will diabetes type 2 worsen

[millenium]

Even with good bld glucose control? Say post meal 9.0 or below,
hba1c 5.8%, fgl 6.5 ave.

Is there any research on whether even with good control, glucose tolerance will still worsen?

 

[steveis36]

Im not a black belt in diabetes but i do believe that it is said "you need to treat the wound rather than the symptoms"
And a low carb low cal diet and excersise is really the way foward.

 

[DavidGrahamJones]

Is there any research on whether even with good control, glucose tolerance will still worsen?

I've not seen any research but I'm only just starting to look at beta cell insulin production rather than the insulin production and insulin resistance that I've been getting measured by self funding the blood tests.

I can tell you that until 4 years ago my type II was getting worse and worse, partially down to being told not to reduce carbs since diagnosis in 1997. 4 years ago I was recommended a low carb diet by a Nutritional Therapist, I was actually initially concerned about what my GP would say, we'd beed discussing going on to Insulin, "a natural progression", something my father had done. Fortunately although not fully supportive, she didn't say "Don't" which previous doctors had done. It didn't take long before I had to stop taking Gliclazide, Januvia and statins.

There has been a change to my insulin resistance and I've now had three blood tests over 18 months. The second was lower than the first (good), somehow the third was higher than the second (not so good). Also, low carb hasn't been as successful as in previous years and I've been trying the Newcastle Diet approach (VLCD) to keep my BG down. I'm almost an accidental vegan which isn't so tricky 5 days a week, but I treat myself to things like red meat and eggs at the weekend.

So, in conclusion (you'll be glad to read), glucose tolerance might change and looking at my insulin resistance and like share prices, might go up as well as down.

 

[rom35]

Is there any research on whether even with good control, glucose tolerance will still worsen?

From my experience with three years of tight BG control (3,9-7,7, mostly under 5,7) I can see, that all my problems (eye, legs, cholesterol) disappeared. But in any case I eat excess carbs, my BG elevates to the sky. So no "cure", but also no progress to worse. From my blood tests and other measurements, I'm perfectly healthy.

 

[Daibell]

The general view is that if you are a 'normal' T2 in general with a low-carb diet and some exercise the condition may never progress. If needed tablets may be added to avoid progression.

 

[millenium]

Seems like if bg is well control and the stage is early, it is very possible to control further deterioration.

 

[millenium]

From my experience with three years of tight BG control (3,9-7,7, mostly under 5,7) I can see, that all my problems (eye, legs, cholesterol) disappeared. But in any case I eat excess carbs, my BG elevates to the sky. So no "cure", but also no progress to worse. From my blood tests and other measurements, I'm perfectly healthy.

I deduce from the case when one has to eat normal carbs level for three days before an ogtt that the body takes around 3 days to adapt to drastic change of carb. If u has been eating say 15g carbs a meal, every sudden 10g more may elevate an additional 2mmol or more.

 

[rom35]

I deduce from the case when one has to eat normal carbs level for three days before an ogtt that the body takes around 3 days to adapt to drastic change of carb. If u has been eating say 15g carbs a meal, every sudden 10g more may elevate an additional 2mmol or more.

there is a question, what is “normal” level of carbs. After 40 years of “healthy plate” with 60 % of carbs there is 50% of obese population, 1 of 8 has diabetes, hard attacks...

 

[xfieldok]

I have just finished The complete guide to fasting and am going through the diabetic code by Jason Fung. I am finding the arguments for fasting compelling.

I could be wrong but a lower BG reading for T2 which has been treated with drugs is not necessarily treating the underlying condition. I have got a lot to learn so happy to be educated.

 

[AdamJames]

black belt in diabetes

Brilliant Also works for people at either end of the blood sugar spectrum!

 

[AdamJames]

Even with good bld glucose control? Say post meal 9.0 or below,
hba1c 5.8%, fgl 6.5 ave.

Is there any research on whether even with good control, glucose tolerance will still worsen?

I wonder about that, too.

It seems that for most practical purposes, if people make big changes, especially to diet, then to all intents and purposes, it doesn't need to measurably worsen and often measurably improves.

But I also wonder why T2 becomes more likely as we age. That could suggest that certain aspects of our metabolism do indeed worsen over time. Not exactly shocking, we are of course all hard-wired to wither up and die eventually. If things like our pancreas didn't get less functional as we age, it would be surprising, because everything else does.

Studies certainly show that visceral fat increases with age, and T2 is strongly correlated with visceral fat. So it probably gets harder and harder to keep on top of T2 as we age, but then it gets harder and harder to do everything.

 

[AdamJames]

Even with good bld glucose control? Say post meal 9.0 or below,
hba1c 5.8%, fgl 6.5 ave.

Is there any research on whether even with good control, glucose tolerance will still worsen?

I think that a "deterioration in glucose tolerance" is not necessarily the main thing to try to avoid. Complications are the thing to try to avoid.

