Diabetes: Have We Got It All Wrong? (T2D)

ickihun

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Insulin is the last resort when all else has been tried. Since treating with increasing doses of insulin causes further resistance it is considered unhelpful in the context of a high carb diet.
Even a low carb diet isn't enough for me so insulin is my only saviour. I take insulin for protein and liver dumps.
 
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HSSS

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Even a low carb diet isn't enough for me so insulin is my only saviour. I take insulin for protein and liver dumps.
I’m assuming you had tests to establish if you are extremely insulin resistant or have lower than normal levels of endogenous insulin?

Obviously if it’s the former you’ll need more than normal to control bloods sugars and may not currently make that extra required to overcome the IR hence the current need for insulin. Perhaps as you continue along your fabulous weight loss, metformin and low carb journey your IR will reduce, despite the high insulin levels, and your own production will come closer to matching the levels required allowing you to ultimately use less or maybe even no exogenous insulin. Fingers crossed for you.

Again obviously if you simply no longer produce much at all, then insulin is the only way to go and it will indeed be your saviour. It’s amazing stuff used in the right cases.
 
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saky

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Another way of looking at insulin resistance is that as it is a default action - ie that when we are imbibing food and drink, toxins etc, that causes a too high insulin production, over time, IR is actually our body's first line of defence. (Along with storing excess energy in body fat in the belly first then all over.)

If only lowered insulin production was the worst medium or long term consequence of IR! In fact, kidney breakdown seems to be the bigger problem. You can see this disease progression very well in the doco series from Aotearoa/NZ 'The disease that is killing my family' (available on youtube/online). (I know - horrible title, but, a son of a man who dies in the course of the doco from diabetic kidney failure is the doco-maker, so....)

Kidney breakdown (where dialysis is called for) is big-time in Polynesia generally, which is shown in one of the docos in particular in the series. (And the limbs rotting 'thing', with amputations.)

Severe insulin resistance diabetes has a different disease make-up and progression - ie the kidney breakdown (according to the Swedish endos/researchers at Lund Uni where I get this info from) to what the same Swedes call mild obesity and mild age related diabetes (the latter two accounts for 66% of all diabetes including auto-immune diabetes). They make the very reasonable point that these different kinds of diabetes need different treatments.

Severe insulin resistance diabetes affects about 15% of all diabetes sufferers (at least in Sweden, numbers as above care of Lund Uni researchers). Those prone to this type of diabetes have a different gene/hormone profile to the rest - my own understanding is that it affects those with a lean and muscular body type (under 'normal' conditions), hence its devastating effects in Polynesian countries, Aotearoa included.
Even I have SIRD. My mom now has CKD and under dialysis. Will watch that series...
 
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AloeSvea

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Hi @saky. Yes - the link between severe insulin resistance (in bodies that would be lean and muscular under 'normal' healthy food and drink conditions), and kidney disease is an interesting one - something I take full note of here in Aotearoa/NZ where kidney disease in T2D is rife...

I am so sorry to hear about your mother and the CKD. Watching that doco series might be big time upsetting for you? I hope you have a good mate or family member who can watch it with you so you have someone to talk to about it afterwards?. (or do so in here?) I've watched it a couple of times, and I find it .... upsetting I don't even know is the word for it. I appreciate the son doco maker sharing this story of his father (and of course - his father doing so!) with us.
 
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saky

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Hi @saky. Yes - the link between severe insulin resistance (in bodies that would be lean and muscular under 'normal' healthy food and drink conditions), and kidney disease is an interesting one - something I take full note of here in Aotearoa/NZ where kidney disease in T2D is rife...

I am so sorry to hear about your mother and the CKD. Watching that doco series might be big time upsetting for you? I hope you have a good mate or family member who can watch it with you so you have someone to talk to about it afterwards?. (or do so in here?) I've watched it a couple of times, and I find it .... upsetting I don't even know is the word for it. I appreciate the son doco maker sharing this story of his father (and of course - his father doing so!) with us.
Watched all the episodes on Sunday while my mother was in hospital for dialysis. Watching it has made me realise I should be very , very careful. My recent Hba1c is 5.2%. I eat low carb and note down my blood sugars almost daily in my food diary.
 
