What's the cause of diabetes again. Ie type 2

[Sunspot]

Someone here told me to read up on it. Can you provide me with links.

I am only asking about type 2 diabetes.

I googled but none of the threads that came up took me directly to an explanation. and the only explanation i found through other means left things pretty in a inconclusive state.

 

[Totto]

This is interesting reading: http://www.phlaunt.com/diabetes/14046739.php

 

[Squire Fulwood]

http://www.diabetes.co.uk/type2-diabetes.html

I think opinions differ greatly as to what causes type 2 diabetes. The popular press says fat people get diabetes but they can't explain why thin people get it also. They also can't explain why some fat people don't get it.

It seems there might be other causes for diabetes but one thing is becoming clearer and that is if you are overweight then losing some of that weight is helpful. This is explained as visceral fat (big gut) interfering with the action of the pancreas.

I suppose the obvious question is how do people get fat and how do you get rid of it. You get fat by eating lots of food. You can get rid of some of it by cutting down on carbohydrates and taking some exercise.

 

[AnnieC]

Why do we get diabetes a question I have asked as it is almost a world wide epidemic now Once it was a very rare thing here so what has caused it now in such vast numbers .Yes we know overweight people are more prone to it but it can't just be down to food and weight as thin people get it also
Different medications taken over a long period can predispose us to it..ie steriods... but thats a minority and not the whole story there must be more to it. Are there pollutants in the atmosphere that could cause it, we really don't know what our bodies are absorbing from the air and the food we eat. Why are people in countries where obesity is not common and diets are good now getting diabetes. This a question I think we all want to know.

 

[Daibell]

I think if you Google the web you will find endless information that highlights that no one really knows many of causes. As the other posters have said, we know that being overweight increases the possibility of becoming T2 thru insulin resistance, but we can't explain that many who are grossly overweight don't become T2. This must be down to genes and possibly other factors. One website I found a few years back listed all the genes found so far that are implicated and it's along list. I'm afraid it's like cancer where research is only scratching the surface of a very complex set of conditions.

 

[Patricia21]

Im 5ft .6 ins and 9stone 5 pounds .I would never have known I had diabetes if I hadnd moved house and changed doctors and had routine check up,It may also be somthing to do with age,or a serious illness,I had Legionairs disese two years ago and my body more or less shut down,it put me in hospital for three months.
I would say to everyone who travels abroad be careful,if you feel like you have flu get it checked out,

 

[Brightside]

A layman's version!

Basically it's disruption of the uptake of insulin by the cells. Insulin allows the cells to convert glucose into energy. There are various reasons for this disfunction such as the pancreas not producing enough (may be due to fat in the pancreas itself) or fat cells stopping the uptake of insulin at the body cells. There are probably a lot of other reasons too as there is a whole hormone household that affects the insulin metabolic cycle. Perhaps a disease/illness affected this cycle! Or there may be underlying liver issues as the liver synthesises the glucose in the blood.

One thing is pretty much proven though. Fat plays a large role in the sense of if you lose it it improves it!

Another factor is sugar. Diabetes is very uncommon in African tribal areas simply because sugar is not part of the diet. Where tribal people become urbanised diabetes starts to increase in the population because people have greater access to sugar eg coke sweets syrups fruit juices etc etc. a fact the sugar industry is trying very hard to deny.
many folks on this forum now include carbohydrates generally as the culprit but at the end of the day carbs are also simply a form of sugar.

Modern medicine feels there is no cure and perhaps this is so, but with weight loss diet medication and exercise the disease can be controlled. In some cases to such an extent that medication may not be needed. However a predisposition is probably there and the person has to monitor their lifestyle.

Not controlling it (blood glucose) will lead to disastrous complications later in life such as blindness, loss of sensation in limbs, loss of limbs, heart disease and many other quality of life robbing issues.

On that positive note I hope and trust all is well with you and that this helps a little in the understanding.

Any POSITIVE critique from the peanut gallery welcome!


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[Sunspot]

Thank you for your replies.

