Sometimes I learn some new medical tidbit that makes me all excited and I share it with patients... they look at me like I am insane and I realize that I have just revealed myself as a science geek. They do NOT respond with the excitement, intellectual interest and joy that I feel.

One is regarding exercise. There is a book, 100 Questions and Answers about Diabetes , that is well written and quite fun. By an endocrinologist. I get a free copy at some conference or other and read it.

And here is the bit that delights me.

Our muscle cells, each individual cell, are so SMART. When you exercise or walk or swim or run up and down the stairs in your house 50 times, the muscle cells need to eat. If you have not been running up and down the stairs 50 times, then the muscle cells get really hungry. They respond by making more insulin receptors and sticking them in the cell wall. Then they can catch more insulin and catch more food. How smart is that?

And if you just sit on the couch for six months.... well, they take them out.

"So," I say to a patient, "You can tell people that you are upregulating the insulin receptors in your muscle cell walls! Not exercising! And your diabetes will be in better control!"

And my patient looks at me with that "You are such a geek..." expression....

Oh, well. It makes ME happy.

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