Type 2 What is it that causes the damage to body ?

Mike Sixx

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I have difficulty to understand the T2 because at the same time I am being told "Do not worry everything is fine as long as you eat right and control your sugars" and at same time I am being told to worry about my legs an that any small cut in my leg will cause them to rot away and to be amputated. I know the sugar levels in the blood damage nerves and the small nerves in feet are the first to go. And was it that the sugar also damages blood vessels and hinders blood flow ? Or was it that the sugar damages the kidney causing protein leak into urine and lack of protein in blood causes the nerve damage ?

1) So is T2 still doing damage even if it was well treated and controlled ?
2) Or is it that even with the perfect care changes in blood sugar levels will cause gradual irreparable damages that accumulate over the time.
3) Or is it that the risk of lapses in control over the years in day to day life make lapses in treatment such a high probability that make the probability of complications high enough to valid constant vigilance of feet ?
 

Guzzler

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This may go some way to help answer your question. A short (4mins) video on glycation.

 
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Mike Sixx

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Sorry, but I did not find video of those two guys shouting very informative. It has absolutely no information on nerve damage mechanics.
 

Mr_Pot

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Damage already done by long exposure to high blood sugar levels may or may not improve with good control depending on the severity of the damage. However, once you are well controlled with low blood sugar why would you have additional complications associated with high blood sugar?
The feet can suffer in two ways, firstly the nerves can be damaged causing numbness and loss of feeling, this can result in accidental injury as you can't feel, say a stone in your shoe. Secondly damage to the small blood vessels results in poor healing so the unnoticed injury can become ulcerated and in the worse case lead to gangrene etc. Your feet should be checked annually by a nurse but better to check yourself for any small injury when you have a shower especially if you have any numbness.
 

poemagraphic

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It is great to see that you are reading and taking stuff in Mike Sixx

As this place is so full of information there is so much to digest, one could be in danger of getting mild T2 indigestion.

Often, we over think stuff. My DN recently...Sorry my x DN told me, that sometimes to much information can be as bad as none for some people. ie. that's why we don't think that giving a meter to T2s is a good thing! ????? What!

My point is, there honestly is a very real danger of stepping on something, "Don't ever walk around with nothing on your feet" I have had drummed in to me at every visit. I always walk bare foot in my home... and on the beach, and in the park, as the song goes. I have spent my whole life, either training and practising in bare feet during my martial arts and yoga sessions etc.
My feet said the 'expert' are the best feet she has ever seen in a person of my age.
I never thought just how bad some diabetics feet are. They can not feel any pain at all! That little optic fibre type thiggie they prod your feet with (whilst you sit with your eyes closed) I feel every single touch however light it is.

I never noticed in the waiting room at the hospital the amount of people with one foot, or one leg, or no feet... and no legs!

These things are, sadly, all to plain to see. And part of a DN everyday life.

Never be complacent. I would add, always be aware. Worrying about any of the many complications of diabetes has never helped anybody. Apart from raising our BSL though stress due to worrying about the stuff we read, sometimes to our detriment perhaps.

Po




 

poemagraphic

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Damage already done by long exposure to high blood sugar levels may or may not improve with good control depending on the severity of the damage. However, once you are well controlled with low blood sugar why would you have additional complications associated with high blood sugar?
The feet can suffer in two ways, firstly the nerves can be damaged causing numbness and loss of feeling, this can result in accidental injury as you can't feel, say a stone in your shoe. Secondly damage to the small blood vessels results in poor healing so the unnoticed injury can become ulcerated and in the worse case lead to gangrene etc. Your feet should be checked annually by a nurse but better to check yourself for any small injury when you have a shower especially if you have any numbness.
Great advice for all Mr Pot
 

poemagraphic

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Sorry, but I did not find video of those two guys shouting very informative. It has absolutely no information on nerve damage mechanics.
You are your own devil, you are your own god
You fashion the path your footsteps have trod
Or NOT!


Po
 

Mr_Pot

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This may go some way to help answer your question. A short (4mins) video on glycation.

I have no idea what that was all about? Apparently he had 200g of sugar in a typical American breakfast and then within 15-20 minutes his liver had converted the sugar to fat which glued his blood cells together into caterpillars with duct tape. All of which was given authority by shouting.
 

Guzzler

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I have no idea what that was all about? Apparently he had 200g of sugar in a typical American breakfast and then within 15-20 minutes his liver had converted the sugar to fat which glued his blood cells together into caterpillars with duct tape. All of which was given authority by shouting.
Well, pardon me for offering up a little knowledge. Ultimately, it is the constant glycation of cells that starts the ball rolling wrt nerve and tissue damage. I shan't bother again.
 
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Mr_Pot

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Well, pardon me for offering up a little knowledge. Ultimately, it is the constant glycation of cells that starts the ball rolling wrt nerve and tissue damage. I shan't bother again.
This is a very complicated subject as the paper @Dark Horse referenced shows. A 4 min video is always going to show an over simplification even if it is not actually wrong.
 

HSSS

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Then there’s a fair bit of study into the effects of hyperinsulimia and insulin resistance on the raised risks associated with diabetes

Risks remain raised even when hypoglycaemia is controlled with medication for example if insulin remains high in an effort to normalise blood glucose ie the classic type 2 situation due to insulin resistance. Hence my belief that adding more insulin when plenty is already produced is counter productive and why the traditional treatment of type 2 leads to a progressive worsening.

