Dr. J and a Tale of 2 Fish



                                                                                                       Photo by M Clock

 Rock Harbor, Orleans Massachussets -   It's all about the environment. 

Not the land, not Global Warming, not even the Ocean temperature, although that's an important part of this story.

I had an interesting talk with Dr. Jameson last week, a noted Seasoned-Statesman of the Endocrine world in Schenectady, about Diabetes care, new trends in treatment, and the role in metabolic surgery in the management of the disease.

He is a big proponent of surgery for the obese patient with Diabetes, especially when other co-morbidites are involve such as OSA, HTN, Hypercholesterolemia, etc.  He wishes death certificates more accurately reflected the true role of Diabetes in the cause of death, either primary or secondary, as it could result in more Federal funds allocation for Diabetes treament and research (see previous post "Roid Rage" and link to top 10 US causes of death).

Our conversation got to the root of the problem with Diabetes: Glucose Toxicity. 

He said, "You can't see it, you can't touch it- and although you can test for it and you know it's there, the damage exerted by it's presence on the body is additive over time", and needs to be treated definitvely and early, and maintained consistently throughout the patients life. Medicines can do it for a while, maintaining euglycemia, but in patients with increasing insulin resistance /   more adipose tissue / elevating weight over time causing even more resistance (as well as it's own toxic effects), leading to sustained hyperglycemia and elevated glycohemoglobins- the net effect of the toxicity is disastrous to the body and its organ systems (it's environment).

His analogy was this question:

"Why do you think the D.E.C. (N.Y. Department of Environmental Conservation) has a list of fish that you can't eat more than once per year?" It's not the fish's fault, in fact the D.E.C. specifies the species, their location where caught, and the limit of what is healthy to ingest.  It's their environment.

As some of you may be aware, Striped Bass are a key resource that keeps the Rock Harbor Fleet busy May to October in the Cape Cod Bay.  I have seen some of those fish to be nearly as tall as the lesser-statured members of the families that come on board the charter boats they go out on.  Beautiful black and silver-white striped fish.  Delicious fish.

So, where would you rather eat one from? The Cape Cod Bay, or the Hudson River? 

Exactly.