Definition of what is type 2

JohnEGreen said:

And that definition would include T1 and T2 but would not include me as I have drug induced diabetes I don't think it's possible to define diabetes as a single entity..

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I tend to agree with you. Bilous does mention things such as drug-induced diabetes (in the table I didn't type out) but these exemptions don't appear to require a change to the sweeping nature of his definition.

Maybe this definitional difficulty is why the popular/media view of diabetes has such a hold - they have the advantage of a simplistic definition. For T2 it would be something like "if you're fat you get diabetes" . It's then much harder to suggest that it's a lot more complicated than that.

I sat and listened to Prof Taylor. I was taken in by his very personable delivery. I kind of get where he is coming from, but I'm very much a lay person trying to get a handle on my sugars. I don't know if I have this wrong, but I can't remember hearing about many Type 2's growing up in the UK. I was born in 1961. I don't come from wealth so we had basic meals. A meat and two veg 5 days a week, a Vesta curry on Fridays and a roast on Sunday. Most days we had a pudding with custard. Nothing fancy. Historically there was no diabetes in my family (excluding my brother who has LADA). My mom had RA. She later became obese as she was in a wheel chair and the RA had crippled her, even then she wasn't diabetic. I don't seem to get my sugars down. I lost his golden 15 kilos. My trigs are very good. I'm on a very low blood pressure medication but I often think I should come off them as my blood pressure can go low but then every now and then it rises so I figure just stick with them. My C-peptides are low/normal. According to him my only risk relating to his Twin Cycle Hypothesis is my age and the fact I put on a few pounds over and above what I was when I was 21 years old. I do so much exercise I cannot imagine there is any sugars left and I have been low carbing since last May and I am in ketosis, but heck I am still pre-diabetic despite it all. And just to add I was diagnosed pre-diabetic in late 2019 so not that long ago. My blood sugars starting really going up at the end of 2022, which was the imputus for me to see what low carbing would do, but my sugars seem entrenched. I listened to his theory about skinny people with fatty livers and fatty pancreas' but I would think that 35lb weight loss should have taken care of the fats surrounding my organs. All those words to say I'm uncertain. (Edited as I forgot to mention my bro)

Melgar said:

My C-peptides are low/normal.

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I thought T2s had high insulin amounts (unless very long term)?

Melgar said:

excluding my brother who has LADA

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Have you been checked for this ? Low cpeptide and sibling with LADA sound like red flags to me. (Disclaimer, am not a doctor).

A lot of the Taylor work is aimed squarely at establishing an approved "remission/reverse" level and method for T2 diabetes, so that, in the UK, this can be incentivised for GPs via a QOF payment linked to HbA1c reduction. If the Newcastle method were to be adopted as the NHS' method of choice (which would probably lead to other health economies picking it up) it would be extremely profitable for the owners of the Newcastle method (or any other in a similar position). This is linked to the decision a couple of years ago to define "remission" as two sub-48 HbA1c readings three months apart without glucose lowering medication. Note no mention of absence of diabetic symptoms despite that being a given for "remission" for other conditions.

The Newcastle method also conveniently does not challenge the present orthodox view on carb consumption and on weight loss, so there is no difficult discussion to be had about why, to lose weight, you were told to avoid carbohydrates (pre-1985ish) then (post-85) base all meals around carbohydrates to avoid a CVD increase that never happened thanks to the decline in smoking. I wouldn't want to be the one to explain that actually there'd been a rethink and you should cut down on those carbs again, sorry for the obesity and T2 crisis, but hey.

So you would (as a government healthcare system) be able to say that you were now rewarding doctors for using a calorie-control method that achieved remission for T2 diabetes by reducing HbA1c without drugs. That would be very attractive for government. It looks like something significant is being achieved for little cost, and no political embarrassment.

The problem is that the Newcastle method might have some short-term success but does not appear to be (on their own evidence) sustainable. They did their best to hide the 93% failure rate longterm. I'm not going to rehash the arguments in other threads on this forum where their claims of success were dismantled.

I wouldn't mind if there was a slightly more open approach to talking about what they're doing - a short-term weight-loss starter via a low-calorie approach that may also show some BG reduction. Given that an 800 calorie diet is almost certainly a low carb diet (max 160g/day assuming zero proteins or fats) even if unacknowledged, it is certainly arguable that what success is achieved is down to the low carb, rather than the low calorie. Low calorie diets for me tend to reduce metabolism and induce hunger - which has not been my experience on low carb (over four years now). And incidentally, for me and many others, BG reduction greatly precedes weight loss, not follows it, as the Newcastle approach has to claim.

I know which works for me. I also know why it's very difficult for a large health economy to change direction quickly.

EllieM said:

I thought T2s had high insulin amounts (unless very long term)?

Have you been checked for this ? Low cpeptide and sibling with LADA sound like red flags to me. (Disclaimer, am not a doctor).

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I know and I hear you. I'm already living with one autoimmune condition. It seems that while I'm controlling my blood sugars through diet and exercise my T2 diagnosis will remain. My Dr is all over the very low carb diet and exercise gig and is encouraging me to stick with it. So I guess while I am controlling my blood sugar it will be a wait and see game.