Pre-diabetes -- Are the Ad Council's PSAs a hit or a miss?

I forgot to mention that I’m also wearing a Dexcom G5 for a week which is showing my after meal blood sugar spikes up to the 170 range. After an intense exercise session on Sunday though I lowered my insulin resistance and had no after meal spikes on Monday. So I prevented signs of diabetes on Monday. No exercise on Monday meant my after meal blood sugar increased on Tuesday.

I’m also taking Metformin to prevent the development of type 2 diabetes. The DPP trial had a lifestyle and a Metformin arm. I’m using a combined approach that wasn’t used in the trial to use a more aggressive treatment method.

I consider a delay of two year prevention. I don’t get into the semantics battle of whether a two year delay is prevention or elimination. I’ll let others argue that point.

@Mark_Harmel…fantastic thread, Everybody! …But Mark, you really shouldn’t be surprised…

I was told I was “pre-diabetic” in late 2006 and told to follow the current medically sanctioned fad diet—the DASH diet—disaster. Within a very short period the scale tipped—of course. That’s a terrible diet for a diabetic. So Eff the term pre-diabetic. Once a diabetic always a diabetic. Somebody needs to tell at least a little truth in a very public way…

My dad came home post WWII from years in the Navy—from Lend-Lease in the North Atlantic to Midway in the Pacific—and returned to a job in the ad industry–with regional accounts including 3M tape division and buick. The ad industry kept a roof over our heads when I was growing up. But in the 1950s, many things were different. Many laws and regulations were different…

Dad’s motto, adapted from a dear friend in the Foreign Service was: “Never tell a lie. Never tell the whole truth. Never pass up an opportunity to go to the bathroom.”…

Ads now, like some of our worst politicians, really have no qualms about lying. In the world of a diabetic life, these lies or “not-quite-true” ads, seductive as they might be, are actually life-threatening…

One reason why I am planning a mass response to Oprah’s “I love bread” ads for weight watchers. I just don’t quite know how to do it yet…

Sorry this has gotten too “ranty”…Blessings all…Onward…

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These are horrible. Period…Blessings all…Love you , Manny, as ever…xx000

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after i look at, i think it might help, for me i did not know about Pre-diabetes,.
so something new, i found out,.

On a recent Sunday, I ate very low carb, went to the gym for a mixed weights/cardio workout - and, as I have a soreness in one shoulder, the emphasis was on the cardio, then went to a movie. Approximately 4.5 hours after my workout and almost 6 hours after my last meal (other than 15-20g carbs to stop my BG from dropping after the cardio workout), I took a bolus for a restaurant meal. While I was sitting in a restaurant getting ready to order dinner, I noticed that my BG was SKYROCKETING (for me), heading toward 300. Apparently my insulin pump site had failed some time earlier. I corrected with an injection and eventually all was well. Note, the next day my BG was quite volatile, despite relatively low-carb food choices…

Good diet + exercise made exactly zero noticeable difference. (I won’t go back and discuss my pre-Dx good lifestyle choices, exercise and weight loss that also missed on the “prevention” scale…)

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I have to say, I have a rather dismal view of the Diabetes Prevention Program (DPP). I think it was ill-conceived to begin with and used a totally wacked approach. The DPP defined an end point that measure how many people with pre-diabetes (which is just diabetes) progressed to full blown diabetes (which is worse diabetes). It measured how many people with diabetes “got worse.” So if you didn’t get worse you “prevented” diabetes. How stupid is that? And the lifestyle treatment? Eat a high carb, low fat calorie restricted diet. I won’t say anything more than that.

So even though the DPP was messed up in design, how well did it work? The recently published follow up (after 15 years) study called the DPPOS found that

At year 15, the cumulative incidences of diabetes were 55% in the lifestyle group, 56% in the metformin group, and 62% in the placebo group.

So let’s make two observations. First, the majority of participants still progressed to diabetes. THEY DIDN"T PREVENT DIABETES! Second, the high carb low fat diet with exercise approach was USELESS! It was no better than just taking a metformin pill. And those patients that did the DPP, on 7% of those saw any benefit at all. Only one in 14 people would see any benefit in delaying their progression of diabetes.

Concluding that the DPP “proved” that diabetes is caused by poor lifestyle is just WRONG! How can one possibly conclude that?

And finally, the bone headed idea that a low fat diet would be “heart healthy” was also found to be a failure.

So I have to ask the question. What good is a public service message to inform people about pre-diabetes when we LIE TO THEM and then tell them they can prevent their diabetes. I have no issue with educating the public about diabetes but I object to lying because I believe it leads to harm (potentially serious harm).

