Triggers for Type 2 Diabetes

[dcle2021]

Ok, so this page https://www.diabetes.co.uk/diabetes-causes.html says

"Type 2 diabetes causes are usually multifactorial – more than one diabetes cause is involved. Often, the most overwhelming factor is a family history of type 2 diabetes.

This is the most likely type 2 diabetes cause."

And this page https://www.diabetes.co.uk/causes-of-type2-diabetes.html says nothing about genetic causes.

Please confirm - is genetic disposition a cause of type 2 diabetes?

If so, why am i being stigmatised by my DN and made to feel like this condition is related to something I am doing or not doing? And if its genetic why would lifestyle change stand any chance of affecting my condition: hint - its hasnt worked and the only thing that brings by BG level down is sessions of 1h+ of vigorous exercise. Diet seems not to be a factor (albeit mildly, variations of ~2-3mmol/l in fasting sugar readings each morning) - exercise is a much bigger factor and can drop it by ~2-3mmol/l per 30-min to 1h of exercise undertaken.

I am just one of those people that has high background BG. Have there been control studies on risk factors for such people, please?

 

[JoKalsbeek]

Ok, so this page https://www.diabetes.co.uk/diabetes-causes.html says

"Type 2 diabetes causes are usually multifactorial – more than one diabetes cause is involved. Often, the most overwhelming factor is a family history of type 2 diabetes.

This is the most likely type 2 diabetes cause."

And this page https://www.diabetes.co.uk/causes-of-type2-diabetes.html says nothing about genetic causes.

Please confirm - is genetic disposition a cause of type 2 diabetes?

If so, why am i being stigmatised by my DN and made to feel like this condition is related to something I am doing or not doing? And if its genetic why would lifestyle change stand any chance of affecting my condition: hint - its hasnt worked and the only thing that brings by BG level down is sessions of 1h+ of vigorous exercise. Diet seems not to be a factor (albeit mildly, variations of ~2-3mmol/l in fasting sugar readings each morning) - exercise is a much bigger factor and can drop it by ~2-3mmol/l per 30-min to 1h of exercise undertaken.

I am just one of those people that has high background BG. Have there been control studies on risk factors for such people, please?

A lot of DN's still live in the dark ages, and for some reason think shaming a patient is a good idea, on top of being completely ignorant of the mechanics of diabetes. It is largely a genetic issue, though it can be brought on by medication use (steroids, statins), etc etc... But the bottom line; you just don't process carbs well, like others may not respond well to gluten or lactose. That IS something encoded in your DNA. Just like certain ethnicities are more likely to get T2, or are more prone to Brittle Diabetes. Genetics.

Why would a lifestyle change impact the condition if it's genetic? It won't heal it, no. But it can control symptoms and progression. I've been a T2 for well over 5 years now (walked around with it or a long time prior to diagnosis), and I will always remain one. But with practically no carbs in my system, I don't suffer the wounds that never heal, the thrush, the bad vision, the extreme fatigue or the NAFLD that went with it. Take away the thing that aggravates a condition, and it'll be controlled. Same with gluten. If you're intolerant, and you don't eat them, your torn-up gut will heal. Lactose? Don't have it and you don't spend your life boated and with the runs. I have rheumatism, and certain foods and drinks can trigger a flare. So I don't usually have them. Makes sense, no?

You said your diet didn't seem to matter, but the last I remember from you, was that you were still eating bread and rice and such... Lower carb variants where possible, but still carbier than what a lot of us can get away with. Have you at any point just gone to the extreme of practically zero carb, to see what that would get you? Not permanently, mind you, but as an experiment. If you say your high background BG is an issue, you need to deplete those stores, most likely... And you'd do that by not putting new carbs in. Maybe try going carnivore for a few weeks (meat, fish, poultry, eggs, hard cheeses, proper butter, and nothing but that), see what that gets you and whether after a while, your liver'll dial down on the dumping some. Then you can re-introduce some foods that are carbier, like above ground veggies. But honestly, if after that trial you go back to breads, rice, potatoes, pasta, corn and such, I don't think it'll get you a whole lot of progress. But just try going really low. It'll make you feel ill most likely as you'll be dehydrated for a bit (can be solved with an electrolyte supplement/salts and lots of water!), but once you're out at the other end of it... Your liver'd have a lot less stored and you might be able to start with a clean (liver-)slate. It's just an idea, mind you, and I'm no pro.... But you seem to want to fight this and keep being told you can't. Well, you CAN. And if it doesn't make one iota of difference, you'll know to go back to the doc and get extra testing done. C-peptide, GAD, maybe Homa-R? See how your insulin production's doing. Because if a very low carb diet isn't working to get your numbers down, there might be something else going on.

