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Am I assuming correctly that this only applies for type 1 diabetes? With type 2 diabetes the body is in general less sensitive to insulin, more insulin produci

Am I assuming correctly that this only applies for type 1 diabetes? With type 2 diabetes the body is in general less sensitive to insulin, more insulin producing cells won't fix the underlying insensitivity issue, right?

whb07 7y ago
Isn't type 2 somewhat reversible by cleaning up diet and a prolonged fast?
- chx 7y ago
  Not sure about a prolonged fast but I had my HbA1c levels at 6.8 (very much diabetic) once and by dropping sugar, white flour, white rice and potatoes and generally eating less (fasting is bad as far as I understand) every check I had since has been 5.3 (very much non-diabetic).
  - flexblue 7y ago
    What's wrong with (intermittent) fasting? Of course if you don't raise your blood sugar as much by changing the diet, your HbA1c goes down by definition. However, limiting your feeding window will naturally reduce the amount of time you spend with elevated blood sugar, without any calorie reduction. Again, that'll lower your HbA1c by definition. Calorie reduction on the other hand can slow down metabolism and cause a yoyo-effect[1]. The real issue is insulin resistance. Even if your blood sugar is "normal", it may take more insulin to achieve those levels. Elevated insulin levels are harmful by themselves. Also, if you go back to your old diet, you will still be insulin resistant. Intermittent fasting can reduce visceral fat particularly in the liver and improve insulin sensitivity[2]. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639963/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639963/ [2] https://www.health.harvard.edu/blog/intermittent-fasting-surprising-update-2018062914156 https://www.health.harvard.edu/blog/intermittent-fasting-sur...
    - chx 7y ago
      https://www.medicalnewstoday.com/articles/321864 https://www.medicalnewstoday.com/articles/321864 > New research suggests that intermittent fasting may raise insulin levels, damage pancreatic cells, and increase the amount of abdominal fat. > Specifically, the new study — led by Ana Cláudia Munhoz Bonassa, a researcher at the University of São Paulo in Brazil — suggests that intermittent fasting may impair the normal activity of the pancreas and the production of insulin, which may, in turn, raise the risk of type 2 diabetes.
      - hombre_fatal 7y ago
        Dr Nicola Guess, Lecturer in Nutritional Sciences at King’s College London, responding to that study: > Firstly, it’s important to bear in mind there are important differences between rodents and humans – particularly with regard to diet. For example, a high fat diet causes insulin resistance in rats but it does not appear to in humans. > The exact method is unclear from the abstract, but if the rats were fasted for one day, this is equivalent to an approximately 3 to 4 week fast in humans! So it’s not applicable to the 24-hour or 48-hour fasts practised by humans on common fasting diets. (Note: the study made rats fast for 3 days) Doesn't seem like the study I'd stop at when evaluating the benefits of intermittent fasting. For example, what about the promising ones that study actual humans and only see all markers improve? I'd certainly stop going around spouting "fasting is bad" if this rat study is all you've got. Reminds me of that political cartoon of a soccer mom digging through a massive stack of studies, finally finding one that says vaccines might be bad, and going "Hah! Knew it!"
        chx 7y ago
        I am very near 100% my attempts at intermittent fasting caused this blood sugar spike but since I do not have a lab result from before I can't prove it but I dislike coincidences like that.
        chx 7y ago
        This is hard to put into the right words especially in a short way but The entire "what should I eat" field is so full of bad science that I disbelieve everything. There is so much money to made here it's astonishing and it makes everyone's motives questionable. I believe in a somewhat closer-to-the-nature approach without going stir crazy. Moving from very processed foods to their less processed versions felt like a good move. I am playing this by the ear because as our conversation shows there is a study to counter every other study. I personally believe that general food advice can't exist because surely our genetics play a role in how our body reacts to different foods -- foodstuff itself is very complex chemically, biologically. In short, intermittent fasting is unnatural and
  - whb07 7y ago
    I mean like a 5 day fast to clear out the crap in your pancreas and what not. I remember reading some article on Scientfic American over 5 years ago something akin to this.
- tintin12 7y ago
  >> prolonged fast That can potentially kill a person with T2 through diabetic ketoacidosis(DKA). Please be careful if you refer this to someone else.
  - Aloha 7y ago
    T1 person, yes, but not T2, at least not with the T2 people I know.
  - whb07 7y ago
    Uhh keto acidosis is not ketosis. But yeah definitely, talk to a real doctor and read the research.
nate_meurer 7y ago
High blood sugar is toxic to pancreatic beta cells. Thus, poorly controlled type 2 diabetes typically progress to some degree of insulin-dependent diabetes. That condition is the worst of both worlds; your insulin levels are insufficient, but even supplementing insulin artificially can't bring your blood sugar under control without significant lifestyle changes. Note that beta cells are hardly unique in this regard. High blood sugar is toxic to all tissues, but the affects on some tissues are especially problematic, examples being retinas, kidneys, endothelium, and peripheral nerves.
- RHSeeger 7y ago
  The reverse tends to also be true. After being a Type 1 diabetic for a good while, it's not uncommon to also start showing signs of insulin resistance (type 2).
Ovah 7y ago
T2D patients also have a reduced amount of insuline-producing beta cells. At diagnosis, there's been a 50% destruction of insuline-producing beta-cells. The destruction progresses with the disease.
- Aloha 7y ago
  I really wish the discussion on T2 would change - I'm tired of being blamed for being diabetic by medical professionals, I even lost a significant amount of weight (well over 100 lbs) but the diabetes returned. In my case, my liver seems to emit a virtually endless amount of glucose, This is probably why I'm fat, and oddly, when my diabetes is well controlled, I'm never hungry, when its poorly controlled I'm hungry all the time and gain weight - which is how I was most of my life, being hungry virtually 24/7, even when my blood sugar was normal.
lolc 7y ago
There is already a therapy that transfers beta cells from healthy people to T1 patients. The trouble is that the patients have to take immunosuppressants ever after to prevent the immune system from killing the cells off again. And I don't think that cells grown from stem cells would fare better, because it was the patients immune system that killed the beta cells in the first place. Your typical T1 will prefer insulin therapy over immunosuppressants.
- guywhocodes 7y ago
  > Your typical T1 will prefer insulin therapy over immunosuppressants. Me and me father both have T1 and he has received transportation of beta cells. Only because he was already on immune suppressants. I'll take insulin every day for the rest of my life happily if I never end up with his general health issues.
- rland 7y ago
  It takes time (several months) for islet cells to get destroyed by the body. That's the origin of the "Honeymoon phase" experienced by some t1ds after diagnosis. So successful islet cell transplants last for a few months; at the beginning, the patient is nearly cured, and then their islet cells are slowly destroyed by the body. So the appeal of stem cell treatment is that you get a single booster of islet cells every couple months. No nasty immunosuppressants required, because the body doesn't reject stem cells crafted from its own cloth.
  - lolc 7y ago
    Ah if it lasts longer I can see how it would become an option. In my case the "honeymoon" took the better part of a year and if that phase could be repeated it would definitely improve my therapy.