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I am still reeling from reading this. I watch almost zero regular television so I must have missed it. Are you telling me that she is seriously telling people to eat lots of bread as part of a weight-loss program?!?

she’s invested in Weight Watchers and I haven’t seen it, but this morning I heard a TV ad she did where she talks about recently losing weight, “and I ate bread every day” (she didn’t say how much bread, or what kind)

I do not think the commercials are too good, many would probably be offended by them, but the ADA is correct in the fact that you can reverse your prediabetes. Michael Mosley, a science journalist trained as a doctor and a PPE graduate from Oxford in Britain, did the documentary Eat,fast, and live longer, and he got his sugars normal again,after losing about 20 pounds through a fasting regimen he dubbed 5:2, he ate normally five days, then 600 calories on his 2 fasting days.

In the program he visits a researcher which is concentrated on fasting, and he is persuaded to fast for 4 days. Durings those fasting days he loses 1.5 lbs and his sugars return from prediabetic to normal, so yeah, prediabetes can definitely be reversed by weightloss.

Here is the documentary

If you go to 31:30 in the video and stop the image, you will see his test results in the hand of the professor.

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So he went back to his diet before being diagnose as pre-diabetic and didn’t return to diabetes? That is amazing!

I’d like to point out there is a huge difference in medicine in reversal (which is a return to a non-disease state) and control. Nobody disagrees that you can control diabetes with diet and fasting. But that doesn’t make it reversal.

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If you are diagnosed as a diabetic, lose some weight, and are able to eat loads of carbohydrates,getting postprandials readings of glucose like a non-diabetic, you are cured in my opinion. And it seems like Michael Mosley is able to do that, then he is cured in my opinion.

There are other example of people managing to do this as well, Here is a lecture by Professor Roy Taylor talking about the newcastle diet

. Some guy from Hawai, found the research on the internet, embarked on it and lost a lot of weight, this is in 2011 mind you. Roy Taylor and him keep in touch on email, and just look from 31:20 in the video lecture I sent you. He shows a picture of his bloodsugars readings after eating a blueberry muffin, 75, and they were from just an hour after eating it! the exact moment the bloodsugar reading is shown, is 33;36. Those are the numbers of a non-diabetic person, so yeah, in my mind that is a cure.

Well, we are each free to use words however we choose. But that is not how the medical profession defines the word “cure”. “Cured” means the condition is gone. Gone for good, gone forever. If you have pneumonia and a course of penicillin gets rid of it, you are cured. You can walk away and never think about it again.

Now, it is indisputable that some people are able to adopt diet and lifestyle changes that keep the condition perfectly under control. If they could then return to their previous habits without the symptoms reappearing, then that would be a true cure. I have yet to see any credible documentation of anyone who’s done that. Absent that, we are talking about great control, but not a cure.

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Thank you for bringing this documentary to my attention. I was in the habit for several months to fast for one 24-hour period each week. After viewing this video, I intend to return to some regular fasting. I think it’s good for my T1D. I’ve heard over many years from many different sources about the good effects of fasting on longevity. My biggest diabetic complication fear is cardio vascular disease and stroke. It’s in my family genetic makeup. Diabetes exacerbates that risk. I don’t see any downside to fasting.

I still don’t like the use of the terms cure or reverse with diabetes unless the person can eat any way they like without adherence to a mitigating eating protocol and still be gluco-normal.

I enjoy BBC productions.

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But diabetes type 2 is not totally like that. It is connected to how much excess fat you have, compared to what your body is able to cope with, before it starts developing diabetes. Say lets take a man at age 23 188cm and 140 kg. He has type-2 diabetes. Lets says his genetic limit for developing diabetes is 90 kg, if he goes 90 kg ,he develops diabetes. He goes down to 72kgs and is able to stay there, but fluctuates 2 kgs up and down at that weight. At this weight he eats what he wants, but is careful about maintaining it around this range. Most likely he will never get diabetes type 2 again, if he stays there. And I know several people like this. So it is possible. So being a diabetic sets limits, but it is possible!

This generalization is clearly not true for many, perhaps even most people with Type 2 diabetes. Certainly was untrue for me.

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But there is a great deal of evidence now that T2 develops and then the weight gain happens not the other way around. And I would never use either the word “cure” or “reversal” about T2. Only good control. I am very much with @David_dns on that one.