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AloeSvea

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An HBA!c of 5.2%/33 is magnificent. So you are no longer a person with prediabetes, but prediabetes-free - well done you!
 
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saky

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An HBA!c of 5.2%/33 is magnificent. So you are no longer a person with prediabetes, but prediabetes-free - well done you!
I follow a low carb diet. 80g per day!
Eat veggies, greens, nuts, curd. Almost vegan.
I think 52% of my beta cells are destroyed?
Fasting insulin in 2006 was 13 units. ..fbs 77mg/dl
2013 ...fasting insulin 17 units. Fasting sugar 84mg/dl
2019 ...fasting insulin 6 units fbs 84mg/dl
2023...fasting insulin 6 units fbs 86mg/dl
Jan 16th ,2023 ...c peptide was 2ng/ml which is a good reserve.
I have pcos also, weight gain in belly area.
Though I look slim.. In have lost a good 13kg since 2019 by exercising, diet, low carbing, intermittent fasting
Am 46 yrs old...
 
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AloeSvea

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@saky - it's good that you have found your carb level for being in a healthy blood glucose zone, and you are fit, to boot. (looking at the pic of - is it you? jogging on the beach). AND you're doing that on an almost vegan way of eating.

I'm a bit confused by the fasting insulin units reported - you were taking insulin? Or you still are? And I must admit - I am familiar with the 'rest of world' way of measuring c peptide, but not so with the mg/dl. I'm still in my bathrobe so can't be bothered using a calculator online just yet :cool: ...oh ok...I will.... (please know I am internally cursing the alternative measuring et al system of the Americas...) (as lovely and wonderful as the Americas and Americans are....) (started to.... no.... can't be bothered... too hard for for first thing in the weekend).

Other than that - I relate to a lot of what what you say. Apart from that I'm in my 60s - so feel Auntyish :D.

What makes you think you have so much beta cell damage? 52% is a lot for someone with an HBA1c of 33/5.2%. Did you get pancreatic damage, and is why you were on/are on insulin?
 
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Antje77

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Even I have SIRD.
What makes you think this?
SIRD stands for Severe Insulin Resistant Diabetes, which implies having diabetes.
You do not have diabetes, nor have your results ever fallen in the prediabetic category.
Fasting insulin in 2006 was 13 units. ..fbs 77mg/dl
2013 ...fasting insulin 17 units. Fasting sugar 84mg/dl
2019 ...fasting insulin 6 units fbs 84mg/dl
2023...fasting insulin 6 units fbs 86mg/dl
Jan 16th ,2023 ...c peptide was 2ng/ml which is a good reserve.
All your FBG's are nicely in the non diabetic range.

What units were used for those fasting insulin tests?
From what I read a normal fasting insulin level is considered anything between 2 and 25, although some sources prefer it to be <20, <15 or even less.
Your C-peptide also falls in the normal range.

Your lower fasting insulin levels in later years make sense if you've lowered your carb intake: your body didn't need to produce more insulin than it did, as proven by your hba1c results. This is not a sign of beta cell damage.

1685740585088.png

(source: https://emedicine.medscape.com/article/2089224-overview)
 
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saky

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@saky - it's good that you have found your carb level for being in a healthy blood glucose zone, and you are fit, to boot. (looking at the pic of - is it you? jogging on the beach). AND you're doing that on an almost vegan way of eating.

I'm a bit confused by the fasting insulin units reported - you were taking insulin? Or you still are? And I must admit - I am familiar with the 'rest of world' way of measuring c peptide, but not so with the mg/dl. I'm still in my bathrobe so can't be bothered using a calculator online just yet :cool: ...oh ok...I will.... (please know I am internally cursing the alternative measuring et al system of the Americas...) (as lovely and wonderful as the Americas and Americans are....) (started to.... no.... can't be bothered... too hard for for first thing in the weekend).

