Variation in carbs tolerance for Type2s

[chrisjohnh]

Considering the T2Ds who can tolerate only very small amounts of carbs, is it the case that there is a known explanation common to most of those cases? For instance, an insulin deficiency? Some other hormone deficiency? Irresolvable insulin resistance? Do we have some good science yet on that?

 

[lucylocket61]

Not that I am aware of in my 10+ years since diagnosis. My tolerance fluctuates. My tolerance for certain foods may be less for me than someone else eating the same thing, and vice versa. It's a mystery to me.

 

[chrisjohnh]

Not that I am aware of in my 10+ years since diagnosis. My tolerance fluctuates. My tolerance for certain foods may be less for me than someone else eating the same thing, and vice versa. It's a mystery to me.

I had not known that even for an individual the extent of carbs tolerance could vary from time to time. My uninformed guess would be that variations between T2Ds in tolerance were owed not to differences in insulin secretion but differences in capacity for their cells to accept glucose.

 

[Oldvatr]

We are all different, and are often affected by things happpening in our lives. So diet variations, stress levels, sickness and inflammation, and exercise can all affect our response to carbs. This site is full of people who have improved their outlook simply through diet changes, and the Newcastle Diet Study (DIRECT) has demonstrated scientifically the effect of one type of diet, and was backed up by MRI scans and OGTT testing. So yes each of us can influence the course of our own condition, but again what works for me may not work for you. There is no magic pill yet. There is no common cause yet identified

 

[chrisjohnh]

We are all different, and are often affected by things happpening in our lives. So diet variations, stress levels, sickness and inflammation, and exercise can all affect our response to carbs. This site is full of people who have improved their outlook simply through diet changes, and the Newcastle Diet Study (DIRECT) has demonstrated scientifically the effect of one type of diet, and was backed up by MRI scans and OGTT testing. So yes each of us can influence the course of our own condition, but again what works for me may not work for you. There is no magic pill yet. There is no common cause yet identified

Thank you. It seems to me that this question of what determines carbs tolerance will have to be scientifically clarified if the NHS view of T2D management through diet is to have any chance of being updated effectively from its current stance. It is unfortunate I think that Direct, Retune etc haven’t reported carbs-specific data out of the studies, though I have seen it claimed that their funding sources would have been averse to raising carbs issues to prominence.

 

[Ronancastled]

Considering the T2Ds who can tolerate only very small amounts of carbs, is it the case that there is a known explanation common to most of those cases? For instance, an insulin deficiency? Some other hormone deficiency? Irresolvable insulin resistance? Do we have some good science yet on that?

All the remission data I've ever read has arrived at the same conclusion, your chances of success are directly related to your duration of T2.
There appears to be a window of opportunity to rescue dormant beta cells before your reach a point of no return.
Taylor suggested 6 years as a cutoff for his trials.
What none of us know is how long we have been T2, pre-diabetic, or diabetes in situ (Kraft) before official diagnosis.
Many of us have probably been over producing insulin to cover our diets for years before any dysfunction appeared.
Another variable is the amount of beta cells we create after birth, I've read of studies where it can vary by as much as 250m at the lower end to over 1 billion in some individuals.
It's only a theory but perhaps a proliferation of beta cells to begin with yields a higher chance of success should they be re-awoken.

 

[chrisjohnh]

All the remission data I've ever read has arrived at the same conclusion, your chances of success are directly related to your duration of T2.
There appears to be a window of opportunity to rescue dormant beta cells before your reach a point of no return.
Taylor suggested 6 years as a cutoff for his trials.
What none of us know is how long we have been T2, pre-diabetic, or diabetes in situ (Kraft) before official diagnosis.
Many of us have probably been over producing insulin to cover our diets for years before any dysfunction appeared.
Another variable is the amount of beta cells we create after birth, I've read of studies where it can vary by as much as 250m at the lower end to over 1 billion in some individuals.
It's only a theory but perhaps a proliferation of beta cells to begin with yields a higher chance of success should they be re-awoken.

These are interesting observations, thank you. If someone finds that they have to maintain very low carbs in order to maintain good control, would not a test of their insulin secretion during a postprandial period be sufficient to rule in or out the pancreatic possibilities you mention?

 

[chrisjohnh]

All the remission data I've ever read has arrived at the same conclusion, your chances of success are directly related to your duration of T2.
There appears to be a window of opportunity to rescue dormant beta cells before your reach a point of no return.
Taylor suggested 6 years as a cutoff for his trials.
What none of us know is how long we have been T2, pre-diabetic, or diabetes in situ (Kraft) before official diagnosis.
Many of us have probably been over producing insulin to cover our diets for years before any dysfunction appeared.
Another variable is the amount of beta cells we create after birth, I've read of studies where it can vary by as much as 250m at the lower end to over 1 billion in some individuals.
It's only a theory but perhaps a proliferation of beta cells to begin with yields a higher chance of success should they be re-awoken.

