Gary Taubes Diabetes treatment - diet essay

[HairySmurf]

yes but how those calories end up varies depending on where they come from. If a subset of calories cannot be efficiently burned as fuel then it ends up stored instead. So we either have energy or excess weight. Very different outcomes from the same intake.

As a type 2 we are not good at burning glucose due to insulin resistance and we also are very good at storing fat due to high circulating insulin leaves. So we store fat easily when we eat carbohydrates (glucose). A metabolically health person burns the glucose better and isn’t so prone to storing fat so they don’t gain weight as easily. Same calories in different outcomes even if the same activity is done by both otherwise identical people.

Wow. It really is astonishing how little I know about Type 2 diabetes. I clearly have a lot more reading to do.

So, a Type 2 diabetic has high circulating insulin levels? I assume then, when a doctor prescribes sulfonylureas, or a GLP1 agonist, or plain old insulin injections, the doctor is like 'This person has got loads of circulating insulin, because this person is a Type 2 diabetic, but loads is not enough! More I say! More insulin!'. Something like that? I'll be sure to ask my doctor about it the next time I see him.

 

[Antje77]

So, a Type 2 diabetic has high circulating insulin levels? I assume then, when a doctor prescribes sulfonylureas, or a GLP1 agonist, or plain old insulin injections, the doctor is like 'This person has got loads of circulating insulin, because this person is a Type 2 diabetic, but loads is not enough! More I say! More insulin!'. Something like that? I'll be sure to ask my doctor about it the next time I see him.

Yes.
High BG causes damage, and if the only way to get BG down is adding more insulin, this may be the best way to go.
I'd much rather have high circulating insulin levels (and I have, being a T1 with insulin resistance, I use relatively high doses of insulin) than high blood glucose, if that's the choice I have.

 

[HairySmurf]

Yes.
High BG causes damage, and if the only way to get BG down is adding more insulin, this may be the best way to go.
I'd much rather have high circulating insulin levels (and I have, being a T1 with insulin resistance, I use relatively high doses of insulin) than high blood glucose, if that's the choice I have.

Is there any chance, maybe, just maybe, Type 2 diabetes may also occur when the pancreas is no longer able to produce enough insulin without being prodded with medication? Or not even then, requiring insulin injections? The whole beta cell damage thing?

 

[Deleted member 532959]

Wow. It really is astonishing how little I know about Type 2 diabetes. I clearly have a lot more reading to do.

I'm quite confident you'll find that these ideas don't hold much water. Please share what you find, though.

 

[Antje77]

Is there any chance, maybe, just maybe, Type 2 diabetes may also occur when the pancreas is no longer able to produce enough insulin without being prodded with medication? Or not even then, requiring insulin injections? The whole beta cell damage thing?

I don't know enough about this to give a very sensible answer. But as far as I know, insulin resistance and insulin overproduction go hand in hand, and T2 occurs when relatively not enough insulin can be produced to keep BG in range.
The insulin resistance means needing more insulin for the same effect, so to start with, T2's are overproducers, just like I inject more than most T1's to keep stable and healthy numbers.

So 'enough' insulin is not an absolute number, enough can be a lot or a little. There is however a normal range for insulin production.
I'm not sure about the beta cell damage thing in T2's, but I've read some things about beta cells not producing a 'normal' amount of insulin anymore after a long time of having T2, possibly because they've overworked themselves for decades. A C-peptide test would be able to show this.

In T2's who have only been diagnosed for a shortish time, having a low C-peptide result is a clear indication to get some more tests to look into different types of diabetes, low insulin production is not something seen in recently diagnosed T2's, but it can be seen in LADA, MODY, T3C, and MIDD (possibly forgetting some here), all types of diabetes with a different cause than T2, and all of them often misdiagnosed as T2 initially.

 

[HSSS]

Wow. It really is astonishing how little I know about Type 2 diabetes. I clearly have a lot more reading to do.

So, a Type 2 diabetic has high circulating insulin levels? I assume then, when a doctor prescribes sulfonylureas, or a GLP1 agonist, or plain old insulin injections, the doctor is like 'This person has got loads of circulating insulin, because this person is a Type 2 diabetic, but loads is not enough! More I say! More insulin!'. Something like that? I'll be sure to ask my doctor about it the next time I see him.