This is pretty much what I'd do in your shoes, but it might go a bit too far for you. (I'm an all-or-nothing type, and I'm aware it's not for everyone!) I mean, keto's an option too, and others may prefer gradual dropping of carbs, but you seem really frustrated at the high blood sugars... So hence the advice to go to extremes. But don't do anything you're not comfortable with. I'm just throwing ideas out there.

Good luck eh.
Jo

 

[sgm14]

And this page https://www.diabetes.co.uk/causes-of-type2-diabetes.html says nothing about genetic causes.

???

Yes it does. It even has a whole paragraph titled Genetic.

 

[Lakeslover]

Yes, I am sure genetics plays a part in developing the condition, but the way it is managed makes it possible to control it.

I spent nine years adjusting my diet to what various nurses told me to eat (even increasing carbs at one point following their adamant instruction), to the point where last November they said there was no way of improving my diet and the next step was injected drugs.

I didn’t want to go down the route of more drugs if I could avoid it. So I decided to get a libre sensor to see what was going on. Searching on line for a libre support group I came across this forum. I took on board the info about low carb and used the sensor to test the effect on my blood sugar of every meal I had, and soon proved for myself low carb is the way to go.

so when you say your diet has no effect what are you actually eating? We may be able to suggest changes which will help…..or indeed confirm that your diet is fine. Do you test your blood sugars before and after meals?

 

[Dark Horse]

A lot of conditions, including type 2 diabetes, have both modifiable and non-modifiable risk factors.

Non-modifiable risk factors include:-

• genetics
• age
• ethnicity

Modifiable risk factors include:-

• diet
• exercise
• weight

You cannot change your non-modifiable risk factors but you can try to change your modifiable risk factors.

 

[Resurgam]

My mother's family were all genetically predisposed to type two diabetes and all their descendants seem to be the same shape ( ) but my aunts and mother all ate low carb and only started to put on weight when they left home and their husbands were perplexed at the lack of starch and sugars.
Possibly the keeping of poultry affected the way my mother fed us - I was the oldest and it was my job to open the hen house and collect the eggs each morning. We ate a lot of eggs.

 

[Mr_Pot]

Diet and portion size are also inherited in families. You often see families that are all overweight including the husband and wife who are presumably not genetically related.

 

[dcle2021]

A lot of DN's still live in the dark ages, and for some reason think shaming a patient is a good idea, on top of being completely ignorant of the mechanics of diabetes. It is largely a genetic issue, though it can be brought on by medication use (steroids, statins), etc etc... But the bottom line; you just don't process carbs well, like others may not respond well to gluten or lactose. That IS something encoded in your DNA. Just like certain ethnicities are more likely to get T2, or are more prone to Brittle Diabetes. Genetics.

Why would a lifestyle change impact the condition if it's genetic? It won't heal it, no. But it can control symptoms and progression. I've been a T2 for well over 5 years now (walked around with it or a long time prior to diagnosis), and I will always remain one. But . Take away the thing that aggravates a condition, and it'll be controlled. Same with gluten. If you're intolerant, and you don't eat them, your torn-up gut will heal. Lactose? Don't have it and you don't spend your life boated and with the runs. I have rheumatism, and certain foods and drinks can trigger a flare. So I don't usually have them. Makes sense, no?

You said your diet didn't seem to matter, but the last I remember from you, was that you were still eating bread and rice and such... Lower carb variants where possible, but still carbier than what a lot of us can get away with. Have you at any point just gone to the extreme of practically zero carb, to see what that would get you? Not permanently, mind you, but as an experiment. If you say your high background BG is an issue, you need to deplete those stores, most likely... And you'd do that by not putting new carbs in. Maybe try going carnivore for a few weeks (meat, fish, poultry, eggs, hard cheeses, proper butter, and nothing but that), see what that gets you and whether after a while, your liver'll dial down on the dumping some. Then you can re-introduce some foods that are carbier, like above ground veggies. But honestly, if after that trial you go back to breads, rice, potatoes, pasta, corn and such, I don't think it'll get you a whole lot of progress. But just try going really low. It'll make you feel ill most likely as you'll be dehydrated for a bit (can be solved with an electrolyte supplement/salts and lots of water!), but once you're out at the other end of it... Your liver'd have a lot less stored and you might be able to start with a clean (liver-)slate. It's just an idea, mind you, and I'm no pro.... But you seem to want to fight this and keep being told you can't. Well, you CAN. And if it doesn't make one iota of difference, you'll know to go back to the doc and get extra testing done. C-peptide, GAD, maybe Homa-R? See how your insulin production's doing. Because if a very low carb diet isn't working to get your numbers down, there might be something else going on.