So it seems to me that genetics plays a key factor but diet is the next most important thing. Given the role of genetics is complicated we can only say its a big factor but not the whole picture. I liken it to depression or other diseases and their gene causes. It just a factor not the whole picture, albeit a very significant one.

And for people who become diabetic but are not overweight, its looks like genetics are even more significant.

I was wondering if the body type is a key indicator of predisposition as well. Do any of you have pear shaped figures? I'm wondering if those prone to diabetes can be identified by having apple shaped figures (for women) and whatever is most similar in men). Apple shaped equals - most weight around the middle and skinny legs.

I am inclined to discount the environmental pollutants as a prime suspect. Its too easy to blame environmental pollutants and too hard to prove it or even demonstrate it. Until more is known, its no better than taking potshots in the dark, especially when you have far more evident factors involved, like diet. And even the diet of pregnant mothers.

I think diet is far more significant. And for the majority, its carbs in general, not just sugar. I think its confusing and unhelpful to reduce all carbs to sugar when discussing these things, when we actually have a food called sugar and there's a meaningful term like refined sugars. I mean don't forget vegetables are also carbs, ultimately sugars. So for me the diet problem is refined carbs and too many of them. Eating more than minimal refined carbs leads to eating a lot of them and there spells trouble.

Given that eating less and losing weight has a significant impact on diabetes , its surely hard to deny that diet is a highly significant factor in the cause of diabetes. This is what i believe. I just wanted to ask the question about its causes in case there was something else i did not know about.

I read the article by phlaunt. It helped me see the complexity of the problem, in particular the genetic situation and the fact that still no one knows a precise cause. But she seemed to point the finger at pollutants and away from diet which to me seems like a case of denial. Generally i like her sites.

So given that refined carbs and too many of them are a major issue, which maybe a lot of diabetics don't really grasp at this point, a low carb diet is really going to be the easiest way to lose weight and get the disease under control. I was quite skeptical of low carb diets when i first started hearing a lot about it earlier this year. But over the course of a few months, i learnt more and more and finally read some books when i decided to try it out for myself just to see what it felt like.

The experience of low carb is quite fun -given all the cream and beautiful cheese you can eat. And eating moderate carbs (around 100-150) is very good which i will do for the long term. Advantages i find are less hunger issues making it easier to limit calories, greater enjoyment of healthy foods like vegetables and salad because i'm not eating refined sugars anymore. More confidence that my nutrition is higher than ever. Disadvantages at very low carb (<50) are: risk of constipation for which you should take psyllium fibre and eat maximum vegies, boredom with limited foods (so gradually move up the scale of food choices until you find a spread that suits you best), and because most of the world is not doing low carb, you have to be more organised with your food when you go out because you just can't eat what you want any more if you don't want to mess up the ketosis experience. (Ketosis being when your body burns fat for energy instead of glucose from carbs).

The books make a very very convincing case for how low carb diets are ideal for diabetics and those with insulin resistance and metabolic syndrome. It just seems to be easier to lose weight this way. Though whether or not its essential to go very low carb, i am not sure. I'd like to see a study done on it to compare weightloss rates with people eating at different levels of low carb e.g. 20, 50, 70, 90, 100 and 130. This would show me whether ketosis is really all its cracked up to be. Certainly the health risks of doing low carb seem to be minimal. I think constipation is the main one ultimately which if not dealt with can cause haemorrhoids.

Books i'm talking about are: Atkins 2006, The Art and Science of Low Carb by Phinney and Volek.
Paleo is another alternative but i haven't read any paleo books as yet. All the ones in the library are permanently on loan these days.

 

[Sunspot]

Why do we get diabetes a question I have asked as it is almost a world wide epidemic now Once it was a very rare thing here so what has caused it now in such vast numbers .Yes we know overweight people are more prone to it but it can't just be down to food and weight as thin people get it also
Different medications taken over a long period can predispose us to it..ie steriods... but thats a minority and not the whole story there must be more to it. Are there pollutants in the atmosphere that could cause it, we really don't know what our bodies are absorbing from the air and the food we eat. Why are people in countries where obesity is not common and diets are good now getting diabetes. This a question I think we all want to know.

