Tighter blood glucose control through medication linked to higher death risk

[Art Of Flowers]

It appears that high glucose levels are bad, but high insulin levels are also bad. So drugs such as insulin and drugs like gliclazide which stimulate insulin production will lower blood glucose, but can lead to high levels of insulin in the body for those people with insulin resistance, typically type 2 diabetics. High insulin levels is associated with increased risk of heart disease, strokes and dementia.

So just looking at lowering blood sugar levels is not enough if you want long life. The way you achieve it is important, so intermittent fasting and a low carb diet may be more beneficial for sufferers of type 2 diabetes.

 

[CherryAA]

Ok, this is related to Type 2 but still kind of interesting. What does everyone think?

http://www.diabetes.co.uk/news/2017...ion-linked-to-higher-death-risk-96381539.html

I believe that one day we will come to understand that T2 diabetes is not actually a disease. Instead it is merely a symptom.
The disease is hyperinsulinaemia. i.e. too much insulin. Too much insulin is triggered by eating refined foods combined with omega 6 seed oils in those susceptible to high insulin responses to foods by reason of genetics or birth . Too much insulin then contributes to many other diseases and this is why longevity studies in people with T1 diabetes have shown that those who manage the condition with the least amount of insulin injected also have better health outcomes for other condition.

For T2 when one treats the symptom with drugs with insulin like properties, one is making the disease worse, hence the higher death risk from tightly controlling the symptom of high blood glucose with additional insulin. One can stop alcoholic tremors by drinking alcohol, it is not curing the underlying disease.

I thus believe that all newly diagnosed people with T2 should be advised to do everything in their power to bring down insulin which is achieved via diet and fasting.

Clearly for some unfortunate people, they will be diagnosed at the point that they can no longer produce insulin and those people will need to take it as a small amount is essential for life . However that is a very small proportion of those with T2 diabetes, simply because the symptoms of the preceeding hyperinsulinaemia are too strong to be ignored in most people.

Thus drugs which mimic the injection of insulin are only helpful when insulin is truly not there. The rest of the time all that is happening is a smoke and mirrors illusion of " doing something" by taking these medications.

This is the best analysis I have seen of the problem

https://idmprogram.com/not-treat-diabetes-t2d-38/

 

[catapillar]

Ok, this is related to Type 2 but still kind of interesting. What does everyone think?

http://www.diabetes.co.uk/news/2017...ion-linked-to-higher-death-risk-96381539.html

Given that you posted the question in the type 1 sub forum I'm assuming you are after people's thoughts on how applicable the "tighter blood glucose control through medication linked to higher death risk" message is to type 1s? The answer is, it isn't. The medication in the studies isn't just insulin - they are oral medications. Tight blood glucose control in a type 1 can be achieved using quantities of insulin that don't stray into "hyperinsulimia" territory because you aren't insulin resistant.

 

[Art Of Flowers]

See https://diatribe.org/low-carb-vs-high-carb-my-surprising-24-day-diabetes-diet-battle

If you inject insulin, you can achieve the same average blood sugar levels on a low carb or high carb diet. The link above shows the difference between the two approaches for someone with type 1, with results from a CGM. The average blood sugar may be the same, but the amount of time spend in hypo/hyper is different. The risk of dying is connected to glucose spikes, which can be short lived an not affect glucose averages and to the risk of hypos which can cause diabetic coma.

 

[Robkww]

Good article @CherryAA - "..sales zoomed from zero to $2.6 billion in 2006.." paints a picture?

 

[Jaylee]

Ok, this is related to Type 2 but still kind of interesting. What does everyone think?

http://www.diabetes.co.uk/news/2017...ion-linked-to-higher-death-risk-96381539.html

Hi @cz_dave , looks like this thread could be a little more productive in the T2 forum..
Though a LCer myself. & not by choice more by work load do the odd bit of IF.
The subject lends itself more to the Ds the experiences of the IR metabolism.

 

[CherryAA]

Good article @CherryAA - "..sales zoomed from zero to $2.6 billion in 2006.." paints a picture?

