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  #1   ^
Old Fri, Mar-02-18, 06:51
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Benay Benay is offline
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Default Five types of diabetes instead of two

In the news this morning is a report of a research study that has identified five types of diabetes instead of two. These findings should offer more specificity to the research on diet - which diet works best with which type of diabetic. As most of us know, low carb does not work well on everyone. Now we might find out why.
Five types of diabetes
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  #2   ^
Old Fri, Mar-02-18, 07:52
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WereBear WereBear is online now
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Fascinating.

Quote:
Among the severe types, a group of patients with insulin resistence -- in which cells are unable to use insulin effectively -- was at far higher risk of kidney disease.

"This group has the most to gain from the new diagnostics as they are the ones who are currently most incorrectly treated," Groop said.


I am sure the success rates reported by Virta-Health opened some minds, and now they have (surprise, surprise, surprise!) found a type of diabetes that regular treatment makes worse, and low carb treatment makes better.

I guess science marches on. Eventually.
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  #3   ^
Old Fri, Mar-02-18, 09:16
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deirdra deirdra is offline
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Quote:
Originally Posted by WereBear
I am sure the success rates reported by Virta-Health opened some minds, and now they have (surprise, surprise, surprise!) found a type of diabetes that regular treatment makes worse, and low carb treatment makes better.
Not to mention that they probably never would have been diagnosed with diabetes if they had been eating LC in the first place.
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Old Fri, Mar-02-18, 10:23
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khrussva khrussva is offline
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Quote:
Originally Posted by deirdra
Not to mention that they probably never would have been diagnosed with diabetes if they had been eating LC in the first place.

I'm fairly certain that I would not have been diagnosed as a diabetic in March 2014 had I not spent all of 2013 in a state of depression and hopelessness, eating whatever and whenever I wanted. I had lost my business and had to declare personal bankruptcy at the end of 2012. That resulted in my SAD eating habits going from bad to worse in the months that followed. Yet I can assure you that I started having health issues related to high blood sugar at least a decade before my diabetes diagnosis. So many issues I had were resolved within months of gong low carb.

I turned out to be in the IR camp of those T2 diabetes types. But I was also becoming ever reactive hypoglycemic as my metabolic condition deteriorated. Although I was not testing my BG at the time, I'm convinced that my blood sugar swings were wild, crazy, and totally NOT NORMAL for years before I achieved the standard definition of what constitutes diabetes. My presumed wild BG swings from eating carbs may have been my issue all along. I've been overweight since birth. I had a glucose tolerance test done when I was around 8 years old. I don't have the results of that test, but I do remember an argument between my pediatrician and my mom's doctor about the results. So, IMO, there was something unusual about the results.

I don't think that my pancreas has ever had any trouble producing insulin, nor do I have a problem storing sugar away as fat. If my response to carbs is a high blood sugar spike followed immediately by an episode of low blood sugar - as I suspect it was, then an A1C test would not be a good indicator of a problem. I could have damagingly high BG at times with an overall average BG in the non-diabetic range. I think that testing my insulin levels over the years would have been very revealing about the road to diabetes that I was on.

So what is my point here? Perhaps classifying more categories of pre-diabetes is in order, too. High blood sugar is bad, period. The idea that it just needs to get below XXX within yyy hours following a meal to minimize damage from high BG is not a healthy action plan. BG should never be too high. Intervention could begin much earlier if they actually caught symptoms that lead to diabetes at their infancy.

Last edited by khrussva : Fri, Mar-02-18 at 11:50.
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Old Fri, Mar-02-18, 11:41
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WereBear WereBear is online now
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Misdiagnosis By Design - The Story Behind the ADA Diagnostic Criteria

This is the little known story of how--and why--the American Diabetes Association keeps doctors from diagnosing Type 2 diabetes early.

If you wait for your doctor to give you a diabetes diagnosis, the chances are good that by the time you are diagnosed you'll already have one or more serious diabetic complications. These include retinal damage, nerve damage, and early kidney damage. It is now known that these diabetic complications only develop after years of chronic exposure to high blood sugars. But, tragically, the way that today's doctors are forced to diagnose diabetes ensures that you will get no warning that you are experiencing those chronically high blood sugars until they have reached a level so high they have already done irreversible damage.

