Is progression/decline inevitable?

[carraway]

The NHS line is that diabetes is progressive.

I think the Newcastle Diet shows promise that this may not be the case, but the sample size is tiny.

So, if control is good and sugar levels stay within limits will things get worse anyway?

It's too early for me to tell yet, I haven't been in the club long enough. I'm type 2 with no meds, just diet and exercise.

However my diet slipped over Xmas and I felt worse. Tingling returned to my fingers. I'm back on the straight and narrow and feel good.


Maybe the progression/ decline is just good control wearing off? People slipping back into the old habits?



I would be interested in everyone's opinions and experiences

Cara

 

[mrman]

Depends on the cause I would think. If someone has type 2 just from a very poor diet and obesity, gets fit and healthy I would say their condition may be reversed, with no further complications. For some though, during that period there may be a percentage loss of insulin production, but, insulin resistance gone. Often carry on believing they are type 2, but no insulin resistance and poor insulin production. Probably why some type 2s are often later discovered to be misdiagnosed.
Then, theres the genetic element, which is managable for an extent, but, for how long probably could not be determined. So, I would think for the majority it its progressive but timescale an unkniwn factor.

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[Daibell]

I concur with Brett. A percentage of those treated by the NHS 'diet' will progress as expected as the excess carbs will make the diabetes worse. A low'ish carb diet with exercise etc may well extend true T2s by many years before complications.

 

[xyzzy]

If you control your bgs to as close to non diabetic levels as you can and do not overstress your pancreas I can't see why your hba1c shouldn't be significantly worse year by year than a non diabetics ie your bgs degrade in line with the non diabetic population

IMHO the Newcastle diet is no better or worse at removing insulin resistance than any other regime that may take longer but achieves the same insulin resistance reducing effects. Like other diets I don't believe ND can repair beta cell loss so even if you remove all your insulin resistance you may still have diabetes to some extent or other.

In any event hba1c rises with age in everybody. As a rough guide I read somewhere that by the time you get to 50ish it's 0.01% for every year older than 20. So at age 55 an average non diabetics hba1c would be 5.35%

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[mo1905]

I think everyone will vary but unfortunately diabetes is progressive. Even with very good HbA1C scores, there will be lows and spikes. All we can do is try to delay any complications as long as poss.


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[mrman]

If controlled well nothing to say you would be worse off than someone without diabetes. With all the health checks required and good.control, probably better off lol, thats how I look at it.

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[Yorksman]

The NHS line is that diabetes is progressive.

Maybe the progression/ decline is just good control wearing off? People slipping back into the old habits?

The NHS line is a self fullfilling prophecy. The advice is stay below 8.5 2 hours after a meal. Roy Taylor writing in Medscape states:

"A clear distinction must be made between weight loss that improves glucose control but leaves blood glucose levels abnormal and weight loss of sufficient degree to normalize pancreatic function. The Belfast diet study provides an example of moderate weight loss leading to reasonably controlled, yet persistent diabetes. This study showed that a mean weight loss of 11 kg decreased fasting blood glucose levels from 10.4 to 7.0 mmol/L but that this abnormal level presaged the all-too-familiar deterioration of control."

Why not try to aim at being less than 6.0 in the morning?

The other point Taylor makes is:

"The extent of weight loss required to reverse type 2 diabetes is much greater than conventionally advised."

Many people on this forum report that people manage very well for many years without medication and only go onto tablet forms as they get older, havng had the disease for a few decades. The danger is that people rely on their medication to do the job for them or that they follow NHS advice which has not been properly communicated in the first place. They are confused, poorly advised and told 'well, there's nothing you can do about it anyway'.

Many posts on this forum are testament to the fact that if you are motivated to be careful with what you eat and do whatever you can to help yourself, you can manage the condition well.

 

[xyzzy]

I think everyone will vary but unfortunately diabetes is progressive.

Have to disagree. I don't believe it's anymore progressive than the progression you get from natural aging if it is caught early enough and the person treats through relevant lifestyle changes to bring bgs, weight, bp etc. under good control. For example why is someone diagnosed pre diabetic with an hba1c of 6.4% perfectly able and medically recognisably able to reverse the condition whereas someone diagnosed full T2 with an hba1c of 6.5% doomed to be told the same condition is progressive and non reversible. That is arbitrary. What about those diagnosed just a few weeks or months later with higher hba1c's. Those higher hba1c's are primarily being caused by insulin resistance in most people not by beta cell loss and insulin resistance is quite reversible with the relevant dietary and lifestyle changes as that is effectively what people who reverse pre diabetes do.

There are loads of us diet only and diet only plus minimal meds who have controlled the condition for years without the merest hint of progression.



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[mo1905]

I don't have any facts or studies so I'll be honest and say I don't know for sure, it's just my opinion. I don't wish to come across as doom and gloom but there are people on this forum with good control who already experience complications. My control has been fantastic, my last HbA1C was 42 yet I'm still on statins and BP meds. I am a big believer in taking control of diabetes and keep myself in shape and I hope I'm wrong of course ! I'd like to hang on to my vision and toes !


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[Jamrox]

I too went off the rails at Christmas and feel awful now . Thought I was being good tonight but think Lentil soup is a no no ....

