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Is T1 diabetes preventable?
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<blockquote data-quote="phoenix" data-source="post: 696377" data-attributes="member: 12578"><p>It takes time for all the beta cells to be destroyed quite a long time, even with young onset T1. Forty or fifty years later many T1s still have a few around but nowhere near enough.</p><p>When you are diagnosed you have already lost a great deal of your beta cell function.(see diagram below)</p><p>How much depends on where in the process that you are diagnosed. They know that there is a pre diabetes period even in children. The autoimmune response causes the bodies own immune system to kill off the beta cells as if they are invaders. Glucose levels rise and there is a period, longer or shorter (depending on how quickly the destructive process ) during which there is too much glucose in the blood This results in glucotoxicity which may itself kill off cells or at least stop them functioning properly. If relative insulin levels are very low (relative because you need more insulin with higher glucose levels) then people start losing weight through the breakdown of fats. When there is a lot of fat in the bloodstream it may causes insulin resistance preventing glucose getting into the cells; everything gets worse signalling a crises, normally DKA.</p><p></p><p>Get rid of the glucose and lipotoxicity by injecting insulin and there may be enough cells to cope for a while . Normally it's called the honeymoon and can even in young people can last for quite a long time.</p><p>Before insulin by using the 'starvation' diet children could last a year or so, some longer but they all eventually died , mostly from going into a diabetic coma. Older adults lasted longer, about seven years In pre insulin days people wouldn't probably have been diagnosed until the condition was quite critical, not everyone today is diagnosed that late .</p><p></p><p>Sadly, once killed, even if we do regenerate a few cells and the juries out on if that is even possible after the age of about 30, it is very few. Even in non diabetics, the number of cells reduces through aging as cells die off and are not replaced.</p><p>Here are two slides : the first diagrams the comparative numbers of beta cells left functioning at diagnosis in T2, LADA and T1 compared with a normally functioning pancreas (Global Diabetes Course, Copenhagen University)</p><p>The second is a diagram from the Faustman lab modelling the progressive loss of insulin production in T1 over 40+ years. It's worth stressing that even at the beginning there are only very small amounts of insulin produced. It is only recently that there has been an assay good enough to detect tiny amounts, before people would say that the T1s tested to produce this model were C peptide negative.[ATTACH=full]8894[/ATTACH]</p><p>[ATTACH=full]8897[/ATTACH]</p></blockquote><p></p>
[QUOTE="phoenix, post: 696377, member: 12578"] It takes time for all the beta cells to be destroyed quite a long time, even with young onset T1. Forty or fifty years later many T1s still have a few around but nowhere near enough. When you are diagnosed you have already lost a great deal of your beta cell function.(see diagram below) How much depends on where in the process that you are diagnosed. They know that there is a pre diabetes period even in children. The autoimmune response causes the bodies own immune system to kill off the beta cells as if they are invaders. Glucose levels rise and there is a period, longer or shorter (depending on how quickly the destructive process ) during which there is too much glucose in the blood This results in glucotoxicity which may itself kill off cells or at least stop them functioning properly. If relative insulin levels are very low (relative because you need more insulin with higher glucose levels) then people start losing weight through the breakdown of fats. When there is a lot of fat in the bloodstream it may causes insulin resistance preventing glucose getting into the cells; everything gets worse signalling a crises, normally DKA. Get rid of the glucose and lipotoxicity by injecting insulin and there may be enough cells to cope for a while . Normally it's called the honeymoon and can even in young people can last for quite a long time. Before insulin by using the 'starvation' diet children could last a year or so, some longer but they all eventually died , mostly from going into a diabetic coma. Older adults lasted longer, about seven years In pre insulin days people wouldn't probably have been diagnosed until the condition was quite critical, not everyone today is diagnosed that late . Sadly, once killed, even if we do regenerate a few cells and the juries out on if that is even possible after the age of about 30, it is very few. Even in non diabetics, the number of cells reduces through aging as cells die off and are not replaced. Here are two slides : the first diagrams the comparative numbers of beta cells left functioning at diagnosis in T2, LADA and T1 compared with a normally functioning pancreas (Global Diabetes Course, Copenhagen University) The second is a diagram from the Faustman lab modelling the progressive loss of insulin production in T1 over 40+ years. It's worth stressing that even at the beginning there are only very small amounts of insulin produced. It is only recently that there has been an assay good enough to detect tiny amounts, before people would say that the T1s tested to produce this model were C peptide negative.[ATTACH=full]8894[/ATTACH] [ATTACH=full]8897[/ATTACH] [/QUOTE]
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