Transition to Diabetic

Mr_Pot

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Reading another thread where there were the usual discussions of reversal/remission/control I realised that I don't know what it means to transition from pre-diabetic to diabetic. It is mostly accepted that, once you are diabetic you are always diabetic, you can control your BG to normal levels but you are not cured. I believe the implication of the term pre-diabetic is that if you take action at this point (which not many people do) you may not become diabetic. Is this cured, or no different from someone who was diabetic but is now controlled? Is there something that happens that results in a cliff edge transition to diabetic, maybe if you have lost function in 50% of your beta cells it is too late but 49% you can recover from? Does anybody know?
 

novorapidboi26

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I would be of the opinion that even pre-diabetic individuals are still diabetic and they are just at very early stages........

its still likely that one day down the line, the diabetes may show itself.....

just my opinion though...;)
 
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sally and james

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My understanding is that it is all just a sliding scale from the new born babe, with (hopefully) a perfect metabolism, to the 60 something drowning in sugar with an HbA1c in the 90's. The powers that be have simply picked on particular numbers for administrative purposes and given them names and decided what they will or will not do about it. Nothing in particular happens when a person crosses one of the divides, they just get put on a different treatment pathway.
Sally
 

Jenny15

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My understanding is that it is all just a sliding scale from the new born babe, with (hopefully) a perfect metabolism, to the 60 something drowning in sugar with an HbA1c in the 90's. The powers that be have simply picked on particular numbers for administrative purposes and given them names and decided what they will or will not do about it. Nothing in particular happens when a person crosses one of the divides, they just get put on a different treatment pathway.
Sally
I agree with this explanation. The cutoff points are arbitrary but that doesn't make them meaningless. Whole committees of doctors would have deliberated on the best places to draw those lines.

The lines serve a purpose, by helping the health system organise itself around levels of need. It's up to individual HCPs to detect nuance and tailor recommendations to the individual who is at a borderline.

When I was in remission (in the 30s of A1c) I didn't actually understand that I was in remission. My mind gravitated toward the fantasy that I could forget all about it. This wasn't a conscious thing.

For that reason I believe it's very important for anyone with an A1c over 42 at any time in their life to understand what remission is and how one can fall out of it. I had to learn the hard way.
 
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Bluetit1802

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My understanding is that it is all just a sliding scale from the new born babe, with (hopefully) a perfect metabolism, to the 60 something drowning in sugar with an HbA1c in the 90's. The powers that be have simply picked on particular numbers for administrative purposes and given them names and decided what they will or will not do about it. Nothing in particular happens when a person crosses one of the divides, they just get put on a different treatment pathway.
Sally

I agree.
 

Crocodile

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My Mum has been a T2 for many many years. I've obviously inherited the genes ( thanks for that Mum ). Both her siblings are T2. My sister has been pre-diabetic for years but has no progressed. I suppose it depends upon our own individual physiology as to whether anyone eventually makes the transition.
 
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Jenny15

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My Mum has been a T2 for many many years. I've obviously inherited the genes ( thanks for that Mum ). Both her siblings are T2. My sister has been pre-diabetic for years but has no progressed. I suppose it depends upon our own individual physiology as to whether anyone eventually makes the transition.
Very true. T1 and T2 are rampant in my extended family. I have relatives who are quite overweight, and older than me, who don't even have prediabetes. Annoying, LOL. but then I remember that we never know what struggles other people have behind closed doors.

My Mum always looks a bit hurt when I thank her for the genes, so I've started thanking her mother instead, who isn't around to respond. "Stuff happens" in life, doesn't it?
 
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Jenny15

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Don't forget the lawyers as well.
Perhaps we need our own version of the song The 12 Days of Christmas.

On the first day of Christmas
My true love sent to me
A lawyer in committee

On the second day of Christmas
My true love sent to me
Two cost accountants
And a lawyer in committee

On the third day of Christmas
Three supervisors
Two cost accountants
And a lawyer in committee...
 
P

pollensa

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Reading another thread where there were the usual discussions of reversal/remission/control I realised that I don't know what it means to transition from pre-diabetic to diabetic. It is mostly accepted that, once you are diabetic you are always diabetic, you can control your BG to normal levels but you are not cured. I believe the implication of the term pre-diabetic is that if you take action at this point (which not many people do) you may not become diabetic. Is this cured, or no different from someone who was diabetic but is now controlled? Is there something that happens that results in a cliff edge transition to diabetic, maybe if you have lost function in 50% of your beta cells it is too late but 49% you can recover from? Does anybody know?

Take my plant off to you Mr. Pot, what pragmatic points you raise, and to be honest, I wont comment on some, as I am from Australia and call a spade a spade that sometimes ruffles ones feathers,even if it is always, I repeat always, any shared info or own experiences put forth in the best interests, help where and where possible if people wish to use info,is another thing. I myself dont know to comment reply fully.

If I may put my euro worth here on couple valid points you raised,

re reversal remission control i.e. once a diabetic always a diabetic, thats the Big question for some Doctors they feel yes it is reversable Dr. Fung for example if one knows how and to aim focus target to treat the CAUSE of diabetes a dietary disease the insulin resistance and not the symptom sugars for this there is hope ,Dr. David Cavan gives a chart in his book "the three stages of diabetes reversal" partial complete and prolonged and gives the numbers and duration of years he is a diabetes specialist of many years I believe.

re Pre Diabtes comments before your post I read an article today i.e. Pre Diabetes is not actually officially recognised as a disease quoting to be defined this is by arbitrary cut off points as many diseases and is not officially recognized as a disease, it does not appear on the world health organisation list of conditions? for this, if diabetes is not officially a disease, its a label, that does not need to be cured perhaps, as its just a Pre something that may or may not happen? caution. Its seems the pre diabetes comes to the fore if one is on the cusp or sugar levels are on upper level, then again, sometimes levels change from one number to another lowering, one can be normal one day, but fall into the label of pre diabetes or diabetic lets say due to changing of cut off levels.

the article refers to those under the umbrella of pre that the pharmaceutical industry is placing pressure to prescribe diabetic medication for many, to reduce their chances of developing full blown type 2.