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[Montana]

Hi I stayed diet controlled for about 10 years but this fact meant I often felt that I could cheat the system and as my bs levels increased I refused medical intervention
Eventually it caught up with me through my own stupidity. However I believe that over time many of us will deplete our own insulin and therefore need more medication to cope. We all have opinions but no guarantees as one coat doesn't fit all.

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[xyzzy]

Wasn't being critical of you mo just of the system that like Yorksman says is pretty much a self fulfilling prophecy. A quick example. The WHO did an analysis of retinopathy problems versus hba1c a while back. The graph is pretty much flat until it hits 7% (48 ) then the incidence of retinopathy problems begins to rise rapidly. My point would be that given correct advice most newly diagnosed people can get under 48 without meds so if they're caught quick enough and advised correctly they should not progress to retinopathy because statistically they have the same chance of retinopathy as anyone else in the population with a sub 48 hba1c. I agree it is far more difficult to stop or reverse any complication once it's developed.

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[anna29]

Diabetic genetic history can be progressive even as best a person tries to prevent this .
Human organs are extremely complex and progression can still happen despite our VERY BEST EFFORTS .

All we can do - is continue to do our best with the knowledge/resources that is currently available and
accessable to us all .
Education, good help and support is essential to assist us in our journey's with Diabetes .
Better to inspire the HCP's to provide this plus 'more' research progress , medical science wise .

It is also important to remember - things like illness,stress,antibiotics,steroid meds/treatments etc
WILL impact on our BS levels " regardless of excellent control " .
Then the battle to get things back on track or within range becomes 'harder' and is frustratingly maddening

I know of - persons who have developed progressive diabetes condition despite being very thin,
really fit and active - plus with excellent diabetes control too .
Family genetics/history - sadly have promoted their progressive diabetes condition .

Bit like related heart disease in the family genetics kind of thing !




.

 

[xyzzy]

Hi I stayed diet controlled for about 10 years but this fact meant I often felt that I could cheat the system and as my bs levels increased I refused medical intervention
Eventually it caught up with me through my own stupidity. However I believe that over time many of us will deplete our own insulin and therefore need more medication to cope. We all have opinions but no guarantees as one coat doesn't fit all.

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I get what you're saying about insulin depletion but that happens to non diabetics too and is presumably why diabetes can develop in anyone as they get progressively older.

The only point I'm making is that if you keep your numbers for bgs and other health indicators like weight and bp etc in normal ranges there should be no medical reason for progression to occur.

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[Yorksman]

There are loads of us diet only and diet only plus minimal meds who have controlled the condition for years without the merest hint of progression.

I think the biggest danger in these cases is that of getting complacent. You manage it for so long, you forget about it and slip into bad habits.

Especially when you have friends like mine who bought me a set of jams and a christmas cake. He has a sick sense of humour.

 

[Yorksman]

I too went off the rails at Christmas and feel awful now . Thought I was being good tonight but think Lentil soup is a no no ....

Lentils are normally very good, most pulses are. They are low GI and much of the carbohydrate content consists of oligosaccharides whch don't get digested by enzymes but which are broken down in the intestine by bacteria. That's why they typically give you wind. Of course, if you buy tins of lentil soup, you don't really know what else in is in there, but cooking them yourself is usually OK. Mixed lentil curry is a favourite of mine

 

[Yorksman]

I know of - persons who have developed progressive diabetes condition despite being very thin,
really fit and active - plus with excellent diabetes control too . Family genetics/history - sadly have promoted their progressive diabetes condition .

Roy Taylor makes this point in his FAQ about controlling it via weight loss:

"This research is in “type 2 diabetes”, the usual common form of diabetes. There are some rare forms of diabetes which may be in correctly called type 2 diabetes:

a) Diabetes occurring after several attacks of pancreatitis is likely to be due to direct damage to the pancreas ( known as “pancreatic diabetes”)

b) Secondly, people who are slim and are diagnosed with diabetes in their teens and twenties, with a very strong family history of diabetes, may have a genetic form (known as “monogenic diabetes”)

c) Thirdly, type 1 diabetes sometimes comes on slowly in adults, and these people usually require insulin therapy within a few years of diagnosis (“slow onset type 1”)​

None of these will respond in the same way as the common, true type 2 diabetes.

So, if you have the common form of type 2 diabetes, this could work for you. However, you should not underestimate just how much change in your day to day life will be necessary to bring this about. It requires motivation and persistence."

 

[Sid Bonkers]

I think its fair to say that it will definitely progress if you do nothing about it and it will probably progress each and every time you loose control.

So the best thing you can do IMHO is to change your lifestyle to one that you can happily continue for the rest of your life. But yoyo dieting and yoyo bg control will probably not have the best outcome.

So find a way thats right for you, what ever that way is

 

[Jamrox]

Hi it was homemade lentil soup.
I had another spike this morning after my usual breakfast, its either the cold I have or the green coffee beans Ivr started taking to help me to loose weight.

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[Shzz46]

Hi yorksman mixed lentil curry never heard of that one would you mind putting the recipe on so I could try it I love a good curry so always willing to try a new one thanks


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