Setting point and insulin secretion

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Bubbleblower

Bubbleblower

Well-Known Member
Relationship to Diabetes
Type 1.5 LADA
everydayupsanddowns said:
Beat's Type 1 Diabetes and Eating Disorders Workshop
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We need a Beat Type 1 diabetes workshop.

AndBreathe said:
It seems, in my observation, there is very little out there to support people with T2 with coexisting diabetes and an ED.

Whilst T2s by and large, are less likely to be insulin dependent, they do have challenges, and of course, we should never forget those with 3c and the other small margin (as in per population, not by importance) types.
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This is a constant problem caused by the discrimination between diabetes types, which even happens on this forum, where only type 2's can achieve remission, which of course is complete nonsense and not very nice.

In reality we aren't type 1 or type 2 or type whatever, that was invented by the pharmaceutical industry a century ago when the hypodermic needle model was still popular, in this case literally too.
Most of us are really more like X% type 1, Y% type 2 and/or Z% something else.
 
Bubbleblower said:
where only type 2's can achieve remission, which of course is complete nonsense and not very nice.
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I’m afraid I don’t think it is very wise to suggest that Type 1 diabetes can be put into remission. It could raise false hopes and be distressing for those newly diagnosed, or parents of children with T1.

In classic type 1 diabetes, the beta cells have been destroyed by autoimmune attack. Even if new islets are introduced (eg in an islet transplant) they are targeted by the immune system and destroyed. So type 1 is absolute insulin deficiency. And exogenous insulin must be taken to survive.

In some cases of LADA (slow onset T1 in adulthood) there may be enough residual insulin production at diagnosis to temporarily achieve glucose balance by following a very low carb diet. But as the autoimmune attack continues eventually beta cell mass will fall below the tipping point, and insulin will again be required.

There are cases of misclassification, of course. But type 1 (and LADA) cannot be treated without medication (insulin) eventually.

It’s great that you are able to manage your diabetes without insulin, but if this continues long-term, I suggest your initial diagnosis may need to be reviewed, as you may have a different form of diabetes – possibly an extremely rare one!
 
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everydayupsanddowns said:
But type 1 (and LADA) cannot be treated without medication (insulin) eventually.
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In the Netherlands they disagree and are taking "mody kind of" type 1's of insulin now.

Diabetes is much more complicated than some stakeholders led us to believe.
 
Bubbleblower said:
In the Netherlands they disagree and are taking "mody kind of" type 1's of insulin now.

Diabetes is much more complicated than some stakeholders led us to believe.
Click to expand...

That’s a misunderstanding I think? MODY is a monogenic form of diabetes. It isn’t T1, though it can be treated like T1 in some cases. It doesn’t have the autoimmune root I don’t think? It’s a modified gene.
 
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everydayupsanddowns said:
That’s a misunderstanding I think? MODY is a monogenic form of diabetes. It isn’t T1, though it can be treated like T1 in some cases. It doesn’t have the autoimmune root.
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I thought there were different types of MODY, all having different managemnets.
 
grovesy said:
I thought there were different types of MODY, all having different managemnets.
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Yes I think you are right. There are several types listed on this page

Maturity onset diabetes of the young (MODY)

MODY is a rare form of diabetes which is different from both type 1 and type 2 diabetes, and runs strongly in families. MODY is caused by a mutation (or change) in a single gene. If a parent has this gene mutation, any child they have, has a 50% chance of inheriting it from them. If a child does...
www.diabetes.org.uk www.diabetes.org.uk
 
Bubbleblower said:
In the Netherlands they disagree and are taking "mody kind of" type 1's of insulin now.

Diabetes is much more complicated than some stakeholders led us to believe.
Click to expand...

That’s nothing to do with Type 1. Some people are mistakenly thought to be Type 1 and put on insulin. They’re actually MODY and some forms of MODY can be treated by tablets rather than insulin. That’s not because they’ve had a remission, it’s because they were misdiagnosed.
 
everydayupsanddowns said:
That’s a misunderstanding I think? MODY is a monogenic form of diabetes. It isn’t T1, though it can be treated like T1 in some cases. It doesn’t have the autoimmune root I don’t think? It’s a modified gene.
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They mix everything up now 🙂 It was said in the context of giving the right diagnosis, so apparently many type 1's are really MODY and then don't need insulin anymore. To find these people they do extra tests now, here is one of the studies this is based on: Clinical and genetic correlates of islet-autoimmune signatures in juvenile-onset type 1 diabetes

Inka said:
That’s nothing to do with Type 1. Some people are mistakenly thought to be Type 1 and put on insulin. They’re actually MODY and some forms of MODY can be treated by tablets rather than insulin. That’s not because they’ve had a remission, it’s because they were misdiagnosed.
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Indeed, so an X percentage of so called type 1's can already achieve remission, simply because they are misdiagnosed. That seemed to be quite a large group, so MODY may not be as rare as previously thought.
 