Other than that - I relate to a lot of what what you say. Apart from that I'm in my 60s - so feel Auntyish :D.

What makes you think you have so much beta cell damage? 52% is a lot for someone with an HBA1c of 33/5.2%. Did you get pancreatic damage, and is why you were on/are on insulin?
Yes. That's me! I run regularly....upto 21.1km....
I have never taken insulin. I wish I don't have to in the future also. Want to control by diet and exercise only if possible.
I did some rough calculation and got 52%! Maybe that percentage is wrong!
 
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saky

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In
What makes you think this?
SIRD stands for Severe Insulin Resistant Diabetes, which implies having diabetes.
You do not have diabetes, nor have your results ever fallen in the prediabetic category.

All your FBG's are nicely in the non diabetic range.

What units were used for those fasting insulin tests?
From what I read a normal fasting insulin level is considered anything between 2 and 25, although some sources prefer it to be <20, <15 or even less.
Your C-peptide also falls in the normal range.

Your lower fasting insulin levels in later years make sense if you've lowered your carb intake: your body didn't need to produce more insulin than it did, as proven by your hba1c results. This is not a sign of beta cell damage.

View attachment 61229
(source: https://emedicine.medscape.com/article/2089224-over
 

saky

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Insulin units in India is milli IU/L ( or micro IU/ml)
Spoke to endocrinologist and he said your insulin levels are low. He prescribed vitamin tablets. So am a bit concerned even though they look like normal values.
I read that insulin levels keep falling as the time progresses and glucose reading climb up.
Got HBA1C (5.9%) in 2019 when I was gaining a lot of weight (though I look slim) with lot of belly fat.
I have pcos (detected in 2004 via ultra sound) and hirusitm (on chin area particularly)
I have a strong family history of diabetes. Mother has been a diabetic since 1996 with MI in 2006 end stage renal failure now. Father is also a diabetic now. I advise him to take low carb ,avoid sweets/junk food .

Good fasting insulin is 4 units or less. around 10 units is insulin resistance. I got that info from Kraft study.


"Your lower fasting insulin levels in later years make sense if you've lowered your carb intake: your body didn't need to produce more insulin than it did, as proven by your hba1c results. This is not a sign of beta cell damage" --------Yes, True.

Suprisingly, my fasting blood sugar range has always been 83mg/dl - 95mg/dl since 2006. Never crossed 100mg/dl.

In 2019 (not doing low carb thing then) fasting insulin levels - 6.57 mIU/L and FBS = 92mg/dl on 1/10/19
Post prandial (1.5 hours) Insulin = 41.5mIU/L and PP sugar = 114mgdl on 1/10/2019

Another day (2/11/2019) = fasting insulin = 5.29mIU/L , FBS = 82.1mg/dl

In 2019 , I was tolerating more carbs.

When I ate carbs (50g) of rice in 2020(september) sugar levels rose to 165mg/dl after one hour or so. I got that info from libre pro CGM.
Another day I ate rice (50g) and chips, it went upto 180mg/dl after 1.5 hours.

In 2021, 2022 - I was feeling frequently hungry even after eating esp after eating carbs(about 40g)
I eliminated rice, roti in 2022 April and my frequent hunger thing came under control.
 
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EllieM

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Spoke to endocrinologist and he said your insulin levels are low. He prescribed vitamin tablets.
This is what confuses me. I thought T2s started with high insulin levels that can eventually go low (after many years of T2). Were you eating low carb when he/she said your levels were low and did he know this?

In any case, hopefully you have staved off any progression to diabetes. Congratulations on a fantastic result,
 
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saky

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This is what confuses me. I thought T2s started with high insulin levels that can eventually go low (after many years of T2). Were you eating low carb when he/she said your levels were low and did he know this?

In any case, hopefully you have staved off any progression to diabetes. Congratulations on a fantastic result,
Yes. Upon his advise only I had started low carb. He recommends low carb for type 2.
I didn't have any knowledge about low carb etc earlier.
 