I'm guessing that the manufacturers of insulin will fight tooth and nail to keep a lucrative share of the T 2 diabetes market regardless of whether that is making us sicker especially as its such a lovely big market to aim for. The truly astonishing thing about all of this is that the two illnesses share almost the same name, one characterised by not enough insulin for which clearly insulin treatment is vital, and the other too much insulin for which treatment with insulin except in those cases where the disease is close to being similar to T1 is effectively simply compounding the problem.

I have seen some doctors trying to rename T2 precisely because of this from T2 diabetes to NID diabetes mellitus - where NID stands for Non Insulin Dependent - just to make it clear that insulin dosage is not the first avenue of treatment in such cases . The research above making it all too clear what the practical effect that has on patients being treated with it when other treatments (e.g. diet) would be more effective. The paper makes it abundantly clear that tight control via diet does not have the same negative consequence as tight control via drugs.

 

[CherryAA]

Given that you posted the question in the type 1 sub forum I'm assuming you are after people's thoughts on how applicable the "tighter blood glucose control through medication linked to higher death risk" message is to type 1s? The answer is, it isn't. The medication in the studies isn't just insulin - they are oral medications. Tight blood glucose control in a type 1 can be achieved using quantities of insulin that don't stray into "hyperinsulimia" territory because you aren't insulin resistant.

The medication being referred to in these studies is mainly the sulfoneareas and insulin. i.e. those with insulin like properties)

Whilst the precise mechanisms may be different, analysis of the " golden years cohort" for T1 illustrates that those with the lowest mortality are also those using the least insulin and having the highest HDL. Those using the least insulin will be those adopting diets that require less insulin. That suggests that those individuals probably adopt similar dietary strategies as do diet controlled T2 - i.e. low carb high fat - known to raise HDL, with similar life enhancing results.

https://www.ncbi.nlm.nih.gov/pubmed/14510860

 

[Jaylee]

Hi @cz_dave , looks like this thread could be a little more productive in the T2 forum..
Though a LCer myself. & not by choice more by work load do the odd bit of IF.
The subject lends itself more to the Ds the experiences of the IR metabolism.

@cz_dave ,

Just to reiterate my earlier post. You have been cordially invited on behalf of a cross section of the moderator team to have this thread moved to the T2 forum, where a more appropriate discussion within context can take place..

Regards.

J>

 

[ickihun]

I use insulin and I don't feel ill on it and hba1c is now 48 which is the lowest it every has been in 14yr of diagnosis.
Proof is in the pudding, I say.

If I wasn't on insulin I would be riddled with rot. Soooooo

What would you do if lchf diet doesn't bring bgs low enough to make the difference and all but metformin I'm intolerant to. Even metformin is off and on.
If it wasn't for insulin I may not even be here, now.
I'm sorry but early death.....when!

 

[ickihun]

@Jaylee .
This has already been discussed in type2 threads so can they be malgimated?

See
(Just off to find link for this post and then I'll edit to add.)
Here
http://www.diabetes.co.uk/forum/thr...-higher-death-risk.129582/page-2#post-1623971

 

[ickihun]

(This thread @Jaylee )
Can they be maligmated to save repeating our posts?

 

[Jaylee]

@Jaylee .
This has already been discussed in type2 threads so can they be malgimated?

See
(Just off to find link for this post and then I'll edit to add.)
Here
http://www.diabetes.co.uk/forum/thr...-higher-death-risk.129582/page-2#post-1623971

Thanks @ickihun ,

I does look like we have a duel topic discussion happening... To avoid confusion on a great debate. I'm quite happy to merge these threads for you!

 

[CherryAA]

I use insulin and I don't feel ill on it and hba1c is now 48 which is the lowest it every has been in 14yr of diagnosis.
Proof is in the pudding, I say.

If I wasn't on insulin I would be riddled with rot. Soooooo

What would you do if lchf diet doesn't bring bgs low enough to make the difference and all but metformin I'm intolerant to. Even metformin is off and on.
If it wasn't for insulin I may not even be here, now.
I'm sorry but early death.....when!

