Diabetes: Have We Got It All Wrong? (T2D)

[kokhongw]

Diabetes: Have We Got It All Wrong?
Hyperinsulinism as the culprit: surgery provides the evidence

1. Walter J. Pories, MD, FACS⇓ and
2. G. Lynis Dohm, PHD

https://care.diabetesjournals.org/content/35/12/2438

 

[millenium]

Who is treating Diabetes T2 by injecting insulin?

 

[Member496333]

Yes.

 

[EllieM]

Who is treating Diabetes T2 by injecting insulin?

It's the last treatment available after drugs have failed to normalise blood sugars. And given the article, I'm guessing that gliclazide is not that great an idea either, since it acts by increasing the amount of insulin produced by the pancreas....

I wonder if there are drugs available to reduce insulin production? (Oh wait, there's a diet called low carb. )

 

[DavidGrahamJones]

Who is treating Diabetes T2 by injecting insulin?

Before his passing away my father was an insulin dependent type II diabetic. I have a cousin who is type II and insulin dependent. Neither ever tried lowering their carb intake, quite the opposite. Not sure if it's relevant, but ....

 

[Brunneria]

Who is treating Diabetes T2 by injecting insulin?

In many parts of the world prescribing insulin injections to T2s is the next step after a progression of T2 drugs have ceased to be effective, and the condition has progressed far enough.

 

[KK123]

Who is treating Diabetes T2 by injecting insulin?

Lots of people.

 

[bulkbiker]

Who is treating Diabetes T2 by injecting insulin?

Treating the symptoms of T2 without addressing the root cause.. might be a more accurate way of looking at it?

 

[JohnEGreen]

Diabetes: Have We Got It All Wrong?

What do you mean we kemosabe.

 

[kokhongw]

What do you mean we kemosabe.

It is notable that it was actually published in ADA's journal in DEC 2012... almost 7 years ago...so the "We" refers to ADA


And many continue to pretend that Hyperinsulinemia doesn't have any clinical significance... and carbs reduction, insulin lowering strategy is the latest unsustainable fad...
But here... we know better...

 

[Member496333]

Treating the symptoms of T2 without addressing the root cause.. might be a more accurate way of looking at it?

I’d go one step further and say exasperating the root cause. The exception being if the patient has reached late stage, has completely nuked their pancreas and is now underproducing. But let’s be honest, the majority never seem to undergo insulin profiling anyway. Pretty sure my doctor doesn’t even know what it is. And no I’m not joking.

 

[satindoll]

I may be in the minority here but I take insulin not out of choice but because I need to.......I low carb to keep my insulin needs as small as possible and I would love to ditch it were it possible but for me and many others its as much of a dream as it is for t1's.

 

[millenium]

Oh I see. When T2 seems to be reaching a full blown stage.

This is a very interesting thread. I need to go thru that paper a few more times as I still do not understand that specific operation procedure mentioned inside after reading it the first time.

 

[millenium]

https://www.bariatric-surgery-source.com/laparoscopic-gastric-bypass-surgery.html

This procedure involved reducing the stomach size and the upper sections of the small intestines. The patient will lose quite a bit of bodyweight because the shortened digestive system will absorb much less nutrients and calories. Patient will also be advised to eat a lesser and taking certain supplements. With lesser carb from such a diet and greatly reduced body weight, it is not surprising that body will secrete lesser insulin and insulin resistance will be reduced.

I have not have time to examine the biochemistry in the paper yet.

 

[JohnEGreen]

It is notable that it was actually published in ADA's journal in DEC 2012... almost 7 years ago...so the "We" referes to ADA


And many continue to pretend that Hyperinsulinemia doesn't have any clinical significance... and carbs reduction, insulin lowering strategy is the latest unsustainable fad...
But here... we know better...

Oh I though you meant the Royal We as in the" we are not amused we" , well I any way have no connection with the ADA so again I say what do you mean we kemosabe

 

[ianf0ster]

I note that the conclusion was suggesting Gastric Bypass instead of Insulin.
I recall that a South African Gastric Bypass surgeon (working in the USA) has said that in the average patient, a Gastric Bypass gives the patient a 6month to 1 year window to implement lifestyle changes before they usually start to find ways around the bypass.
So surgery is not a permanent solution on its own, but a lifestyle change such as LCHF + exercise is !

 

[Tophat1900]

I’d go one step further and say exasperating the root cause. The exception being if the patient has reached late stage, has completely nuked their pancreas and is now underproducing. But let’s be honest, the majority never seem to undergo insulin profiling anyway. Pretty sure my doctor doesn’t even know what it is. And no I’m not joking.

I had a feeling I wasn't producing enough insulin anymore, so I went to my gp and asked to check my c-peptide. He had no idea what a c-peptide test was.... that pretty much sums up the level of knowledge and experience that can be encountered at the local gp level. Part of why I asked for a referral for an endo after that.

 

[HSSS]

I may be in the minority here but I take insulin not out of choice but because I need to.......I low carb to keep my insulin needs as small as possible and I would love to ditch it were it possible but for me and many others its as much of a dream as it is for t1's.

In which case if a type2’s own supply of insulin has ceased then Hyperinsulinemia is not (or no longer) the issue and as you say insulin is now a requirement. As a type 2 on insulin though, unlike most type 1, insulin resistance may remain a problem.

Whilst the above is undoubtedly true for some type 2 on insulin sadly there’s probably a lot out there who are still overproducing their own. Without testing it’s guesswork who is who.

 

[Lamont D]

The viscous circle of glucose derived from carbs, sugars, high glucose, high insulin production, higher insulin resistance, and even higher circulating insulin that is so bad for us (hyperinsulinaemia), symptoms, more carbs and so on for years will progress from, prediabetes, weight gain, more symptoms! More carbs, less initial insulin response, more Hyperglycaemia, more insulin resistance and the viscous circle continues.
Glicizide and gliptins work to stimulate the initial insulin response, because of the insulin resistance, so that the actual spike is lower than usual and keeps the blood sugar levels lower after food. This helps management of blood sugar levels, and helps with overall capacity to lower blood sugar levels.
But as we all know, a reduction in carbs at the prediabetic stage will prevent going T2.
Even those who are T2, will have better control with LCHF!

Hyperinsulinaemia, and insulin resistance is one of the major causes of diabetes!


I would have not had to go through all my battles of diagnosis, if my surgery tested my insulin levels early this century and possibly saved the NHS a lot of time and money!

 

[TriciaWs]

Who is treating Diabetes T2 by injecting insulin?

One of my T2 friends get insulin to inject