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Antje77

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Thanks for your information @saky .
To me, your results sound like you may have some risk factors of developing diabetes at some point in the future (family history, that one hba1c of 5.9%, which is still below the prediabetic threshold in the UK or my country, just over the prediabetic threshold in some other countries), so good thing to keep an eye on it.

But I don't understand the continuous testing of all those things when your results are completely undiabetic and have been so for years.
None of your results point to SIRD at all, nothing screams severe insulin resistance, and absolutely nothing in your results say diabetes, let alone severe diabetes.
SIRD means you have diabetes, which you don't have. It takes an hba1c of 6.5% to be diagnosed with diabetes, and a random BG of over 200 mg/dl to be strongly suspected of having diabetes, but only if this is backed up with an hba1c.
 
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AloeSvea

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Yes. That's me! I run regularly....upto 21.1km....
I have never taken insulin. I wish I don't have to in the future also. Want to control by diet and exercise only if possible.
I did some rough calculation and got 52%! Maybe that percentage is wrong!
Ah! It was the insuin units measurement that threw me.

I would venture to say, if you had that much beta cell damage - your HBA1c would not be in such a healthy range. And beta cells, for those with metabolic diabetes (as opposed to autoimmune diabetes) - regenerate. There are various studies saying this.
 

AloeSvea

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Thanks for your information @saky .
To me, your results sound like you may have some risk factors of developing diabetes at some point in the future (family history, that one hba1c of 5.9%, which is still below the prediabetic threshold in the UK or my country, just over the prediabetic threshold in some other countries), so good thing to keep an eye on it.

But I don't understand the continuous testing of all those things when your results are completely undiabetic and have been so for years.
None of your results point to SIRD at all, nothing screams severe insulin resistance, and absolutely nothing in your results say diabetes, let alone severe diabetes.
SIRD means you have diabetes, which you don't have. It takes an hba1c of 6.5% to be diagnosed with diabetes, and a random BG of over 200 mg/dl to be strongly suspected of having diabetes, but only if this is backed up with an hba1c.

Indeed. What does shout insulin resistance is the PCOS - which is the body slowing or shutting down reproduction, is my understanding in the early stages. But rather than SIRD , as yes, as you say Antje - one does have to have diabetes to have SIRD. And as is my situation - for years and decades! And even then it is intermittent, is how I have seen it. (You can actually feel wee cysts when you have them, and ones reproductive cycle is directly affected, so you do know when your reproduction system is functioning well, the cysts have retreated etc, and yes this is usually in conjuction with belly fat and fat, as it is to do with sick fat cells, underlying it.)

I would characterise @saky's situation as preventative - lower carbing and exercising for prevention of type two. And the PCOS - intermittent disease depending on body fat and the degree of sick fat cells affecting the insulin/glucose balance and regulation.
 
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Antje77

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What does shout insulin resistance is the PCOS
I knew I forgot something to the risk factors I mentioned, this was the one indeed.
Still, it's another risk factor, PCOS can come without insulin resistance.
 
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AloeSvea

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I knew I forgot something to the risk factors I mentioned, this was the one indeed.
Still, it's another risk factor, PCOS can come without insulin resistance.

Um.... dish the dirt @Antje77! Very interested person here.

PCOS is an insulin resistance based disease to my knowledge. I look at it as hormone imbalance caused by inappropriate food for the healthy human body.

It tends to/affects women with a certain body/ type hormone profile to begin with athletic body types and more testosterone than most other women - characterised by shoulders broader than their usually slim hips, and bigger more responsive muscles. About 25% of women have this body type and hormone profile. And most (if not all?) naturally athletic women. That testosterone in the wrong food environment can play havoc with our health, forming those ghastly cysts on our ovaries and playing havoc on our fertility, is how I see it, and certainly experienced.
 
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saky

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Ah! It was the insuin units measurement that threw me.

I would venture to say, if you had that much beta cell damage - your HBA1c would not be in such a healthy range. And beta cells, for those with metabolic diabetes (as opposed to autoimmune diabetes) - regenerate. There are various studies saying this.
Ok.
 
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