whb07 7y ago

Isn't type 2 somewhat reversible by cleaning up diet and a prolonged fast?

chx 7y ago
Not sure about a prolonged fast but I had my HbA1c levels at 6.8 (very much diabetic) once and by dropping sugar, white flour, white rice and potatoes and generally eating less (fasting is bad as far as I understand) every check I had since has been 5.3 (very much non-diabetic).
- flexblue 7y ago
  What's wrong with (intermittent) fasting? Of course if you don't raise your blood sugar as much by changing the diet, your HbA1c goes down by definition. However, limiting your feeding window will naturally reduce the amount of time you spend with elevated blood sugar, without any calorie reduction. Again, that'll lower your HbA1c by definition. Calorie reduction on the other hand can slow down metabolism and cause a yoyo-effect[1]. The real issue is insulin resistance. Even if your blood sugar is "normal", it may take more insulin to achieve those levels. Elevated insulin levels are harmful by themselves. Also, if you go back to your old diet, you will still be insulin resistant. Intermittent fasting can reduce visceral fat particularly in the liver and improve insulin sensitivity[2]. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639963/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639963/ [2] https://www.health.harvard.edu/blog/intermittent-fasting-surprising-update-2018062914156 https://www.health.harvard.edu/blog/intermittent-fasting-sur...
  - chx 7y ago
    https://www.medicalnewstoday.com/articles/321864 https://www.medicalnewstoday.com/articles/321864 > New research suggests that intermittent fasting may raise insulin levels, damage pancreatic cells, and increase the amount of abdominal fat. > Specifically, the new study — led by Ana Cláudia Munhoz Bonassa, a researcher at the University of São Paulo in Brazil — suggests that intermittent fasting may impair the normal activity of the pancreas and the production of insulin, which may, in turn, raise the risk of type 2 diabetes.
    - hombre_fatal 7y ago
      Dr Nicola Guess, Lecturer in Nutritional Sciences at King’s College London, responding to that study: > Firstly, it’s important to bear in mind there are important differences between rodents and humans – particularly with regard to diet. For example, a high fat diet causes insulin resistance in rats but it does not appear to in humans. > The exact method is unclear from the abstract, but if the rats were fasted for one day, this is equivalent to an approximately 3 to 4 week fast in humans! So it’s not applicable to the 24-hour or 48-hour fasts practised by humans on common fasting diets. (Note: the study made rats fast for 3 days) Doesn't seem like the study I'd stop at when evaluating the benefits of intermittent fasting. For example, what about the promising ones that study actual humans and only see all markers improve? I'd certainly stop going around spouting "fasting is bad" if this rat study is all you've got. Reminds me of that political cartoon of a soccer mom digging through a massive stack of studies, finally finding one that says vaccines might be bad, and going "Hah! Knew it!"
      - chx 7y ago
        I am very near 100% my attempts at intermittent fasting caused this blood sugar spike but since I do not have a lab result from before I can't prove it but I dislike coincidences like that.
      - chx 7y ago
        This is hard to put into the right words especially in a short way but The entire "what should I eat" field is so full of bad science that I disbelieve everything. There is so much money to made here it's astonishing and it makes everyone's motives questionable. I believe in a somewhat closer-to-the-nature approach without going stir crazy. Moving from very processed foods to their less processed versions felt like a good move. I am playing this by the ear because as our conversation shows there is a study to counter every other study. I personally believe that general food advice can't exist because surely our genetics play a role in how our body reacts to different foods -- foodstuff itself is very complex chemically, biologically. In short, intermittent fasting is unnatural and
- whb07 7y ago
  I mean like a 5 day fast to clear out the crap in your pancreas and what not. I remember reading some article on Scientfic American over 5 years ago something akin to this.
tintin12 7y ago
>> prolonged fast That can potentially kill a person with T2 through diabetic ketoacidosis(DKA). Please be careful if you refer this to someone else.
- Aloha 7y ago
  T1 person, yes, but not T2, at least not with the T2 people I know.
- whb07 7y ago
  Uhh keto acidosis is not ketosis. But yeah definitely, talk to a real doctor and read the research.

