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Moving into insulin!
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<blockquote data-quote="Ellenor2000" data-source="post: 2091541" data-attributes="member: 508208"><p>The thin type 2 clinical picture can be caused by one of two things: the person has overexpanded a particularly meagre fat store and so is "fat" without being overweight (liposuction/lipodystrophy), or the person is also type 1 at the same time but they're still in the honeymoon phase somehow so they're not running pathologically high ketones (so they may have the autoimmune pancreatic damage that they would have only seen until it got far more severe had they not been driving the DM2 cascade).</p><p></p><p>And yes it can be both to a degree.</p><p></p><p></p><p></p><p>Even type 1s can-but-shouldn't eat anything they want because the physics of intramuscular or peripheral vein insulin do not work the same as insulin injected into the hepatic portal vein (which the pancreas does, or doesn't in the case of DM1). Persons with insulin agenesis often develop insulin resistance and the resulting metabolic syndrome as a result of a high-carbohydrate diet and trying to match the blood sugar rises with bucketloads of peripherally injected insulin. This can work reasonably well (in the sense of not ever getting too high to function and rarely getting too low) for a long time if they have no family history of type 2 diabetes or its prodromes (idiopathic hypertension, obesity, unexplainable low HDL and high triglycerides (explainable high trig would be due to coffee)), but if they have that family history of insulin resistance, the doses of insulin rapidly escalate (as they do in their non-type 1 family, it's just that their family don't have to inject it and they retain glycemic control for much longer) and it becomes an unmanageable nightmare.</p><p></p><p>One thing is clear though: DIABETES IS NOT YOUR FAULT, AND NEITHER ARE ITS COMPLICATIONS. Whether it's insulin agenetic or insulin resistant, it's not ultimately your fault. You have a hand in solving the high blood sugars it causes (in type 1, this is done with insulin treatment and a diet leg that does not require of the patient unreasonable amounts of insulin to cover, and in type 2 without any element of type 1 this is done with just the diet that doesn't require of the pancreas unreasonable amounts of insulin to cover) but it's not ultimately your fault. <strong><span style="font-size: 18px"><span style="color: #ff0000">In a very misleading, mechanistic sense</span></span></strong>, type 2, and complications of both type 2 and type 1, are the sufferer's fault, but the sufferer is not to blame for it - they're just a victim of a broken food system (for both types), and of dentists that can't seem to find tooth infections (for some very bizarre type 1 cases where brittle blood sugars appears to be caused by an asymptomatic tooth infection), among other incompetent parts of The System.</p></blockquote><p></p>
[QUOTE="Ellenor2000, post: 2091541, member: 508208"] The thin type 2 clinical picture can be caused by one of two things: the person has overexpanded a particularly meagre fat store and so is "fat" without being overweight (liposuction/lipodystrophy), or the person is also type 1 at the same time but they're still in the honeymoon phase somehow so they're not running pathologically high ketones (so they may have the autoimmune pancreatic damage that they would have only seen until it got far more severe had they not been driving the DM2 cascade). And yes it can be both to a degree. Even type 1s can-but-shouldn't eat anything they want because the physics of intramuscular or peripheral vein insulin do not work the same as insulin injected into the hepatic portal vein (which the pancreas does, or doesn't in the case of DM1). Persons with insulin agenesis often develop insulin resistance and the resulting metabolic syndrome as a result of a high-carbohydrate diet and trying to match the blood sugar rises with bucketloads of peripherally injected insulin. This can work reasonably well (in the sense of not ever getting too high to function and rarely getting too low) for a long time if they have no family history of type 2 diabetes or its prodromes (idiopathic hypertension, obesity, unexplainable low HDL and high triglycerides (explainable high trig would be due to coffee)), but if they have that family history of insulin resistance, the doses of insulin rapidly escalate (as they do in their non-type 1 family, it's just that their family don't have to inject it and they retain glycemic control for much longer) and it becomes an unmanageable nightmare. One thing is clear though: DIABETES IS NOT YOUR FAULT, AND NEITHER ARE ITS COMPLICATIONS. Whether it's insulin agenetic or insulin resistant, it's not ultimately your fault. You have a hand in solving the high blood sugars it causes (in type 1, this is done with insulin treatment and a diet leg that does not require of the patient unreasonable amounts of insulin to cover, and in type 2 without any element of type 1 this is done with just the diet that doesn't require of the pancreas unreasonable amounts of insulin to cover) but it's not ultimately your fault. [B][SIZE=5][COLOR=#ff0000]In a very misleading, mechanistic sense[/COLOR][/SIZE][/B], type 2, and complications of both type 2 and type 1, are the sufferer's fault, but the sufferer is not to blame for it - they're just a victim of a broken food system (for both types), and of dentists that can't seem to find tooth infections (for some very bizarre type 1 cases where brittle blood sugars appears to be caused by an asymptomatic tooth infection), among other incompetent parts of The System. [/QUOTE]
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