Diabetics who just don't care enough

Hi Kelly: A commonly stated myth is that in Type 2 diabetes, insulin production by the beta cells declines over time, or “poop out” as you say. This is not true, according to “Latent Autoimmune Diabetes in Adults: Definition, Prevalence, Beta Cell Function and Treatment” in Diabetes Vol. 54, Supplement 2, December 2005. In that article, the authors point out that if you remove people with autoimmune markers for Type 1a diabetes (aka slow onset Type 1 diabetes in adults almost always misdiagnosed as Type 2) from studies of Type 2 diabetics, “beta cell function was unaffected and preserved 12 years after diagnosis among individuals without islet antibodies.” If patients with LADA are appropriately removed from studies looking at beta cell function in Type 2 diabetics, there is no decline in production of insulin in the true Type 2 diabetics.

Actually, beta cell function can progressively decline in Type 2. Type 2 is characterized by insulin resistance and dwindling supplies of insulin and other gut hormones.

The loss of beta cell function happens over many years, so with tight blood glucose control, it may be possible to halt, minimize, or delay the loss of beta cells.

There are many studies that have and are examining this in type 2. Most of the studies look at how various drugs can help improve beta cell function/prevent beta cell decline. In fact, early use of insulin as medication has had some promising results in restoring beta cell function.

http://qjmed.oxfordjournals.org/cgi/content/abstract/96/4/281
http://clinicaltrials.gov/ct2/show/NCT00232583
http://care.diabetesjournals.org/content/27/11/2597.full.pdf+html?sid=507ad006-e5e5-4615-ac69-53c7da0cb10a
http://www.diabetes.org/diabetes-research/summaries/Gastaldelli-drug-improves-cell-function.jsp
http://www.journals.elsevierhealth.com/periodicals/ymeta/article/PIIS0026049502633748/abstract

Hi Kelly: The problem with the studies for which you provided links is that the researchers apparently didn’t screen out the people with autoimmune diabetes (who definitely show a decline in beta cell function) who had been misdiagnosed as having Type 2. I just skimmed the articles, but I could not see anywhere where antibody testing (the gold standard for Type 1 autoimmune diabetes) was performed in any of those studies. The study I mentioned DID screen out those Type 1’s misdiagnosed as Type 2, and saw no decline in beta cell function in a 12 year timeframe in the true Type 2’s. Just as an example, in the landmark United Kingdom Prospective Diabetes Study (UKPDS) of Type 2 diabetes, 10% of the study participants that supposedly had Type 2 had ICA and/or anti-GAD antibodies, and clearly had Type 1 diabetes (Zimmet et. al., 1999). All that said, I think there is a lot more work to be done in this arena, because Type 2 certainly is complex.

The key to my control is that I’m turned on by research, by analyzing problems, by looking at their components, by turning them over and writing down approaches that I haven’t tried on myself. Then I devise a plan of attack. Whether it is from an exercise approach, a food approach, a recording of observations approach, or an insulin/long acting/bolus dosing approach.
Lately I’ve been checking my dosing two ways for meals - how far up will that number of grams take me & how much, if 1 u drops me 50, shall I take to land me at the target, considering I’m going to be, for instance, walking a couple miles this afternoon? Does that check out with my 1:7 ratio or is it closer to 1?8??? What’s the safe compromise?
I guess, if I could, I’d get every diabetes patient thinking this way. We could be the greatest group of researchers there ever was!

LOL! that is exactly how I think! My only thing is a recent change from Humalog to Novolog has messed me up. I’m having to re-figure the whole thing out. It’s frustrating.
Keep up the good work!
Huggles
MeadowLark

Agreed! The issue of type 1s misidentified as type 2s is ongoing and the numbers of people with LADA are not clear.

I know a mother and a teenager who has Diabetes. Mother has Type 2 and the teenager has Type 1 Diabetes since almost two years ago. They eat whatever they want and once in a while checks their blood sugars. They go to a family doctor because she cannot afford to drive 4 hours to see an Endo. He’s A1C is 9.0 and the family doctor said that’s good for a teenager. All I can say is take care of yourself, not worry about other people who have diabetes even though they are your friends and they’re going to do whatever they want.

I’ve known people who did not take care of their D and it cost them their life. When I was dx it was those folks who came to mind and I resolved not to be that way about it and to take care of myself.

What is our purpose in life but to teach and to learn, to help others where we can.

If I had not witnessed the devastating effects of D on people that I knew and cared about my response may have been completely different. When I worked in the addictions field we believed that no addict dies in vain, that their loss helped buy sobriety for someone else that was affected by their death. We don’t live in a vaccum, what we do and how we live affects many people and we probably are not aware of 90% of the impact we have on others.

Hey now, I have red hair! :stuck_out_tongue: