Roy Taylor writing in Medscape adds some useful background information for Type 2 diabetes. The 9 web pages cover the following topics:
Introduction
Reversal of Type 2 Diabetes by Bariatric Surgery
Reversal of Type 2 Diabetes by Diet Alone
New Perspectives on Insulin Resistance
New Perspectives on the β-cell Defect
The Time Course to Development of Type 2 Diabetes
The Twin Cycle Hypothesis of Etiology of Type 2 Diabetes
Implication for Management of Type 2 Diabetes
Interested readers will probably be attracted to the last section, Implication for Management of Type 2 Diabetes which starts with the following:
"The extent of weight loss required to reverse type 2 diabetes is much greater than conventionally advised. A clear distinction must be made between weight loss that improves glucose control but leaves blood glucose levels abnormal and weight loss of sufficient degree to normalize pancreatic function."
and offers some very good advice, exercise is not just about improved fitness and an aid to weight loss:
"The role of physical activity must be considered. Increased levels of daily activity bring about decreases in liver fat stores and a single bout of exercise substantially decreases both de novo lipogenesis and plasma VLDL."
Walking off a meal doesn't mean attempting to burn the calories just consumed. Exercise helps to reduce the amount of fat produced from the carbs from being deposited in the liver. It is the deposition of fats in the liver, according to Taylor, which leads to the onset of diabetes:
"The accumulation of fat in liver and secondarily in the pancreas will lead to self-reinforcing cycles that interact to bring about type 2 diabetes. Fatty liver leads to impaired fasting glucose metabolism and increases export of VLDL triacylglycerol which increases fat delivery to all tissues, including the islets. The liver and pancreas cycles drive onward after diagnosis with steadily decreasing β-cell function."
Of particular interest is the statement:
"β-Cell number following reversal of type 2 diabetes remains to be examined, but overall, it is clear that at least a critical mass of β-cells is not permanently damaged but merely metabolically inhibited."
Introduction
Reversal of Type 2 Diabetes by Bariatric Surgery
Reversal of Type 2 Diabetes by Diet Alone
New Perspectives on Insulin Resistance
New Perspectives on the β-cell Defect
The Time Course to Development of Type 2 Diabetes
The Twin Cycle Hypothesis of Etiology of Type 2 Diabetes
Implication for Management of Type 2 Diabetes
Interested readers will probably be attracted to the last section, Implication for Management of Type 2 Diabetes which starts with the following:
"The extent of weight loss required to reverse type 2 diabetes is much greater than conventionally advised. A clear distinction must be made between weight loss that improves glucose control but leaves blood glucose levels abnormal and weight loss of sufficient degree to normalize pancreatic function."
and offers some very good advice, exercise is not just about improved fitness and an aid to weight loss:
"The role of physical activity must be considered. Increased levels of daily activity bring about decreases in liver fat stores and a single bout of exercise substantially decreases both de novo lipogenesis and plasma VLDL."
Walking off a meal doesn't mean attempting to burn the calories just consumed. Exercise helps to reduce the amount of fat produced from the carbs from being deposited in the liver. It is the deposition of fats in the liver, according to Taylor, which leads to the onset of diabetes:
"The accumulation of fat in liver and secondarily in the pancreas will lead to self-reinforcing cycles that interact to bring about type 2 diabetes. Fatty liver leads to impaired fasting glucose metabolism and increases export of VLDL triacylglycerol which increases fat delivery to all tissues, including the islets. The liver and pancreas cycles drive onward after diagnosis with steadily decreasing β-cell function."
Of particular interest is the statement:
"β-Cell number following reversal of type 2 diabetes remains to be examined, but overall, it is clear that at least a critical mass of β-cells is not permanently damaged but merely metabolically inhibited."