This is pretty much what I'd do in your shoes, but it might go a bit too far for you. (I'm an all-or-nothing type, and I'm aware it's not for everyone!) I mean, keto's an option too, and others may prefer gradual dropping of carbs, but you seem really frustrated at the high blood sugars... So hence the advice to go to extremes. But don't do anything you're not comfortable with. I'm just throwing ideas out there.

Good luck eh.
Jo

Thanks for the ideas.

"with practically no carbs in my system, I don't suffer the wounds that never heal, the thrush, the bad vision, the extreme fatigue or the NAFLD that went with it"

I have no symptoms. None. Failing to see why a genetically inherited high number has anything to do with my health I need to take action on.

Also, since I posted previously I have did carbs down to zero. Fasted, everything. Bit I'm still scoring 10.3mmol/l in the morning.

So no, it doesn't work unless I starve myself completely or do excessive levels of exercise. Which is, you know, unsustainable and life limiting.

My GP and DN refuse to test. I had to borrow a test kit to get these numbers. I keep telling them my experience and they keep ignoring me.

 

[dcle2021]

A lot of conditions, including type 2 diabetes, have both modifiable and non-modifiable risk factors.

Non-modifiable risk factors include:-

• genetics
• age
• ethnicity

Modifiable risk factors include:-

• diet
• exercise
• weight

You cannot change your non-modifiable risk factors but you can try to change your modifiable risk factors.

None of the suggested changes to modifiable risk factors seem to work for me.

 

[dcle2021]

???

Yes it does. It even has a whole paragraph titled Genetic.

I'm really sorry, i don't know how I didn't see that. Doesn't help though does it? Non-modifiable as someone else also pointed out (thank you to them).

Why won't the NHS test properly?

 

[Dark Horse]

None of the suggested changes to modifiable risk factors seem to work for me.

Didn't you say that earlier that vigorous exercise was bringing your blood glucose down? If you keep that up on a regular basis, it should bring your HbA1c (blood glucose average over the last 3 months) down to some degree.

When you say that diet hasn't worked, had you tried a low carb diet? How many g of carbohydrate per day?

When you say that losing weight hasn't worked, what percentage of your starting weight have you lost?

 

[JoKalsbeek]

Thanks for the ideas.

"with practically no carbs in my system, I don't suffer the wounds that never heal, the thrush, the bad vision, the extreme fatigue or the NAFLD that went with it"

I have no symptoms. None. Failing to see why a genetically inherited high number has anything to do with my health I need to take action on.

Also, since I posted previously I have did carbs down to zero. Fasted, everything. Bit I'm still scoring 10.3mmol/l in the morning.

So no, it doesn't work unless I starve myself completely or do excessive levels of exercise. Which is, you know, unsustainable and life limiting.

My GP and DN refuse to test. I had to borrow a test kit to get these numbers. I keep telling them my experience and they keep ignoring me.

If your doc ignores your requests, you might want to get C-peptide, GAD and Homa-r done privately. Then if results are divergent, slap the practice over the head with them. They'd have to take action. If you went zero carb etc, your numbers should have improved. Since they didn't, that *could* indicate a T1 variant. You wouldn't believe how many people get misdiagnosed. Something to mull over.

 

[Lamont D]

I'm really sorry, i don't know how I didn't see that. Doesn't help though does it? Non-modifiable as someone else also pointed out (thank you to them).

Why won't the NHS test properly?

Hi, just a couple of questions. When do you test fasting levels?
Do you test pre meal and two hours after first bite.

Quite a few T2s, have insulin resistance and this does effect first phase insulin response. If you, in the past, been having carbs laden meals. This will almost certainly give you an Hba1c reading that is diabetic. The amount of insulin not being used keeps growing until, your body dispose of it, but the amount of unused insulin is higher than what it is getting rid of. This is why a very low carb diet works. The insulin response required is enough to convert the glucose into energy.

The tests required to diagnose diabetes is a blood panel tests including, Hba1c levels, liver function, kidney function and an overview of anything abnormal.
The second test is doing finger prick testing. This is slightly difficult to work out because of +- monitor accuracy. When you done the tests and what did you eat, how many carbs, fats and proteins, and some recommendations from doctors/dsns about healthy non fat non sugar foods, which are worse because the fat is replaced by sweeteners and industrial sugars.
What could be happening to you, is on waking or very soon after, you test, this is too early because of probably what is known as dawn phenomenon. Your liver will give you a boost of glucose, this is normal, except for T2s, this will distort your fasting levels because of how your body can't cope with the glucose. You eat breakfast, even if it is low carb, you then go to the gym and do some serious exercises. During this exercise, your liver will dump more glucose, for the energy you have used because you have not become fat adapted.
You still need glucose from carbs, and until you go low carb enough for a good while, will you adapt.
For me, that strenuous exercise will result in hypos.
I know that you probably need to lose weight, but having too many liver dumping, will have your blood glucose levels up and down on a rollercoaster ride all day. And from there to more symptoms.
You have to find the right balance of protein, fats and veg, that you can tolerate.
Walking may be better for you, and I do a lot.

It is no wonder why so many T2s get really confused between a healthy diet and a low carb diet. A healthy diet is responsible for my condition. A very low carb diet is responsible for giving me my health back and better than at least thirty years ago.

Keep asking, until you understand what is going on, and don't be afraid to ask for a referral to a specialist endocrinologist. Who knows, he could get you the tests necessary.
It is your body, your health, you need the knowledge to stop your diabetes getting worse.

Keep safe

 

[dcle2021]

If your doc ignores your requests, you might want to get C-peptide, GAD and Homa-r done privately. Then if results are divergent, slap the practice over the head with them. They'd have to take action. If you went zero carb etc, your numbers should have improved. Since they didn't, that *could* indicate a T1 variant. You wouldn't believe how many people get misdiagnosed. Something to mull over.

Thanks, this approach makes sense to me. I just switched job and there is private medical cover but I haven't taken it out yet because I disagree with that in principle but feels like I will have to go there.

 

[dcle2021]

Didn't you say that earlier that vigorous exercise was bringing your blood glucose down? If you keep that up on a regular basis, it should bring your HbA1c (blood glucose average over the last 3 months) down to some degree.

When you say that diet hasn't worked, had you tried a low carb diet? How many g of carbohydrate per day?

When you say that losing weight hasn't worked, what percentage of your starting weight have you lost?

0g of carb/day (0g of food for 48h) and I have lost 11.2% of original body mass. Which wasn't that overweight anyway. 107kg down to 95kg, am 187cm tall. Levels still randomly around 9-10 mmol/l at waking/7am.

 

[Lamont D]

Thanks, this approach makes sense to me. I just switched job and there is private medical cover but I haven't taken it out yet because I disagree with that in principle but feels like I will have to go there.

If your company is providing health insurance at no cost or cheap cover, then I wouldn't hesitate in using it.
But beware of the extent and exemptions of the insurance, what your company is trying to do, is look after its employees by getting medical advice from a private health care company, some are good, some don't cover much and some are dreadful, especially when paying you back, for the treatment you have paid for.
I agree with you on principle, but my company had its own doctor, ambulance and surgery, equipped with medical and meds. Physio, and regular tests and advice were always available, the nurses were good at first aid especially for the cuts and bumps. And a regular couple of pain killers after a night in the pub.

 

[Dark Horse]

0g of carb/day (0g of food for 48h) and I have lost 11.2% of original body mass. Which wasn't that overweight anyway. 107kg down to 95kg, am 187cm tall. Levels still randomly around 9-10 mmol/l at waking/7am.

Fasting might be counter-productive - if glucose levels go too low in the night, the body will respond by trying to bump them up and may overshoot causing a raised fasting glucose - rebound hyperglycaemia. https://my.clevelandclinic.org/heal...ses-of-high-blood-sugar-levels-in-the-morning
You might be better off trying a steady, low-calorie diet like the 'Newcastle Diet' used in the Direct trial. https://www.ncl.ac.uk/magres/research/diabetes/reversal/#publicinformation

In the trial, the average weight loss required for remission from type 2 diabetes was 15 kg (more for some people) so it would be worth trying to lose some more weight to see if it helps.

Alternatively you could try a steady low-carbohydrate diet. https://www.dietdoctor.com/low-carb