I thought you couldn't reverse diabetes?

[am64]

i have noticed over the years that the dx of T2 has lowered ....when i was first dx a level over 7.2 was quoted ...now correct me if im wrong but 6.4 is banded about ?

 

[Northerner]

You DO suddenly become dxed Type 2 Diabetic when Insulin Resistance outweighs Beta Cell Mass as plotted against each other on the Starling Curve of the Pancreas. ...

Not according to this, it appears that this is a cause for debate:

http://www.touchendocrinology.com/a...arly-use-glitazones?mini=calendar/2011/4/all&

 

[mcdonagh47]

Not according to this, it appears that this is a cause for debate:

http://www.touchendocrinology.com/a...arly-use-glitazones?mini=calendar/2011/4/all&

Read the first sentence again Northie ..."Type 2 diabetes mellitus is a result of a progressive and complex inability to maintain normoglycaemia".
It specifically says that Type 2 Diabetes is the RESULT of, not the progressive development itself i.e Type 2 Diabetes is the end product of something else.
Don't what statius that web page has, it looks like an Opinion Piece.

 

[Northerner]

Read the first sentence again Northie ..."Type 2 diabetes mellitus is a result of a progressive and complex inability to maintain normoglycaemia".
It specifically says that Type 2 Diabetes is the RESULT of, not the progressive development itself i.e Type 2 Diabetes is the end product of something else.

But reading further:

Moreover, it becomes clear that the disease process is continuous and starts very early in the NGT range. The point along this continumm where glycaemia, fasting or postprandial, is to be called ?diabetes? is completely arbitrary. The threshold for diabetes mellitus has more to do with increasing risk of complications, census or reimbursement issues but not with something pathological suddenly happening.

 

[mcdonagh47]

But reading further:

The second quotation is Opinion Northie and individual interpretation. the use of the term "arbitrary" in a pejorative sense tell us that. And what does it mean by "glycaemia", does the writer mean hyperglycaemia ? The article seems to be simplistic dumbing down ; there is no "continuum" IFG - IGT -Type 2 Diabetes. Most of the People who test out as IFG on an OGTT very rapidly progress to Type 2 Diabetes within a year without passing through IGT. The majority of people who test out as IGT (60%) will never be dxed as Type 2. 50% of people who test out as IGT in one OGTT subsequently revert to normal in further tests. So there is no smooth progress to Type 2 Diabetes through these stages.

 

[am64]

please translate into plain english ?

 

[wallycorker]

please translate into plain english ?

Hear! Hear! Am64 - that's all much too complicated for me too even though I have a scientific background!

By the way, I was diagnosed more than ten years ago on the basis of a fasting blood glucose level of 7.2 mmol/L. I've never had an oral glucose tolerance test.

Certainly, I've never even heard of some of the stuff in this thread before never mind having been tested for it.

 

[veganlass]

I havent read all the posts, but according to recent news on TV they interviewed a chap who was diagnosed T2 and he changed his lifestyle around did more exercise and managed to reverse it.

My Gp suggested my T2 maybe due to the pancreas wearing out due to old age!!.

This may be true but I am jolly well going to try to reverse it by diet and lifestyle changes if i can. Lost 6lb in weight in less than a fortnight so far.

 

[Ellie Jones]

The proof of the pudding of reversal is eating the pudding!

To reverse you taking the condition back to a previous state and the same criteria but you've only improved because you've changed the criteria, if you return to the same criteri it soon return...

As we for T2's there is phrases like pre-diabetic and glucose intollerance these were brought in many years ago when organisations such as WHO were deciding at what point T2 is offically diagnosed! The bar was slightly raised and pre-diabetes and glucose intollerance placed, as to give somebody the diagnosed with T2 it effects their life insurance and medical insurance etc!

 

[veganlass]

Ellie love that first line, so appropriate.🙂

 

[HelenM]

Originally Posted by mcdonagh47
You DO suddenly become dxed Type 2 Diabetic when Insulin Resistance outweighs Beta Cell Mass as plotted against each other on the Starling Curve of the Pancreas.

Beta cell death is certainly a major factor in T2 and there has been a big reduction in beta cells by the time someone has developed impaired fasting glycemia.(prediabetes)

At the Mayo clinic they looked at pancreases (pancreata?) of a number of subjects immediatley after death. http://diabetes.diabetesjournals.org/content/52/1/102.full

People who were obese, but not T2 had a 50% greater beta cell volume than people who were lean and not diabetic. So obese non diabetics have the capacity to produce more insulin.

Those who were obese and had T2 had 63% less beta cell volume than non diabetic obese controls
Those who were obese and had impaired fasting glycemia had 40% less volume than non diabetic obese controls.
Those who were lean and had T2 had 41% less volume than lean non diabetic controls.
(it was the number of cells, not the size of the cells that made the diffference in volume)

They looked at the apoptosis,( programmed cell death) and replication (increase following division) of the beta cells.

Apoptosis was slightly, but not significantly greater in obese diabetics than obese non diabetics. It was significantly greater in lean diabetics than lean non diabetics.
BUT as those with diabetes had a smaller volume of cells in the first place.
There was a relative 3 fold increase in the frequency of apoptosis in obese diabetics compared with obese non diabetics

There was a 10 fold increase in the frequency of apoptosis in lean diabetics compared with lean non diabetics.

Replication was the same in all cases, obese or lean, diabetic or non diabetic , it occurred but it was slow and it declined with age.