Annnie, I think the reasons why those people are getting it now is because their diets are changing, e.g. in India. Although i have heard some time ago that indians do have a greater genetic predisposition to diabetes than caucasians. I've noticed that more of them are apple shaped too. But i've spent a lot of time in india and its clear their diets are changing radically. And they eat a ton of sugar. Wealth is causing them to eat more. Though there are also poor people who get diabetes there. Other than india, i'm not sure what countries you are talking about but i would suspect the influx of western foods i.e. processed foods. So if countries like Japan and China are also showing more diabetes, then it has to be diet. I read recently that when say africans move to America they quickly start catching up with diabetes stats. The same book even said, that some populations may have less genetic defences against things like diabetes. The argument was convincing but i can't easily paraphrase it all back to you. It was in an excellent book called In Defense of Food which i think all of us would benefit from reading.

 

[Robbity]

Re constipation and low carbs - the only time I suffered at all was when I first started with a lowish carb diet, and trying the blasted psyllium fibre caused me to feel as though I was going to get appendicitis! However I found once my body got used to a low carb diet, just eating plenty of roughage type veggies and plenty of nuts keeps me "regular". Eating more fat seems also to help me.

I'm actually eating a much more interesting and varied diet now too... I'm well happy with it currently.

As I see it ketosis "only" switches you into fat burning mode, you don't necessarily lose weight as I've accidentally discovered over the last few months, and I assume you will gain it too if you consistently eat more than your body actually needs. I'm currently eating between 20 and 50 grams of carbs a day, and can see mainly moderate to high levels of ketones.

Robbity

 

[Sunspot]

Robbity, i thought it worth mentioning the constipation because i have come across other people who have quit the low carb diet because of it. Its an issue for me because i take an antidepressant which also causes constipation so i have a double whammy.

Also if you are following induction a la Atkins method, you can't eat nuts in that phase because its only 20 carbs a day and you need to prioritise the the green vegies. However, i agree that nuts are great for helping with this problem and i have also wondered about the benefits of fat for constipation. I don't actually find vegetables are sufficient for me. When i'm not on such low carbs i rely on chickpeas, lentils and beans as well as nuts to help.

Psyllium is best done with a small amount first and then not too much. But i have also heard some others have difficulties with it. But i have used it long term and not had issues with it. Atkins recommends it because it has no calories or net carbs, only fibre.


As to ketosis, i can't debate it from personal experience but Atkins insists that you burn more calories when burning fat than carbs because it requies more energy. But frankly i don't think it s worth worrying about. There are other good reasons for doing low carb to both lose weight and also for diabetes management.

To lose weight, you have less hunger on a low carb diet. This is because with fat you won't run out of energy. But with carbs you can run out and that's what causes the hunger in the first place. I am never hungry in the same way on low carb as when i'm on carbs.

Yes its important not to eat to your hearts delight as you will indeed put on weight. That's why ultimately you must watch your calories. I think its critical because its too easy to overeat calories on low carb because the food is more calorie dense. So its important to eat to numbers and not til you are full. Meals must be smaller on low carb and i can tell you that you should not feel at all deprived. I've been monitoring my satiety levels since before starting very low carb and i'm always satisfied at the end of my meal to a great or less extent but i don't stop eating when i'm hungry. The experience of hunger, once you get pasted onset of ketosis, is subtler i think.

 

[AnnieC]

I did read somewhere a time ago now one theory about T1 was that sometimes it may be triggered by a person having a virus infection this could be more likely in late onset T1's
I am prediabetic but I really do not fit the groups most likely to get T2. I have never had a sweet tooth so hardly ever ate cakes biscuits puddings and never had sugar in tea or coffee. I don't like rice or pasta and was never a big bread eater I have never been overweight in my life.. present weight 8.8st.. I do not have any other medical conditions and no history of T2 in my family. My doctor says sometimes there is just not any explanation as to why someone gets T2 if there are no obvious indications

 

[Sunspot]

Same with lots of cancer and other diseases annie. Sometimes a clear explanation cannot be identified.

Given that there has been an increase in the incidence of it, there has to be an environmental factor in play for many of the diagnoses, and so far the most likely candidate seems to be diet.