Research has certainly been done which suggests that if you can keep your post-meal bgs less than 7.8 then you greatly reduce the risk of complications.

So, even if your glucose tolerance worsens with age, then so long as you eat less and less carbs so that you still keep post-meal spikes low, it may not matter at all. If you are already eating a low carb diet, then you may not have to adjust anything - you'll keep on getting spikes so small that no damage is being done.

This page has something to say on this subject with a few references to scientific studies including the one I'm referring to:

http://www.phlaunt.com/diabetes/14046702.php

 

[bulkbiker]

Even with good bld glucose control? Say post meal 9.0 or below,
hba1c 5.8%, fgl 6.5 ave.

Is there any research on whether even with good control, glucose tolerance will still worsen?

Not sure I would class post meal below 9 to be "good control".. post meal below 7.0 or even better 6.0 would be good control and will probably knock those diabetes issues for six.

 

[kokhongw]

There's 2 types of long term damages to consider.
1) Damages due to glucose spikes or elevated levels.
2) Damages due to insulin spikes or elevated levels.


FBG of 6.5 would still suggest elevated insulin levels...and is considerably higher than the magical 4.6 mmol...

 

[millenium]

One way to combat it is to increase lean body mass to recomposite the body and increase metabolism. But for those over 6O and even up to 8O yo. it will not be easy as the testo level is probably very low already.

 

[millenium]

There's 2 types of long term damages to consider.
1) Damages due to glucose spikes or elevated levels.
2) Damages due to insulin spikes or elevated levels.


FBG of 6.5 would still suggest elevated insulin levels...and is considerably higher than the magical 4.6 mmol...

Your standard is very high. That will require 10 carb per meal.

 

[millenium]

Not sure I would class post meal below 9 to be "good control".. post meal below 7.0 or even better 6.0 would be good control and will probably knock those diabetes issues for six.

I have succeeded in keeping to the targets given in the start of the thread for my 80 yo early diabetes father. Isnt post meal recommendation level is 7.8 or below? Is 7 realistic? Zero carb?

 

[millenium]

That is a

I think that a "deterioration in glucose tolerance" is not necessarily the main thing to try to avoid. Complications are the thing to try to avoid.

Research has certainly been done which suggests that if you can keep your post-meal bgs less than 7.8 then you greatly reduce the risk of complications.

So, even if your glucose tolerance worsens with age, then so long as you eat less and less carbs so that you still keep post-meal spikes low, it may not matter at all. If you are already eating a low carb diet, then you may not have to adjust anything - you'll keep on getting spikes so small that no damage is being done.

This page has something to say on this subject with a few references to scientific studies including the one I'm referring to:

http://www.phlaunt.com/diabetes/14046702.php

That is a good link. Thank you.

 

[kokhongw]

Your standard is very high. That will require 10 carb per meal.

That's not my standards...it is what has been observed to be constant among normal healthy individuals in various CGM studies etc...

Again reference to Jenny Ruhl's excellent resource
http://www.phlaunt.com/diabetes/16422495.php

Between 70 mg/dl (3.9 mmol/L) and 92 mg/dl (5.0 mmol/L) .

This is the finding of a considerable body of research. People whose blood sugar tests at this level do not develop diabetes over the next decade or longer. Those with supposedly normal blood sugars above 92 mg/dl often do. Nevertheless, most doctors consider any fasting blood sugar below 100 mg/dl (5.6 mmol/L) as completely normal

An other studies..
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769652/

The mean 24-hour interstitial glucose concentration under everyday life conditions was 89.3 ± 6.2 mg/dl (mean ± SD, n = 21), and mean interstitial glucose concentrations at daytime and during the night were 93.0 ± 7.0 and 81.8 ± 6.3 mg/dl, respectively.

http://www.amjmed.com/article/S0002-9343(08)00231-3/fulltext

Results
Subjects developed diabetes at a rate of less than 1% per year during a mean follow-up of 81.0 months. Each milligram per deciliter of fasting plasma glucose increased diabetes risk by 6% (hazard ratio

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1.06, 95% confidence interval [CI], 1.05-1.07, P < .0001) after controlling for other risk factors. Compared with those with fasting plasma glucose levels less than 85 mg/dL, subjects with glucose levels of 95 to 99 mg/dL were 2.33 times more likely to develop diabetes (HR 2.33; 95% CI, 1.95-2.79; P < .0001). Subjects in the 90 to 94 mg/dL group were 49% more likely to progress to diabetes (HR 1.49; 95% CI, 1.23-1.79; P <.0001). All other risk factors except sex were significantly associated with a diabetes diagnosis.

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My interpretation of all this is that keeping our glucose levels around 4.0-6.0 mmol is about as good as it gets...

 

[stephenlopez]

Hi, I'm one of the newly diagnosed ones and this thread grabbed my attention because it mentions 'worsen'. Well, I'm a little scared right now as I don't really want to get my condition worse. I'm doing regular exercise and even started to eat a balanced diet. Is this enough?