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Don't involve yourself in the blame game.

  • Thread starter Thread starter catherinecherub
  • Start Date Start Date
Only just to join the forum, and the first message I read was about being fat. I was always given the impression I had diabetes because I was fat. No, I found out that I was fat because I had unknown diabetes All my life. If that was the case, why After losing nine stone and exercising loads, swimming and hiking, etc., do I still have diabetes 2.
 
In my opinion remission or cure is a personal thing, I think it’s something to aspire too but not achievable for the majority.

My definition- and this is only me personal opinion, no one is ever truly cured, to be cured then you would be able to eat anything you want with a ton load of carbs and not show diabetic numbers, not anything I’ve seen. Remission is different you can get to remission if you’re lucky by changing your life style but you have to stay on that lifestyle, start to eat more carbs than you can handle and your BG will begin to rise to diabetic levels again. I also think that it depends how long you’ve had T2 before your diagnosed if you can catch it early and someone has every chance of getting into remission.

I’m like you, I lost over 11st, my HbA1c was 11.2 at diagnosis 14 years ago, I was running finger pricks of 28 - 30! I got my HbA1c down to 49 and reduced my meds & carbs until I’m now diet only but have to keep my carbs below 20g a day - but stray from that and my numbers start to rise, I’m still very much diabetic and always will be

Diabetes is a very individual thing and all each of us can do is our very best to keep the numbers we are happy with. Look how far you have come! Losing all that weight and changing your lifestyle isn’t to be sniffed at! Well done
 
@Ruth clarke Hi and welcome to the forum.

I'm a slim type 2 diabetic (in remission for over 4yrs) not cured. You may be unaware, but it is thought that around 10% of Type 2 diabetics either have a normal BMI or are only slightly overweight. I was 2lbs overweight at diagnosis having gained about 30lbs over the prior 3 decades.

Nobody can say for sure whether you got fat because of having insulin resistance (the underlying cause of Type 2 Diabetes) or whether you developed insulin resistance because you put on too much visceral fat (the fat that causes slim people to develop Type 2 diabetes). They are too closely linked that it's impossible to sat which came first, however there are lots of non-diabetic fat people who have sub-cutaneous 'normal fat', so although excess weight and Type 2 are closely linked in the general population, they are not necessarily closely linked for any particular patient.
 
I’m a lean diabetic , 19 BMI . I think it also depends on what is causing your diabetes. Around 85% of Type 2 diabetes is caused by insulin resistance. That means around 15% of type 2 diabetics do not have insulin resistance. My understanding is that weight loss impacts insulin resistance. It reduces it. It is by far the main player in elevated blood sugars in Type 2 . Insulin resistance can only cause elevated blood sugars if your beta cells are unable to overcome the resistance to insulin. People can be highly resistant to insulin and still not be diabetic because their beta cells can produce enough insulin to over come the resistance.

The other factor cited in elevated blood sugars therefore, is an inability of your pancreas to produce enough insulin. There are a number of reasons why your pancreas fails to produce enough insulin. a lose of beta cell mass can prevent a sufficient supply of insulin. It could be genetic. Genetics can mean that one has a depleted beta cell mass. It could be beta cell exhaustion from continuously high blood sugars over time. An inability of the beta cells to produce enough insulin to overcome insulin resistance, or an inability of your pancreas’ beta cells to produce enough insulin without the burden of insulin resistance, but unable to control blood sugars because of too many carbs for it to handle is another.
Then of course you can be overweight and have late onset Type 1. We often think if Type 1’s as being skim, but that is not the case. There are many examples of Late onset type 1’s being over weight.

Im not suggesting you are Type 1 I’m just throwing up reasons why weight loss may not be as effective at lowering your blood sugars as often cited. In short it depends on what is causing your diabetes and how many carbs your body can deal with.
 
Hi @Ruth clarke - and welcome to the forum - I hope you find something useful here...

It all seems pretty complicated, and mainly that's because the more you learn, the more there is to learn, and your history, your gut boime, your genetics, your epigenetics .. all make you unique..

on the flip side of that - you can argue that the majority of the Western World (and by extension) the entire world eventually are headed toward T2DM ... simply because our diets encourage insulin resistance.

.. and immediately you are into "well, what the hell is insulin resistance" - and to be clear, there is a not a great deal of common ground, and it is complicated, so it's difficult to divine what is true from wrong from lie.

But - I think there are two lines that are non-controversial that are worth understanding..
1 - it has been known for centuries that "starches and sugars are fattening" - literally, you can go back to the 1820's and the literature is word for word. The reason is that starches and sugars drive a need for insulin to get the resultant sugar out of your blood, where it's toxic, which leads to...
2 - in the presence of raised insulin and sufficient energy, your fat storage cells will grow. This is a simple summary of medical text relating to how we get bigger at a cellular level. It's simply unavoidable for a lot of people - ironically, "big" people can have less risk of diabetes per se, because they are better able to clear out the sugar.

