1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2022 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Type 2: Low carb cannot repair damaged beta cells

Discussion in 'Diabetes Discussions' started by Tannith, Feb 13, 2021.

  1. Tannith

    Tannith · BANNED

    Messages:
    1,230
    Likes Received:
    449
    Trophy Points:
    103
    Low carb cannot put T2 diabetes into remission by repairing damaged beta cells. Only weight loss can do this. All it can do is lower blood sugar. Off course if the low carb diet chosen is one that simultaneously causes weight loss then it can play a part in repairing beta cells. Eg Some, but not all, low carb diets involve just reducing calories from carbs without replacing them with equivalent calories from other macronutrients such as fat. And there are some versions in between that replace only some of the missing carb calories with fat calories. These can also bring about a degree of weight loss. Repairing Beta cell function is the only way of putting T2 diabetes, as opposed to it's symptom, high blood sugar, into reverse.
    "Insulin resistance in muscle and liver and β-cell failure represent the core pathophysiologic defects in type 2 diabetes. It now is recognized that the β-cell failure occurs much earlier and is more severe than previously thought. Subjects in the upper tertile of impaired glucose tolerance (IGT) are maximally/near-maximally insulin resistant and have lost over 80% of their β-cell function) Treatment should be based upon reversal of known pathogenic abnormalities and not simply on reducing the A1C, and therapy must be started early to prevent/slow the progressive β-cell failure that already is well established in IGT subjects. A treatment paradigm shift is recommended in which combination therapy is initiated with diet/exercise, metformin (which improves insulin sensitivity and has antiatherogenic effects), a thiazolidinedione (TZD) (which improves insulin sensitivity, preserves β-cell function, and exerts antiatherogenic effects), and exenatide (which preserves β-cell function and promotes weight loss)."

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2661582/
     
    #1 Tannith, Feb 13, 2021 at 8:52 PM
    Last edited by a moderator: Feb 13, 2021
  2. zand

    zand Type 2 · Master

    Messages:
    10,504
    Likes Received:
    16,372
    Trophy Points:
    298
    @Tannith You are very fortunate that you were diagnosed so early. I had insulin resistance for over 20 years (perhaps as many as 30) before I realised what was wrong. Unfortunately the NHS has never bothered to find out why obese people are obese, it has always been assumed they eat too much and move too little. I now know that IR (T2) was the problem all along, but that's usually only diagnosed when the beta cells can't cope anymore and BGs are raised. If only someone had told me about LCHF 30+ years ago I never would have exhausted myself and my body with low cal diets. I find your constant knocking of LCHF rather galling. Some of us have no choice, low cal diets don't work for us.
     
    • Agree Agree x 5
  3. hankjam

    hankjam Type 2 (in remission!) · Well-Known Member

    Messages:
    3,846
    Likes Received:
    13,912
    Trophy Points:
    198
    Good enough for me. It's hardly a life sentence.
     
    • Agree Agree x 4
    • Like Like x 2
  4. lucylocket61

    lucylocket61 Type 2 · Expert

    Messages:
    6,101
    Likes Received:
    2,653
    Trophy Points:
    178
    Remission is fine. Given that I cannot lose weight, (even my GP accepts that), I am happy to remain in control by low carbing and being nourished safely and healthily.

    Thinking about how science evolves, what we thought we knew changes, and how flawed some studies turn out to be, I will continue with what works for me. I dont accept that the final word has been said on whether or not damaged beta cells can be repaired. I KNOW from years of experience that a low calorie diet harms me. I will stick to what i know to be true.

    I am a whole person. Lowering calories unnecessarily to the point of malnutrition would cause other damage to my body and mental health , just as severe as type 2 diabetes. I take the holistic approach.

    In the end, what difference does it make if I have long term control for the rest of my life by low carbing, versus long term control losing weight?The result is the same, according to that study.

    I wonder what happens with those diagnosed when at the right weight or even underweight?

    How are your fasting blood levels now @Tannith? Its been a couple of weeks since your last update. How much weight have you lost?
     
    • Agree Agree x 3
    • Like Like x 1
  5. zand

    zand Type 2 · Master

    Messages:
    10,504
    Likes Received:
    16,372
    Trophy Points:
    298
    @Tannith You say that losing weight is the only way to repair beta cells, very many here have lost weight using LCHF with the added benefit that they aren't slowing down their metabolism by starving themselves.
     
    • Agree Agree x 6
    • Winner Winner x 3
    • Like Like x 1
  6. Ronancastled

    Ronancastled Type 2 · Well-Known Member

    Messages:
    1,027
    Likes Received:
    654
    Trophy Points:
    173
    @Tannith you do realise that many T2s are actually overproducing insulin at diagnosis.
    Insulin resistance is the enemy plus the lack of insulin sensitivity.
     
    • Agree Agree x 2
    • Like Like x 1
    #6 Ronancastled, Feb 13, 2021 at 10:36 PM
    Last edited by a moderator: Feb 13, 2021
  7. bulkbiker

    bulkbiker Type 2 · Oracle

    Messages:
    19,044
    Likes Received:
    12,607
    Trophy Points:
    298
    Then please explain the successes that many of us have had using low carb to lower blood sugar, improve insulin sensitivity and put T2 into remission passing every diagnostic test going?
     
