So what really causes type II?

[graj0]

I've started this thread rather than clag up the diabetes reversal thread. Some say weight reduction cures diabetes, in which case was it weight increase that caused it? Some say carb reduction cures diabetes, too many carbs certainly contributes towards the onset of insulin resistance and then diabetes.

Obviously this is all anecdotal so proves nothing. At one end of the scale, my aunt, now in her late 70s, very overweight, not diabetic, not even high cholesterol requiring a statin, I wonder how she got away with that.

At the other end of the scale, how come Steve Redgrave (Olympic rower, just in case) is type II. He actually sees the same consultant as I've been to in High Wycombe. In Steve Redgrave's case his high carb intake was part of the problem, needed when he was training and needed something daft like 6,000 calories a day. He was taking insulin 6 times a day to help with his high carb intake.

Is it weight reduction that "cures" diabetes or reducing insulin resistance, which may go hand in hand? So, type IIs, is just weight or just carbs that causes type II.

Having just read a bit about the Newcastle diet I found the very first two paragraphs very interesting:-

"Our work has shown that type 2 diabetes is not inevitably progressive and life-long. We have demonstrated that in people who have had type 2 diabetes for 4 years or less, major weight loss returns insulin secretion to normal.

It has been possible to work out the basic mechanisms which lead to type 2 diabetes. Too much fat within liver and pancreas prevents normal insulin action and prevents normal insulin secretion. Both defects are reversible by substantial weight loss".

So they're only talking about people who have had diabetes for less than 4 years and do not have normal levels of insulin secretion. So that doesn't apply to those of us who have normal levels of insulin secretion (I paid for my own c-peptide test), or others like me who have had diabetes for over 4 years (17 years for me). The other thing I found very interesting is that although some people seem to talk about this diet as a low calorie diet if you look at the first 8 weeks where you can't have bread, pasta, root vegetables (potato, sweet potato, turnip), pulses, fruits,alcohol, that say low carb big time, no wonder BG readings get better quickly, it's not weight loss, it's low carbs. Add in a bit of no meat, poultry fish or dairy products, that makes it low fat as well. 700 calories a day will undoubtedly allow most people to lose weight. I'm not knocking it because I haven't tried it, but it can be described as a VLCLF diet, not just The Newcastle Diet.

So, if the initial problem was a fatty pancreas causing low insulin secretion then weight reduction is the way to go. If there's no problem with the pancreas then low carb (should help weight reduction anyway) is the way to go. The Newcastle Diet will do it for both groups, good luck. I'm happy with low carb, I didn't increase fat so it's LCNF (Low Carb Normal Fat). Will I be able to reverse diabetes? I'll have to wait and see when I get to target weight, one thing I do know is that if I eat the recommended "Eatwell Plate" amount of carbs, it will increase my BG readings.

Apologies for wondering off target, more of a brain dump really. No axe to grind, just some things to think about because "we're all different". By that I mean that as a type II you may be a man, you may be a woman, you might be old, you might be young, you may be fat, you may be thin, you may not be producing enough insulin or you may be insulin resistant or sadly you may be both. Hopefully that covers it all.

 

[Totto]

You only give two possible causes, obesity and carbs. I would like to add genes. As in you aunt's case she probably lacks the diabetic genes so regardless of her level of insulin resistance her pancreas can cope.

I am of normal weight or rather I was normal before I quit smoking and still developed diabetes while low carbing gently. Since I quit tobacco three months and a bit ago I have gained close to 10 kilograms without any change in diet but improved my blood glucose which I find a bit strange.

I do however have a strong diabetic inheritance so sort of knew I would get it some day.

 

[AndBreathe]

If someone has dying, as opposed to poorly functioning beta cells, then they will be extremely susceptible, due to a weakened “infrastructure”, so, for me, in the following I’m not going to consider them. I’ll concentrate on people, like me (or how I believe myself to be and have been), who believe themselves to be otherwise healthy and discovered diabetes during routine, MOT tests.

