Is Diabetes 2 really a progressive disease

My personal theory is that current medical and dietary advice makes T2 progressive. T2 has been known for ages and yet we've only been hearing about progression for something like 10 years [at least Ihave] So if it is inevitably progressive, why didn't they know agess ago?
Also "progression" seems to have arrived not long after we started being told we can eat anything we like and that there's no such thing as a diabetic diet. In fact it's come simultaneously with the "obesity epidemic".
Although i often write about the difference between "Cause" and "link". I do wonder in this case.
I've read Daid Mendosa on the subject. I know he's a T2 of some years who has managed to keep excellent control and minimise medication.
Hana

Well, I have been T2 for 10 years, I have managed to keep it under control quite well, but I am aware that it is getting a bit more arduous these days. Maybe I am becoming more insulin resistant or maybe my long suffering pancreas is beginning to give up trying, who knows?

I do believe that it is progressive and that the progression can be slowed almost to a halt, but not completely, in time things will change.
Of course it could be that by careful diet control the rate of progression is so slow as to be negligible, and then it is tempting to claim a "cure", but of course it is no such thing it is simply tight control.

Anyway my HbA1c is due soon so I will see how I am doing compared to previous years.

H

Hi. One of the difficulties is that those diagnosed with 'T2' includes around 20% who don't fit the insulin resistance pattern and hence the cause and duration to insulin isn't determined. Of the 80% presumably insulin resistant T2s then diet and exercise do appear to greatly affect the duration to insulin. Since the NHS mantra says to eat loads of starchy carbs at every meal, there are many diabetics who will progress because of this deffective advice and it is therefore difficult to assemble any meaningful statistics. So, the answer must remain open.

I was diagnosed in July 2003
I had slight retinopathy at diagnosis, so had presumably been diabeic for some years. [It's in my family]
I was initially put on 3 x 500Metformin + 1 x Gliclazide per day. and eating what the NHS call a healthy balanced diet.
I have cut my Metformin to 2 x 500 per day and zero Gliclazide. I'm low carbing and my BG seems to hold in the 5s and a few 4s pretty well on that. I occasionally see a 6. HbA1c has stayed pretty stable in the 5s. I've never been able to get down to the 4s.
My retinopathy is minimal and seems to be improving, from what I can see on the photos.
If my T2 is progressing, I can't detect it. Although i find it harder to keep those BGs down if I drop my vigilance on eating and reduce my exercise
That's why i think "progression" isn't inevitable
Hana

Angelyne said:

I'm pretty sure that eating too many carbs is not the problem. However carb restriction is definitively part of the therapy, since having high blood sugar so damaging..

I've read some interesting theories regarding the cause of diabetes. A compelling theory is that it's caused by systemic inflammation from gut dysbiosis which is in turn caused by environmental toxins, stress, industrial "food", deficiencies, and overuse of antibiotics.

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I think that you are on the right track for a lot of things. We have been conditioned to look at diabetes, high blood pressure, obesity, IBF and other metabolic problems as separate issues. but, given that our digestive system is 80% of our immune system and a huge effector of the remaining 20, it is highly possible that all of these problem find their origins in the treatment we give our gut by the liberal administration of the Modern Western Diet. I take issue with your belief that carbs are not the problem however. Most of the carbs that one must remove from their diet to control their BG, that is, the highly processed and easily broken down carbs, are also highly inflammatory. Sugars are a 'pre' biotic for harmful bacteria, which, when allowed to thrive, destroys the good bacteria in our gut. This imbalance helps to set up 'home grown' toxicity and inflammation in the remaining 20% of our immune system. I think that the refined and processed foods (mostly carb based although processed meats (read grain fed and hormone injected) and dairy play a part) are the root cause of most of our ailments.... an if we where to eat the same diet without the benefit of the only true medical breakthrough in the last 100 or so years, penicillin, we would be dying earlier than ever before in history.... Just one diabetics opinion.

Kenny

Some posters live in the 4s and 5s. That is superb for them.

For me, I do all the right sort of things but always wake up in the morning in the 7s and decline to the 6s later. I only go down to 5.7 (my minimum) after intense exercise.

I think that everyone will have a different story.

I am sure that T2 diabetes is progressive and is likely to become more challenging to manage as the years pass. For instance, I am 56 now but will I still be able to swim 2500 metres daily in ten years' time? Will there become a time when I am not in control of managing my own food intake?

The better medical opinion that I have received warns that diabetes is difficult to control. It is essential to recognise that difficulty and manage accordingly.

hanadr said:

I was diagnosed in July 2003
I had slight retinopathy at diagnosis, so had presumably been diabeic for some years. [It's in my family]
I was initially put on 3 x 500Metformin + 1 x Gliclazide per day. and eating what the NHS call a healthy balanced diet.
I have cut my Metformin to 2 x 500 per day and zero Gliclazide. I'm low carbing and my BG seems to hold in the 5s and a few 4s pretty well on that. I occasionally see a 6. HbA1c has stayed pretty stable in the 5s. I've never been able to get down to the 4s.
My retinopathy is minimal and seems to be improving, from what I can see on the photos.
If my T2 is progressing, I can't detect it. Although i find it harder to keep those BGs down if I drop my vigilance on eating and reduce my exercise
That's why i think "progression" isn't inevitable
Hana

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Hana Im so encouraged by what you say. I too am hoping that D would not be progressive.
In fact, I have taken the step to quit my meds, glucophage 850mg x 2 tabs daily and manage it by diet alone.
I am now on my 5th day, and whilst the metformin may still be in my system, I am watching it closely and register
my fbs in the 5's. I know of a number of people who quit meds and have successfully managed it for a number of years.

Conversely as Sterling points out below, how well would we manage it as we age, and that is where progression comes into play.
That said, my dad of 84yro, have not officially been diagnosed, yet takes the same oral meds, 1500mg (stronger). He continues to eat anything, ie sweets, and have been lucky enough to not have lost a limb, eyesight or anything of note.

He is being cared for, but for anyone on their own might not be so easy, unless one can always remember to stay away from carbs. It requires effort and that may be the problem. That said, I will happily stay in denail for now, while my memory still work reasonable well.