    • Agree Agree x 5
  8. lucylocket61

    lucylocket61 Type 2 · Expert

    Messages:
    6,101
    Likes Received:
    2,653
    Trophy Points:
    178
    Tannith isn't interested in remission.

    She is looking for a way to be no longer diabetic at all regardless of what she eats.
     
    • Informative Informative x 2
  9. Flora123

    Flora123 Type 2 · Well-Known Member

    Messages:
    1,078
    Likes Received:
    609
    Trophy Points:
    173
    What if you don’t need to lose weight? What about thin T2s?
     
    • Like Like x 2
    • Agree Agree x 1
  10. ziggy_w

    ziggy_w Type 2 · Well-Known Member

    Messages:
    3,023
    Likes Received:
    8,607
    Trophy Points:
    198
    @Tannith,

    You might be interesting in the following scientific article https://www.cell.com/cell-metabolism/fulltext/S1550-4131(14)00114-4. It says that glucotoxicity (toxicity due to high blood sugars) causes beta cells to differentiate into other types of cells (they turn into delta cells if I remember correctly) and once blood sugars normalize due to insulin treatment, they redifferentiate into beta cells.

    So, if normalizing blood sugar levels due to insulin leads to a recovery of at least some beta cells, why wouldn't normalizing blood sugar levels due to low carbing do the same thing (even without weight loss)?

    I agree with you that a fatty pancreas is a problem for many, if not most, T2s. However, I also believe that pancreas fat can also be be reduced by cutting out fructose (and possibly other carbs) rather than just reducing calories.

    Dr. Robert Lustig has conducted a study (https://www.ucsf.edu/news/2017/08/408151/switching-sugar-starch-leads-less-fatty-liver-kids) where he substituted fructose (as in table sugar) with starchy carbs in children while keeping calories the same. What he observed was that while they did not lose weight, they lost fat from the liver. The question that follows from this is why wouldn't we also lose weight from other internal organs such as the pancreas, when we are losing fat from the liver?
     
    • Winner Winner x 4
    • Informative Informative x 3
    • Agree Agree x 1
    #10 ziggy_w, Feb 13, 2021 at 11:21 PM
    Last edited: Feb 13, 2021
  11. VashtiB

    VashtiB Type 2 · Moderator
    Staff Member

    Messages:
    1,788
    Likes Received:
    1,069
    Trophy Points:
    198
    @Tannith

    Every time I see you post I really feel sorry for you- you seem ato be clutching at straws. I've told you my story before but for newbies briefly I had regular blood tests before diagnosis as I have a family history of type 2 diabetes -thanks mum and dad. So I had been diabetic less than 12 months before diagnosis- maybe less than 9 months can't really be sure. I've gone low carb and brought my blood sugar levels into the normal range in less than 3 mo nth from diagnosis. I've lost over 30 kgs- so l.ots of weight loss. I am still a diabetic. If I have anything above a very low level of carbs in a meal I spike- not as much as before but still more than I like. I keep my spikes less than 7 as I keep very low carb. I also desperately wanted to believe I could be cured. I am a arboholic and low carb is in n way my preferred way of eating. I persist because it works. My dr does not support low carb but even she acknowledges begrudgingly that my blood sugar levels are no longer a concern as I maintain very low carb.

    I would love to be cured but I'm not. The minute I am diagnosed with a termination al illness with a very short time to live then carbs are back!!!

    I'm really sorry but I do not believe weight loss alone cures diabetes otherwise why am I not cured?

    So your title could read weight loss does not cure damaged beta cells.
     
    • Agree Agree x 3
    • Like Like x 1
  12. Resurgam

    Resurgam Type 2 (in remission!) · Expert

    Messages:
    9,211
    Likes Received:
    5,517
    Trophy Points:
    198
    Perhaps I have never had damaged beta cells, even though I was labelled a very bad diabetic at diagnosis.
    I had a few feelings of hypos during my backtracking to normality, which - if my insulin output was high rather than low, would be perfectly predictable. Once my hysterical pancreas settle down all was well and has continued to be so.
     
    • Winner Winner x 1
  13. Tophat1900

    Tophat1900 Type 3c · Well-Known Member

    Messages:
    2,408
    Likes Received:
    1,364
    Trophy Points:
    178
    This is really just a continuation of the conversation on this thread below, except there are now two threads.

    https://www.diabetes.co.uk/forum/th...he-secret-to-treating-diabetes.178134/page-24

