TERRIFIED T2

Who is telling you this rubbish?

Julie27318 said:

I read it online

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Best ignore whatever site that came from..

Julie27318 said:

So it's not true?

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I would say not providing you can control your diabetes with diet then you won't be over stressing your pancreas so why would it fail? With Type 2 this shouldn't happen.

I agree with @bulkbiker, as long as you control your diabetes with a low carb diet you shouldn't have any problems with your pancreas.

I think what you read was that as a person becomes more insulin resistant, they produce more and more insulin, trying to move glucose from the blood and into the tissues. Eventually this will cause the cells in the pancreas to fail. This is talked about by quite a lot of reputable people, but there is very little information in the scientific literature.

The main thing to remember is that by controlling your BG you are stopping the pressure on your pancreas and lowering your insulin resistance by diet and lifestyle changes will save your insulin secreting cells from damage.

Julie27318 said:

I read that the pancreas stops making insulin eventually i thought this was only the case with type 1's.How long before this happens? i was told i'm making insulin but not using it properly i was never told that my pancreas would stop making it eventually!!!

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That is certainly a possibility.
T2 diabetes is either your body having so much insulin resistance that your pancreas can't keep up, or your pancreas throwing in the towel because it is knackered. Or a combination of the two.

As far as I know you can keep your pancreas limping along for a long time by reducing the requirement to produce insulin as much as possible. You can achieve normal BG levels by diet, exercise and possibly Metformin.

If you catch the problem early enough and diet hard enough to strip the excess fat from your liver and pancreas then you can return to normal. If your pancreas is already damaged then you may not get back to 100% but it can still be "good enough".

Body parts wear out over time. This is life. My knees and feet are already knackered. Teeth not too frisky. Arms and chest not a patch on the muscular hunk (allegedly) that I was in my 20s.

In your case, start using your insulin properly! You are in the lucky position that your pancreas is still producing so if you get rid of your Insulin Resistance then you should be good to go!

You don't (as far as I can tell from your posting history) say what your current weight is or your current diet.

One approach is just to go for LCHF (see many, many threads on here) and aim to get your weight and waist measurement back to what it was when you were 20. If you can remember. Or try the Newcastle Diet with the aim of a rapid weight loss, especially the fat around the liver and pancreas.

Stuff wears out. Treat it gently and it will last a lot longer.

LittleGreyCat said:

Treat it gently and it will last a lot longer.

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Nudge, nudge, wink, wink.

LittleGreyCat said:

T2 diabetes is either your body having so much insulin resistance that your pancreas can't keep up, or your pancreas throwing in the towel because it is knackered. Or a combination of the two.

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I would just argue that diabetes II is complex function of 5 variables: liver, pancreas, muscle mass, visceral fat and insulin resistance.

But yes, main cause is insulin resistance combined with limited pancreas work.

For 30 years, I had thot as you did, that T2D leads to premature exhaustion of our pancreas and that is will eventually lead us to lifelong dependancy on insulin, just like T1D.

But one of the most surprising and life changing realization about T2D is that the above is often mis-represented and is actually misleading.

This is a well understood T2D progression chart


Looking at the lower graph, you can see that following standard dietary advice and treatment insulin levels will decline and beta-cells function approach zero after 30 years.

But note that for up to 10 years BEFORE and AFTER diagnosis, we typically continue to produce MORE insulin than normal. That means there is at least 10 years of excessive beta-cells demand that we can control.

The reason for this is exactly what the others have pointed out. The build up of insulin resistance means we need MORE insulin to process/handle the same amount of carbs.

Dr Joseph Kraft's graph illustrates this with great clarity


The obvious solution then is to reduce the amount of carbs so that we place minimal demand on our remaining functional beta-cells and achieve normal glucose/insulin levels. This will also give our pancreas a chance to regenerate more beta-cells than it is losing....many of us do this using a carbs lite fats friendly approach. Others choose a combination of very low calorie diet (Newcastle diet), Vegan diet, exercise, and intermittent fasting.

Welcome to the forum and your journey to beta-cells recovery...

Hi there,the only advice I can offer is Do NOT use Dr "google" I am a T1 and have been for over 55 years and I only beleave what my GP or Consultant says

In the weeks after diagnosis, using a meter, I could see that the same meal was having less effect on my readings - which reassured me, as I reasoned that I was dealing with the carbs better, so lowering my BG which would in turn mean less pressure to make more insulin, as it is turned out in response to high BG levels. That has to mean a happier pancreas in the long run.

kokhongw said:

For 30 years, I had thot as you did, that T2D leads to premature exhaustion of our pancreas and that is will eventually lead us to lifelong dependancy on insulin, just like T1D.

But one of the most surprising and life changing realization about T2D is that the above is often mis-represented and is actually misleading.

This is a well understood T2D progression chart

Looking at the lower graph, you can see that following standard dietary advice and treatment insulin levels will decline and beta-cells function approach zero after 30 years.

But note that for up to 10 years BEFORE and AFTER diagnosis, we typically continue to produce MORE insulin than normal. That means there is at least 10 years of excessive beta-cells demand that we can control.

