• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Is Type 2 a progressive disease?

G

goji

Well-Known Member
Messages
251
Hi

Just wondering, is Type 2 diabetes a progressive disease? ie. Does the body become more and more insulin resistant with age or does it level out at some point?

thanks
goji
 
The professionals will say Yes it is, But i believe that if you can keep those BG numbers at non diabetic levels by whatever method works for you then Ie Low carb/High carb with or without meds Then you should be able to avoid many of the complications of diabetes.

As someone said Diabetes will not kill you its the complications that will so if we can avoid those then life should be great.

Brian
 
Hi goji,
As Brian says, the experts tell us that it is.

IMHO it depends as to how much damage has been done to your beta cells prior to diagnosis. There is a school of thought that this could have been occuring for up to 12 years prior to diagnosis and there is also a genetic element to beta cell destruction.

The experts also say,

The younger that you are at diagnosis then the more likelihood that you will experience progression.

If you are overweight then the sensible option is to lose weight and not put such a strain on your body.

The nearer you can keep your fasting, postprandial levels and HBA1c to acceptable levels then you are doing all you can to halt the progression.

I have heard of some Type 2's who do all this and still end up with complications.

It really is a lottery for some but if you do nothing then you will never know how far you have halted the progression.

There is no black and white answer really. We are all different at diagnosis.
 

It would seem to be a case of using physical, mental, medicinal and nutritional gymnastics! 8) :roll:
 
There is some evidence that you can halt or dramatically slow down the progression - but it strongly depends on when you start.

If you take decisive action (exercise, weightloss diet modification) at an early diagnosis, then your chances are improved. If you don't do these things for a very long time after diagnosis (or at all) then your outlook is less rosy.

One centre in Japan has trialled putting newly diagnosed T2s immediately on short term intensive insulin - they've had quite some success and have returned glucose levels to normal (but no long term info is yet available) and they've stayed normal after all treatment has finished.

All the evidence points to remaining overweight, sedentary and eating junk food as the best way to ensure a decline in your diabetic health! If all those things are *known* to facilitate progression, it is at least tempting to consider that the reverse is also true.

I know that there are a handful of newly-diagnosed normal weight T2s around, but it seems that the overwhelming majority (according to media stories) are overweight (at least), do little exercise and eat 'badly'.

Is lowcarbing the holy grail to prevent progression? No idea; I've never read Bernstein (though bloodsugar101 says a lot of interesting things) and eat a moderatecarb diet.

My personal drivers are weightloss and exercise - but I'm sure it would be even more politically incorrect to ask people about obesity and activity on a public forum as it would be to push extreme low-carbing...

So, returning to your original question.

My *personal* belief is that progression is *not* guaranteed if you take immediate and dramatic steps to improve your lifestyle as soon as diagnosed. If you stick with an unhealthy lifestyle for an extended period after diagnosis (thus increasing the rate at which you burn out your betacells), the chances are far worse.

mark.
 
Thanks guys for you input. It's very helpful to know that we do have some say in the development of progression.

I'm T1 but due to my family history of T2s (grandmother, father, soon-to-be-mother), I worry that I will develop T2 as well.

Goji x
 
I'm back with that spanner that goes in the works again. I have been battling this belief that T2 is progressive for a while now. My strategy is to keep to non-diabetic sugar levels( for which I've been ridiculed on this forum)
In 6 years since diagnosis, I have reduced my need for medication, so Idon't think I'm "progressing" noticably,although my GP says it's inevitable.. HOWEVER, I have never found any evidence that beta cell burnout actually happens or is the cause of progression.
It has been assumed to be the cause, but I don't think there's any evidence.
Hana
PS if it were OK to have higher than non-diabetic BG, non-diabetics would exhibit diabetic progression and complications.
 
catherinecherub said:
http://qjmed.oxfordjournals.org/cgi/con ... l/96/4/281
Click to expand...

Interesting. It doesn't seem to mention (unless I missed it) about how rigorously the patients actually stuck to the diet.

Perhaps only the '10 year success' patients actually stayed on the wagon. If they have a projected 15.4 years of 'normality' before needing insulin, then that seems a good enough reason to be pretty strict dietarily.

Some medical friends of mine say that almost all of their diabetic patients are quite obviously lying about their diet, in that the *say* they are eating and exercising sensibly, yet their weight either remains high or gets higher still - and obesity is known to favour the development of insulin resistance.

Similarly, the study makes no mention of exercise regime - again, exercise is known to reduce the impact of insulin resistance.

Finally, the authors assume in their projection (and the late stage for the 10year success people is *only* a projection) that once you hit a certain level of betacell loss, all patients will go into the same rapid decline NO MATTER HOW FAST OR IN WHAT MANNER they got to that point. It beggars belief that a morbidly obese sedentary person will decline at the same rate as an otherwise healthy active one.

So interesting, yes, but the paper is 7 years old and it would be interesting to see further supporting studies - suitably compensated for weight and exercise regimes.

I certainly don't see it as wholly worrying or negative, the prospect of staying normoglycemic for 15+ years through good adherence to dietary control (especially at my age coming up on 59) is pretty appealing - a lot of medical research can come tofruition in a decade and a half.

I would be very keen to see a further analysis of the original data - extended to cover the elapsed 7 years since publication to see just how accurate their projection was. Also important, would be to reanalyse the data against obesity and activity levels.

I tend toward optimism; immediately after diagnosis, I threw myself into exercise and dietary control and lost well over one third of my body weight to rapidly get my BMI back into the normal range. As a result, my fasting, postprandial and A1c measurements now fall into the normal range and I even pass an OGTT (at one and two hur points, since some studies suggest that the 1 hour may be a better predictive marker).

With the agreement of my gp, I've stopped medication, but I may talk about going back on low dose Glucobay next time I have an appointment. I found that if I used anything above a tiny dose of Metformin with meals, I tended to have a rebound effect causing my fasting to go up a little.

mark.
 
Hi mark,
The paper was in response to the previous post and not to prove anything. It is difficult to find studies on this topic and there are no rigid conclusions to the paper. We can only do our best for our future health.

 
At diagnosis 10 years ago, I was assured that diabetes was progressive. Sure enough, after conscienciously following all the NHS/DUK recommendations for 8 years, the neuropathy set in, & I had to consider becoming disabled.

I found this forum, & found the advice of some to drastically cut the carbs. Within 3 months the neuropathy was gone & I was fully active again.

The dietitian never suggested carb control, so had I not found this forum & tried Fergus' advice, I would be fully endorsing the thread question.

As it is, 10 years from diagnosis I am fit & well, & my aim is to avoid any progression.

Thanks to those of you who have been prepared to risk the wrath of others to promote low carb. It works. If you can get good control by other means, keep it up, but I thought my control was OK, & so did my Dr, until.....
 
yes low carb works, i've been doing it for about 4 weeks now and i feel so much better, more energy, bs gone down (yes i know i am on tablets, 4 metformin and 2 gliclazide) but my bs goes way up if i was to have any of the main carbs. i'm still new to all of this but i am working hard on my diet, bearing in mind i am very overweight and have an eating disorder - but i'm definitely achieving more control over food and my bs. my only problem seems to be that sometimes my bs goes up after i have been for a brisk walk - seems strange oh and i don't feel too good when this happens - infact i can always tell when my bs will be up - i'm just pushing on with this - obviously because i'm overweight i have to be selective about the exercise i do, but i have to move, anything, i just keep moving. I thought the carbs were putting me to sleep, they made me so sleepy but now i just want to keep building on more and more energy. I'm so happy that i am in control of my food intake and my body feelings seem to be inline for the first time ever.
 
Hi
I'm new to this forum. Can anyone tell me what constitutes a low carb diet? I was diagnosed 4 yrs ago and have been on 2 x day Metformin for 3 years. My 3 monthly reading has gone up to 7.1, in spite of what I see as healthy eating ( I'm vegetarian.) My BMI is fine. I sometimes get pre-meal readings as low as 1.9 and after meal as high as 11. I thought Metformin was meant to stabilise this. Does anyone know if there is a way of telling whether I am just not producing enough insulin, or whether I am not using it properly? My nurse bucks this question.
 
catherinecherub said:
Equally so there is no evidence that beta cell burnout doesn't happen.

This is an interesting paper,

http://qjmed.oxfordjournals.org/cgi/con ... l/96/4/281
Click to expand...

It is disturbing. however, we need to know more about the Belfast Diet Study on which it is based. All I can tell so far is that the patients were sucrose-limited. I'd like to see a study that also limited 'fast' carbs of all kinds and included exercise, IOW the sot of regimes that modern T2D warriors are familiar with.

pete
 
I was diagnosed with Diabetes in 1993 and worked my way up to 4 Insulin injections a day. I then discovered Victoza (on these forums) and now I am no longer Insulin dependent. I exercise 3 times a week at the Gym and have lost 5.75 stones (approx). My BS are the best I've ever had. You can make out of this what you want, but I am delicted with my progress
 
You must log in or register to reply here.
Menu
Log in
Register
Cookies are required to use this site. You must accept them to continue using the site. Learn More.…