Have you read/seen Professor Taylor’s presentation, from late last year? (I think it was @cold ethyl who went.) Professor Taylor believes that a liver/pancreas carrying fat, above the individual’s fat threshold significantly impacts on insulin resistance. That’s the reason that weight (reduction of liver/pancreatic fat) loss has such an impact on glycaemic control. When our systems are awash with insulin, it doesn’t work properly, so in turn our blood becomes away with the glucose the insulin isn’t dealing with, which in turn signals for more insulin production – Professor Taylor’s bicycle theory?

For me, I get that, and it chimes incredibly clearly with my own experience, and it is this hypothesis that I will use to steel my will, if my weight starts to creep upwards. I don’t know where my personal fat threshold is, but my feeling is it’s pretty low, as I certainly carried some excess, but not that much.

I didn’t do the ND, and didn’t learn about it until I had been diagnosed a short while. By then, I had started to get my bloods into a better place and my clothing was loosening off, so I carried on in my own sweet way. When I had my first HbA1c after diagnosis, it had come down from 73 to 37, so immediately outside the diabetic ranges and has gone on to 34, 32 and 33 in subsequent tests. I’m not due another in UK until late summer-ish; whenever I come back to UK, but I’m pretty certain I’ll have an interim one abroad, just to ensure I remain where I should be – especially as my finger prick test averages and HbA1cs don’t closely match (although they do track).

Obviously what I’m suggesting here is a chicken and egg theory around fat and insulin resistance, but I believe carbs play their part in containing the blood scores along the way, and training ourselves away from the foods that can create the blood sugar rollercoaster – even in the non-diabetic population. Clearly the difference with them is their bodies just deal with it.

Lucky beggars!! Or are they?

Whilst I would much rather never have had a diabetic diagnosis, my overall bloods and other health markers are significantly improved as a result of the interventions I have made. Had I not had the diagnosis, I doubt I’d have intervened, so maybe something else would have caught up with me, given time.

Sorry for such a long response, but I've just had my very own brain dump, so it may not make sense to anyone else.

 

[AnnieC]

I believe there is a lot more to diabetes and why some people get it and some don't regardless of their weight diet and lifestyle. It seems to be known that some other medical conditions and medications like steriods can make some people more predisposed to it as can family history of diabetes.I don't know if it has been proved that there is a gene that can cause it.
I have never been overweight in my life .. I am now 75...and.I don't have any other illnesses. Being of the older generation I have never really joined the fan club for fast foods takeaways or ready meals I like to cook meals from fresh and I never had much of a sweet tooth There was no family history of T2 despite my mother and her close family always being overweight.. thankfully I did not take after them.. yet I am prediabetic so what has caused that.

 

[graj0]

You only give two possible causes, obesity and carbs. I would like to add genes. As in you aunt's case she probably lacks the diabetic genes so regardless of her level of insulin resistance her pancreas can cope.

I am of normal weight or rather I was normal before I quit smoking and still developed diabetes while low carbing gently. Since I quit tobacco three months and a bit ago I have gained close to 10 kilograms without any change in diet but improved my blood glucose which I find a bit strange.

I do however have a strong diabetic inheritance so sort of knew I would get it some day.

I did forget, daft really, father (skinny as a beanpole) is type II, another aunt type I, an Uncle (large) and 2 cousins (one large, one not) type II. Similar to you, when I was diagnosed I just thought it was meant to be because of family with diabetes. In some ways that made accepting it easier because I just went along with it. For me personally low carbing has meant that I no longer have to take Gliclazide, Januvia or atorvastatin, because readings are good.
That's a real bummer when quitting smoking. Weight gain/loss where do you start? My problems started with Rosiglitazone and when I complained about weight gain (like you no change in diet or exercise) the quack put me on Citilapram so I got very fat (27st) and couldn't have cared less. Not so good some of those anti-anxiety drugs, Citilapram seemed to lower my anxiety just a bit too much. It's now 8 years since I came off Rosiglitazone and although I lost weight initially I gained when prescribed Gliclazide. So it's been a long haul to get down to 19st with 5 to 6 st to go. I'm currently eating about 80gms carb a day and about 1000 calories so a lot less than the 2000 calories calculated by the Harris Benedict equation.