The suggested finite window of opportunity to have the prospect of remission is terrifying and would point up an urgent need for universal regular HbA1c screening.

 

[lucylocket61]

I am over 10+ years post diagnosis. I have probably, looking back, been pre diabetic for 10 years before that. I have just gone into pre diabetic again. Hba1c 45. We all respond differently, the research can't be done due to situations and differences, sometimes several times a day, in what affects our blood sugar levels.

I assume this is why type 1 control is so hard for them. There is no formula to follow which guarantees success.

Timelines for successful remission are just guesses. Until relatively recently type 2 remission wasn't even considered possible, so any research is nee and often based on flawed studies and incorrect assumptions.

 

[Ronancastled]

These are interesting observations, thank you. If someone finds that they have to maintain very low carbs in order to maintain good control, would not a test of their insulin secretion during a postprandial period be sufficient to rule in or out the pancreatic possibilities you mention?

Surgeries don't typically offer them, an Endo might however but even that seems rare.
Testing glucose levels in the "healthy" population is often the standard course, either in a HbA1c or an FBG test.
A 75g OGTT would be even more enlightening but these are done rarely nowadays & typically only for pregnancy.
Those would a real dysfunction could be identified decades earlier by a Kraft Insulin Assay as shown below.
A 3 hour 75g OGTT where they test glucose & insulin at 30 min intervals.

2 people with completely normal glucose profiles yet the hidden beneath the iceberg is that one is covering it by 4x the insulin production.
These test are only administered by private labs at a cost but would identify & prevent a huge percentage of future T2s.

 

[lucylocket61]

but would identify & prevent a huge percentage of future T2s.

I disagree. Yes, it may identify but, given current medical thinking and treatment, it won't prevent type 2 diabetes happening.

 

[chrisjohnh]

I am over 10+ years post diagnosis. I have probably, looking back, been pre diabetic for 10 years before that. I have just gone into pre diabetic again. Hba1c 45. We all respond differently, the research can't be done due to situations and differences, sometimes several times a day, in what affects our blood sugar levels.

I assume this is why type 1 control is so hard for them. There is no formula to follow which guarantees success.

Timelines for successful remission are just guesses. Until relatively recently type 2 remission wasn't even considered possible, so any research is nee and often based on flawed studies and incorrect assumptions.

It comes back to this view that one has to be one’s own experiment, one’s own researcher and one’s own dietitian, perhaps even one’s own doctor, as far as T2D is concerned. Still, medical science in many other areas, e.g. oncology, immunology…, has made progress despite the huge spectrum of individual differences.

 

[Lamont D]

These are interesting observations, thank you. If someone finds that they have to maintain very low carbs in order to maintain good control, would not a test of their insulin secretion during a postprandial period be sufficient to rule in or out the pancreatic possibilities you mention?

Yes.
It is the response of insulin main!y that determines your intolerance.
For example, if it was known, like me, that wheat is something that I can't eat!
So how can I have since birth be lactose intolerance?
Some people can eat 50g carbs and not be effected.
You have to get your head around not only hormonal but but biotics as well.
There are millions of live bacteria in your digestive system, mostly good, but varies with the bad.

A lot of T2s, and I did have the condition called hyperinsulinimia. Which is very high circulating insulin levels that won't help with the glucose derived from food or drink. And this if tested can be detected in the prediabetic stage but it is never tested.
My first eOGTT, .my insulin levels were high and I still produced too much every time, I would eat more than as little as 10g, which was sending me into Hypoglycaemia.
Having had many weird symptoms crop up on the RH forums, the possibility of getting the best treatment for each of us, is many years away, because even the so called experts and specialist endocrinologist, just can't understand why these symptoms and test results, do not make sense.
Then throw in other conditions, and there are so many, that can effect you from one day to another.
That is why it has been frustrating to not to get what is the right diet for you, because the medical books oor training i is behind the times. There are many sub types within the T2 umbrella and the researchers are finding more all the time.
I wish those medics who are stuck in the dark ages would stop treating T2s as if they are T1 or similar!
It is individual as is the treatment should be. It doesn't make sense and is illogical, if you have a high intolerance to starch, why do they say, you can still eat, even if it makes you ill?
I have battled against this thinking for nearly two decades. When will it end?

 

[chrisjohnh]

Surgeries don't typically offer them, an Endo might however but even that seems rare.
Testing glucose levels in the "healthy" population is often the standard course, either in a HbA1c or an FBG test.
A 75g OGTT would be even more enlightening but these are done rarely nowadays & typically only for pregnancy.
Those would a real dysfunction could be identified decades earlier by a Kraft Insulin Assay as shown below.
A 3 hour 75g OGTT where they test glucose & insulin at 30 min intervals.

2 people with completely normal glucose profiles yet the hidden beneath the iceberg is that one is covering it by 4x the insulin production.
These test are only administered by private labs at a cost but would identify & prevent a huge percentage of future T2s.