The reason for this is exactly what the others have pointed out. The build up of insulin resistance means we need MORE insulin to process/handle the same amount of carbs.

Dr Joseph Kraft's graph illustrates this with great clarity

The obvious solution then is to reduce the amount of carbs so that we place minimal demand on our remaining functional beta-cells and achieve normal glucose/insulin levels. This will also give our pancreas a chance to regenerate more beta-cells than it is losing....many of us do this using a carbs lite fats friendly approach. Others choose a combination of very low calorie diet (Newcastle diet), Vegan diet, exercise, and intermittent fasting.

Welcome to the forum and your journey to beta-cells recovery...

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All good informative stuff - however you say "This will also give our pancreas a chance to regenerate more beta-cells than it is losing". I think it should be made clear that it increases the possibility that the pancreas can recover, but there is no guarantee that it will.

I am diagnosed 10 years and I recently had an insulin resistance test. This showed that I had a higher fasting BG level (not sure how that happened) and a low level of insulin production. So I certainly wasn't over producing insulin.

However as I eat LCHF and am mainly in ketosis then I would expect a naturally low level of insulin production because there is a low daily requirement.

The one thing the test ruled out was that I was highly insulin resistant and still over producing insulin.

I would love to see the evidence of regeneration of human beta cells.

A few years ago when I first encountered the idea that beta cells could regenerate and insulin production could go back up, I got all excited and ransacked the internet for studies on the subject.
All I found were several over-excited articles by journalists promising a 'cure' 'within 10 years'
and a few rodent studies, where young lab mice and rats could grow new beta cells.

Hopefully the research has moved on since then, but I think it is a bit of a stretch to suggest that a middle aged human pancreas (with/without being a fatty pancreas) can regenerate beta cells like a young, non-fatty, rat or mouse pancreas.

Anyone know if there is evidence out there for studies on adult humans with prior diagnoses of T2?
Very interested to read them, if there are.

LittleGreyCat said:

All good informative stuff - however you say "This will also give our pancreas a chance to regenerate more beta-cells than it is losing". I think it should be made clear that it increases the possibility that the pancreas can recover, but there is no guarantee that it will.

I am diagnosed 10 years and I recently had an insulin resistance test. This showed that I had a higher fasting BG level (not sure how that happened) and a low level of insulin production. So I certainly wasn't over producing insulin.

However as I eat LCHF and am mainly in ketosis then I would expect a naturally low level of insulin production because there is a low daily requirement.

The one thing the test ruled out was that I was highly insulin resistant and still over producing insulin.

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Yes, there is no guarantee as there is currently no specific(readily available) test to baseline our insulin response before and after diagnosis. Or measure our beta-cells mass.

I believe the fasting insulin test would only determine that we are no longer chronically having higher than normal insulin levels.

To determine if we are having insulin resistant the Kraft OGTT with insulin assay to measure our insulin response would be more deterministic, unfortunately that is not a standard test that is readily available.

Another point is that if we have higher fasting glucose, it would likely mean that our liver is not insulin sensitive enough to stop the rising glucose levels in the morning.

Brunneria said:

I would love to see the evidence of regeneration of human beta cells.

A few years ago when I first encountered the idea that beta cells could regenerate and insulin production could go back up, I got all excited and ransacked the internet for studies on the subject.
All I found were several over-excited articles by journalists promising a 'cure' 'within 10 years'
and a few rodent studies, where young lab mice and rats could grow new beta cells.

Hopefully the research has moved on since then, but I think it is a bit of a stretch to suggest that a middle aged human pancreas (with/without being a fatty pancreas) can regenerate beta cells like a young, non-fatty, rat or mouse pancreas.

Anyone know if there is evidence out there for studies on adult humans with prior diagnoses of T2?
Very interested to read them, if there are.

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There has been limited studies on human as explained by Dr Peter Butler in his TedX video

He has published a number of studies on beta-cells regeneration...
http://grantome.com/grant/NIH/R01-DK077967-08

And this one seems particularly interesting and hopeful...
β-Cell Mass and Turnover in Humans
Effects of obesity and aging
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526241/

CONCLUSIONS
β-Cell mass in human obesity increases by ∼50% by an increase in β-cell number, the source of which is unknown. β-Cell mass is well preserved in humans with advanced aging.

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And this
β-Cell Deficit in Obese Type 2 Diabetes, a Minor Role of β-Cell Dedifferentiation and Degranulation
https://academic.oup.com/jcem/article/101/2/523/2810769

Conclusions:
Therefore, although we concur that in type 2 diabetes there are endocrine cells with altered cell identity, this process does not account for the deficit in β-cells in type 2 diabetes but may reflect, in part, attempted β-cell regeneration.

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I am beginning to think what we have in T2D is more of a signalling and functional loss, not necessarily a complete physical loss as per T1D. That may explain why certain intervention can bring about rapid normalization, eg bariatric surgery and FGF1 protein injection (though experimental in animal models).

Thanks @kokhongw
I will put those on my 'reading list' and digest them at my leisure!