Once A Diabetic, Always A Diabetic?

[gettingamoveon]

Can one become a former diabetic? Are the bodies of people who have had a diagnosis of diabetes, but then lose weight and return to normal levels of blood glucose and insulin sensitivity still different from those who have never been diabetic?

Or another way: is a diabetic merely a person who has discovered, thanks to blood testing, roughly how fat they have to get to trigger a diagnosis of diabetes?

 

[Resurgam]

Sigh - so you've been told that you got diabetes because you are one of those naughty fat people?
Sometimes I think that there are HCPs who just do not have the slightest inkling.

As a type two diabetic, you can't process carbs in the 'normal' way.
Your pancreas puts out loads of insulin, but it is either totally ignored, or it has some effect eventually - sometimes very abruptly so it gives you the wobblies, 'fake hypo', or even a real one. The pancreas gets hysterical, it can give up altogether.
It is possible to have normal readings for blood glucose and Hba1c by eating low carb, and that can reverse the weight gain - or you could try a low calories short term diet to try to put your metabolism back on track, but I know that my eating a low carb diet is going to be permanent, as although I have negated my diabetes, I still put on weight so quickly, as fat, if I eat carbs in the 'normal' amounts.
I think that my pancreas is feeling better, and my response to insulin is improved, but I will always have a problem metabolizing carbs.

 

[Deleted Account]

To answer the question in your subject line:
A person with Type 1 diabetes will always have diabetes.

I just had to put in the little reminder that "diabetics" are not just people with type 2 - there are others of us out here.
I don't mean to come on too strong and apologise if I do sometimes.

 

[gettingamoveon]

To answer the question in your subject line:
A person with Type 1 diabetes will always have diabetes.

I just had to put in the little reminder that "diabetics" are not just people with type 2 - there are others of us out here.
I don't mean to come on too strong and apologise if I do sometimes.

Thank you for reminding me. It had slipped my mind that this is a 'mixed' forum.

 

[Guzzler]

The short answer is that once you are diagnosed with a type of Diabetes then that diagnosis stays with you for life. There is no cure. What we can all hope for is a measure of good management that signifies an improvement in insulin sensitivity but in my opinion the fact that (in T2) we will always remain insulin resistant to some degree means that we will always have a metabolic dysfunction.

As to your comment about 'being fat' and weight loss being the only aspect needing change, I am afraid that you may be under the illusion that becoming overweight triggers T2. It doesn't. Weight gain is a common symptom of T2 and there are many, many people diagnosed with T2 who are not, and never have been, overweight. Weight loss is important when trying to manage our condition but this centers on ectopic fat around the organs (the fat that you can't see), this improves Insulin resistance which in turn improves weight loss around the waistline (or the fat you can see).

 

[kev-w]

I don't expect to be diabetic in the next life but its never showed any signs of going away during this one

 

[gettingamoveon]

Thanks to Resurgam and Guzzler for their answers.

The reason I asked was because I saw in Professor Roy Taylor's guidelines on reversing diabetes (I give the link, though I am sure the document is well-known to most here)

https://www.ncl.ac.uk/media/wwwncla...ecentre/files/2017 Diabetes reversal info.pdf

the claim that the insulin-producing cells of the pancreas can be 'woken up' if fat in the pancreas can be reduced 'by losing a substantial amount of weight'. He also mentions a 'personal fat threshold' at which the insulin-production of these cells becomes impaired. This, combined with the lack of a single mention of the word 'carbohydrate' in his guidelines, made me wonder if weight loss alone is enough to achieve remission.

Of course, I would rather continue my present ketogenic regime, which is giving me excellent results so far, than the calorie-restriction recommended in the Newcastle diet!

 

[Pipp]

Confusing, isn't it, @gettingamoveon ?
I had T2 for 6 years before I got my blood glucose levels down to HbA1c in the 30s. My GP was going to remove me from his Diabetes register. I didn't know what that was, but he was suggesting I was no longer diabetic. I wasn't sure, but asked not to be removed so I could continue to get the foot checks and retinopathy checks. Sure enough, recently have had incresed BG and HbA1c back in diabetes levels. GP maybe needs to reconsider. I have probably been well controlled T2 for the last 7 years, but not 'cured'. That could start another discussion about ' reversed /remission/ pre-diabetes' etc.

 

[Pipp]

Thanks to Resurgam and Guzzler for their answers.

The reason I asked was because I saw in Professor Roy Taylor's guidelines on reversing diabetes (I give the link, though I am sure the document is well-known to most here)

https://www.ncl.ac.uk/media/wwwnclacuk/newcastlemagneticresonancecentre/files/2017 Diabetes reversal info.pdf

the claim that the insulin-producing cells of the pancreas can be 'woken up' if fat in the pancreas can be reduced 'by losing a substantial amount of weight'. He also mentions a 'personal fat threshold' at which the insulin-production of these cells becomes impaired. This, combined with the lack of a single mention of the word 'carbohydrate' in his guidelines, made me wonder if weight loss alone is enough to achieve remission.

Of course, I would rather continue my present ketogenic regime, which is giving me excellent results so far, than the calorie-restriction recommended in the Newcastle diet!

I do think Prof Taylor et al would attract less criticism if they made it clear that their subjects were T2 who were actually overweight or obese at the start, but that not al people with T2 are fat, and not all fat people have T2.

 

[Guzzler]

Thanks to Resurgam and Guzzler for their answers.

The reason I asked was because I saw in Professor Roy Taylor's guidelines on reversing diabetes (I give the link, though I am sure the document is well-known to most here)

https://www.ncl.ac.uk/media/wwwnclacuk/newcastlemagneticresonancecentre/files/2017 Diabetes reversal info.pdf

the claim that the insulin-producing cells of the pancreas can be 'woken up' if fat in the pancreas can be reduced 'by losing a substantial amount of weight'. He also mentions a 'personal fat threshold' at which the insulin-production of these cells becomes impaired. This, combined with the lack of a single mention of the word 'carbohydrate' in his guidelines, made me wonder if weight loss alone is enough to achieve remission.

Of course, I would rather continue my present ketogenic regime, which is giving me excellent results so far, than the calorie-restriction recommended in the Newcastle diet!

The 'Personal Fat Threshhold' that Prof. Taylor speaks of is, at present, an hypothesis. It is one that I am in agreement with because, to me, it is a logical assumption. Where I cannot reconcile with Prof. Taylor is on the question of carbohydrates specifically, so I am in agreement with you on that one.

 

[gettingamoveon]

I do think Prof Taylor et al would attract less criticism if they made it clear that their subjects were T2 who were actually overweight or obese at the start, but that not al people with T2 are fat, and not all fat people have T2.

True - when Professor Taylor says 'fat', maybe he should consider adding the words 'around the pancreas'

It could be the new 'big bones' e.g. 'I'm not diabetic, I'm just fat around the pancreas'.

 

[gettingamoveon]

Confusing, isn't it, @gettingamoveon ?
I had T2 for 6 years before I got my blood glucose levels down to HbA1c in the 30s. My GP was going to remove me from his Diabetes register. I didn't know what that was, but he was suggesting I was no longer diabetic. I wasn't sure, but asked not to be removed so I could continue to get the foot checks and retinopathy checks. Sure enough, recently have had incresed BG and HbA1c back in diabetes levels. GP maybe needs to reconsider. I have probably been well controlled T2 for the last 7 years, but not 'cured'. That could start another discussion about ' reversed /remission/ pre-diabetes' etc.

Thank you for your answers. Good luck with getting your bg back down again.

 

[DCUKMod]

I do think Prof Taylor et al would attract less criticism if they made it clear that their subjects were T2 who were actually overweight or obese at the start, but that not al people with T2 are fat, and not all fat people have T2.

Richard Doughty a non-obese t2 reversed his T2, in very short order using the ND, as I recall it. Of course Richard Doughty wasn't in Professor taylor's study cohort, but just wanted to mention it.