 

[phoenix]

Sorry this got complicated, I tried to put the genetic bit simply but it's hard to do it and after spending a long time on it . I wasn't sure about posting it. Please ignore if too much!

Family history of diabetes, overweight, unhealthy diet, physical inactivity, increasing age, high blood pressure, ethnicity, impaired glucose tolerance. History of gestational diabetes, and poor nutrition during pregnancy. These are considered the major risk factors by the IDF.

Researchers investigate what translates these risks into developing the condition from many different perspectives; exercise, diet, psychology, biochemistry, genes etc .
Putting findings together into a cohesive whole is difficult (impossible?) and people find new facets every day.
There is no one, simple answer, it's one big jigsaw (or maybe lots of big jigsaws)

Fat cells , specifically overfilled fat cells resulting in fat being deposited where it shouldn't be is thought to play a big part in why people become insulin resistant. I wrote briefly about it here:
http://www.diabetes.co.uk/forum/threads/guarantee-diabetes.60294/#post-575102)
. Just to show how complicated, this one aspect is: here is a whole technical book about the role of fat cells in T2 (and though I know a bit, most of it is way above my head)
http://www.intechopen.com/books/role-of-the-adipocyte-in-development-of-type-2-diabetes

Genes
There are specific gene mutation like those involved in MODY or the cyclist in this article ( He has very few fat cells, that's why he's thin and why fat becomes deposited in the wrong places resulting insulin resistance and T2 like diabetes). I'm sure that more of these specific mutations will be found.

For most , genes play just a part . People may have genetic variations that lead to bit less insulin being secreted than others or to fewer fat cells or to less efficient signalling between cells or some other differences in metabolism.
Twin studies have found T2 to be about 26% heritable (in European populations, it may be higher/lower in other ethnic groups, we don't know) .
http://www.snpedia.com/index.php/Heritability
This means that though about a quarter of the variation between those who have it or don't have it may be influenced by genetic difference, the other 75% of variation is influenced by environment .
There is a gene/environment interaction.
There have been over 40 genetic variations ( ie SNPS) found so far , Each individual variation only increases the risk of developing T2 by a tiny amount. Someone with a lot of these genetic variations would have a higher risk of diabetes than someone with only a few but it seems by not very much.

The four graphs here show those who developed diabetes over a period of 10 years.

The graphs are shown in increasing order of genetic risk., the graph on the left shows results from people with the lowest genetic risk, the one on the right the group with people at the highest risk.
The black lines show those with a BMI of 30 and above, the blue lines BMI of 25 but less than 30 , the red lines those with a BMI of less than 25.

If you look at the red line (BMI under 25) in each graph, you will see that even in the highest risk group there is only a slight increase in those that developed diabetes.
If you look at the black line (BMI over 30) in each graph , you will see that these people had a higher risk of getting diabetes even when they were in the lowest risk group with only a small number of 'diabetes gene variations' (caveat has to be known variations , if there is a genetic variation that has a huge influence, it's not been found yet,)



The study found that younger, leaner people with many of the genes had a higher risk of developing diabetes than those that had only a few . However, this was in real terms a low risk. So basically, with the genes we know about so far, they only have a very small influence on whether people develop diabetes or not
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001647
(these findings are not applicable to people of other ethnic origins, only people with European ancestry. The data sets were European , and a very big sample including the UK, they looked at 49 SNPs )

Epigenetic changes which is where genes and the environment meet.
Epigenetic changes are not a change in the DNA but a change in the way inherited DNA is bound up . How tightly or loosely sections of DNA is bound up and folded determines whether the code at that section can be read and acted on.
Really excellent diagram here
Epigenetic changes can arise in the womb and be transmitted to offspring.
Studies in mice have shown that the grandmothers diet can effect the tendency of her grandchild towards obesity The male mice from mothers who were starved at the end of pregnancy were of small birthweight and prone to be glucose intolerant. The male offspring of these mice were in turn prone to be glucose intolerant. ( lots of research going into the different epigenetic markers that may 'cause' this.)
http://epigenome.eu/en/1,63,0
Dutch famine and effects
http://www.naturalhistorymag.com/features/142195/beyond-dna-epigenetics)
Epigenetic changes to DNA also take place during the life of people so may for example influence the expression of the genes that are involved in insulin production
http://www.eurekalert.org/pub_releases/2014-03/lu-ecc030714.php

 

[mcdonagh47]

Someone here told me to read up on it. Can you provide me with links.