So - with these two simple pieces of well-agreed knowledge, you can figure the rest out for yourself. A typical diet of carb heavy meals and snacks will have the body in storage mode pretty much constantly - even if you are doing lots of exercise and reducing calories and following the guidelines on staying away from saturated fat and red meat. Especially so, because you have to replace it with .. usually more starches and sugars.

I lost 3 stone over a three year period of religiously scanning and weighing everything, and increasing the amount of exercise and reducing calories, and being hungry all the time, but I had no idea about sugars/starches and insulin, so at the end of that period, at my ideal weight, I was diagnosed diabetic.

The good news though, is that it doesn't need to be hard, and reversing T2DM is possible for a lot of people. Discovering that increasing fats in my diet can lead to better health, as well as loosing weight has been one of the bigger revelations in my adult life.

Whether you are or are not diabetic at any point in time seems critical, but to me is becoming less important - through various strategies, I am reducing the levels of insulin in my body (and I need to be careful here - very low level of insulin is not the goal, but becoming more sensitive to it is..) which over time is making me feel better and better, and in a few months I should be able to be listed as in remission. Already, I have lower blood glucose than most non-diabetic people, but it's all about finding a way to live and eat that brings maximum enjoyment, and the best long-term health; and all of that is a constant journey of learning, and brings in a lot of other important stuff, like learning to be more at peace, and to have better sleep; which is a hell of a short statement ... hell, we could have entire forums about either of those as topics...
 
Hi everyone, got diagnosed with type 2 a couple of weeks ago and I was very shocked. Have been normal weight/underweight all my life, loads of exercise, ate a healthy diet etc etc. Only known family history is a great aunt with t2 and an aunt with gestational and now prediabetic. Feeling like I've been cursed or something! Also have Asperger's and ADHD so just seems like I'm destined to live life in the hard mode :-( Am finding the diagnosis quite overwhelming tbh.
 
Hi everyone, got diagnosed with type 2 a couple of weeks ago and I was very shocked. Have been normal weight/underweight all my life, loads of exercise, ate a healthy diet etc etc. Only known family history is a great aunt with t2 and an aunt with gestational and now prediabetic. Am only 40.

Feeling like I've been cursed or something! Also have Asperger's and ADHD so just seems like I'm destined to live life in the hard mode :-( Am finding the diagnosis quite overwhelming tbh. Have got myself a Libre trial monitor and am trying low carb on the advice of this wonderful forum.

I do agree that the average Western diet is probably responsible for the increase in diabetes (and many other diseases) but not sure how they relates to me other than that I have always eaten (mostly wholemeal) carbs. I don't feel it's fair to blame individuals though - I have a close friend who the NHS has labelled as 'morbidly obese' (horrible term) - she has normal blood sugar levels but various other health issues and it seems the message from doctors is always 'just lose weight' which is very hard for her, both due to metabolism and because food is a coping mechanism. I doubt they tell smokers to 'just stop smoking' without giving them structured help with that.

I'm also a bit suspicious about this assumption everyone seems to have that everything is linked to being overweight, especially as I'm almost the only t2 diabetic I know of a similar age and I know a lot of people of varying body types. Seems like a cop out so resources don't have to be allocated to proper investigation and treatment.
 
This is just my personal view, but for me the problem lies with the broad definition of Type 2. It’s too broad. Whilst many people fit comfortably within this category, there are diabetic people who don’t. It makes it difficult to navigate the T2 diagnosis and effectively bring our blood sugars down. You feel nothing applies.
 
Yes, absolutely! I kept trying to explain this to the gp but she wasn't very receptive, think she thinks I'm a 'special snowflake'!!
 
Somehow you have to get the balance right - I have a lot of respect for my GP, and think that together, we can agree a plan that works for me, but I need to be involved, because I am not satisfied with how the entire system treats diabetics. Having dug into the history of both the medical understanding, and the way that the treatment has evolved alongside other "modern chronic diseases" - I feel I have a better grasp of what might work for me, and why I think the system is misguided - but I don't help anyone if I have an antagonistic relationship with my GP. Maybe even someone else's treatment might be improved if I can show results that make her think, but I know I don't have enough time to try to persuade with arguments.

If you are motivated, there is a lot you can do for yourself and I am utterly convinced that for me; this whole thing is going to be positive in terms of a whole life; I feel really quite blessed to know some of the stuff I was ignorant of only a year ago.