Ultimately my aim is to reduce resistance thus lowering the insulin required to normalise blood glucose levels. The more normal all 3 elements are the lower my risks, in my opinion.

edit to add a couple of examples
https://diabetes.diabetesjournals.org/content/55/1/202
https://www.physiology.org/doi/full/10.1152/ajpendo.00064.2015

I’m sure @Jim Lahey can add more. (Sorry Jim keep referring to you today)
 

poemagraphic

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Then there’s a fair bit of study into the effects of hyperinsulimia and insulin resistance on the raised risks associated with diabetes

Risks remain raised even when hypoglycaemia is controlled with medication for example if insulin remains high in an effort to normalise blood glucose ie the classic type 2 situation due to insulin resistance. Hence my belief that adding more insulin when plenty is already produced is counter productive and why the traditional treatment of type 2 leads to a progressive worsening.

Ultimately my aim is to reduce resistance thus lowering the insulin required to normalise blood glucose levels. The more normal all 3 elements are the lower my risks, in my opinion.

edit to add a couple of examples
https://diabetes.diabetesjournals.org/content/55/1/202
https://www.physiology.org/doi/full/10.1152/ajpendo.00064.2015

I’m sure @Jim Lahey can add more. (Sorry Jim keep referring to you today)

(Sorry Jim keep referring to you today)[/QUOTE] I seem to be quoting you and jim a lot these days lol
 
M

Member496333

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I believe everyone (including doctors) focuses too much on blood glucose and not enough on how it's being achieved. Elevated blood glucose is only the outward facing symptom of type 2. The important thing is always to have low circulating insulin as often as possible, irrespective of blood glucose. It's possible to have apparently good blood glucose whilst still having very high insulin levels, particularly if using exogenous injections or some oral hypoglycaemic medicines. The aim, in my opinion, is low blood glucose and low insulin. In my view, "eating to the meter" doesn't cut the mustard if you want to ensure a complication-free future, especially if you have had very serious resistant diabetes for many years, possibly even undiagnosed.

The best example of unexpectedly poor outcomes is using exogenous insulin on top of existing hyperinsulinemia. This has been shown not to reduce the risk of complications despite the blood glucose appearing fine. Eyes can also be very unpredictable. In those who had unmanaged or undiagnosed diabetes for a long time, retinopathy & macular oedema can arise or worsen for up to 3-4 YEARS after regaining glucose stability.

In summary, blood glucose levels, in isolation, are not a good marker of future outcomes. Again, only in my (considered) opinion.
 

poemagraphic

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I find it interesting that Jim can write something that begins like a foreign language to me, and makes a terse comment in his summing up, that is like hitting the translate button.
Po
 

Mike Sixx

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Well, pardon me for offering up a little knowledge. Ultimately, it is the constant glycation of cells that starts the ball rolling wrt nerve and tissue damage. I shan't bother again.

I was not criticizing you, just the video. That was helpful information.
 

Mike Sixx

Well-Known Member
Messages
86
I believe everyone (including doctors) focuses too much on blood glucose and not enough on how it's being achieved. Elevated blood glucose is only the outward facing symptom of type 2. The important thing is always to have low circulating insulin as often as possible, irrespective of blood glucose. It's possible to have apparently good blood glucose whilst still having very high insulin levels, particularly if using exogenous injections or some oral hypoglycaemic medicines. The aim, in my opinion, is low blood glucose and low insulin. In my view, "eating to the meter" doesn't cut the mustard if you want to ensure a complication-free future, especially if you have had very serious resistant diabetes for many years, possibly even undiagnosed.

The best example of unexpectedly poor outcomes is using exogenous insulin on top of existing hyperinsulinemia. This has been shown not to reduce the risk of complications despite the blood glucose appearing fine. Eyes can also be very unpredictable. In those who had unmanaged or undiagnosed diabetes for a long time, retinopathy & macular oedema can arise or worsen for up to 3-4 YEARS after regaining glucose stability.

In summary, blood glucose levels, in isolation, are not a good marker of future outcomes. Again, only in my (considered) opinion.
Thank you very much. Again very good information. My doctor also explained something about the sugar damaging netting in kidneys that filters out the protein from the blood. When that is damaged the protein leaks into urine and I got the feeling that at that point there is not much that can be done. And at that point it is pretty much fairly fast down hill.
 

ianf0ster

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Thank you very much. Again very good information. My doctor also explained something about the sugar damaging netting in kidneys that filters out the protein from the blood. When that is damaged the protein leaks into urine and I got the feeling that at that point there is not much that can be done. And at that point it is pretty much fairly fast down hill.
Not necessarily.
Dr Jason Fung was originally an endocrinologist specialising in Kidney disease. Now he runs a clinic for morbidly Obese patients to help them reduce their weight and control their Blood Glucose. I'm pretty sure I heard in at least one of his videos that at least some Kidney damage can be reversed.

It is truly amazing how much damage to eyes, feet, legs, liver, pancreas from Diabetes can be partially reversed if low insulin and good Blood Glucose levels are maintained for years (it isn't fast).