Very interesting, thank you.

 

[Ronancastled]

I disagree. Yes, it may identify but, given current medical thinking and treatment, it won't prevent type 2 diabetes happening.

Sadly you might be correct

 

[chrisjohnh]

Yes.
It is the response of insulin main!y that determines your intolerance.
For example, if it was known, like me, that wheat is something that I can't eat!
So how can I have since birth be lactose intolerance?
Some people can eat 50g carbs and not be effected.
You have to get your head around not only hormonal but but biotics as well.
There are millions of live bacteria in your digestive system, mostly good, but varies with the bad.

A lot of T2s, and I did have the condition called hyperinsulinimia. Which is very high circulating insulin levels that won't help with the glucose derived from food or drink. And this if tested can be detected in the prediabetic stage but it is never tested.
My first eOGTT, .my insulin levels were high and I still produced too much every time, I would eat more than as little as 10g, which was sending me into Hypoglycaemia.
Having had many weird symptoms crop up on the RH forums, the possibility of getting the best treatment for each of us, is many years away, because even the so called experts and specialist endocrinologist, just can't understand why these symptoms and test results, do not make sense.
Then throw in other conditions, and there are so many, that can effect you from one day to another.
That is why it has been frustrating to not to get what is the right diet for you, because the medical books oor training i is behind the times. There are many sub types within the T2 umbrella and the researchers are finding more all the time.
I wish those medics who are stuck in the dark ages would stop treating T2s as if they are T1 or similar!
It is individual as is the treatment should be. It doesn't make sense and is illogical, if you have a high intolerance to starch, why do they say, you can still eat, even if it makes you ill?
I have battled against this thinking for nearly two decades. When will it end?

My goodness, so much for me to think about there, thank you. So even the endos are at a loss for a full understanding. Yet Taylor makes a point of stating that contrary to traditional thinking T2D “is a very simple condition“. Too much fat for one’s own body; get rid of the fat; and bingo, your sorted. Mmmm … we can wish.

 

[Oldvatr]

This may be of interest

Type 2 diabetes: 1 in 20 may achieve remission

A recent study finds that as many as 1 in 20 people may be able to reverse a type 2 diabetes diagnosis through lifestyle changes alone.

www.medicalnewstoday.com

Note that the remission they record seems to be in old people who have had bariatric surgery.

 

[Oldvatr]

My goodness, so much for me to think about there, thank you. So even the endos are at a loss for a full understanding. Yet Taylor makes a point of stating that contrary to traditional thinking T2D “is a very simple condition“. Too much fat for one’s own body; get rid of the fat; and bingo, your sorted. Mmmm … we can wish.

I would be careful of treating what Taylor claims as gospel. Yes his studies are useful and give hope, but he is having to chase the funding for his department, and some of his claims are not viable. His studies use meal replacement shakes that are both ultra low calorie and low carb, but he cannot claim low carb plays any part since this would affect his ability to raise funds from the NHS and DUK and he would lose the support from the nutritionists. His studies seem to show pancreatic fat is the main culprit, but there are at least two forms of Insulin Resistance and his plan seems to only address one of them. Remember that in the original single pass study and also DIRECT the success was only 47% and many of those reverted bcak over time. The Retune is claiming 70% success, and this demonstrates that the technique is not providing a permanent solution. So it is not suitable for all and he was very picky in who he invited to take part at the start of each trial. It is also not the only way to get to remission.

 

[lucylocket61]

My goodness, so much for me to think about there, thank you. So even the endos are at a loss for a full understanding. Yet Taylor makes a point of stating that contrary to traditional thinking T2D “is a very simple condition“. Too much fat for one’s own body; get rid of the fat; and bingo, your sorted. Mmmm … we can wish.

Taylor is frequently wrong, he just has a loud voice, lots of funding and access to a big media platform. Have a search on this forum for discussions about the many flaws and false equivalences in his research and conclusions.

I didn't start getting rid of my vast amount of body fat until 3 months ago, I still have a long way to go, but I have maintained good blood glucose levels for nearly a decade through my way of eating. I have ME and can't exercise. It's all about the carbs.

 

[Lamont D]

My goodness, so much for me to think about there, thank you. So even the endos are at a loss for a full understanding. Yet Taylor makes a point of stating that contrary to traditional thinking T2D “is a very simple condition“. Too much fat for one’s own body; get rid of the fat; and bingo, your sorted. Mmmm … we can wish.

T 2 is not in any way at all 'simple'!
How can it be when most doctors rummage around for the cause.
Do you know for definite, how or why, you got diabetes, the root cause or causes?
So if you don't know why, how can you solve the problem?
These supposed experts, have a agenda, and if they get an audience, they may get lucky with some but it is dangerous to advise people as though every one of us got diabetes the same way and it's about lifestyle!
which is total ********!
You are right, you have to know what your body copes better with and for a decade nearly, I have advised, control of blood glucose levels is the single important factor in trying to gain remission.