This is not an accident. Years ago a committee of medical experts whose task was to decide how diabetes should be diagnosed decided it was better to avoid diagnosing patients with diabetes than to give them early warning that they were suffering from elevated blood sugars. As a result, these medical experts intentionally set the standards for diagnosing diabetes artificially high, so that most patients do not get diagnosed until their blood sugar has reached a level where they may soon develop the diabetic eye disease that leads to blindness.

Their reasons for doing this this made sense in the late 1970s when these diagnostic criteria were originally crafted. At that time there was no treatment that could help people with early diabetes, while delivering a diabetes diagnosis could make it impossible for their patients to get health or life insurance. These circumstances led the experts to conclude that an early diagnosis of diabetes was more likely to harm than help their patients. So they defined diagnostic criteria that wouldn't diagnose patients with diabetes until late in the disease process, when their blood sugars were bad enough that they could safely use insulin and the early insulin stimulating drugs. These were very unsafe to use in the late 1970s unless patients had extremely high blood sugars, since patients had no access to real time blood sugar testing, as there were not yet any blood sugar meters available to patients for home use.



More at the link. Things are more proactive now.
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  #6   ^
Old Fri, Mar-02-18, 14:56
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cotonpal cotonpal is online now
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I can't help but get the feeling that they're making it up as they go along. There needs to be more out of the box creative thinking. This sounds more like taking the box that exists now and putting more compartments in it. I don't think I am making myself very clear here but my overarching perspective is that the whole concept of a "disease" needs revising or specifying or something. We tend to think of diseases as things but they are really ideas advanced to explain bodily functions and symptoms considered to be abnormal and dangerous or harmful. I guess I am underwhelmed by this and probably not making much sense.

Jean
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Old Fri, Mar-02-18, 18:02
M Levac M Levac is offline
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I don't believe a word of it. I mean, they have no clue. There's only two types. The article doesn't mention anything else but absence of insulin, and inability to use insulin which is produced. Instead, I prefer to distinguish them by actual genuine distiguishing characteristics only found in either type.

Type 1

Hyperglycemia
Absence of insulin
Hyperketonemia (tons of ketones in the blood)

Type 2

Hyperglycemia (the only common characteristic)
Hyperinsulinemia
Absence of blood ketones


OK, so they have no clue, otherwise they'd notice that the cause of hyperketonemia in type 1 is absence of insulin, and in type 2 there is a ton of insulin and zero ketones, so insulin is the thing that inhibits ketogenesis in the liver, which means that in type 2 insulin works just fine when it hits the liver. Therefore insulin resistance is a false diagnosis, i.e. the condition doesn't actually exist.

When all is well, insulin is degraded in the liver once it's done its job of first inhibiting ketogenesis, then inhibiting glycogenolysis. So, when a diagnosis of insulin resistance is made, what is actually diagnosed is interference at the second step of inhibition of glycogenolysis. When this step is interfered with, blood glucose that hits the liver is not stored, it lingers in the blood, we get high BG.

Ketones activate insulin receptors in the liver (probably in all other cells as well but let's stick to the liver for our purpose). This means that the proximal cause of what's called insulin resistance - interference with second step of inhibition of glycogenolysis - is absence of ketones. Never mind that insulin receptors work just fine for the purpose of inhibiting ketogenesis, i.e. ketones are not needed for that function. But then this also means that the proximal cause of absence of ketones is hyperinsulinemia. But then this also means that the proximal cause of hyperinsulinemia is hyperglycemia. But then this must mean that the proximal cause of hyperglycemia is dietary carbs. It's truly genuinely exquisitely ironic that the test for insulin resistance is an oral glucose tolerance test - dietary carbs. It's like the test for smashed thumb syndrome is to smash the thumb with a hammer.

The primary diagnostic criteria for diabetes type 2 is some variation of hyperglycemia depending on specific conditions, more than one of which are measured using an OGTT (again with the irony). Let's make it clear in the most basic terms I can possibly think of. If ya got high blood glucose, and it don't matter how ya got high blood glucose, ya got diabetes type 2. Ya know why they go with an OGTT? Cuz dietary glucose is the most reliable agent to cause diabetes type 2. They tried all kinds of other ways to test. But no, pure glucose by mouth is the shiznitz.

Jebus, I got mad just writing this. I mean, how could an expert be so blind to the ridiculously obvious?
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