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Message: <blockquote data-quote="HairySmurf" data-source="post: 2684834" data-attributes="member: 583820">That kind of statistic, that a Type 2 is likely to need insulin in 10 to 15 years following diagnosis, should be looked at in the context that people tend to put on weight and become less active as they age.  There is a still-prevalent assumption amongst the medical community that Type 2 diabetes inevitably progresses, without any solid evidence showing exactly how and why it tends to progress over time.The two main issues are insulin resistance and insulin secretion.  Roy Taylor proved that weight loss quickly results in the reduction of ectopic fat in the liver, and that this reduces insulin resistance in that tissue in the majority of Type 2 cases.  It also either reduces the export of triglyceride from the liver, or if his 'personal fat threshold' theory holds water, it empties out fat stored in adipose (fat cell) tissue which enables more of that tissue to sponge up excess triglyceride from the blood.  Lower blood triglyceride levels over time is thought to lead to lower levels of ectopic fat stored in the pancreas.  In susceptible individuals pancreatic ectopic fat (droplets of fat inside cells in the pancreas) causes lipid toxicity (fat poisoning) of beta (insulin producing) cells in the pancreas.  Reducing pancreatic fat levels leads to at least partial recovery of beta cell function in most recently-diagnosed T2 cases.  Taylor suggests that the longer beta cells are exposed to high fat levels the less likely it is that those cells will become fully functional again when lipid toxicity is reduced.  He further suggests that a person's genetics determine how resilient their beta cells are and thus how long they can remain in a dysfunctional state and still return to full function, if at all.You mention that you are at a healthy weight, and if you have lost weight since diagnosis to get there then you've done all you can on the liver and pancreas front.  You just need to keep the weight off to keep the fat out of your liver and that side of things is handled.  If your weight has remained steady since diagnosis it may be worth investigating Taylor's paper on testing the effects of going from a BMI of around 25 to a BMI of around 22.5.  If you're at the mid to lower end of the 'normal' BMI range then there's no solid information available on how to get fat out of your liver - if there's even much in there to begin with.[URL unfurl="true"]https://portlandpress.com/clinsci/article/137/16/1333/233394/Aetiology-of-Type-2-diabetes-in-people-with-a[/URL]Insulin resistance in adipose and muscle tissue are the other areas that can have a big effect on blood glucose levels.  There's no solid information on how to manage insulin resistance in adipose tissue other than, perhaps, weight loss.  Insulin resistance in muscle tissue can be improved with regular exercise.  Extended exercise will also burn off ectopic fat in muscle tissue, which will cause that tissue to sponge up triglyceride from the blood, which may help to keep levels low and prevent fat build-up in other tissues such as the pancreas.  There is a theory that a high blood insulin level is itself the cause of insulin resistance, and if that's true and if it's a reversible condition, a low carb diet may bring down insulin levels and thus lead to lower levels of insulin resistance.  I'm dubious of this theory, or if it's true then it might be irreversible, because I have yet to read any reports of people being on low carb diets for years, losing a lot of weight on such a diet, and then finding they can eat a 'normal' amount of carbs again without issue having 'cured' their insulin resistance.  There is absolutely no doubt in my mind though that a low carb diet is one that keeps blood glucose levels as low as possible and so is likely to help delay or maybe even prevent the onset of many diabetic complications for a Type 2.What I'm getting at with all this is that the average Type 2 who might have been expected to need insulin within 10 to 15 years after diagnosis in the past had little to none of this information available to them.  They likely put on weight over time and exercised less, and probably ate pretty much the same things they always ate.  I'd wager that just by being on this forum your odds might be much better than that old average.</blockquote>

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