Cut From Steel

HE NEVER GOT THE WARNING. YOU CAN HAVE IT THIS WEEK.

Jackie Robinson broke into the major leagues in 1947 and absorbed more abuse in one season than most men take in a lifetime. He was strong, fast, and famously hard to rattle. Doctors told him he had diabetes around the time he retired from baseball, when he was about thirty-seven years old.

Robinson kept playing the part of the man who was fine. He worked, he traveled, he carried the disease through his forties, and it kept moving underneath all of it. The test you can order this week did not exist for him. HbA1c was first proposed as a measure of blood sugar control in 1976, four years after Robinson was gone.

Jackie paid for that gap in his eyes. By 1971 he had lost almost all the sight in his right eye, and the other one was badly impaired. He was fifty-two years old.

Robinson walked out at the World Series on October 15, 1972, to be honored on the field. He was fifty-three and moving like a much older man. Nine days later he died of a heart attack at his home in Stamford, Connecticut.

You are reading this because Robinson never got the warning you can get for the price of a blood draw. His body ran high for years, and nobody could put a number on it. A number you can see is a number you can fight. He never had that. You do.

THE WORD THAT PUT YOU BACK TO SLEEP

You got your blood work back and scanned it the way every man does. Your eyes ran down the margin looking for red. Nothing was flagged, so you folded the paper and put it in the drawer. Your doctor said the word normal, and you believed him, because he is a doctor and you had somewhere to be.

I will tell you what that word is covering. The line marked A1c, or HbA1c, is roughly your average blood sugar over the last two to three months. Both the CDC and the American Diabetes Association put normal below 5.7 percent. They put 5.7 to 6.4 percent in a band called prediabetes. Most lab reports do not raise a flag until 6.5 percent. So a man sitting at 6.1 gets a clean-looking page and no conversation at all.

You are not alone in that drawer. The CDC counts 115.2 million American adults with prediabetes, which is more than two in five. Roughly eight in ten of them have no idea they are in the band. Mayo Clinic notes that it often shows no clear symptoms for years.

YOUR NUMBER DID NOT CLIMB BY ACCIDENT

You did not wake up one morning at 6.1. That number moved over years, and three things did most of the moving.

01 / YOUR MUSCLE

You store most of the sugar from a meal inside your muscle. Research puts skeletal muscle at over eighty percent of the glucose your body clears after you eat. Less muscle means less room, so more sugar stays in the blood. Men lose muscle through their forties and fifties unless they train against it.

02 / THE WEIGHT AT YOUR BELT

You carry fat around your organs, not only under the skin, and that deeper fat is linked to insulin resistance. Insulin is the key that opens the door for sugar. When the lock stiffens, your body makes more key, and the sugar waits outside. A rising A1c is what that waiting looks like on paper.

03 / THE HOUR AFTER DINNER

You eat, then you sit down. Blood sugar tends to peak thirty to ninety minutes after a meal, and sitting through that peak can make it higher. Cleveland Clinic says even a two to five minute walk may bring it down a little. That is not a cure for anything. It is a lever you already own.

WHAT TO DO WITH THE NUMBER

You should pull up the portal tonight and find the paper copy if you have one. Look for A1c or HbA1c, then read the number instead of the flag. If it sits at 5.7 or higher, book the appointment. The American Diabetes Association says a diagnosis usually needs a second test on another day, so ask for the repeat.

You have better odds here than most men expect. In the Diabetes Prevention Program trial, people who made lifestyle changes lowered their risk of developing type 2 diabetes by 58 percent, and by 71 percent among those aged sixty and over. The targets were five to seven percent of body weight and 150 minutes of activity a week. Nobody is promising a cure here, and only your doctor touches your medication.

You cannot argue with a number, and that is exactly why it is on your side. A warning you can read is a warning you can answer. Go and read yours.

— Travis

Insider Member's Corner

6 free habits that keep your blood sugar honest:

You didn't put in 45 years to settle for beige.

01 / KNIFE · CHRIS REEVE SEBENZA

Chris Reeve built the first Sebenza in 1990 and named it with the Zulu word for work. He also invented the frame lock that the rest of the industry copied, where the handle itself becomes the lock bar. Every one is still cut and finished in Boise, Idaho, in titanium, and the small model starts around $425. You buy a knife like this once, and then your son inherits it.

02 / CAR · LAND ROVER DEFENDER

Land Rover built the last classic Defender at Solihull on 29 January 2016, and men have been hunting for good ones ever since. Prince Philip thought enough of the thing to design a modified Defender as his own hearse, and it carried him at Windsor in April 2021. The new Defender arrived in 2019 on an aluminium monocoque, sharing no parts with the old one. Buy the old one if your weekends are the point. The new one earns its keep on long miles.

03 / BOOK · MEDITATIONS BY MARCUS AURELIUS

Marcus Aurelius ran the Roman Empire from 161 to 180 and wrote these notes to himself in Greek, much of it while he was on campaign. He never meant another living soul to read them, which is exactly why they land. You will not find advice in it, only the most powerful man alive talking himself into doing the hard right thing one more day. Start with the Gregory Hays translation and keep it on the nightstand.