And I long ago stopped trusting anything out of the ADA. If I had followed any of their advise longer than the 6 months I gave it, I would never have gotten control. Nine years in, I am still controlling with a low carb/exercise approach, but I don’t expect that to last for ever…

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30% of those diagnosed with type 2 diabetes have a normal bmi. But a normal bmi is quite a wide range, from 18.5 to 24.9

According to my height 188cm, from going to the lower end of bmi to the higher, my weight could be everything from 65 kg to 88 kg, this is a 23 kg range, and still be considered a normal bmi. And this figure also says nothing about my bodycomposition, I could very well have a bmi of 20, but a bodyfat of 25% which would classify my as an obese person in terms of bodyfat.

look at this picture. These are two famous professors in diabetes research, they measured bmi and bodyfat in lots of people in both India and England,and compared the results, they also tested themselves. by coinsidence they both had a bmi of 22.3, but the one to the left has a bodyfat of 9% the one to the right 21% ! Same bmi,nearly double the difference in bodyfat!


Also look at this chart, which shows how bmi and bodyfat is not necessarily correlated.

16% of women have a normal or underweight bmi, but bodyfat of over 35%, counting them as being obese.

6% of men had the same figure but their limit for obesity in terms of bodyfat is 25%.

3% of women had bodyfat of under 35%, but overweight bmi, and the same figures for men where 12% again with the limit at 25%.

Also look at this history.

This man had a Bmi of 21 at a height of 5 feet 7 inches(170 cm) , when he got diagnosed with diabetes type 2. He when went on the newcastle diet, and and reached a weight of 56 kg, giving him a bmi of 19.4. He then got sugars like a non-diabetic, and he does not eat a lowcarb diet, but a rather silly one, he belives saturated fats are bad for instance. But again, weight is the important thing, but far more imporant is where the fat is stored and lost.

Also Type-2 store fat in abnormals places like the liver,pancreas, and as visceral fat, which is tge cause type 2, people which not do not get diabetes, however large their bmi, do not store fat this places.

Roy Taylor did a brilliant study that showed this.

http://care.diabetesjournals.org/content/early/2015/11/29/dc15-0750?patientinform-links=yes&legid=diacare;dc15-0750v1

Individuals listed for gastric bypass surgery who had T2DM or normal glucose tolerance (NGT) matched for age, weight, and sex were studied before and 8 weeks after surgery

Weight loss after surgery was similar (NGT: 12.8 ± 0.8% and T2DM: 13.6 ± 0.7%) as was the change in fat mass (56.7 ± 3.3 to 45.4 ± 2.3 vs. 56.6 ± 2.4 to 43.0 ± 2.4 kg). Pancreatic triacylglycerol did not change in NGT (5.1 ± 0.2 to 5.5 ± 0.4%) but decreased in the group with T2DM (6.6 ± 0.5 to 5.4 ± 0.4%; P = 0.007). First-phase insulin response to a stepped intravenous glucose infusion did not change in NGT (0.24 [0.13–0.46] to 0.23 [0.19–0.37] nmol ⋅ min−1 ⋅ m−2) but normalized in T2DM (0.08 [−0.01 to –0.10] to 0.22 [0.07–0.30]) nmol ⋅ min−1 ⋅ m−2 at week 8 (P = 0.005). No differential effect of incretin secretion was observed after gastric bypass, with more rapid glucose absorption bringing about equivalently enhanced glucagon-like peptide 1 secretion in the two groups.

CONCLUSIONS The fall in intrapancreatic triacylglycerol in T2DM, which occurs during weight loss, is associated with the condition itself rather than decreased total body

In short, type diabetics lost fat from the liver, nondiabetics did not despite the fact that both the control and diabetic group lost the same amount of weight!

So yeah, diabetes and prediabetes can be reversed as long as you loose enough fat, and the fat needed to be removed is highly variable largely dependent on genetics. You could of course be a LADY or Mody, and I feel for you, those groups are really let down by the medical community, but a standard type-2 would reverse his condition like the thin man described in the daily mail article.

My skepticism is higher in any argument using a source such as the British tabloid, the Daily Mail. Wikipedia has this to say about medical stories covered by the Daily Mail:

The paper has been criticised by doctors and scientists for its sensationalist reporting on medical subjects.[14]

I regularly read The Guardian, another UK newspaper, and an excellent source of news. My sense of the Daily Mail is that it is similar to America’s National Enquirer, a good source of celebrity gossip and tawdry scandals. It’s not a news source I would depend on when seeking quality information about things medical. We’re all aware of such rags that specialize in gaudy headlines written in “end of the world” font sizes.

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LOL Terry. My favorite supermarket tabloid headline, from several years ago, is “Bush’s Secret Plan To Invade The Moon.”

All other issues aside, how do you “invade” a place that’s uninhabited?

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Never reversed. Once a diabetic always a diabetic…and good heavens, you’re citing a tabloid?..Interesting choice of source…

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