    In the link posted by the op is this for the treatment of T2

    ADA ALGORITHM FOR TREATMENT OF TYPE 2 DIABETES
    The ADA algorithm for the treatment of type 2 diabetes advocates a stepwise therapeutic approach that is based upon reduction in the plasma glucose concentration and NOT upon known pathophysiological disturbances (49). It dictates the initiation of therapy with lifestyle modification plus metformin to achieve an A1C < 7.0% (Fig. 18). If the goal is not reached or if secondary failure occurs, the ADA algorithm suggests one of three options: 1) First is the addition of basal insulin, an option unlikely to be chosen by primary care physicians or most endocrinologists in the U.S. and unlikely to achieve the desired level of glycemic control based upon well-designed studies by experts in the field of insulin therapy (302308). Moreover, all of these insulin-based add-on studies have been associated with a high incidence of hypoglycemia and major weight gain (range 4.2–19.2 lbs, mean 8.5 lbs within 6–12 months or less) (Fig. 19). 2) Second is the addition of a TZD, but this option is unlikely to be chosen because of the concerns raised in the ADA algorithm about this class of drugs. Thus, the ADA algorithm basically guides the physician to select a sulfonylurea as the choice for a second antidiabetic agent. Moreover, third party reimbursers like this option because sulfonylureas are inexpensive. Neither the GLP-1 analogs nor the DPP-4 inhibitors are included as an option in the ADA algorithm (49). Since neither the sulfonylureas nor metformin exerts any effect to preserve β-cell function (see previous discussion and Fig. 16), the 20% of β-cell function that was present at the time of diagnosis of diabetes (4042) will largely have been lost by the time that combined sulfonylurea/metformin therapy has failed, and the majority of these patients will require insulin treatment. Insulin therapy is difficult for most primary care physicians, and even in the hands of experienced endocrinologists it is not easy to achieve and maintain an A1C <7%—let alone <6.5%—without significant hypoglycemia and weight gain (302308). Moreover, it is unclear why one would initiate insulin before exenatide, since insulin rarely decreases the A1C to <7.0% and is associated with significant weight gain and hypoglycemia (302308) (Fig. 19). Most recently, an ADA Consensus Statement has significantly revised the ADA therapeutic algorithm (309). A two-tier approach is advocated, and sulfonylureas have been elevated into the first tier and are to be used if diet/exercise plus metformin fail to reduce the A1C to <7.0% (Fig. 20). From the pathophysiological standpoint, this represents a major step backward, since an overwhelming body of evidence-based medicine (Fig. 16) conclusively demonstrates that sulfonylureas do not preserve β-cell function and do not achieve durability of glycemic control. Although this algorithm is not the official policy statement of ADA, it is likely to be interpreted as such by most third-party payers. "

    The link you posted is all about ADA drug treatment for t2 diabetics. I could find no mention to low carb at all. If I missed it please point it out to me.

    The article then states this below. This view imo is incorrect. Obesity is in my view mostly a sign of metabolic dysfunction. The ADA clearly believes it is a cause.

    "It is abundantly clear that the current epidemic of diabetes is being driven by the epidemic of obesity"

    @Tannith in regards to your copy n paste, it is clear you have posted fragments and it is not one copy n paste. The article is titled.

    From the Triumvirate to the Ominous Octet: A New Paradigm for the Treatment of Type 2 Diabetes Mellitus

    It is not titled
    Type 2: Low carb cannot repair damaged beta cells

    In fact I couldn't find any discussion on diet at all. Let alone a claim that low carb cannot do as you state. The article is about the ADA's algorithm drug therapy approaches. And a A1C goal of 7%




    Summary: Treatment.
    Although this paradigm shift, which is based upon pathophysiology, represents a novel approach to the treatment of type 2 diabetes, it is substantiated by a vast body of basic scientific and clinical investigational studies. Because this algorithm is based upon the reversal of known pathophysiological defects, it has a high probability of achieving durable glycemic control. If the plasma glucose concentration can be maintained within the normal nondiabetic range, the microvascular complications of the disease, which are costly to treat and associated with major morbidity and mortality, can be prevented. Most importantly, this will enhance the quality of life for all diabetic patients.

    So, the goal of the ADA is jump straight to drugs and try to achieve an A1c goal of 7%... I did see maybe 6.5% being mentioned somewhere, but it's a long article. Either way, not a good outcome. And given the hostility and ignorance towards low carb by much of the medical world it doesn't surprise me that it isn't mentioned.


    Tannith please point out anything I missed or got wrong. I am operating on zero coffee at the moment.
     
    • Winner Winner x 5
    • Agree Agree x 2
    • Like Like x 1
  14. Krystyna23040

    Krystyna23040 Type 2 (in remission!) · Well-Known Member

    Messages:
    4,948
    Likes Received:
    8,517
    Trophy Points:
    178
    @Tophat1900 Thank you for taking the time to ascertain that the research that @Tannith has selectively cut and paste did not look at a low carb diet at all and the research was only about drug treatment for T2.

    I must admit that as a skinny T2 on diagnosis - weight loss is not an option for me - so low carb is my only option and is working much better than the insulin i took for 4 years.

    I felt really down when I read @Tannith 's post because I was hoping in the long term that my beta cells would recover, but feel much more upbeat this morning after reading everyone 's replies to the OP.
     
    • Like Like x 4
    • Hug Hug x 4
    #14 Krystyna23040, Feb 14, 2021 at 9:49 AM
    Last edited: Feb 14, 2021
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook