Bgs below traditional diabetes cut offs can cause damage

[Tannith]

I was prompted by a post in the thread "cured" to look again at the traditional FBG cut off points for T2. Some may find this article interesting:
Glucose can also start killing beta cells at levels below 140. One study found that people with fasting blood glucose from 110–125 (within the official “prediabetic” range) had already lost up to 40% of their beta cell mass.

Italian researchers found that even with glucose levels in the supposedly “normal” range, beta cells started to fail. Ruhl says that researchers “found that with every small increase in the 2-hour glucose tolerance test result, there was a corresponding increase in…beta cell failure. The higher a person’s blood sugar rose within ‘normal’ range, the more beta cells were failing.”

Failing beta cells will lead to worsening diabetes, a truly vicious cycle. Slightly elevated glucose has also been shown to cause eye damage (“retinopathy”) and increased rates of heart disease, kidney damage, and stroke.

https://www.diabetesselfmanagement.com/blog/new-research-on-high-glucose-levels/

 

[IrishAyes]

Exactly. That's what I have cube to understand as well. Exactly why it's so important to cut the carbs and eat only to your meter. We need to RUN away from those providers who tell us we can "eat anything in moderation."

 

[bulkbiker]

I was prompted by a post in the thread "cured" to look again at the traditional FBG cut off points for T2. Some may find this article interesting:
Glucose can also start killing beta cells at levels below 140. One study found that people with fasting blood glucose from 110–125 (within the official “prediabetic” range) had already lost up to 40% of their beta cell mass.

Italian researchers found that even with glucose levels in the supposedly “normal” range, beta cells started to fail. Ruhl says that researchers “found that with every small increase in the 2-hour glucose tolerance test result, there was a corresponding increase in…beta cell failure. The higher a person’s blood sugar rose within ‘normal’ range, the more beta cells were failing.”

Failing beta cells will lead to worsening diabetes, a truly vicious cycle. Slightly elevated glucose has also been shown to cause eye damage (“retinopathy”) and increased rates of heart disease, kidney damage, and stroke.

https://www.diabetesselfmanagement.com/blog/new-research-on-high-glucose-levels/

"Keeping normal numbers may require extraordinary effort. It may require very low carbohydrate intake."

Odd you didn't quote this part.

 

[Mr_Pot]

I was prompted by a post in the thread "cured" to look again at the traditional FBG cut off points for T2. Some may find this article interesting:
Glucose can also start killing beta cells at levels below 140. One study found that people with fasting blood glucose from 110–125 (within the official “prediabetic” range) had already lost up to 40% of their beta cell mass.

Italian researchers found that even with glucose levels in the supposedly “normal” range, beta cells started to fail. Ruhl says that researchers “found that with every small increase in the 2-hour glucose tolerance test result, there was a corresponding increase in…beta cell failure. The higher a person’s blood sugar rose within ‘normal’ range, the more beta cells were failing.”

Failing beta cells will lead to worsening diabetes, a truly vicious cycle. Slightly elevated glucose has also been shown to cause eye damage (“retinopathy”) and increased rates of heart disease, kidney damage, and stroke.

https://www.diabetesselfmanagement.com/blog/new-research-on-high-glucose-levels/

I thought the problem with research into beta cells dying was that there was no way to measure it apart from an autopsy. What technique did they use?

 

[Antje77]

I thought the problem with research into beta cells dying was that there was no way to measure it apart from an autopsy. What technique did they use?

From the first link in Tannith's post:

"At the Mayo Clinic some of these difficulties are overcome. Autopsies are performed within 12 h of death (usually <6 h), including weekends. The Mayo Clinic integrated medical record system allows easy access to the prior clinical records of the cases. As the Mayo Clinic tends to be the primary health care provider for people hospitalized at the medical center for their final illness, most of the autopsy cases have had a general medical examination (including a fasting blood glucose) during the year before death.

In the present study, we took advantage of the unique autopsy material available at the Mayo Clinic to study 124 human pancreata from cases with and without diabetes and matched for obesity. All cases had a well-preserved pancreatic specimen and documented general medical exam, including a fasting blood glucose obtained during the 12 months before death."

 

[KennyA]

"Keeping normal numbers may require extraordinary effort. It may require very low carbohydrate intake."

Odd you didn't quote this part.

Indeed. The 48 for diagnosis is almost completely arbitrary, being misapplied by medics, and not much practical use to the patient. Many of us report diabetic symptoms occurring at BG levels well below 48 and years before formal diagnosis. All this is well known. The issue is early intervention and adoption of a low-carb diet as soon as BGs start to rise.

 

[Andydragon]

Diabetes is based on cut off levels that are arbitrary so it makes perfect sense that for some, complications can arise without being “in the club” just as some don’t get complications even within the range

but I don’t know if much research is carried out into levels close to or below the cut offs. Below the pre diabetic levels mentioned above, are the impacts non existent or so low as to not show up in research I wonder

 

[Member496333]

The pathology of T2 and metabolic syndrome is excessive circulating insulin over many decades, so it’s not surprising the results are unexpected when you measure the wrong thing.

 

[Mr_Pot]

From the first link in Tannith's post:

"At the Mayo Clinic some of these difficulties are overcome. Autopsies are performed within 12 h of death (usually <6 h), including weekends. The Mayo Clinic integrated medical record system allows easy access to the prior clinical records of the cases. As the Mayo Clinic tends to be the primary health care provider for people hospitalized at the medical center for their final illness, most of the autopsy cases have had a general medical examination (including a fasting blood glucose) during the year before death.

In the present study, we took advantage of the unique autopsy material available at the Mayo Clinic to study 124 human pancreata from cases with and without diabetes and matched for obesity. All cases had a well-preserved pancreatic specimen and documented general medical exam, including a fasting blood glucose obtained during the 12 months before death."

Sorry, I hadn't noticed that the highlight was a link.

 

[ianf0ster]

At first I was horrified when I looked up my risk of retinopathy and neuropathy after having got my HbA1C down into the higher end of the pre-diabetic range. I didn't like those odds at all!
That helped give me motivation to keep pushing for at least 'normal 'levels. Though in the normal range in the UK, I would still be considered pre-diabetic in the USA so I will try not to relax my carb cutting too much.

 

[lucylocket61]

Due to having several health issues to juggle, I achieve around 48-52 hba1c most of the time. I do my best. I can see the benefits of lowering my blood sugar levels more, but accept the risks of harm due to the increased risks in other health issues if I focus more on lowering my bloods. It's the way it is.

 

[Ronancastled]

Great recent write up here on Beta Cell mass in T2s

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098467/

β-cell mass in human pancreas can be measured by volumetric morphometry and roughly consists of 250 thousand to one million pancreatic islets or around 250 million to one billion β cells 9,10. In a study of 52 non-diabetic adult humans β-cell mass varied considerably ranging from 0.25 to 1.5 gm

Some interesting takeaways

With the insulin resistance of obesity, a given β-cell mass chronically secretes more insulin. β-cell mass as determined from study of cadaver pancreases is increased in obese subjects, but only modestly, with estimates being only about 20–50% more than that of normal weight individuals 11,12,31. Yet, the rate of insulin secretion over a 24-hour period is 100% more than normal

There have been a number of hemi-pancreas transplants done in humans such that individual donate about 50% of their pancreas to a recipient with T1D, but it has become clear that the donors have increased risk of developing diabetes. A follow-up study published in 2008 evaluated 15 donors who had hemi-pancreatectomies at the University of Minnesota between 1997 and 2003, with the finding that 43% had either glucose intolerance or diabetes 82. Another study followed 37 patients after removal of about 50% of their pancreases for either benign or malignant neoplasms and found similar results

 

[Tannith]

What blood sugar level causes eye damage?
High blood sugar causes the lens of the eye to swell, which changes your ability to see. To correct this kind of blurred vision, you need to get your blood sugar back into the target range. For many people this is from70 mg/dL to 130 mg/dL before meals and less than 180 mg/dL one to two hours after the start of a meal

Diabetes, Blurred Vision, and High Blood Sugar Levels

https://www.webmd.com › Diabetes › Reference

 

[lucylocket61]

Would anyone care to translate the numbers into UK ones please?

70 appears to be 3.9 which even my non diabetic people don't get as a rule, so how can it be a dangerous level?

 

[Mr_Pot]

Would anyone care to translate the numbers into UK ones please?

70 appears to be 3.9 which even my non diabetic people don't get as a rule, so how can it be a dangerous level?

I think it says 70 to 130 is the target level. 3.9 to 7.2 mmol/L.

 

[zand]

7.2 before meals seems a bit high as a target?
@Tannith what are your own pre meal bg levels like?

 

[EllieM]

Would anyone care to translate the numbers into UK ones please?

It's saying 3.9 to 7.2 before meals, and 10 after meals, which is actually a bit weaker than the NICE recommendations for adults. My understanding is the 48 (6.5 in old units) hba1c recommendation was chosen because few people had eye issues if they kept under it.

Having said that, here's a link with a nice little graph,
A1c And Complications Chart | DiabetesTalk.Net

6% corresponds to 42 mnol/mol.

 

[Tannith]

7.2 before meals seems a bit high as a target?
@Tannith what are your own pre meal bg levels like?

My FBG was 5.6 this morning on waking.

 

[zand]

My FBG was 5.6 this morning on waking.

But what about your pre meal readings? And the post meal readings? I thought that maybe you were worried about them as your post #13 seems to indicate?

 

[Tannith]

But what about your pre meal readings? And the post meal readings? I thought that maybe you were worried about them as your post #13 seems to indicate?

I almost never take pre or post meal readings. Haven't done so since around 2017. But my 2 hour ogt is 10.9, JUST below the diabetic level, at the very top of the prediabetic range. I took it recently for the first time in 8/9 months. It is the nearest thing I have to a post meal reading.