On my reading this, thoughts came into my mind, why would I personal point of view only I stress, want to take medications for something that may not even happen? it seems more common sense, all I have to do is change my lifestyle and diet to ensure I take the best measures possible to lower any higher normal sugars? But then I am not a doctor, only a person trying to put it all together. Prof Yudkin UK argues, thre is no proven benefit from treating pre diabetics with drugs? so who or what do we believe? After all it seems these days everything is becoming pre something, pre diabetes, pre dementia, pre cholesterol?

I feel sure if one comes under prediabetes whether not officially recognized or not, its just somewhere inbetween normal and diabetes, it would be only good common sense to take heed of the caution bell, do something about it change lifestyle and diet, really, we should all be doing that anyway, even if normal for a better quality and longer life Yes or No? As you say not many people do how right you are, that is a great pity people perhaps do not hear the warning bell sadly.

If it is not an official disease? I view it as caution zone and act upon that, which I have, my own case turned it around, and was medically noted on records two weeks ago not pre diabetic now non diabetic range, no medications taken, and reversed lowered higher normal numbers to normal on all levels including A1C in 1 year.

Its a delicate and not easy to understand situation overall. Hope comments within may prove of assistance to your questions these type of questions on the forum should be more forthcoming as its great to hear always good news what can take place, but reality is there whether people want to hear or not, some black and white areas that lead to confusion doubt that should be able to be discussed now and again as they are valid and not often raised to attention, for this I applaud your comments today.
 
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sally and james

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I'm always interested in the research that shows that you are more likely to become T2 if your husband/wife/partner is T2. There was something very recently about this, sorry can't remember where. The implication is that environment (I'm guessing food on the table, rather than air pollutants) is very much to blame. Relatives will, of course, usually have shared an environment or a food culture, so this muddies the water of the, "my mother was T2, so what chance did I have", argument.
Perhaps we inherit a pre-disposition, but our surroundings/culture is/are the cause.
Sally
 
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Crocodile

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Very true. T1 and T2 are rampant in my extended family. I have relatives who are quite overweight, and older than me, who don't even have prediabetes. Annoying, LOL. but then I remember that we never know what struggles other people have behind closed doors.

My Mum always looks a bit hurt when I thank her for the genes, so I've started thanking her mother instead, who isn't around to respond. **** happens in life, doesn't it?

Edited by moderator for language
Yeah, poop does happen, I'm T2 but thankfully the rest of me is good except for a small amount neuropathy in my feet that doesn't really bother me much. Lucky I suppose that at 61 there's nothing else. Years ago now my wife and I lost our eldest child to cancer. Kind of puts a reality check and a bit of perspective on a T2 diagnosis. Some people are just way worse off than me. I'm thankful every day for that at least.
 
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Jenny15

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I'm always interested in the research that shows that you are more likely to become T2 if your husband/wife/partner is T2. There was something very recently about this, sorry can't remember where. The implication is that environment (I'm guessing food on the table, rather than air pollutants) is very much to blame. Relatives will, of course, usually have shared an environment or a food culture, so this muddies the water of the, "my mother was T2, so what chance did I have", argument.
Perhaps we inherit a pre-disposition, but our surroundings/culture is/are the cause.
Sally
One idea I have about this phenomenon is that since diabetes is such a relatively common disease, the odds of two people with the genetic predisposition for it marrying could be a bit higher than other possible combinations. I don't know.
 
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Bluetit1802

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I'm always interested in the research that shows that you are more likely to become T2 if your husband/wife/partner is T2. There was something very recently about this, sorry can't remember where. The implication is that environment (I'm guessing food on the table, rather than air pollutants) is very much to blame. Relatives will, of course, usually have shared an environment or a food culture, so this muddies the water of the, "my mother was T2, so what chance did I have", argument.
Perhaps we inherit a pre-disposition, but our surroundings/culture is/are the cause.
Sally

I think it was one of those DCUK BOT things.
 

derry60

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I find it odd that a person who can be very obese not have Diabetes or even Pre-Diabetes and have normal sugar levels. I suppose it goes to show that it is not just all about weight.
 

Bluetit1802

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I find it odd that a person who can be very obese not have Diabetes or even Pre-Diabetes and have normal sugar levels. I suppose it goes to show that it is not just all about weight.

Yet ...... who knows what is developing inside the body.
 

Crocodile

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I find it odd that a person who can be very obese not have Diabetes or even Pre-Diabetes and have normal sugar levels. I suppose it goes to show that it is not just all about weight.
And some people with diabetes are so thin that they don't even cast a shadow if they turn side-on.

I've got a theory about weight but don't know if it is right. If you are overweight you have more cells. Therefore more insulin is required to cause uptake of glucose. If the ol' beta cells can't keep up then bingo.
 

Mr_Pot

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I like the idea that there is a sliding scale from normal to seriously diabetic with arbitrarily assigned labels for levels as suggested by @sally and james but it doesn't account for the difference between those on the way up the scale and those who have come down. Take two people, both with an HbA1c of say 27, where one has never been higher and the other had an HbA1c of 60 before they controlled their carb intake and became controlled/in remission/reversed. They are both at the same point on a diabetes scale but they are not at the same point on what we really need to describe their condition, which is a "glucose tolerance scale".
 
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