ickihun
Master
What's classed as 'mild'. Lower bgs without meds?
Is 100+ in a hba1c on eat well diet and exercise?
What's classed as 'mild'. Lower bgs without meds?The five types are ...
Both mild types can be treated with metformin and lifestyle changes. I am not sure which category I would fit best as I was obese (BMI 33) and 63 years old when diagnosed.
- MARD - Mild Age Related Diabetes
- MOD - Mild Obesity Related Diabetes
- SIDD - Severe Insulin Deficient Diabetes
- SAID - Severe AutoImmune Diabetes = Type 1 + LADA
- SIRD - Severe Insulin Resistant Diabetes
Diet HELPS all groups but doesn't cure or put them in remission. I find.Sadly but not unexpectedly the researchers predict that drugs will be able to be targeted more effectively to suit the different needs of these various groups, but diet is never mentioned except by implication when they say that the 5th group (age-related mild diabetes) could be addressed by life-style measures. It seems to me that in fact diet is the one treatment appropriate to all groups.
I lost muscle mass but more fat visible being on insulin therapy.According to Jenny Ruhl, going low carb causes a big weight loss due to loss of fluid not fat, and adding carbs back into your diet entails a sudden weight gain which is additional fluid not fat. Hope that helps!
So the 4in I lost from my waist was fluid? I think not.According to Jenny Ruhl, going low carb causes a big weight loss due to loss of fluid not fat, and adding carbs back into your diet entails a sudden weight gain which is additional fluid not fat. Hope that helps!
But thats because of your low carb diet (treatment) right. Or just weight loss??Dont think I fit neatly into the categories - diagnosed at 39 with sugars at 28 but told Id been diabetic for at least 15-20 years. Significant (9-10 stone ) weight loss many years (17) prior to diagnosis. Still on same meds at same dose 21 years post diagnosis even tho they that are only meant to control T2 for 5-10 years max. Hba1c in non diabetic range
Definitely.true, but its a strt in moving away form the rigid and narrow classifications they have now.
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.So the 4in I lost from my waist was fluid? I think not.
Not really. The weight loss was way before diabetes diagnsis.Treatment has been with sulfonylureas.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.
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.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
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.I lost muscle mass but more fat visible being on insulin therapy.
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:Maybe someone who speaks "scientific study language" could take a look and translate for us mere mortals...
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!!!clearly I am no expert but since I've been on the forum there have been at least four sub forums covering different types... so 5, probably different, didn't seem like news to me....
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.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.
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.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:
They also looked at genetic markers but noted that their stratification could be further refined by including additional genetic 'biomarkers, genotypes or genetic risk scores'.
- Age
- BMI
- HOMA 2-IR
- Presence or absence of GAD antibodies
- Fasting glucose and C-Peptide to estimate HOMA 2.
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?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.
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 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?
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