Beta cell failure in T2

[bulkbiker]

Only then would I consider low carb or better still drugs

So you'd rather medicate than eat differently...

Funny old world eh..

 

[Oldvatr]

Yes. and this may well show that insulin output improved, but his explanation as to the causes is not necessarily correct, and it is his (and yours) explanations that i cannot say were proven by his studies. I do not dispute that the insulin response recovered, which is why i support the use of the diet itself, but the science behind it remains a mystery in my mind.

I am not sold on the notion of dedifferentiation of cells. I have noticed in my own journey that insulin response can and does recover, evem after 50 years of abusing my pancreas and liver.

The Test he used for insulin response appears to be this variation of the euglycemic clamp normally used in mice studies
"Euglycemic insulin clamp technique. The plasma insulin concentration is acutely raised and maintained at approximately 100 muU/ml by a prime-continuous infusion of insulin. The plasma glucose concentration is held constant at basal levels by a variable glucose infusion using the negative feedback principle. Under these steady-state conditions of euglycemia, the glucose infusion rate equals glucose uptake by all the tissues in the body and is therefore a measure of tissue sensitivity to exogenous insulin."
Note the closing comment. This form of the test is a measure of the body sensitivty to insulin, i,e, insulin resistance, It is not measuring the beta cell output response curve at all. It is infusing exogenous insulin, so the body insulin will be tempered by this.

 

[Member496333]

Anecdotes aren't "evidence"

Of course they are. Evidence <> proof.

EDIT: I just checked the dictionary and apparently it literally does mean proof, but the point is hopefully clear.

 

[Oldvatr]

>>>>>
Because without C Peptide tests, or at the very least the more rough and ready OGTTs you can't tell the difference between bg improvement caused by lower sugar INPUT and BG improvement caused by better sugar REMOVAL by increased insulin output. <<<<<<

Ye gods and Little fishes! The ND diet studies used diet shakes that wer Low Carb as well as low calorie, hence were by essense low sugar input.

Improved insulin output may be your goal, but insulin is the storage hormone, and where does the glucose go? unless you up your activity greatly, then you will be storing more glucose as fat. You may have fine FBG's but it will show up in other ways. That is the connundrum of T2D. Without HbA1c monitoring, or plentiful spot checks of bgl then you could be masking your symptoms.

Reduced IR is a goal, but all it means is that it is easier for the glucose to enter the mitrochondria, and easier for the liver to store glycogen, or for lipids to be moved into adipose tissues., but unlesss you use it then it gets stored in the mitochondria as glycogen, and as lipids in the liver and adipose tissues. Like we said, what goes in must come out again. in the case of carbs, it is your CO2 and ketone and glucose excretion that must come out at the rate the carbs go in, or you store it instead. Nothing to do with calories.

 

[Member496333]

Ye gods and Little fishes! The ND diet studies used diet shakes that wer Low Carb as well as low calorie, hence were by essense low sugar input.

Improved insulin output may be your goal, but insulin is the storage hormone, and where does the glucose go? unless you up your activity greatly, then you will be storing more glucose as fat. You may have fine FBG's but it will show up in other ways. That is the connundrum of T2D. Without HbA1c monitoring, or plentiful spot checks of bgl then you could be masking your symptoms.

Reduced IR is a goal, but all it means is that it is easier for the glucose to enter the mitrochondria, and easier for the liver to store glycogen, or for lipids to be moved into adipose tissues., but unlesss you use it then it gets stored in the mitochondria as glycogen, and as lipids in the liver and adipose tissues. Like we said, what goes in must come out again. in the case of carbs, it is your CO2 and ketone and glucose excretion that must come out at the rate the carbs go in, or you store it instead. Nothing to do with calories.

Bingo. There's never going to be a silver bullet for type 2 until we stop putting glucose into the body and burn off what's already there. Not sure where people think it goes...

 

[Mr_Pot]

Bingo. There's never going to be a silver bullet for type 2 until we stop putting glucose into the body and burn off what's already there. Not sure where people think it goes...

I think it becomes CO2 and water releasing ATP for cell energy. Your idea that the body is full of glucose doesn't seem to be supported by any evidence.

 

[bulkbiker]

Your idea that the body is full of glucose doesn't seem to be supported by any evidence.

So what causes high blood glucose levels then?

 

[Member496333]

I think it becomes CO2 and water releasing ATP for cell energy. Your idea that the body is full of glucose doesn't seem to be supported by any evidence.

If it were that simple you could fully reverse type 2 diabetes in 48h just by not eating.

 

[Mr_Pot]

So what causes high blood glucose levels then?

Regulation of glucose by insulin is not sufficient to bring it down to normal levels. The total amount of glucose circulating in 5 litres of blood is about 1 teaspoonful, 2 teaspoonsful if your blood glucose is raised to 10 mmol/L. About 100 grams of glucose is stored as glycogen in the body. It is the suggestion that the whole body is full of glucose like a crystallized fruit that I disagree with.

 

[Mr_Pot]

If it were that simple you could fully reverse type 2 diabetes in 48h just by not eating.

If you define diabetes by a spot check on blood glucose then after a 48 hour fast you might well be reversed, unfortunately as soon as you ate anything the diabetes would be back. Long term energy storage is in the form of fat not glucose.