Kind of. The insulin you have is likely high and likely not enough all at the same time, because of insulin resistance. So yes more insulin works the same way as hitting harder with a bigger hammer. It gets there in the end to reduce blood glucose. And as that’s the only measure most drs measure to assess the state of diabetes it apparently works. So when you read about type 2 not having enough insulin it’s a relative not enough (to overcome the IR) rather than an absolute not enough (literally not producing any or very little) as a type 1 would be.

There are cases where some type 2 do actually end up producing little but that appears to be mostly after years of overproduction and in overly simplistic terms it’s as if the pancreas and beta cells get burned out after working at double/treble time for years/decades. Sadly they rarely test insulin and many drs just assume when someone’s glucose goes up their insulin has gone down rather than checking if their resistance is what’s actually gone up, and they add more insulin rather than reduce the resistance to it. This is why most type 2 on insulin use way more than a type 1 who generally isn’t metabolically damaged or insulin resistant, or not inherently so like a type 2.

Type 2 also seems to be a catch all diagnosis, meaning it’s diabetes that doesn’t fall into any other named category. Over the years in here I’ve seen there are some that respond incredibly well to a moderate carb reduction and weight loss and maintain that comparatively easily. Other need to be drastic and despite weight loss or if it’s unnecessary struggle much more to achieve even reasonable results. Now a few of those might actually be undiagnosed slow onset type 1. Others might be much more susceptible to insulin resistance genetically

What this style of glucosed focus management ignores is the effects of that high insulin, even when the glucose marker is being controlled. Which is why even when on medications to control it type 2 was still seen as progressive - because insulin remained high! This brings along with it all the other metabolic syndrome effects as well as high glucose, eg bigger waist, organ fat, fatty liver, high blood pressure, high triglycerides, dark skin patches, skin tags, damage to nerves and blood vessels etc etc

 

[HSSS]

Is there any chance, maybe, just maybe, Type 2 diabetes may also occur when the pancreas is no longer able to produce enough insulin without being prodded with medication? Or not even then, requiring insulin injections? The whole beta cell damage thing?

Yes there’s a chance. But it’s not so common. And define not enough? Absolute not producing or relative not producing enough to achieve the desired results. These can be very different things sometimes. And as so few drs test insulin what’s happening now is based on assumptions mostly.

Also you need to ask why it’s got that way. If you really have quickly lost all your beta cells isn’t that when you should be asking if in fact you are type 1 not type 2?

 

[HSSS]

I'm quite confident you'll find that these ideas don't hold much water. Please share what you find, though.

Plenty are confident they do. Not sure why you resist the idea or concepts so much without explaining why.

How are your experiments going btw with your high carb regime? Have you achieved control (without meds) or are you still demonstrating it doesn’t really work all that well? If your experiments of n=1 have yielded a successful outcome Im sure we’d all love to hear more about it and try it too.

 

[Antje77]

Which is why even when on medications to control it type 2 was still seen as progressive - because insulin remained high! This brings along with it all the other metabolic syndrome effects as well as high glucose, eg bigger waist, organ fat, fatty liver, high blood pressure, high triglycerides, dark skin patches, skin tags, damage to nerves and blood vessels etc etc

Can you please share some literature on damage to blood vessels and nerves in people with high insulin levels but normal BG? Asking out of personal interest.
I do have a big waist, no indications for fatty liver, moderately high BP (medicated), no dark skin patches, a few skin tags, perfect lipids including triglycerides (unmedicated), and high insulin levels, be it injected insulin and not my own. How does this add up?

 

[gb350]

On the 'inflammation, oxidative stress, endothelial dysfunction and atherosclerosis' thing I'd appreciate a few links to good info along these lines, if you have any handy. It's a topic I've become curious about.

On the calories in/calories out thing - everything we put in our mouths must be used to build new cells, burned as fuel, stored as fat or dumped by the body (in the toilet). Calories out is complex but not rocket science, it's secondary school biology. There's no calorie fairy that can make food vanish. This Mr. Taubes doesn't actually contradict that, does he?

Hi HairySmurf,
A simple internet search will bring up plenty of well evidenced articles re: these issues.
This was one of the first ones to come up.
https://openheart.bmj.com/content/5/2/e000898

 

[Deleted member 532959]

Hi HairySmurf,
A simple internet search will bring up plenty of well evidenced articles re: these issues.
This was one of the first ones to come up.
https://openheart.bmj.com/content/5/2/e000898

And for some counter-balance, I'd recommend Googling "A Comprehensive Rebuttal to Seed Oil Sophistry" (Won't link to it as it contains some adult language ).

