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  #1   ^
Old Mon, Aug-13-18, 12:05
teaser's Avatar
teaser teaser is offline
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Posts: 12,920
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
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Location: Ontario
Default Early type 1 diabetes shortens women's lives

https://www.sciencedaily.com/releas...80810091103.htm

Quote:
Early type 1 diabetes shortens women's lives by 18 years

Women who developed type 1 diabetes before the age of ten years die an average of nearly 18 years earlier than women who do not have diabetes. Men in the corresponding situation lose almost 14 years of life. The lives of patients diagnosed at age 26-30 years are shortened by an average of ten years, according to research published in the British medical journal the Lancet.

"These are disappointing and previously unknown figures. The study suggests that we must make an even greater effort to aggressively treat patients diagnosed at an early age to reduce the risk of complications and premature death," says Araz Rawshani, researcher at the Department of Internal Medicine, Sahlgrenska Academy, and the Swedish National Diabetes Registry.

The research is based on extensive material from the registry which has monitored 27,195 individuals with type 1 diabetes for an average of ten years. The group was compared with 135,178 controls from the general population who did not have diabetes, maintaining the same distribution regarding gender, age and county of residence.

While researchers already knew that type 1 diabetes is associated with a lower life expectancy, until now it was unclear whether and how much gender and age at onset of illness affect both life expectancy and the risk of cardiovascular disease.

The probability of severe cardiovascular disease generally proved to be 30 times higher for those who developed type 1 diabetes before the age of ten years than for controls. With a diagnosis of diabetes at the age of 26-30 years, the corresponding risk increased by a factor of six.

One of the highest increases in risk noted in the study involved heart attacks in women who developed type 1 diabetes before the age of ten years. The risk for these women is 90 times higher than for controls without diabetes.

"The study opens up the potential for individualized care. We know with certainty that if we maintain good blood sugar control in these patients, we can lower the risk of cardiovascular damage. This makes it important to carefully consider both evidence-based medications and modern technological aids for blood sugar measurements and insulin administration in patients diagnosed with type 1 diabetes at an early age," says Araz Rawshani.

"At the same time the study must also be viewed in the light of the tremendous progress that has been made in the past few decades. Management of type 1 diabetes is nowadays highly sophisticated, with modern tools for glucose monitoring, delivery of insulin and management of cardiovascular risk factors. Those who live with diabetes today, and those who will acquire the disease, will enjoy longer and healthier lives in the years to come," says Araz Rawshani.

Type 1 diabetes is one of the most common chronic diseases that affect children in Sweden. The majority are diagnosed between the ages of 10 and 14 years. The number of diagnoses among children is increasing and the percentage is among the highest in the world; Sweden is second after Finland. Between 50,000 and 60,000 people in Sweden suffer from the disease.

"From the patient perspective this study is tremendously important. Suddenly we can answer questions about complications and life expectancy that we were previously unable to answer. Now there is robust evidence that survival largely depends on the age at which the patient develops the disease, and that there is a difference between men and women," says Araz Rawshani.


They seem to have forgotten to mention the importance of diet.

Hopefully they're right about modern sophisticated tools improving things.

One problem is delivery of insulin. Normally the lion's share of insulin is sopped up by the liver and never makes it into general circulation. Obviously not something that's going to happen if the method of delivery is right into the general circulation. A diet that doesn't require as much insulin decreases the difference in how much insulin should be present peripherally and centrally. It's not just a matter of small numbers making for small errors and Dr. Bernstein always points out.
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  #2   ^
Old Mon, Aug-13-18, 12:14
Ms Arielle's Avatar
Ms Arielle Ms Arielle is offline
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Plan: atkins
Stats: 247/218/153 Female 5'8"
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Default

How ironic you should post this.

About a month ago I started to talk diet to a friend that is T1, since a child. Over the last 9 years, she was put on abot 30 pounds. The insulin is just making her fatter.

Twice I have talked food, carbs, the biochemistry. SHe doesnt want to know. SHe is having bg spikes, and the doc has altered her meds but it is not countering the spikes.

THe spikes started after a course of prednisone.

SHe uses a pump so readings are regular and insulin is trickled in as needed.

The bottom line is that I see the typical SAD foods, and a 3 out of 4 are over weight.

I cannot say anymore. The doctor needs to step up.... but he can only see the insulin, and bg NOT the food that drives it all.

Is there a book I can hand a T1???

PS. Her sister is also T1. To help one, would to help the other, too.
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  #3   ^
Old Mon, Aug-13-18, 12:17
Ms Arielle's Avatar
Ms Arielle Ms Arielle is offline
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Plan: atkins
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My burning question is how does a T1 do keto with out triggering ketoacidosis?
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  #4   ^
Old Wed, Aug-15-18, 08:42
teaser's Avatar
teaser teaser is offline
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Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
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Default

I think the best book is probably still Dr. Bernstein's Diabetes Solution. He doesn't advocate actually being in ketosis necessarily--the plan he describes I'm sure will have some people in a mild state of ketosis at times, at least.

Obviously extra problems for a more ketogenic diet for type I's. I think you'd probably need to test blood ketones and glucose regularly, that could get expensive. If one of Dr. Bernstein's patients measured a blood glucose of 60, he'd have them taking a couple of grams of glucose to correct the hypo. But occasional glucose that low is within normal variation for somebody on a high fat ratio ketogenic diet. A few years ago when I first tried a higher ratio diet, my blood glucose went into to mid-60's pretty regularly sometime in the afternoon. You can't tell from that blood glucose number alone whether you're in a true hypo.

A non-diabetic can probably figure it's fine if they feel fine, but type I's get resistant to the early signs of hypo, by the time it's more obvious, it can be too late.