Most important thing to recognise is that for T2, you have much fewer critical short term life-threatening risks, and that where you are has taken time to develop.. so settle in for the long term, realise that you can effect things, but slowly slowly... it's a game of figuring out the things that work for you, and making them a part of your life.
 
Agreed @Chris24Main. Learning how to manage type 2 diabetes takes time. It's not achieved overnight.

Keeping blood glucose readings in check is a daily challenge, but well worth the effort and with experience it gets easier.
Slow and steady win the race.
 

Hi @RachelG. Me just joining in on a very interesting discussion you and @Ruth clarke got re-going in here.

First of all RachelG, considering your neurodiversity and ADHD - you might find it comes to your aid with T2D, if you like collecting data, dealing with numbers, and finding patterns. I gave you a virtual hug for the horrible shock and feeling overwhelmed at your recentish diagnosis, but I immediately thought that your neurodiverse 'brain wiring' might be a positive thing for you dealing with the complex nature of T2D.

Ruth - re the body fat thing. Because T2D is quite complex (but I have no problem with T2D being an umbrella term for the different kinds of T2D), losing weight does not always lead to remission. It just depends on how your diabetes plays out in your individual body. I have been normal weighted after orginally being fat at diagnosis, and stayed normal weighted, after three to six months of starting to lower my carbs. But apart from periods of time, some even quite long, I have not been able to sustain imcomplete remission (to prediabetic levels), and now remain resolutely alas, a person with T2D. I can't remember the stats - I think it is something between 30 and 50% of folks who lower carbs and/or body weight can get to remission and stay there. Metabolic disease is multi faceted indeed, and sick fat cells is just one part of the T2 puzzle.

All that exericse is not just about increasing your chances of remission, but very importantly - lowering your risk of cardio vascular disease (CVD), which is what we mostly die from (60% in Aotearoa/NZ if memory servers). That is how I have always seen it - physical activity is about keeping your arteries as healthy as possible. If you are lucky enough to be a hyper responder to physical activity it can lead to contributing to lowering your blood glucose by quite a lot too. There is some evidence too that less body weight works in well with less risk of CVD, but that may be due to less insulin resistance (ie all-cell level), rather than at 'just' fat-cell level. Cheers!
 


Thanks, and yes you're right, I do love data and research and have become a bit obsessed with the CGM I got on trial and reading research papers. SO far my blood glucose goes up temporarily with exercise (as expected) - I might pay for another monitor and do more HIIT say, and see if that lowers anything. I fear if I were a 'hyper responder' I would never have developed diabetes though as I'd have been responding a lot throughout my life!

It's really interesting to read that your glucose levels didn't remain improved with lower weight or low carb diet. So far my CGM results seem to indicate that I do respond very differently to low carb meals than anything with grains in. I know there's also this 'skinny fat' theory which I kind of doubt applies to me as I'm quite muscular and have low triglyceride levels and ALT (so I think unlikely to have NAFLD) but I might give something like the Newcastle Diet a go and see if being close to underweight within the normal BMI range makes a difference. A friend did a low GI veg based, very low calorie diet because she was interested in the autophagy benefits but it backfired because she lost a lot of muscle mass (she is slim and athletic) which is something I would want to avoid.

One thing I'm looking for and can't seem to find anywhere is research on long term health in people with T2D who are in all other respects 'metabolically healthy' - good blood stats, ALT, blood pressure, weight, lifestyle etc. If anyone has come across that then please let me know!
 
Hi again @RachelG. Re the hyper-responding to physical activity - that still leaves the food and drink! . Being a hyper responder leaves one very vulnerable to times of inactivity, and heaven forbid - disability (my situation). So I would not wish it upon anyone.

I like stats, and the go-to stat regarding the impact of physical activity/exercise on weight at least is 20% - food and drink 80%.

I would not say my BG levels didn't improve, I believe I said - remained improved? If I didn't make that clear, let me clarify it here. For longterm remission. What happens longterm is the really interesting but for folks like me - the depressing! - thing about metabolic disease. It depends on where in your blood glucose dysregulation the damage is done, and what kind of damage. My experience is you won't find the answer to that in the medical profession - for me it's after a decade of much experimentation. But I have certainly learnt an enormous amount about T2D this way.

I have read of a TOFI guy, a journalist so it is well documented, who did the Newcastle Diet and it worked for him. The only way you are going to know is if you give it a try. I've done a Very Low Calorie Diet (VLCD) twice, as a normal weighted person post low-carbing with T2D, and it did not work for remission for me. Again, I don't regret the experiment. Please note - I was very well medically supervised.

One also has appetite suppressing/digestion hormone impacting anti-diabetes drugs at ones disposal, do not forget. There are side effects to those of course, but nothing a fullsome discussion with your diabetes team/GP/diabetes nurse could not help you with of course.
 
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