So when you hear people laugh about slow metabolism, they should at least be able to tell you why you gained weight without changing diet and why I have a calorie deficit of 1000 without currently losing, if it isn't something to do with the rate at which we use the energy we consume. For further reading Google Krebs Cycle.

 

[graj0]

I believe there is a lot more to diabetes and why some people get it and some don't regardless of their weight diet and lifestyle. It seems to be known that some other medical conditions and medications like steroids can make some people more predisposed to it as can family history of diabetes.I don't know if it has been proved that there is a gene that can cause it.
I have never been overweight in my life .. I am now 75...and.I don't have any other illnesses. Being of the older generation I have never really joined the fan club for fast foods takeaways or ready meals I like to cook meals from fresh and I never had much of a sweet tooth There was no family history of T2 despite my mother and her close family always being overweight.. thankfully I did not take after them.. yet I am prediabetic so what has caused that.

Hi Annie,
this diabetes lark certainly isn't straight forward. I never joined the burger brigade either, just as well. What seems a bit unfair is that type II suspects or prediabetics aren't routinely given a c-peptide blood test which will tell them if their pancreas is doing it's stuff indicating insulin resistance.

 

[AndBreathe]

I believe there is a lot more to diabetes and why some people get it and some don't regardless of their weight diet and lifestyle. It seems to be known that some other medical conditions and medications like steriods can make some people more predisposed to it as can family history of diabetes.I don't know if it has been proved that there is a gene that can cause it.
I have never been overweight in my life .. I am now 75...and.I don't have any other illnesses. Being of the older generation I have never really joined the fan club for fast foods takeaways or ready meals I like to cook meals from fresh and I never had much of a sweet tooth There was no family history of T2 despite my mother and her close family always being overweight.. thankfully I did not take after them.. yet I am prediabetic so what has caused that.

Annie - I agree about the plethora of causes, and I often refer to Diabetes as a portfolio condition, because it isn't just one thing. I also think that a few years ago pre-diabetics would never have known they were diabetic, and similarly those who were symptom-free would perhaps never have know either. We have a lot more blood tests done these days, and even 15 (?) years ago MOTs were not usual, unless you had private medical cover.

 

[DeejayR]

Further to points raised above, should we factor in the way diabetes is diagnosed, or not diagnosed? I have no history of diabetes in my family, yet my brother and I were both diagnosed as Type 2 within a few months of each other, although neither of us has ever been overweight, we live in different places, and were both active and felt well. We were called in to our surgeries on routine MoT checks, or so I assume.

 

[Arab Horse]

Further to points raised above, should we factor in the way diabetes is diagnosed, or not diagnosed? I have no history of diabetes in my family, yet my brother and I were both diagnosed as Type 2 within a few months of each other, although neither of us has ever been overweight, we live in different places, and were both active and felt well. We were called in to our surgeries on routine MoT checks, or so I assume.

I too was diagnosed last year after being offered a routine health check. I was gobsmacked to find I had a really high blood glucose and HbA1c levels. My paternal grand father had diabetes (don't have any details as he died before I was born) and as far as I am aware no other relatives have had it. I was normal weight (8 and a half stone and 5' 3"), reasonably active as I have horses and worked full time. I am sure mine was lifestyle. I got far too little sleep, stressful job and working in a lab (no eating or drinking in lab) where I rarely had time to take a break so I often went from breakfast at 7.00am (up at 4.30am to do horses) until 9.00pm and then it was often something quick and easy and straight to bed. For breakfast I had grapefruit followed by cereal (bran flakes) with chopped up fresh fruit (strawberries/blueberries/grapes/raspberries) so high carb and sugar but I always thought it was a pretty healthy start to the day!

I find I can't tolerate carbs, even a small amount sends my glucose high although it does come down before the next meal so I am on a very restricted diet at the moment. I hope I will eventually bve able to eat a few more things than I do now.

 

[Totto]

I believe there is a lot more to diabetes and why some people get it and some don't regardless of their weight diet and lifestyle. It seems to be known that some other medical conditions and medications like steriods can make some people more predisposed to it as can family history of diabetes.I don't know if it has been proved that there is a gene that can cause it.
I have never been overweight in my life .. I am now 75...and.I don't have any other illnesses. Being of the older generation I have never really joined the fan club for fast foods takeaways or ready meals I like to cook meals from fresh and I never had much of a sweet tooth There was no family history of T2 despite my mother and her close family always being overweight.. thankfully I did not take after them.. yet I am prediabetic so what has caused that.

Type 2 is generally referred to as polygenetic as opposed to MODY which is monogenetic. There is a lot of research going on diabetes genes and gene expression. I think it is probable epigenetics could play a role too but haven't seen any research on that.

 

[DeejayR]

Lifestyle? At different stages of our lives my bro and I drank rather a lot of beer ... obviously, that's the cause ...
Shall I ring the Daily Mail or will you?

 

[Scardoc]

I have always believed that the human body - the most magnificent, and complex, design on the face of the Earth - knows what it is doing.

So, could T2 be a natural occurrence? Sounds stupid but when you look at who has T2 the overwhelming majority are over 50 years old and the over 70's account for approx. just over half of the total. To me, it makes a bit of sense that back in the old days when humans were hunting and gathering they led a very active life. As they reached their twilight years and started to slow down could it be that they needed more glucose available to them to fuel the body? To keep warm for example? Perhaps T2 was a way of doing this? Now, I would immediately argue with myself and say "surely then the body would just produce less insulin rather than it being less effective".......and I can't answer that off the top of my head!

However, I do wonder what our Grandparents used to do when they could no longer join the hunt or so foraging? With a much shorter lifespan perhaps T2 was part of a natural degenerating process?

 

[AndBreathe]

I have always believed that the human body - the most magnificent, and complex, design on the face of the Earth - knows what it is doing.

So, could T2 be a natural occurrence? Sounds stupid but when you look at who has T2 the overwhelming majority are over 50 years old and the over 70's account for approx. just over half of the total. To me, it makes a bit of sense that back in the old days when humans were hunting and gathering they led a very active life. As they reached their twilight years and started to slow down could it be that they needed more glucose available to them to fuel the body? To keep warm for example? Perhaps T2 was a way of doing this? Now, I would immediately argue with myself and say "surely then the body would just produce less insulin rather than it being less effective".......and I can't answer that off the top of my head!

However, I do wonder what our Grandparents used to do when they could no longer join the hunt or so foraging? With a much shorter lifespan perhaps T2 was part of a natural degenerating process?

in some ways, your post goes complements mine suggesting in past years many people would simply not realise they had T2. As life expectancy and expectation for quality of life was different then, potentially some un-diagnosed diabetics, largely asymptomatic or with some of the "modest" complications; for example neuropathy or loss of some vision might just have been attributed to the aging process.

We are very fortunate to have all of this knowledge and expertise readily available to us, but we were having a discussion at Chrsitmas, around the table, reminiscing with family members about our, sadly all departed, parents. In particular, my OH was relating a story of a time when his mother was in hospital in her late 80s, making her way to the earthly exit, having battled hospital contracted MRSA and a long term heart condition, being urged to reduce the full fat in her diet. She was a great believer in butter on her bread, and "proper" (full fat) milk in her tea etc., so that suggestion didn't go down to well!!

Sometimes, when it gets to that stage, I wonder if those sort of changes maybe even do more harm than good. Similarly with asymptomatic T2 in their very much twilight years. Of course, don't ask me to define twilight years, because I think that would very much depend on the individual and their overall package of wellbeing/ailments/mental capacity.

OK, @graj0 - second big ramble of the day. It's all your fault! I should get some "work" done, or I won't be sailing into the tropical sunset any time soon!

 

[Bluetit1802]

My T2 came on quite suddenly. January 2013 my MOT tests showed no diabetes, not even pre. (Just a fasting test). January 2014 I was T2 with an Hba1c of 53. So no slow slide for me. I was overweight by 4 stones. No family history other than a gt. gt grandfather who died of diabetes in 1897 (according to his death certificate). His photos show him to have been a very portly gentleman.

I am also of the generation where fast foods never reached the table. Everything cooked from fresh, and not a particularly sweet tooth. I don't recall ever eating a ready meal and have never been in a fast food restaurant. (except the odd Little Chef). I think I am the only person in the world that has never once eaten a burger.

During that year between being non-diabetic and Type 2 I received 6 cycles of chemotherapy over 4 months, including steroids at certain times of each cycle, followed by another 9 months of further drug infusions every 3 weeks.. Naturally I was stressed. My carb intake increased significantly, having to eat certain foods recommended to help with side effects, and of course the perennial comfort food because I felt sorry for myself.

I believe my T2 was a result of the stress of the cancer diagnosis and treatment, and the food I ate as a consequence of it. Unless I inherited my gt. gt. grandfather's genes!!

I should add that the extra foods I ate were all sugary and fruit. Lucozade daily, cranberry juice daily, several bananas daily, manuka honey by the bucket load, and so on

 

[Brunneria]

Other health complaints play a huge part too (and the drugs that treat them), as with Bluetit.

Me?
Microprolactinoma = excess prolactin hormone production for er... 35(?) years = strong tendency to gain weight + generally messed up hormones
Medication for microprolactinoma => increased insulin resistance and increased chance of developing T2 (surprise!)
Also PCOS = generally messed up hormones and a strong tendency to gain weight...

So my (probably dormant) T2 genes had all the fuel they needed. Might have made it to my 70s (like various other relatives) if I hadn't had that triple whammy.

By the way, I have recently read (in Keto Adapted by Maria Emmerich) that there is often scarring left in the liver after the fat has been dieted away.
Apparently up to 60% of defatted livers have scarring, to variable extents.
I've not seen it mentioned elsewhere, but I can guess that a scarred liver is less efficient than an unscarred one, and that the liver owner may well have a permanently reduced weight and carb threshold as a result - which would be all the more reason to treat your carb intake gently after losing weight!

 

[cold ethyl]

I'm guessing a combination of genes ( my great gran and several of her sisters and cousins developed type 2) , exceeding my own PFT through over indulgence in carbs mainly as result of stress and addiction and probable untreated PCOS. I think of it as a multi factorial disease for which I ended up holding a full winning hand.

 

[Patricia21]

I was diognosed with type 2 at age 73,I have never been overweight,I dont know my family history as I was adopted as a baby.
I have put it down to ageing and body parts wareing out.
On the other hand I contacted Legionares Disease three years ago,which nearly cost me my life,it caused most of my organs to pack up,kidney failure ect,so I will never know if its come from that.

 

[AndBreathe]

Other health complaints play a huge part too (and the drugs that treat them), as with Bluetit.

Me?
Microprolactinoma = excess prolactin hormone production for er... 35(?) years = strong tendency to gain weight + generally messed up hormones
Medication for microprolactinoma => increased insulin resistance and increased chance of developing T2 (surprise!)
Also PCOS = generally messed up hormones and a strong tendency to gain weight...

So my (probably dormant) T2 genes had all the fuel they needed. Might have made it to my 70s (like various other relatives) if I hadn't had that triple whammy.

By the way, I have recently read (in Keto Adapted by Maria Emmerich) that there is often scarring left in the liver after the fat has been dieted away.
Apparently up to 60% of defatted livers have scarring, to variable extents.
I've not seen it mentioned elsewhere, but I can guess that a scarred liver is less efficient than an unscarred one, and that the liver owner may well have a permanently reduced weight and carb threshold as a result - which would be all the more reason to treat your carb intake gently after losing weight!

