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Diabetes Discussion
Type 2 Diabetes
T2 or NAFLD? ...or, a funny thing happened on the way to the surgery
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<blockquote data-quote="BarbaraG" data-source="post: 2689695" data-attributes="member: 47277"><p>Forgive me, I’m not good on paying attention to details….. but if I’ve got this right, you seem to be suggesting that you had NAFLD all along, and the diagnosis of diabetes was incorrect? But you did have alarmingly high BG levels, so you do (or did) have diabetes. The type is open to question.</p><p></p><p>Here’s another interpretation: you do indeed (or did) have NAFLD, because the aetiology of T2D involves excessive fat in the liver. That causes insulin resistance in the liver, so gluconeogenesis is not adequately suppressed. Therefore there is a gradual rise in fasting glucose - but unless you’re testing that, you wouldn’t notice. Post-meal glucose levels are contained because the pancreas shovels out more insulin to compensate. The liver increasingly tried to get rid of this excess fat by sending it out into the bloodstream. Some of it gets lodged in the pancreas - and in those who are susceptible, the islet cells become less effective at making insulin. There is then a pretty quick increase in both fasting and post-meal glucose - hey presto, diagnosis of diabetes. This is the Twin Cycle Hypothesis by Prof Roy Taylor of Newcastle University.</p><p></p><p>Unfortunately, you were assumed to be type 1, and treated as such. They gave you insulin, the weight piled on, you became every more insulin resistant as a consequence.</p><p></p><p>Anyhow - I realise this doesn’t fully fit the facts, because your diagnosis of diabetes came after a period of weight LOSS - which should have released excess fat from the liver and pancreas. OTOH, if you lost weight on a low calorie bit rather carb rich diet, it may be that your carb intake was simply too high for your personal carb tolerance, even as you were losing weight? Just a theory - I’ve seen multiple exam0es on low carb sites and books which say that carb tolerance varies from person to person, and what’s fine fot you may be too much for me, or vice versa.</p><p></p><p>In summary - it’s not either/or with NAFLD and T2D. You can have both.</p><p></p><p>Fortunately, a lower carb approach is good for both.</p></blockquote><p></p>
[QUOTE="BarbaraG, post: 2689695, member: 47277"] Forgive me, I’m not good on paying attention to details….. but if I’ve got this right, you seem to be suggesting that you had NAFLD all along, and the diagnosis of diabetes was incorrect? But you did have alarmingly high BG levels, so you do (or did) have diabetes. The type is open to question. Here’s another interpretation: you do indeed (or did) have NAFLD, because the aetiology of T2D involves excessive fat in the liver. That causes insulin resistance in the liver, so gluconeogenesis is not adequately suppressed. Therefore there is a gradual rise in fasting glucose - but unless you’re testing that, you wouldn’t notice. Post-meal glucose levels are contained because the pancreas shovels out more insulin to compensate. The liver increasingly tried to get rid of this excess fat by sending it out into the bloodstream. Some of it gets lodged in the pancreas - and in those who are susceptible, the islet cells become less effective at making insulin. There is then a pretty quick increase in both fasting and post-meal glucose - hey presto, diagnosis of diabetes. This is the Twin Cycle Hypothesis by Prof Roy Taylor of Newcastle University. Unfortunately, you were assumed to be type 1, and treated as such. They gave you insulin, the weight piled on, you became every more insulin resistant as a consequence. Anyhow - I realise this doesn’t fully fit the facts, because your diagnosis of diabetes came after a period of weight LOSS - which should have released excess fat from the liver and pancreas. OTOH, if you lost weight on a low calorie bit rather carb rich diet, it may be that your carb intake was simply too high for your personal carb tolerance, even as you were losing weight? Just a theory - I’ve seen multiple exam0es on low carb sites and books which say that carb tolerance varies from person to person, and what’s fine fot you may be too much for me, or vice versa. In summary - it’s not either/or with NAFLD and T2D. You can have both. Fortunately, a lower carb approach is good for both. [/QUOTE]
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