug with the young, healthy, and diabetes-free crowd.

Is an ancient compound the new “wonder drug”?

Metformin, a common medication to control diabetes, has become the controversial darling of tech’s health-conscious digerati who are enticed by preliminary research suggesting it might help promote longevity, reduce risk of dementia and prevent a whole host of other conditions – including, most recently, long COVID.

With origins that date back to Medieval Europe, metformin has been used for decades as a powerful tool to lower blood sugar in people with diabetes. In those patients, it also offers cardiovascular benefits and weight loss.

Now, it is increasingly popular for use in conditions that have nothing to do with diabetes. Intrigued by early studies and promotion on TikTok, Instagram and health-focused blogs, Americans are seeking “off-label” prescriptions for metformin, using the drug for a different condition than what is FDA-approved...

Metformin, or dimethylbiguanide, traces its history back to a traditional herbal medicine in Europe called Galega officinalis, or goat’s rue. While it can cause side effects in people with kidney problems, it improves blood-sugar control by improving insulin sensitivity, reducing the amount of sugar released by the liver into the blood and increasing glucose absorption.

It is now the fourth most widely prescribed medication in the nation. About 20 million Americans were prescribed the drug in 2020.

What is tantalizing are preliminary findings — based on animal studies and imperfect clinical trials that have not been reproduced — that hint that the drug may help slow aging and increase life expectancy. While the underlying mechanism remains unclear, it may create cellular changes that improve the body’s responsiveness to insulin and boost blood vessel health.

Its reputation has grown with a recent barrage of social media attention, including a viral posting by Silicon Valley-based internet entrepreneur and “biohacker” Serge Fague, who described taking two grams of the medication every day.

“Have you heard about metformin?” asked one Twitter influencer. The New York City-based longevity company NOVOS, which has enlisted Harvard’s Dr. George Church and other highly esteemed scientists to its advisory board, posted on Instagram: “Metformin: The secret to anti-aging?”....

Off-label prescribing is legal and common. An estimated 20% of all prescriptions in the U.S. are for off-label use, according to the Agency for Healthcare Research and Quality. Beta-blockers, for instance, are approved to reduce risk of high blood pressure and heart problems but are used off-label to treat anxiety. But off-label prescriptions may put people at risk of receiving ineffective or even harmful treatment if there is a lack of scientific evidence, said Chin-Hong.

“In tech circles, people use a lot of things off-label — for example, for weight loss,” said Chin-Hong. “It’s promoted by celebrities on TikTok. But it’s always a dangerous enterprise to use something off-label.”

Doctors have long prescribed metformin off-label for these conditions:

• Menstrual irregularities.

• Gestational diabetes mellitus.

• Prevention or delayed diabetes.

• Weight gain from antipsychotic medicines.

Other studies looked at the potential of metformin to:

• Reduce the risk of dementia or stroke.

• Slow aging.

Under my current drug plan I pay less than $20 for 180 500-mg tablets. In addition to lowering blood sugar from potentially hazardous levels, Metformin helps me to lose weight and possibly to live longer. Some of the best things in medicine are nearly free.

Getting There

Following my annual physical exam of five years ago the doctor gave me four instructions, three of which continue (marked "2017", right), after this year's physical.

The fourth, weight loss, was stricken from the current list because I had dropped a few pounds since 2017. Also, the A1C had fallen from last year's 7.8 (7.0 is the red line for diabetes) to 6.3, which is still too high but much better.

Then he added four items: colonoscopy, skin exam (to check out moles, spots, and tags), COVID booster (the last one was in December), and the annual flu shot.

He asked when I had gotten my last tetanus-diphtheria-pertussis (TDAP) shot. It was administered before I got my driver's license, I said, so his nurse gave me an injection straightaway.

We scheduled the next appointment in September, 2023. I like his optimism.

Just Desserts

The line is onto the sidewalk at Schlok's on
Fell St. in San Francisco (Chron photo)

A lifetime of poor eating habits caught up with me last August when I was diagnosed with Type II diabetes. That means I'm going to have to engage very sparingly in a high-carb trend in Bay Area restaurants.

Overwhelming demand for Bay Area bagels is driving a new wave of expansion

The bagel demand is unceasing — and not just at this particular shop [Schlok's] but all over the Bay Area.

