What kick starts the pancreas into action?

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Mynxie

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Type 2
I know weight loss is an important factor in controlling type 2 diabetes. Can you repair a fatty liver and get the pancreas to start producing insulin again and if so how do you know you’ve reached that point?

Ive lost 2 stone since being diagnosed in February this year and test regularly and it seems to me that I’m not getting such high spikes as I was a month or two ago. Is this just wishful thinking or could it be that my body is starting to repair itself?

I havnt been able to get a doctors appointment or see a diabetic nurse since I was diagnosed ( over the phone) so haven’t been able to ask any questions in person.
 
Sorry, I should say I’m not on any diabetes medication and my hBac1 was 43 when I was last tested in May
 
Type 2 is often associated with insulin resistance @Mynxie The pancreas can make insulin but the cells are resistant to it. Losing weight will have helped you become less resistant and be good for your general health too, I’d hope.
 
T2 is generally a combination of insulin resistance and a reduction in insulin due to beta cell dysfunction (Either by them dying or something called ’de differentation’ which means they revert to a different state and no longer produce insulin - pancreas cells start off generic and then specialise, but when they de differentate they revert back to an old state.) that is brought about by stress on beta cells by the excess glucose in the bloodstream. There is also a problem with the signalling that takes place - first line insulin response is often missing in T2s and this tells the liver to stop producing glucose.

From what I’ve read, when beta cells die (Aptosis?) they are gone, but de-differentiation might be reversible. They certanly have managed to reverse this in mice, even in cells that have been de-differented for a long time.

The work at Newcastle had around half their patients who lost weight return to full insulin production, both the first line and second line, although I believe the response was slower than in non-diabetic patients. I think it took up to a year for Beta cells to return to full production.

The insulin resistance may be due to excess fat in the bloodstream (Triglycerides) which interferes with the interaction between insulin and cells that take up glucose via insulin.

Your BG will come down just by losing weight anyway - a small amount per kg lost.

Most of the research into this has been done one mice, but the Newcastle results seem to indicate that in some people the cells can recover…

Fascinating stuff, although I’d rather not have it. 🙂
 
Mynxie said:
I know weight loss is an important factor in controlling type 2 diabetes. Can you repair a fatty liver and get the pancreas to start producing insulin again and if so how do you know you’ve reached that point?

Ive lost 2 stone since being diagnosed in February this year and test regularly and it seems to me that I’m not getting such high spikes as I was a month or two ago. Is this just wishful thinking or could it be that my body is starting to repair itself?

I havnt been able to get a doctors appointment or see a diabetic nurse since I was diagnosed ( over the phone) so haven’t been able to ask any questions in person.
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I don't know about fixing the pancreas but I do know that three years ago I had early stages non alcoholic fatty liver disease, gall bladder pain and high blood pressure and a type 2 diagnosis with a hba1c of 67.
I changed my eating choices and cut carbs - that was my way of dealing with it. I haven't lost much weight but I have lost some and I am still fat - not so fat that people will turn around in the street but middle aged spread sort of fat - and I have always been chunky, chubby, overweight and at this stage I am still fat but losing size very slowly and as a side effect rather than a quick thing.
Anyway - within 6 weeks my hba1c was 55 my fatty liver disease cleared up, and my blood pressure was better too. Today I haven't had any gall bladder problems for three years, my blood pressure is mostly normal and last hba1c this June was 40 which is normal readings.
I am doing more exercise these days because I feel better and want to and enjoy it - so my way has been to change my lifestyle but do it all in a way that made me happy and made my eating and general life better - that means I could keep it up without any real effort because although the changes in eating are time consuming and challenging I enjoy the challenge and very much enjoy the results of the food experiments.

I think it is true that the liver is the most amazing organ in the body and can bounce back from a very sorry state if you give it the right conditions to do so. I think of mine as a friend and I try and be kind to it and not overwork it in any way and give it rests and drink lots of water and get good sleep if I can and avoid medication if possible and keep my home as free from synthetic chemicals as I can. I am lucky in that my body has responded well to that approach.
 
It is possible to go into remission, I managed to following bariatric surgery but then developed pancreatitis and now struggling to get my Hba1c under control as no matter what I eat really poorly and my sugar levels shoot up despite still loosing weight.
Definitely your on the right track by healthy eating and weight loss combined with exercise will give you the best chance of remission but from what I know it’s a very personal journey not one any of us can guarantee for you, hope this helps.
 
My own approach seems to have worked for me

1. Significant reduction in carbs combined with an increase in protein and fats (not saturated fats which I keep low).

2. Significant increase in exercise coupled with a significant reduction in body weight

3. No diabetic meds.

4. Lots of specific blood glucose testing to see if any foods affect my blood glucose response badly, and if so, avoid or reduce those (none found)

5. Kept records of everything and plotted graphs to show teacher, er, diabetic nurse to help with the strategy going forwards and to clearly show what is going on. Not that any doctor or diabetic nurse has had much contact and certainly no advice (bar ensuring I take the Lansoprzole 30 minutes before the first meal of the day - nothing to do with diabetes as far as I know)

Result seems to be remission and zero symptoms (now) and BG always well within the normal range. I always feel there may be a secret trap door waiting to spring open when I say that.
 
There is often an excess of insulin in a type 2's system - the pancreas, far from not producing is turning it out at a high rate, but it is unable to do its job.
I found that I was going a bit dizzy from time to time once my levels started to drop, and I suspect, although it is termed a false hypo, it was the result of rapid drops in blood glucose as the insulin managed to get itself noticed and the brain - used to a warm sugary bath for so long, panicked at the sudden change. It did not last long, and once normal levels became the usual thing, all seems to be going well.
 
In the early stages, the pancreas ups insulin production and beta cells appears be able to deal with the rise in BG caused by insulin resistance - but by the time 'T2' sets/is diagnosed in there's been around 25%-50% reduction in beta cell mass (This has been seen in postmortem studies on T2 patients, whose beta cells have also lost the ability to reproduce) so sugar levels can no long be controlled and hba1c increases. The cause is thought to be due to fatty acids interfering with the cells and causing 'de-differentiation.' (Although in some cases the cells might die and be cleaned up by the body's natural processes for handling cell apoptosis.)

Hence why it's better to make the lifestyle changes early to prevent/reduce this dysfunction/damage. (i.e. when pre-diabetic.)

Losing weight/changing lifestyle reduces the fatty acids in the bloodstream and Beta cells can start working again for some people. (And this also reduces the IR as well.)

We have a few people here who appear to have been able to go back to their 'old' diet, which is somewhat different to those of us (Like myself) who can control BG by diet and lifestyle. As I've reversed the metabolic syndrome, I'm hoping that what insulin I am still producing is used and keeping bloody sugar is cutting strain on what's left of my beta cells!
 
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