Will I always be a diabetic?

[theblokefromstoke]

Hi all,

I was diagnosed in January and my fasting BG was 26. Since then I have lost over 5 stone, dropped from 4 metformin to 2 and my fasting BG is around 5.2 with my Hba1c at 5.5.

All good news. The nurse a couple of weeks ago suggested I dropped to 1 metformin per day and see how it went for a week. Well, I stuck it for 2 days - 1 of which I had to spend in bed feeling like i was dying, my fasting BG was creeping up into the 6's so I went back onto 2 and was instantly better.

Diabetes has had some press over the past few days on the local radio here in Staffordshire and all of it sounds so negative doesn't it. These so called experts came on telling how diabetes type 2 was all about obesity and type 2's are a drain on the stretched NHS, particularly as 'they' have free prescriptions etc.

Well, It made my blood boil listening to them making out that type 2's have only themselves to blame etc etc. One doctor even suggested that type 2's be treated like long term smokers who refuse to give up and thus refused NHS treatment. It was belittling, honestly. I felt pathetic.

My point is that I know many type 2's who are and never have been anything other than a normal healthy weight. My circumstances are that i was overweight, I have lost this weight but still need the metformin to help with my BG.

I understand that type 2 can be either the pancreas reducing output over time (will it stop eventually?), the body building up a resistance over time to insulin, or the body fat interfering with the body's ability to absorb insulin.

How on earth do we know which catagory we fall into and how can we go about improving this negative press we are served.

 

[Dippy3103]

My GP cheerfully told me that once diagnosed I will have the "diabetic label" for life, and that I can slow down or virtually halt progression but it will never go away.
Happy days.

 

[thebear]

Happy days.

Ha!

 

[ShyGirl]

I don't think you ever stop being Diabetic and no matter how healthy you appear to be your insides will always be "abnormal" in some way.

 

[Csfrowantree]

That kind of attitude really annoys me also.
I suppose I could be classed as the total opposite to the classic Type 2. Slim build, very active and sporty, eat a healthy diet. dont smoke, hardly drink etc etc.
Yet I still have been dignosed with type two. I personally have feel i inherritted the condition, is that my fault, I dont think so.
Yes obesity does contribute to type 2 but its not the only cause, therefore to stick the same label on us all annoys me to say the least.
Lets face it non of us want to have diabetes, as its a real pain in the proverbial.

 

[Sid Bonkers]

Obesity does NOT cause diabetes :evil:
eating too many sweet things does NOT cause diabetes :evil:
Diabetes is NOT self inflicted :evil:

 

[anniep]

Yes it is perfectly true that most T2's are overweight, BUT it is NOT true that most overweight people are T2. There is a genetic link of some sort, there is a complex relationship between weight and T2 and which is the chicken and the egg is not proved. I have heard it hypothesised that maybe they are both symptoms of something else, that is not found yet. If weight alone caused diabtes there would be a heck of a lot more of it even than there is now.

 

[Cliff2]

Are obesity and T2 linked in some way? Probably yes, but links do not prove causation. Perhaps insulin resistance leads to obesity rather than the other way round.

Imagine an insulin resistant person eating a high carb diet and then think of the pancreas working overtime to overcome the insulin resistance. Lots of insulin plus glucose that cannot be fully taken up by the muscles is not a good mix, given that the excess glucose is converted to triglycerides and laid down as fat around your stomach. Just a thought from a (now) normal weight T2.

 

[kateincornwall]

Cliff , I`m in a similar situation to you . Type 2 runs in the maternal side of my family, Mum and Gran had it and were not overweight . I was diagnosed last year and yes , I admit that I was overweight , I ate healthily, but too much ! I told the nurse that I wanted to try diet and exercise, she was sceptical, but I went ahead and over a period of 9 months, have lost 4 stones, HbA1c in the 5`s , BG is good but only as long as I eat the right foods ! At my last visit earlier this week , the nurse said that she didnt need to see me for 4 months and quote Your Diabetes has gone away unquote . Now , I always thought that once diagnosed , you had this blasted disease for life and that you might control it well but it was always lurking ? I was pleased with her words at first, until it struck me that they were rather dangerous words , they could lead to some people resuming their previous eating plan in the false knowledge that they were cured !

 

[Cliff2]

Kate - When I was diagnosed 11 months ago, I was on the overweight/obese borderline but now have a BMI of 23.2. I had very high cholesterol and triglycerides but now they're normal range (no meds). I had sky high BP and now it's lower (not normal range yet but I'm working on it). On most days, if I had a fasting blood test taken, I would not be diagnosed as diabetic - possibly, I would be viewed as pre-diabetic depending on what side of 6mmol/L I happened to fall on that day. A random reading would never flag me as diabetic nor would my HbA1c according to the diagnostic criteria (we can discuss whether or not the crireria are appropriate for ever and a day).

So, am I still a diabetic? Of course I am, just well controlled.

 

[Dippy3103]

Obesity does NOT cause diabetes :evil:
eating too many sweet things does NOT cause diabetes :evil:
Diabetes is NOT self inflicted :evil:

Too true. I was diagnosed at 39. My 70 year old Dad told me today he has had his annual mot with fasting bloods of 4.8mmol. Dad has allways been obese.
Diabetes runs on my Mum's side of the family but not my Dad's.I dare say being overweight didn't help but isn't the only factor that has led to my diabetes.

 

[markd]

There is pretty compelling evidence that obesity (particularly belly fat) is the main trigger for T2 diabetes - though you have to carry the genetic susceptibility (similar to cancer and smokers; everyone knows of a chain-smoking relative who lived to 99, but didn't happen to have the genetic susceptibility).

This article sets out some current thinking on the causal link:

http://www.ehow.com/how-does_4923548_ob ... betes.html

In particular, this paragraph explaining one of the mechanisms is the clearest explanation about how insulin resistance develops that I've come across.

(and I think 'overnutrition' can be said to imply overeating and eventually obesity)

------
The endoplasmic reticulum (ER) is a specialized membrane, inside the cell, that synthesizes proteins and processes blood fats. Overnutrition is a state where the body has more calories and fat that it can process at one time. When the body enters a state of overnutrition, this puts stress on the ER, causing it to signal the insulin receptors to stop responding to insulin. Temporarily reducing insulin receptivity allows the ER to catch up with its workload. If the body repeatedly enters a state of overnutrition, the ER continually signals the cells to dampen their insulin receptors. Over time, the body is no longer able to respond to insulin properly.
-----

The explanation about Resistin and how it was an evolutionary mechanism to help us survive famines is also interesting - another obesity-related cause.

I guess once a diabetic you'll always have the *propensity* to (re-)develop it, but many people find that Diet Exercise and WeightLoss make all the symptoms go away (including being able to pass the usual diagnostic tests) - particularly if the D, E & WL program is started as soon as possible after an early diagnosis.

For how long? Who knows; but as experience grows, it's looking to be years and maybe even decades - I'm certainly optimistic!

mark