 

[Grant_Vicat]

To answer the question in your subject line:
A person with Type 1 diabetes will always have diabetes.

I just had to put in the little reminder that "diabetics" are not just people with type 2 - there are others of us out here.
I don't mean to come on too strong and apologise if I do sometimes.

Hi @helensaramay and @gettingamoveon I am an ex Type 1 (at least in my view as all injections have ceased and no more hypo's or hyper's) thanks to a pancreas transplant. The medical profession do not class me as cured since any retinopathy or similar condition could still increase. Thus I go to Diabetes Eye Screening every year. Keep well!

 

[Pipp]

Hi @helensaramay and @gettingamoveon I am an ex Type 1 (at least in my view as all injections have ceased and no more hypo's or hyper's) thanks to a pancreas transplant. The medical profession do not class me as cured since any retinopathy or similar condition could still increase. Thus I go to Diabetes Eye Screening every year. Keep well!

I did think of your situation after I had logged out earlier, so glad you popped in with that info, @Grant_Vicat . Don't suppose there are many in your situation?

 

[gettingamoveon]

The 'Personal Fat Threshhold' that Prof. Taylor speaks of is, at present, an hypothesis. It is one that I am in agreement with because, to me, it is a logical assumption. Where I cannot reconcile with Prof. Taylor is on the question of carbohydrates specifically, so I am in agreement with you on that one.

Yes, both his shake-based diet, and his 'slower standard' (half your portion sizes, use a smaller plate etc.) are exactly the kind of diet which come with a very high risk of failure. I agree, based on what I have read so far, that Professor Taylor's fatty pancreas hypothesis seems very plausible - unfortunately, his dietary advice sucks. Low carb eating appears to achieve the same goal in a far more satisfying way. (To be fair, of course, Professor Taylor does acknowledge that different approaches will suit different individuals better).

 

[Guzzler]

Yes, both his shake-based diet, and his 'slower standard' (half your portion sizes, use a smaller plate etc.) are exactly the kind of diet which come with a very high risk of failure. I agree, based on what I have read so far, that Professor Taylor's fatty pancreas hypothesis seems very plausible - unfortunately, his dietary advice sucks. Low carb eating appears to achieve the same goal in a far more satisfying way. (To be fair, of course, Professor Taylor does acknowledge that different approaches will suit different individuals better).

Just to clarify, it was the PFT hypothesis that I was referring to. Whether or not ND is sustainable is still up for debate. The fatty liver/pancreas theory is sound in my opinion.

 

[Pipp]

Well I remained in non-diabetic BG for 6 years following Newcastle diet, despite still having much weight to lose. (originally lost 49kg, but regained around half, stabilized for 3 years low carbing). I believe steroids meds plus being fat have tipped me back into diabetic numbers.

 

[Guzzler]

Well I remained in non-diabetic BG for 6 years following Newcastle diet, despite still having much weight to lose. (originally lost 49kg, but regained around half, stabilized for 3 years low carbing). I believe steroids meds plus being fat have tipped me back into diabetic numbers.

Which proves the point of the OP, I think. Medications or lapses in criteria can cause a return to higher numbers therefore the Diabetes has not 'gone' anywhere. It is always there and those of us with T2 or Pre D must keep one wary eye on it.

 

[bamba]

A google seach on Diabetes Remission throws up the following ( at 4th position when I searched )
http://www.diabetes.org/research-an...ss-to-research/type-2-diabetes-remission.html

It does happen but recorded instances are statistically low.

Bear in mind this is an American article.

See also on Bloodsugar101.com Misdiagnosis By Design - The Story Behind the ADA Diagnostic Criteria ( http://www.phlaunt.com/diabetes/14046782.php ) a tract on how an why the dignosis criteria fro diagnosing diabeties was set so that the disease had progressed to an almost irreverable condition before they would diagnose it due to the 'stigma' and the resulting lack of medial insurance resulting from it.