 

[Member496333]

It is the suggestion that the whole body is full of glucose like a crystallized fruit that I disagree with.

So when the body's muscle and liver glycogen stores are full, adipocytes are bursting, and the liver and pancreas begin backing up with fat, where does the glucose go now? If it only goes into the blood then you could cure diabetes in a matter of days simply by not eating. But you can't. It takes months or years. And the longer you've been diabetic the longer it takes.

Of course you are welcome to disagree but that is my rudimentary understanding of the basic mechanisms at the heart of it all.

EDIT: Also if glucose cannot backup into the entire body then why is the lens of the eye affected by diabetes?

 

[lucylocket61]

No you haven't. You have SAID you have but not actually posted any. Probably because there aren't any, so how could anyone refer me to them. All I ever get referred to is anecdotal stuff from forums etc, never any scientific tests/trials.I have also searched for these myself independently and not found any. Someone did once refer me to the Virta study but when I looked it up I found that around half the participants were still on drugs like metformin and a few were even still on insulin!

over the past months you have been directly replied to, with many links and quotes from scientific studies. Please dont start denying what people have done to help you understand.

 

[lucylocket61]

Only then would I consider low carb or better still drugs if I can tolerate them

Direct and simple question:

why are you anti low carb?

 

[lucylocket61]

https://www.nih.gov/news-events/new...how-insulin-stimulates-fat-cells-take-glucose

fats cells are the holding bays for glucose which has been converted into fat, otherwise, what is the point of fat stores if they are not releasable energy stores? This is why weight loss can raise blood sugar levels temporarily.

 

[Oldvatr]

Regulation of glucose by insulin is not sufficient to bring it down to normal levels. The total amount of glucose circulating in 5 litres of blood is about 1 teaspoonful, 2 teaspoonsful if your blood glucose is raised to 10 mmol/L. About 100 grams of glucose is stored as glycogen in the body. It is the suggestion that the whole body is full of glucose like a crystallized fruit that I disagree with.

Insulin is merely a gatekeeper, like the bouncer on the nightclub door or Cerberus at the gates of Hell. You only need enough insulin molecules to act as keys in the process. The comparison on weight alone is meaningless.

As regards excess glucose, it is upconverted to lipids and stored as fat. It is not limited to the 100gms you postulate. I believe body fat is measured in kilos and lbs.

 

[Mr_Pot]

Insulin is merely a gatekeeper, like the bouncer on the nightclub door or Cerberus at the gates of Hell. You only need enough insulin molecules to act as keys in the process. The comparison on weight alone is meaningless.

As regards excess glucose, it is upconverted to lipids and stored as fat. It is not limited to the 100gms you postulate. I believe body fat is measured in kilos and lbs.

I said about 100g of glucose is stored as glycogen. Energy can be stored as fat made from glucose but fat is not glucose. I don't understand the first part of your post.

 

[Member496333]

The problem (overflow hypothesis) occurs when you can no longer get any fatter. No one has unlimited fat storage capacity. You don’t just balloon into the marshmallow man. When your body begins running out of places to store the fat, that is when a diagnosis of diabetes is around the corner. If you keep eating glucose at this point then it must go somewhere.

 

[Mr_Pot]

The problem (overflow hypothesis) occurs when you can no longer get any fatter. No one has unlimited fat storage capacity. You don’t just balloon into the marshmallow man. When your body begins running out of places to store the fat, that is when a diagnosis of diabetes is around the corner. If you keep eating glucose at this point then it must go somewhere.

Above about 10 mmol/L it goes into your urine.

 

[Member496333]

Above about 10 mmol/L it goes into your urine.

For sure some of it does, but if that’s all there is to it then why does blood glucose rise up to three times higher than that in some people even if they haven’t eaten for two days? And why is the lens of the eye affected?

EDIT: Also, if glucose lives exclusively in the blood then why do type 2 who have been using hardcore insulin therapy for decades with good blood glucose control still suffer bad future outcomes with blindness and loss of limbs, organ failure etc?

Anyway this is probably drifting off topic now…

 

[Tannith]

The Test he used for insulin response appears to be this variation of the euglycemic clamp normally used in mice studies
"Euglycemic insulin clamp technique. The plasma insulin concentration is acutely raised and maintained at approximately 100 muU/ml by a prime-continuous infusion of insulin. The plasma glucose concentration is held constant at basal levels by a variable glucose infusion using the negative feedback principle. Under these steady-state conditions of euglycemia, the glucose infusion rate equals glucose uptake by all the tissues in the body and is therefore a measure of tissue sensitivity to exogenous insulin."
Note the closing comment. This form of the test is a measure of the body sensitivty to insulin, i,e, insulin resistance, It is not measuring the beta cell output response curve at all. It is infusing exogenous insulin, so the body insulin will be tempered by this.

I think you are confusing the Hyperinsulinemic-euglycemic clamp technique which was NOT used in the Direct trial,- and is as you say normally used to measure insulin resistance- with the Hyperglycemic clamp technique. The latter is the one which WAS used in the DIRECT trial and is used to measure insulin secretion over time. You can see if you look at the extract I quoted that the measurements are taken over time, ie per minute. “ nmol/min/m2”