nate_meurer 7y ago

High blood sugar is toxic to pancreatic beta cells. Thus, poorly controlled type 2 diabetes typically progress to some degree of insulin-dependent diabetes. That condition is the worst of both worlds; your insulin levels are insufficient, but even supplementing insulin artificially can't bring your blood sugar under control without significant lifestyle changes. Note that beta cells are hardly unique in this regard. High blood sugar is toxic to all tissues, but the affects on some tissues are especially problematic, examples being retinas, kidneys, endothelium, and peripheral nerves.

RHSeeger 7y ago
The reverse tends to also be true. After being a Type 1 diabetic for a good while, it's not uncommon to also start showing signs of insulin resistance (type 2).

Ovah 7y ago

T2D patients also have a reduced amount of insuline-producing beta cells. At diagnosis, there's been a 50% destruction of insuline-producing beta-cells. The destruction progresses with the disease.

Aloha 7y ago
I really wish the discussion on T2 would change - I'm tired of being blamed for being diabetic by medical professionals, I even lost a significant amount of weight (well over 100 lbs) but the diabetes returned. In my case, my liver seems to emit a virtually endless amount of glucose, This is probably why I'm fat, and oddly, when my diabetes is well controlled, I'm never hungry, when its poorly controlled I'm hungry all the time and gain weight - which is how I was most of my life, being hungry virtually 24/7, even when my blood sugar was normal.

lolc 7y ago

There is already a therapy that transfers beta cells from healthy people to T1 patients. The trouble is that the patients have to take immunosuppressants ever after to prevent the immune system from killing the cells off again. And I don't think that cells grown from stem cells would fare better, because it was the patients immune system that killed the beta cells in the first place. Your typical T1 will prefer insulin therapy over immunosuppressants.

guywhocodes 7y ago
> Your typical T1 will prefer insulin therapy over immunosuppressants. Me and me father both have T1 and he has received transportation of beta cells. Only because he was already on immune suppressants. I'll take insulin every day for the rest of my life happily if I never end up with his general health issues.
rland 7y ago
It takes time (several months) for islet cells to get destroyed by the body. That's the origin of the "Honeymoon phase" experienced by some t1ds after diagnosis. So successful islet cell transplants last for a few months; at the beginning, the patient is nearly cured, and then their islet cells are slowly destroyed by the body. So the appeal of stem cell treatment is that you get a single booster of islet cells every couple months. No nasty immunosuppressants required, because the body doesn't reject stem cells crafted from its own cloth.
- lolc 7y ago
  Ah if it lasts longer I can see how it would become an option. In my case the "honeymoon" took the better part of a year and if that phase could be repeated it would definitely improve my therapy.