I think I've seen a case study for a type I diabetic who also had epilepsy...

Quote:
Successful treatment of type 1 diabetes and seizures with combined ketogenic diet and insulin.
Aguirre Castaneda RL1, Mack KJ, Lteif A.
Author information
Abstract
Diabetic ketoacidosis (DKA) is a life-threatening condition and a major cause of morbidity and mortality in children with type 1 diabetes mellitus. The deficiency of insulin leads to metabolic decompensation, causing hyperglycemia and ketosis that resolves with the administration of insulin and fluids. However, an induced state of ketosis is the basis for the success of the ketogenic diet (KD), which is an effective therapy for children with intractable epilepsy. We report the case of a 2-year-old girl who presented to the emergency department with 1-week history of decreased activity, polyuria, and decreased oral intake. Her past medical history was remarkable for epilepsy, for which she was started on the KD with a significant improvement. Her laboratory evaluation was compatible with DKA, and fluids and insulin were given until correction. Because of concerns regarding recurrence of her seizures, the KD was resumed along with the simultaneous use of insulin glargine and insulin aspart. Urine ketones were kept in the moderate range to keep the effect of ketosis on seizure control. Under this combined therapy, the patient remained seizure-free with no new episodes of DKA.


Just the abstract... looks like type I probably developed when the child was already on the ketogenic diet, the ketogenic diet didn't cause ketoacidosis (it's even likely to have prevented it for a time, the extremely low insulin requirement of the ketogenic diet might have masked what would otherwise have shown as insulin insufficiency sooner on a diet with a higher insulin requirement).

Urine ketones... okay, I guess that makes sense. At mild levels of ketosis, they're not a perfect match for blood ketones. But at ketoacidosis levels--they are always going to show deep purple, the colour depends on blood levels of acetoacetone available to pass into the urine, and the kidney's ability to reabsorb those ketones from the urine, at ketoacidosis levels, the levels in the urine will be far past the kidney's ability to reabsorb enough ketones to make the strips a paler colour. Dark purple does not mean you're in ketoacidosis, but a moderate colour means you're probably not, at least on a ketogenic diet (although on a non-ketogenic diet it will likely mean that you are insulin insufficient).

Which all sounds like while you should get a good doctor to help with this if you're following Dr. Bernstein's not-quite-ketogenic plan, you might need an even better doctor if you want to tip over into ketosis a bit more.
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  #5   ^
Old Wed, Aug-15-18, 09:33
Ms Arielle's Avatar
Ms Arielle Ms Arielle is offline
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Posts: 8,628
 
Plan: atkins
Stats: 247/218/153 Female 5'8"
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Progress: 31%
Location: Massachusetts
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I'll have to read that book and give friend a copy.

Just frustrating that most people I talk to have no interest in changing their way of eating. When I read DANDR and learned I could change my stars I jumped on the band wagon. Maybe it is because Im ok with biology, biochem etc. And most people just want a pill.
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  #6   ^
Old Tue, Aug-21-18, 09:17
teaser's Avatar
teaser teaser is offline
Senior Member
Posts: 12,920
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
Default

http://www.ketohackingmd.com/

Jimmy Moore has Dr. Carrie Diulus on to discuss his hypoglycemia issues.

She's a type I diabetic does vegan keto, she goes into some of the ins and outs for doing keto as a type I.

https://ketowomanpodcast.com/carrie-diulus/

Another interview here, I haven't listened to this one yet, but this podcaster usually does a decent interview.
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  #7   ^
Old Tue, Aug-21-18, 10:19
Bonnie OFS Bonnie OFS is offline
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Plan: Dr. Bernstein
Stats: 188/175/135 Female 5 ft 4 inches
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Location: NE WA
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Quote:
Originally Posted by Ms Arielle
I'll have to read that book and give friend a copy.


I hope she'll read it. It was Dr. B's book that woke me up to low carb. A friend had been trying to get me to read it, but I thought it was just another fad thing.

Dr. B describes diabetes - mostly T1, but also T2 - so well that even I, a non-scientific type, can actually understand it. Tho I had to read it about 3-4 times to really get it.

But even understanding it doesn't mean one will follow the diet. I've done fairly well until recently when some bad things going on in my life put me into an emotional tailspin. Trying to get back on the horse now - I feel too crappy to keep on this way.
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  #8   ^
Old Tue, Aug-21-18, 12:29
Ms Arielle's Avatar
Ms Arielle Ms Arielle is offline
Senior Member
Posts: 8,628
 
Plan: atkins
Stats: 247/218/153 Female 5'8"
BF:
Progress: 31%
Location: Massachusetts
Default

Thanks for the support BOnnie. I want to give it to a good friend. SHe is type 1 and seems to need a lot more support to control her blood sugars; and the dad , well, he had a heart attack in his 30's and went back to smoking asap. SHeesh. Im hoping I can reach her thru her children. SHe has one that will dependent on her for his lifetime...... and she needs her life to last as long.
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  #9   ^
Old Tue, Aug-21-18, 14:35
JEY100's Avatar
JEY100 JEY100 is offline
To Good Health!
Posts: 10,402
 
Plan: IF Fung/LC Westman/Primal
Stats: 222/171/169 Female 5' 9"
BF:45%/25.3%/24%
Progress: 96%
Location: NC
Default

These suggestions in addition to Dr. B...

Dr Keith Runyon wrote a book for Type 1 with Ellen Davis. I haven't read it myself but have Ellen's cancer book, she's a good clear science writer.

https://www.ketogenic-diet-resource.com

And for practical help and wonderful support...TypeOneGrit Facebook page. Here is a link to the NYT article on the study about their results and to the page.

https://www.nytimes.com/2018/05/07/...1-diabetes.html
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