 

[HairySmurf]

Hi HairySmurf,
A simple internet search will bring up plenty of well evidenced articles re: these issues.
This was one of the first ones to come up.
https://openheart.bmj.com/content/5/2/e000898

Your Google must work differently to my Google. When I search either 'does omega 6 increase cardiovascular risk' or 'does omega 6 decrease cardiovascular risk' I get the same kinds of results, all of which appear to contradict the notion that Omega 6, when eaten in moderation, causes any harm. What terms do I need to search for to get the link you posted there?

 

[gb350]

Your Google must work differently to my Google. When I search either 'does omega 6 increase cardiovascular risk' or 'does omega 6 decrease cardiovascular risk' I get the same kinds of results, all of which appear to contradict the notion that Omega 6, when eaten in moderation, causes any harm. What terms do I need to search for to get the link you posted there?

Hi Hairy Smurf,
Google omega 6/3 ratio and see what you find

 

[HSSS]

Can you please share some literature on damage to blood vessels and nerves in people with high insulin levels but normal BG? Asking out of personal interest.
I do have a big waist, no indications for fatty liver, moderately high BP (medicated), no dark skin patches, a few skin tags, perfect lipids including triglycerides (unmedicated), and high insulin levels, be it injected insulin and not my own. How does this add up?

Honesty I’d have to look up again. It’s stuff I’ve read over the years. But I’ll see what I can find

 

[HSSS]

Your Google must work differently to my Google. When I search either 'does omega 6 increase cardiovascular risk' or 'does omega 6 decrease cardiovascular risk' I get the same kinds of results, all of which appear to contradict the notion that Omega 6, when eaten in moderation, causes any harm. What terms do I need to search for to get the link you posted there?

It’s more about the balance with omega 3 than the amount.

 

[gb350]

It’s more about the balance with omega 3 than the amount.

Correct. As I understand it the ratio of omega 6/3 in pre industrial populations was between 4/1 and 1/4.
This has escalated to around 16/1 largely due to the introduction of seed/vegetable oils and processed foods.

 

[HairySmurf]

Hi Hairy Smurf,
Google omega 6/3 ratio and see what you find

Ahhhh... I see what you did there. There was a time not so long ago, before the media went wild about conspiracy theories, when googling 'evidence that the earth is flat' would get you some interesting results. Evidence. You can still see the effect though if you know what to search for. Try Googling 'evidence that water is not wet' and pick a side on this important, controversial topic

 

[MissMuffett]

So the massive omega 6 / omega 3 imbalance in seed oils doesn't bother you?
Proven to lead to inflammation, oxidative stress, endothelial dysfunction and atherosclerosis.
I don't know if cutting them out helps to reduce obesity, any more than you know that consuming them doesn't cause obesity.
You also have no idea of what I eat or what I do.
What does appear obvious is that you are wedded to the calories in/calories out mantra.
I prefer to keep an open mind.

There is also on going research done by Dr Knobbi (spelling?) showing seed oils is causing macular degeneration. It used to be called age related MD but people are suffering with it at a younger age and the upward trend in diagnosis is matching the upward trajectory of seed oil consumption. I’m following this closely as I’ve been diagnosed with macular degeneration in the last 9 months.

 

[Outlier]

Regarding the energy in/energy out: as a personal experiment of one I am now taking in far more calories as a very low carb eater than I ever was in the decades of diligent calorie control I conducted for most of my life. Although I was eating "healthy" food then, it wasn't healthy for me, and calorie restriction to the level I had to make left me permanently ravenously hungry, with all the physical miseries that entails (list on request). Eating whatever I need with carb restriction (aiming for as low as possible) gives no issues whatever, and as an unexpected side-effect I lost an appreciable amount of weight. No amount of internet searching and medical theories can disprove what I have achieved, and many others here have found similarly. Doesn't mean it's the only way, doesn't mean anything more or less than its results, but also doesn't mean that to lose weight automatically requires calorie restriction for everyone.

 

[zand]

My experience is the same as @Outlier 's. I can lose weight on 2000+ calories a day if carb intake is minimal, yet lose nothing at all on 1000 calories a day if I have alot of carbs.

To me the calories in/calories out type of diet made sense. After several years of it my body didn't agree and I thought I was the only one whose body didn't work properly. Then I found this forum.