I take issue with “many” @Bubbleblower And what you’ve said isn’t what you said earlier (that Type 1 can be put into remission). Obviously, if someone is misdiagnosed as Type 1, then they’re not actually Type 1 so they haven’t gone into remission from Type 1 at all.

If you think you have MODY, why don’t you have the screening tests?
 
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Bubbleblower said:
Indeed, so an X percentage of so called type 1's can already achieve remission, simply because they are misdiagnosed. That seemed to be quite a large group, so MODY may not be as rare as previously thought.
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Just because someone doesn’t need insulin doesn’t mean they won’t need other interventions, more than diet. It’s my understanding of MODY that even though they may not need insulin, people with MODY usually have to take other diabetes drugs to keep it under control. I didn’t think you can ever get MODY into remission.
 
Yes, that’s right @Robin More than that, when I was investigated for MODY around 25 years after my diagnosis, my consultant said that even if I did have a form of MODY, it was possible I’d have to stay on insulin anyway as it had been so long after diagnosis. Some forms of MODY are a lot more common than others. She thought I might be a certain type that could be treated with tablets but pointed out that people with this type often ended up on insulin after many years. Some forms of MODY also come with additional health problems.
 
Inka said:
I take issue with “many” @Bubbleblower And what you’ve said isn’t what you said earlier (that Type 1 can be put into remission).
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I don't like the "many" either, I want numbers, but this is what Dr. aanstoot said, which I translated. Everything I said isn't what I said earlier, I am not a recordplayer, I still think type 1 can be put in remission if you have the right kind.

Inka said:
If you think you have MODY, why don’t you have the screening tests?
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Then I have to convince my doctors first.

I don't believe I have MODY, but MODA, in fact I believe we all do and also that it is possible to lower our setting point.
 
I don't believe I have MODY, but MODA, in fact I believe we all do and also that it is possible to lower our setting point.

What’s MODA? And what do you mean by “setting point” @Bubbleblower ?
 
Robin said:
How do you account for the fact that before people with Type 1 had the option of injecting insulin, even on a zero carb diet which was the only known therapy, they died?
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You just reclassify the Type 2s as Type 1s, it seems @Robin
 
Your father was exercising and eating a whole food ketogenic diet? (At a guess.)
Everybody still needs insulin, even for protein. Injecting it with a screwed pancreas is still the only way for type ones, regardless of diet. Insulin is still required for glycogen produced by the liver, too.

I’m starting to think, my friend. Your comments touching on (& possibly promoting.) “insulin omission” is inappropriate and missleading on a topic regarding T1 eating disorders.
 
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Satan’s little helper said:
Your father was exercising and eating a whole food ketogenic diet? (At a guess.)
Everybody still needs insulin, even for protein. Injecting it with a screwed pancreas is still the only way for type ones, regardless of diet. Insulin is still required for glycogen produced by the liver, too.

I’m starting to think, my friend. Your comments touching on (& possibly promoting.) “insulin omission” is inappropriate and missleading on a topic regarding T1 eating disorders.
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What comments touching on "insulin omission"?
Your post is based on a wrong assumption you start with and you react to things I never said or implied.
Of course you need insulin, just not for the thing I said you didn't need it for. This is a quote from a study:

"muscle contraction (in vitro or in situ) and exercise increase glucose uptake into skeletal muscle. However, the contraction/exercise pathway of glucose uptake in skeletal muscle is an independent pathway to that of insulin"
Skeletal muscle glucose uptake during exercise: A focus on reactive oxygen species and nitric oxide signaling

So exercise is one great way to lower the setting point, also for type 1's.

Now tell me what exactly I said wrong and why was my post censored? What I said was true.


<Edit> I just read the reason, it was unhelpfull, never mind lowering the setting point.
 
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