I think you've posted elsewhere that you are managing to bring down your insulin by quite a bit as you lose the weight, via your carbohydrate lowering strategy .. Dr Fung himself doesn't expect everyone on insulin to be able to get off it immediately instead it reduces overtime in a virtuous circle. You will probably find exactly the same happens if you continue down the route you are currently on. Slow but sure !

 

[ickihun]

I think you've posted elsewhere that you are managing to bring down your insulin by quite a bit as you lose the weight, via your carbohydrate lowering strategy .. Dr Fung himself doesn't expect everyone on insulin to be able to get off it immediately instead it reduces overtime in a virtuous circle. You will probably find exactly the same happens if you continue down the route you are currently on. Slow but sure !

I'm in it for the long haul, for sure.

I see no choice. The weight has to come off to give me a fighting chance.
I don't lose weight easily because of underactive thyroid and PCOS . My IVF professor allowed me to be 15.5st to start ivf compared to some others. I was muscular dense and was tested for Anderson's disease and Cushings. I have endocrine problems, for sure. Metformin does help me.

With regards to tighter control. I did post already to note I only lose wait if in tight control and longterm.
Metformin used to do that with me but I need insulin too now ti have same positive response to my metabolism.
My poor body is a tad complicated. Diabetes isn't its only symptom causing problems.
This proclamation of tighter glucose control has a negative effect is actualky inaccurate for me as my system has more confusion and disorders messing it up.
Consultant is surprised I've lost weight. My dn asks me how I'm losing my weight.
It shouldnt be happening, in their experience. Consultant knows how ridged and strict my routine has had to be to get my result.
I still envy those who do lchf and the weight falls off.
It's very very hard work, for me. Only tight control helos me achieve weight loss. Which includes using insulin until I can either stop it or reduce to very little. Maybe a new type2 tablet out which I can try then, maybe. We'll see.

 

[ickihun]

@cz_dave. Thank you for posting this thread.
Other type1s may still comment. I'm hoping @Cumberland and @donnellysdogs might.

 

[Oldvatr]

Agreed @ringi, Dr. Jason Fung explains the failure of the ‘glucotoxicity paradigm’ to address the real issue which is insulin toxicity in the following October 2017 article:
“Failure of the Blood Glucose Paradigm”:

“If the problem is both insulin toxicity and glucotoxicity, then increasing insulin toxicity to reduce glucotoxicity is not a winning strategy.”​

https://idmprogram.com/failure-blood-glucose-paradigm/
The last paragraph is informative.

As far as I am aware the IF in the quoted section is only a hypothesis, and is not yet shown to be the mechanism at play. There may be insulin toxicity, but if this is the case, then I would expect those who are ID would show this, but the predominant effect of too much insulin is generally hypo which is how deaths are probably recorded as COD. I am not a T1D, but I am not aware of a long term effect due solely to the insulin.

Diabetic coma is a result of extremes of hyper and hypo glycocaemia.

 

[ringi]

Remember the inslin levels (both body produced, and injected) in Type2 are often at least 10 times as much as in Type1........

 

[ickihun]

Remember the inslin levels (both body produced, and injected) in Type2 are often at least 10 times as much as in Type1........

Insulin is mooted to be one if the culprits of atherosclerosis via inflammation. So type2s a higher risk because of insulin, rather than the meds themselves?
Insulin like meds is whst the study was all about, right?

 

[ickihun]

As far as I am aware the IF in the quoted section is only a hypothesis, and is not yet shown to be the mechanism at play. There may be insulin toxicity, but if this is the case, then I would expect those who are ID would show this, but the predominant effect of too much insulin is generally hypo which is how deaths are probably recorded as COD. I am not a T1D, but I am not aware of a long term effect due solely to the insulin.

Diabetic coma is a result of extremes of hyper and hypo glycocaemia.

I thought the sameand noted it here, somewhere. Coma is a higher risk, surely.