Is progression/decline inevitable?

[Andy12345]

if its high glucose that causes complications....if your glucose stays where it should be then how can it cause complications?

i for one have no intention of letting it progress, I'm staying healthy if it kills me.

 

[mo1905]

Because even with an average if say 6.5, that will probably mean levels ranging from 4 to 9 or so. Over many years, there will be damage caused. Our job is to minimise this.


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[Andy12345]

my bg dosent go to 9 unless I'm stupid on the very rare occasion, if my bg is more than 5.5 I'm screwing and try harder, i am for it to be between 4 and 5 all the time, i understood things to mean bg above 6 persistently can cause complications? if I'm in denial its the denial of db hurting me with good control

 

[CollieBoy]

I'm with Andy <G>

 

[fatbird]

Is progression/decline inevitable?

NO

FB

 

[xyzzy]

On the bg levels thing its worth noting that for the average non diabetic population eating average meals i.e. individuals can vary somewhat ...

100% score under 7.8 after 2 hours
95% (that is 19 out of 20 people) score under 6.5 after 2 hours
75% (that is three quarters of the population) score under 5.5 after 2 hours

Like Andy I aim for my BG's to be mostly in the 4's and 5's prior to eating and for run of the mill days to certainly be under 6.5 two hours later after eating. I realise for any number of reasons that everyone can't achieve that but if you can then all the better.

 

[Daibell]

I agree with most of the previous comments. I believe that most T2s ( around 80%?) suffering insulin resistance can be prevented from noticeable progression with time by having the right diet and exercise. The NHS' and general bad diet advice will make a proportion of those progress. The 20% who are not overweight but still labelled T2 contains a range of conditions of which LADA is a noticeable factor if forum postings and my own experience is anything to go by. Many/most of these will progress due to a declining pancreas for a range of reasons; antibody destruction being a major factor. If the NHS was a lot better at separating out the types beyond T1/T2 it would make it easier to direct the right treatment regime. Yes, diet and exercise always apply but the right meds regime for each group might slow decline rather than today's relative HCP guesswork (well, mine was!)

 

[tonyS54]

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.

The NHS diet is a fast track to progression for type 2, been there done that worn the T shirt. I turned it around with LC/HF, that's not to say it wont progress as others have said age is another factor.

 

[luceeloo]

The progression/decline is what puts the fear into me. I can't get my bg into the 4's and 5's... 3 months ago I had a spate of 5's. But the last 2 months have crept up to the 7's and 8's. I started the Atkins Induction last week and expected to see at least a little reduction in my bg. 20g or less of carbs per day, surely that should give me better control? Not so. 6.4mmol is the lowest fasting, but 7.5mmol is about average. I don't wake up in a morning to anything less than 8mmol, but usually closer to 9mmol.

My DSN doesn't worry. Apparently I'm her star patient with my bg control and hba1c... but I don't feel very in control. Her attitude is usually "oh you've lost so much weight and the numbers will shoot down when you lose more". I've tried to bring up my concerns, but all she ever does is glance over my record book, tell me my numbers are good and that I have nothing to worry about. When I speak to other T2's, or read the forums here, I know for a fact that my numbers are nothing to write home about.

I'm frightened that progression *is* inevitable and if, being in my thirties and nearly 6 months into this disease, I can't reel those numbers in quite a lot more, then the future is a concern. I have T2 relatives who have tried hard for years (I have an 80 year old uncle who cycles miles each day), but still progressed fairly quickly into a range of complications, then I have T2 relatives who drink pints of ale, eat junk food, and seem to still get better readings than I do (not that I would like to drink ale!).

We have this "diabetes is a progressive disease, and it will progress" mentality pumped into us by the NHS...but then no actual real support or workable advice on how to reduce the odds of decline. It bugs me. Actually, no it scares me.

I'm losing the point of my post, other than the need to vent what is becoming a big fear!

 

[Yorksman]

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

You may know it as Mixed Dal. I use a south indian recipe from Prashad's Southern Indian Vegetarian Cooking but here is a northern recipe on the web. In fact there are loads with many variations. Manjula's Kitchen has many lentil recipes. The different Dals are mostly different coloured lentils and you can get a lot of them at Lidl thesedays.

Many asian shops sell pre mixed Garam Masala, I like the East End brand which you can get in some supermarkets. The asian shops however sell many masala powder mixes. They vary in taste and strength of the chili added.

Basically, as with chick pea curries, you simmer the lentils or chickpeas in boiling water until cooked, 20 - 30 mins and leave to stand. You saute some onion and garlic, maybe some ginger and then add your masala mix, either from a packet of a mix that you made yourself from raw spices, to make a paste. You might add a tin of chopped tomatoes to the lentils or gram, bring to the boil and then add the paste, stirring it in and letting it simmer. I sometimes add cinnamon bark. Basically you let it simmer until some of the water has evaporated to give it a nice thick texture. I often do a trio, mixed lentils, gram beans with tomato, called Chole, and a spicy mix of mushrooms and garlic. Although a tin of chckpeas may cost arund 60p in a supermarket, they are nearly always on offer in asian shops. I get a pack of 12 for £2.99. The various dals, white, yellow, red etc etc are very cheap and you don't use that much. I got 5 packs which lasted me ages and I got many many meals from them. You don't have to follow the recipes exactly, basically you just make sure the gram or dals are cooked through and flavoured with a spice mix which suits you.