So, your hormones are pretty much,..........................................................























Broken!?

 

[Brunneria]

So, your hormones are pretty much,..........................................................























Broken!?

Lol
Yup.

Its like herding cats.

And I'm a dog person.

 

[Lamont D]

The simple answer as to why diabetes is because the pancreas cannot produce enough of the hormone insulin to counter the abundance of glucose and glucagon in the bloodstream.
I also believe the amount of visceral fat that surrounds and invades our endocrine system has a huge influence of the organs ability to cope with the amount of carbs and sugars.
I admit and I'm certainly guilty of abusing my endocrine system and I certainly have over indulged more than a lot of diabetics or even non diabetics. My kidney , liver and pancreas have certainly been battered by my fast food and unhealthy diet.
I thought in the last 15 years I was eating 'healthy' ! I was prediabetic and diagnosed T2! That's how my docs treated me. I was misdiagnosed. No blame at all because the docs didn't know better. Why is there a lack of educated docs in the NHS? Why in their training isn't there more understanding of diabetes? I find it increasingly negligent of the government how patients are treated for diabetes.
By all accounts my pancreas should be knackered as the bloke next door!
There is, a fine balance in our bodys, when there is sufficient insulin to offset any amount of abuse, it must be down to wear and tear in most cases.
How can it function like that for so long? By which I mean, why don't potential T2s or prediabetics get the resistance earlier in life?
It has a lot to do with lifestyle and diet for most. I believe that's why there is a real increase in diabetes especially T2.
For me it is logical. It has been knowledge for a long time that what is bad for us, that too much starch and sugar will put weight on, hence the no bread, beer and spuds diet of the seventies! Never mind the polyunsaturated fats, that the industrialists use.

For me because I flush insulin my weight has always steadily increased year on year because my body only knows how to store the excess insulin by turning into visceral fats.
I believe my condition came about because my fatty liver became Iess fatty in a short time. And my pancreas reacted to the less demand on it and kept producing at the same rate as before. How true, I don't know.
I have often asked my specialist, why?
And why, I'm different in the way my RH developed?
What is it that makes my condition rare?
Why is my endocrine system different to the vast majority of the diabetic population and also in the general population?
My endocrinologist couldn't answer and my GPs don't have a clue!
I've never been different in such a way!
I've not had to cope with different! I'm just an average joe!
I have asked what is in my future?
Because I am in control and feel so good, I often feel as if this is a big joke that somebody is playing on me! I don't get it! Why me?
I believe I was quite happy being diabetic, yes! It was a shock at first, but I am a positive guy, I was part of a growing gang, one of the pack!
I know that there are other hypoglycaemics masquerading as diabetics out there, that's why I stick around (as wl as the good people) to help those who are banging their heads against the wall like I did, when I knew that there was something going on that just wasn't what my GPs were saying! The docs just don't know different, that I'm convinced of!
But the reason, I am where I am, makes me different again, than hypoglycaemics, I developed my condition natrually, no trauma, no major illness, no surgery!
One of the many things my endocrinologist keeps saying, that what I have is very rare!
There is a scientific paper in the near future about me!
Other people with RH are now being treated with the same diabetic drug because of me. I was the guinea pig!
How the hell do I cope with that?
My specialist has been so instrumental in changing my life for the better and I'm healthier, fitter and more than living my life properly instead of being 'ill'!
I was in a bad place, the list of symptoms was never ending and it wasn't nice being me. Because I was awful and angry and my family put up with a lot.

Different! You couldn't handle different!
Or something like that!

I am rare, special, one in a billion according to my endocrinologist!!!!!!!!

How different is that?

I'm a different than any different than most will ever meet!

Best wishes and good low carbing forum members.

Sorry about the length!

That's a brain grinder! Going for a lie down and a strong black tea!