Reversal as well as increasing insulin sensitivity would have to include being able to stop this rate of death and increase the number of beta cells so sufficient insulin can be produced at all times, not just with a reduced carbohydrate intake. Otherwise when there was a big demand on insulin as for example in some illnesses there might not be enough production capability.
A major problem is that cell replication is slow and declines with age.

It is possible that new islets are formed elsewhere and when this paper was written in 2003 they were optimistic as the site they thought new cells were produced was normal. They said that they had found the the presence of islets budding from exocrine ducts in all pancreata irrespective of obesity or diabetic status. As I understand it, they thought new cells were able to be formed in these ducts.
Unfortunately, the juries out on this one. Recently other researchers have found what they say is proof that new beta cells are not formed in the exocrine ducts after birth

 

[wallycorker]

..........The proof of the pudding of reversal is eating the pudding!............

I like that first line too Ellie. Brilliant!

However, I am coming to the conclusion that maybe we should never have been eating the "pudding" that you refer to in the first place?

Maybe it was the "pudding" - or "starchy carbohydrate" as I call it - that caused my diagnosis with Type 2 in the first place more than ten years back - and it's progression for eight years after that?

Anyway, I'm very happy indeed with what has happened to me since I cut back on eating the "pudding" - or "starchy carbohydrate"!

I'll stick mainly with the fruit for my carbohydrate intake. Oh! and the chips too that I eat with my meat because, these days, rather surprisingly I find that they too seem to be OK, at least, in sensible amounts as served with the pub meals that I buy!

People can call it what they want but I'm very happy indeed that today all my health indicator numbers (HbA1c, post-prandial blood glucose levels, blood pressure, TC, LDL, HDL, creatinine - and in particular triglycerides are all very much better than they have ever been. Also, that the many diabetic symptoms that I had experienced to varying degrees have disappeared virtually altogether.

I'm quite content to contine to consider what has happened to me as being "reversal" - i.e. things are much better than they were in the first place. Or, as my dictionary defines the noun reversal - "a change to an opposite direction, position or course of action". That sounds to describe my current Type 2 diabetic situation quite admirably!

Long may it stay that way!

Best wishes - John

 

[everydayupsanddowns]

...Reversal as well as increasing insulin sensitivity would have to include being able to stop this rate of death and increase the number of beta cells so sufficient insulin can be produced at all times, not just with a reduced carbohydrate intake. Otherwise when there was a big demand on insulin as for example in some illnesses there might not be enough production capability.
A major problem is that cell replication is slow and declines with age....

Crikey there's a lot to take in there Helen!

Did you catch the report on Joslin50 T1s (type 1 for over 50 years) a few years back which showed that some still had signs of insulin production, functioning islet cells (creation? not sure now) and continuing autoimmune destruction of islet cells long after it would be expected for them to have run out. Seem to remember there was a thought about looking into ways of supporting the insulin production of those cells.

 

[lanzlady]

I feel as though I am reading some script from medcial notes in some replies
as AM quotes plain English please some replies are so long I can't be bothered reading them

This is only my opinion🙂



Lanz

 

[everydayupsanddowns]

I feel as though I am reading some script from medcial notes in some replies
as AM quotes plain English please some replies are so long I can't be bothered reading them

This is only my opinion🙂

Lanz

Tee Hee! Yes there are a few very technical posts here, along with the more general anecdotal ones.

Here's my summary:

Q: Can you 'reverse' diabetes?
A: Yes*. And no*.

* it depends on what you consider to be meant by the term 'reverse'. 🙂

 

[HelenM]

I feel as though I am reading some script from medcial notes in some replies
as AM quotes plain English please some replies are so long I can't be bothered reading them

This is only my opinion🙂



Lanz

Yes, my post was long, I'm sorry for that and realised when I'd posted it that not every one will want to read it (maybe no-one😉 ) Indeed I almost cut the whole thing when I saw the final post.
It was a summary, it took a very long time rewriting it to the fewest possible word yet still be accurate.

 

[Northerner]

Yes, my post was long, I'm sorry for that and realised when I'd posted it that not every one will want to read it (maybe no-one😉 ) Indeed I almost cut the whole thing when I saw the final post.
It was a summary, it took a very long time rewriting it to the fewest possible word yet still be accurate.

Don't apologise Helen. I find your research very interesting. I can see that not everyone has the time or inclination to read the technical stuff, but it does provide useful information to those that do 🙂 Often what starts out as a particular question can turn into quite a wide-ranging discussion, and of course this is one of the key topics in diabetes today, so all input is welcomed 🙂

 

[everydayupsanddowns]

Absolutely Alan. (and thanks for your post Helen!)

M

 

[mcdonagh47]

Here's my summary:

Q: Can you 'reverse' diabetes?
A: Yes*. And no*.

* it depends on what you consider to be meant by the term 'reverse'. 🙂

Here's my summary ;
You can no more reverse Type 2 Diabetes than you can ride to the Moon on a bike.
And using the term "reverse" in relation to Type 2 Diabetes is irresponsible because it misleads Newbies about the fundamentals of their condition.
IMHO

 

[Andy HB]

Here's my summary ;
You can no more reverse Type 2 Diabetes than you can ride to the Moon on a bike.
And using the term "reverse" in relation to Type 2 Diabetes is irresponsible because it misleads Newbies about the fundamentals of their condition.
IMHO

My summary is that some T2 diabetics can reverse the diabetic symptoms if they diet and exercise regularly resulting in improved insulin sensitivity.

But I think you're right, once a diabetic, always a diabetic (for now).

Andy 🙂

p.s. And your post was interesting to me too Helen. 🙂