For meat dishes, chicken with spinach or minced beef/lamb with garden peas and onion are easy to make and to which you can add a pre mixed masala. Those are good dishes for people who like to go very low carb but, as I stated above, lentils are often OK for people who want to go low GI.

 

[Yorksman]

I'm frightened that progression *is* inevitable and if, being in my thirties and nearly 6 months into this disease, I can't reel those numbers in quite a lot more, then the future is a concern.

6 months isn't that long. You have to learn about foods and what suits you and what does not suit you. It involves a fair amount of testing. Also weight loss via a diet and improved insulin sensitivity through exercise helps. But, there's a lot to go at and you may not have much spare time during the day.

I am fortunate because I work from home. That saves me 2 hours per day which I can use for exercise, usually once in the morning and once in the afternoon and also time to prepare food from raw ingredients. Time is a big problem for most people because even when you get home in the evening, you are often too tired to bother.

But, you have brought things down close to normal levels and are trying new things like the atkins diet. To find an entirely new way of exercising, cooking and dividing up your day is not easy. You have to find something that feels natural, or you will give up. Don't worry about finding it time consuming to working it all out. You have to try, fail, think up something new, try that again and so on and so on.

My 4s and 5s were a jump from 5s and 6s which I had had for ages. I was happy with the 5s and 6s and only dropped down when I started on an exercise bike in earnest. But, it took me more or less a year to get fit enough to be able to use one. When I was diagnosed, walking from the supermarket checkout to the car in the car park was a chore. You are in this for the long haul.

 

[tonyS54]

The progression/decline is what puts the fear into me. I can't get my bg into the 4's and 5's... 3 months ago I had a spate of 5's. But the last 2 months have crept up to the 7's and 8's. I started the Atkins Induction last week and expected to see at least a little reduction in my bg. 20g or less of carbs per day, surely that should give me better control? Not so. 6.4mmol is the lowest fasting, but 7.5mmol is about average. I don't wake up in a morning to anything less than 8mmol, but usually closer to 9mmol.

My DSN doesn't worry. Apparently I'm her star patient with my bg control and hba1c... but I don't feel very in control. Her attitude is usually "oh you've lost so much weight and the numbers will shoot down when you lose more". I've tried to bring up my concerns, but all she ever does is glance over my record book, tell me my numbers are good and that I have nothing to worry about. When I speak to other T2's, or read the forums here, I know for a fact that my numbers are nothing to write home about.

I'm frightened that progression *is* inevitable and if, being in my thirties and nearly 6 months into this disease, I can't reel those numbers in quite a lot more, then the future is a concern. I have T2 relatives who have tried hard for years (I have an 80 year old uncle who cycles miles each day), but still progressed fairly quickly into a range of complications, then I have T2 relatives who drink pints of ale, eat junk food, and seem to still get better readings than I do (not that I would like to drink ale!).

We have this "diabetes is a progressive disease, and it will progress" mentality pumped into us by the NHS...but then no actual real support or workable advice on how to reduce the odds of decline. It bugs me. Actually, no it scares me.

I'm losing the point of my post, other than the need to vent what is becoming a big fear!

I'd give the Atkins diet a little bit longer if then you see no improvement then you need to see you DSN again and insist on being referred to a specialist. You should not be seeing BGs in that range with 20g carbs, there may be other medical reasons why this is happening which your DSN has not picked up on.

 

[Weens12]

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

Cara,

I’m optimist that with good control diabetes doesn’t need to be progressive. I’m D&E like you, and absolutely determined to carry on that way, if it’s possible. I want to prove it can be done, as Andy says “if it kills me”! I’ve heard of some T1 diabetics of over 50 years without complications. It’s time for us T2’s to step up to the mark.

The data that the NHS premise is based on is old and out of date. We are the new generation of “internet” diabetics who are better informed about our condition and what WE can do about it even if the NHS isn’t similarly enlightened.

We are able to access more recent data about trials and research which, I think, gives us hope that scientists are coming closer to finding out some of the causes of diabetes and therefore are hopefully edging closer to finding solutions. That aside, those of us who have the condition can exchange experiences and information about managing our condition in a way which wasn’t possible when the original data about Diabetes progression was written in stone tablets, and handed down to the Gods of the NHS.

Diet advice has also changed a lot in that time. For all I know, slavishly following the “healthy” low-fat, low salt, carby lifestyle for years might have been a contributing factor in my diabetic condition. At least I’ll know who to sue!