All of the hype is fueling serious growth: Nearly all of the Bay Area’s bagel pop-ups, many born during the pandemic, have opened or announced plans for their first permanent shops, including Schlok’s, Poppy Bagels in Oakland, Paulie’s Bagels in Napa and Ethel’s Bagels in Petaluma. Berkeley’s nationally renowned Boichik Bagels, meanwhile, is building a massive bagel factory and adding a second location on the Peninsula. Even Michelin-starred chefs are getting in on the bagel game.

I had my first toasted bagel after the first legal beer (the drinking age was then 18). A Jewish roommate introduced me to the wondrous toppings of lox, capers, and cream cheese, and that became the personal template for bagel bliss.

Today the growth in demand and the competition among suppliers have resulted in a burst of bagel innovation. I'll only be able to sample a small part of that revolution and have only myself to blame.

(Image from Schlok's website)

Back to Bareface

For the caffeine fix this morning I walked to the Honolulu Coffee Co a quarter mile away. Every table was taken, but not every seat; the facility was at about one-third of its 187-person capacity.

No one followed the protocol of raising one's mask "between sips" though the Hawaii indoor mask mandate won't be lifted until March 26th. I have a couple of co-morbidities--late onset asthma and diabetes--plus I'm over 65 (is old age a co-morbidity?), so I complied with the current rules though no one else was doing so.

Lessons we've learned from the past two years: 1) hypochondriacs sometimes have a point; 2) hypochondriacs shouldn't be in charge of anything that lets them tell people what to do.

After consuming a cuppa joe (black), I walked home, feeling the glucose being reduced with every step.

Two Medicines with Off-Label Benefits

Metformin: two 500-mg tablets taken separately per day.

All prescription medications may have harmful side effects, and I'm lucky that the ones I've taken have manifested none so far. In fact, two may have "off-label" benefits.

The corticosteroid budesonide, which I inhale twice a day for asthma, speeds the recovery and lessens hospitalization of early COVID-19 patients.

Metformin, which I've been taking since August for type II diabetes,

affects a variety of age-associated cellular functions, including improving metabolism, tamping inflammation and boosting the mitochondria. It also has a long history of use in people, with a good safety profile.

In other words Metformin may extend my life, and not just because it treats diabetes. A six-year systematic study on its anti-aging properties is about to commence.

On rare occasions the treatment for a disease leaves the patient better off than he was before he contracted it. I may just be one of the fortunate few.

Sugar Rush

At $38/dozen I was compelled to try Sibby's cupcakes.

The forecast from 2½ weeks ago has been fulfilled. Our house has been inundated with sweetmeats.

We've received over two dozen boxes of candy, cakes, and cookies. The fruitcake will go into the disaster-preparedness inventory, but the rest will have to be consumed in the next month or two. Some sharing outside the house is unavoidable.

Getting serious about a recent diabetes diagnosis, I bought a continuous glucose monitor. Let's not rush it: I will wait until after New Year's Day to put it on.

Season of Temptation

After three months on Metformin my A1C reading fell from 7.8 to 6.7. That's an improvement but still well above the danger zone for Type II diabetes. In the coming year I hope to make some lifestyle changes, continue with Metformin, and use technological aids to help drive the indicator down.

It doesn't help that the Christmas treats have started to arrive from friends and relatives.

They have absorbed the news about supply-chain disruptions and have conscientiously sent their gifts early.

The packages in the other room are calling with their siren songs and tempting smells. Without taking a bite I can feel the glucose rising....

Fit as a Cello

While everyone was enjoying pastrami sandwiches
at the Refuge this week, I had the low-carb plate.

As expected, the blood test showed an A1C level of 7.8, well over the 7.0 threshold for diabetes. A lifetime of poor eating habits had caught up with me. The doctor repeated his annual instructions to cut the sugar, exercise, lose weight, etc. but added a prescription for Metformin to control blood sugar.

My father, upon being told that he was diabetic nearly 30 years ago, lost 50 pounds over the ensuing decade, walked every day, and was able to get off prescription medications. Living to the age of 94, he showed how it is possible to win the battle against diabetes.

Do I have his discipline? We'll find out soon enough.