I am only asking about type 2 diabetes.

I googled but none of the threads that came up took me directly to an explanation. and the only explanation i found through other means left things pretty in a inconclusive state.

The causes of Type 2 Diabetes ( also Type 1 ) are unknown - that's why there is no treatment for either of them.

 

[Sunspot]

Phoenix, thanks for all your effort. I will need to reread it but i have understood quite a bit of it.

 

[Totto]

The causes of Type 2 Diabetes ( also Type 1 ) are unknown - that's why there is no treatment for either of them.

It isn't that easy. Type one is autoimmune and autoimmunity may be poorly understood but apart from what triggers autoimmunity the workings of antibodies on the pancreas seems to well known. If you are not type 1 you are type two and that seems to be a very varied condition so the causes are varied to but it does seem to have a lot to do with genes. And the different treatments for different kinds of diabetes are also well known. But as to cure, that is more complicated.

 

[Sunspot]

Totto, good post except i think to say it has a lot to do with genes must surely be an oversimplication also.

You seem to be saying that you do not think diet or anything is part of the cause. Is that the case.

To me it seems clear that diet has to be part of the cause.

Its like cancer, Many have a genetic predisposition to it. But you can have a predisposition to it and not actually get it if you don't trigger the environmental switches. This is my understanding for things like cancer, diabetes 2 and depression to name only a few.

I think the whole picture is very very complicated because i think there are many routes to the same end. e.g. i think there may be many ways one could end up with diabetes, cancer or depression but most of them would start with a predisposing gene set.

So when someone (as happened on a thread on this site) says to me that diet or overeating does not cause diabetes, i am inclined to think they are just in denial and not helping themselves if this is their view.

Still no one has commented on the body shape. Are you all apple shapes. (most of the weight around the middle with skinnier legs and often a flattish backside) Are any of you pear?(big backside, normal or smallish top end). I am a pear, don't have diabetes and am wondering if i am not likely to get diabetes despite how much junk food i eat or how fat i get. I'm just wondering and I never see this addressed. But we know that the way fat is deposited in pears is more risky than for pears, Hence my hypothesis.

 

[Adele99]

Because we now see dogs with increasing levels of diabetes I feel the connection has to be largely with increased food consumption , especially of the processed type, and reduced exercise. . Dogs have a really fast digestion process compared to people and are designed to eat meat and fat with a few greens and partly digested things from the stomachs of the animals they killed. In the wild they couldn't visit the local bakery or corner shop.for a loaf. Lol. And their system is designed not to eat every day , but still be able to run fast enough to hunt and catch something.

Now dogs are fed very day, and often fed complete dry foods mainly comprising starches to bulk them out and reduce cost. Mind you tinned food often isn't much better .

Obviously it's not just a single factor, but with the huge increase in type 2 these days has to be mainly connected to diet and weight surely?

 

[donnellysdogs]

Ref earlier mention of constipation on low carb diets... Flax seed is very good. There are actual warnings to start off introducing flax seed gradually. I have just a teaspoon of flax seed in my berries and yogurt each morning, and considering that I have been admitted to hospital with morphine 3 times previously due to impacted faeces, then this stuff is brilliant.
I was diagnosed with slow colonic transit and enemas and laxido were on my repeat prescriptions. I do not have any meds now and am completely discharged from gastro dept care. This was achieved by 3 things... Giving up jelly babies as my hypo stoppers, taking Phoenix's advice on fat, and therefore increasing my daily amounts of fat and also the teaspoon of flaxseeds each day.

I have been a low carber for the vast majority of my 50 years, not realising that I was also a low fat eater too. Huge thanks from me to Phoenix for giving me information on another posting.


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