This information exchange on tweaking diets and effective ways to exercise, and even at the most basic level of what carbohydrates are, (never mind which ones are good or bad), is empowering. It gives us information on how to better manage our condition ourselves. We see it every day on this forum – It really is ‘Knowledge is Power’ in action. With the result, that on this forum at least, more and people are reporting that they have good control.

We shouldn’t underestimate the effect of this global diabetic community to spread the word, and affect the outcome.

You said that your diet slipped over Xmas, but you knew what to do to fix it and you have good control again – a mere blip in the scheme of things. I’m sure we all slipped to some extent, but the point is, you climbed back on the horse.

You have the tools and the knowledge to control your condition, and the backup of medication if it turns out that diabetes really is progressive regardless of our efforts. It may be too early to say for certain, but I really do believe that you can be hopeful of not progressing if you maintain that good control.

Take care
Elle

 

[Pez68]

Cara,

I’m optimist that with good control diabetes doesn’t need to be progressive. I’m D&E like you, and absolutely determined to carry on that way, if it’s possible. I want to prove it can be done, as Andy says “if it kills me”! I’ve heard of some T1 diabetics of over 50 years without complications. It’s time for us T2’s to step up to the mark.

The data that the NHS premise is based on is old and out of date. We are the new generation of “internet” diabetics who are better informed about our condition and what WE can do about it even if the NHS isn’t similarly enlightened.

We are able to access more recent data about trials and research which, I think, gives us hope that scientists are coming closer to finding out some of the causes of diabetes and therefore are hopefully edging closer to finding solutions. That aside, those of us who have the condition can exchange experiences and information about managing our condition in a way which wasn’t possible when the original data about Diabetes progression was written in stone tablets, and handed down to the Gods of the NHS.

Diet advice has also changed a lot in that time. For all I know, slavishly following the “healthy” low-fat, low salt, carby lifestyle for years might have been a contributing factor in my diabetic condition. At least I’ll know who to sue!

This information exchange on tweaking diets and effective ways to exercise, and even at the most basic level of what carbohydrates are, (never mind which ones are good or bad), is empowering. It gives us information on how to better manage our condition ourselves. We see it every day on this forum – It really is ‘Knowledge is Power’ in action. With the result, that on this forum at least, more and people are reporting that they have good control.

We shouldn’t underestimate the effect of this global diabetic community to spread the word, and affect the outcome.

You said that your diet slipped over Xmas, but you knew what to do to fix it and you have good control again – a mere blip in the scheme of things. I’m sure we all slipped to some extent, but the point is, you climbed back on the horse.

You have the tools and the knowledge to control your condition, and the backup of medication if it turns out that diabetes really is progressive regardless of our efforts. It may be too early to say for certain, but I really do believe that you can be hopeful of not progressing if you maintain that good control.

Take care
Elle

Elle what a brilliant post, take my hat off to you. Just read this thread and in simple terms for a simple man I couldn't have gained any knowledge without this forum.


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[IanD]

The NHS line is that diabetes is progressive.

...........

I would be interested in everyone's opinions and experiences

Cara

That's what I was told when I was diagnosed in 2000 (at 61) - however well I complied with the NHS/DUK high carb, low sugar/fat/salt diet.

By 2008 the prediction was devastating true - intense muscle pain that made it painful to get out of bed, beginning of retina bleeds, extreme tiredness. My active life was over. Then I discovered low carb - from this forum. I immediately gave up all the obvious carbs.

In three months I was out of pain & after six years I have NO complications - even the retina bleeds have gone. At 74 I am fit & well.

For a talk on my experience with low carb, I prepared this "diet pyramid."

That contrasts with the usual diat pyramid with carbs at the base & fats at the point.

 

[Andy12345]

very hard to argue with that not that id want to lol

 

[Andrew S]

I have been wondering about the progession issue, so I am glad we have this thread. My GP and DN have given me the advice to have low carbs and avoid saturated fat. I think I may possibly one day have issues as to whether I really am a Type 2. Time will tell!

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[Jumapi]

Hey thanks! that triangle really helps me. Hope it's ok to photo it to use daily. I'd like to tape it to my kitchen wall.

 

[Jenraven]

This is an issue that's been on my mind a lot. I am extremely worried about the progression of diabetes as I was diagnosed last yr, at the age of 23 with a hba1c of 89 and 4 months later its still high at 85. Being this high and starting this 'journey' so young (comparable to other type 2's) makes me worry about where it will take me. I already have background retinopathy too. I don't wanna be blind or lose limbs in my 40's, which would be already 2 decades in!
I need to get better control - and that's all I can do really, is try, and keep trying till it happens, wether it means changing my diet more using info ive read on this forum or even more meds!
In the time being though, im just gonna try stay positive, progressive or not, I know what I can do to minimize damage.
Hey, and that's all we can do right?
x

 

[IanD]

Hey thanks! that triangle really helps me. Hope it's ok to photo it to use daily. I'd like to tape it to my kitchen wall.

Of course