ickihun
Master
What's classed as 'mild'. Lower bgs without meds?
Is 100+ in a hba1c on eat well diet and exercise?
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5 different types of diabetes identified now
- Thread starter lucylocket61
- Start Date
Is 100+ in a hba1c on eat well diet and exercise?
ickihun
Master
Diet HELPS all groups but doesn't cure or put them in remission. I find.
ickihun
Master
I lost muscle mass but more fat visible being on insulin therapy.
Mr_Pot
Well-Known Member
So the 4in I lost from my waist was fluid? I think not.
ickihun
Master
But thats because of your low carb diet (treatment) right. Or just weight loss??
I think these classifications are relevant to the raw conditions of diabetes. Not after treatment improves it. I think.
ickihun
Master
Definitely.
Alexandra100
Well-Known Member
Sorry, I didn't make it clear, she is talking about a sudden initial weight loss / gain which is dramatic enough to delight /dismay. I haven't experienced this personally, but it is certainly true that people can often be found here asking why their weight loss on as low carb diet has stalled after an extremely promising start.
ickihun
Master
This backs up up my theory. If I have severe diabetes, i need a severe resolution. Surely???
Boo1979
Well-Known Member
- Messages
- 1,849
- Type of diabetes
- Other
- Treatment type
- Tablets (oral)
Not really. The weight loss was way before diabetes diagnsis.Treatment has been with sulfonylureas.
because I was initially classified as insulin dependent I was aware of carbs and started testing sraight off and found 35ish carbs per meal worked. I have reduced carbs as needed to the current level in my signature in order avoid any any increase in meds. Sulfonylureas generally only work for 6 years before 50% of those treated with them are on insulin and 8 years before 75% are on multiple therapies.
The exception is some varients of monogenic diabetes which respond particularly well to sulfonylureas - my medical team have said my disease presentation seems more like monogenic diabetes than type 2. This study and its 5 classifications omits / skirts over monogenic diabetes
ickihun
Master
If I had been tested after I lost 7st in the 80s I would have been put on meds too. It doesn't stop diabetes once it's there. Well not for me.
My symptoms in 70s tells me any hba1c in 80s may have showed prediabetes levels but ignored. If i was tested.
Good diet disguises diabetes on the hba1c test. As we know.
I was diabetic throughout.
Alexandra100
Well-Known Member
Yes, clearly adding insulin to low carb changes everything. I believe weight loss usually involves muscle loss as well as fat loss. It certainly did for me when I lost weight unintentionally. My physio was shocked and showed me photos of my previously muscular back.
LOL, @bulkbiker! I read this study a couple of weeks ago and was tempted to share then but it was like a Russian novel - I needed to write down a glossary of abbreviations just to keep them all straight as I read! My head was spinning! Anyway I did take notes with an intent to share and this is my takeaway:
The overarching message is that this new classification (if generalisable to other ethnic groups) will enable health systems to tailor treatment and/or screening to the underlying metabolic defect or complication associated with a particular cluster. So, think more 'precision medicine' than 'one size fits all'.
They identified 2 new, more severe forms of diabetes previously masked within T2DM: Clusters 2 & 3.
Cluster 2: Associated with a higher risk of Diabetic Retinopathy:
In terms of screening for complications, individuals with Cluster 2 may be best served by receiving more intensive screening for diabetic retinopathy, while those in Cluster 5 (for example) may only need to be screened every 2 years (again, using scarce healthcare funds wisely to have maximum benefit for the most people).
Cluster 3: Associated with a higher risk of Diabetic Kidney Disease (DKD):
Similarly, those in Cluster 3 warrant very close observation/screening for development of chronic kidney disease, as this cluster had 5 times the risk of developing End Stage Renal Disease than Cluster 5. This would also have implications for prescribing certain medications: for example Metformin should perhaps be used with caution in this group.
The big takeaway with Cluster 3 was that their marked increase in Diabetic Kidney Disease was seen 'in spite of a relatively low HbA1c, suggesting that glucose-lowering therapy is not the ultimate way of preventing DKD'.
The study looked at the following 5 quantifiable variables, and they suggest that following these 5 variables is superior to measuring glucose alone:
- Age
- BMI
- HOMA 2-IR
- Presence or absence of GAD antibodies
- Fasting glucose and C-Peptide to estimate HOMA 2.
ickihun
Master
My underactive thyroid influences my cholesterol and kidney health so maybe thats why my kidneys are good in cluster 3?? Also no alcohol or many toxins in my water I drink?
Not news to us perhaps, but news to the decision makers who decide how the resources are allocated! We are way ahead of the curve on this forum!!!
lucylocket61
Expert
I can promise you, I didnt lose a stone in fluid when starting low carbing........................and if i did, I have bigger problems than diabetes.
But I wonder if in cluster 3, which I would have thought I was in before diagnosis, was the kidney disease in the low HbA1c cohort caused by their medication. As per usual the study probably raises far more questions than it answers.
I still think you may benefit greatly from cutting carbs further. I know you are unwilling to do this but "lowish" carb doesn't seem to be working well for you. Is it time to try fewer and see what happens?
lucylocket61
Expert
no, I mean the stone I lost wasnt all fluid, in answer to the point suggested that low carb weight loss in the initial stages is all or mostly fluid, not fat.
I see my specialist in a couple of months and will raise the idea of changing my diet with him. thank you for your concern.
