There’s no reversing Type 2 insulin resistant
mellitus only management, just like T1DM.
2 major keys to management of T2DM are lifelong carbohydrate restricted diet and regular daily or near daily exercise of a minimum of 30 consecutive minutes.
Those 2 keys are necessary even if taking T2DM meds and/or insulin.
Weight gain is a symptom of the combination of fatigue because cells are poorly fueled, high BG which causes high insulin secretion causing the liver to convert excess glucose into triglycerides to be stored as fat and starving cells signaling the need for glucose.
Regular exercise increases cell receptors to accept insulin allowing glucose to enter.
I think the C-Peptide testin fasting would be one of the best ways to differentiate between T1DM and zT2DM
A person with functional Beta cells an high insulin resistance would have a high C-Peptide level, higher than the normal range.
That only works in the early stages of T2DM. After a while the Beta cells die off from over work.
That is almost standard in the US but the UK NHS disagrees about the usefulness of the C-Peptide test. I meant to mention that in my previous post to make @RigbyT aware their doc might not like the idea. Makes me wonder how much the Medicare requirement for the C-Peptide test affects what you and I think about it.
I’ve spoken to My GP who is writing to the care team to question their decision due to the positive test for me, and he has promised to continue my care with regular testing to support me.
I also questioned the care team and have a consultant app in 4 weeks.
Unfortunately I am struggling to find a way to pay for C-peptide testing without a private consultant app -( who would be the consultant I am seeing in 4 weeks) and costing me £300 just for an initial app without any test.
You are right, c-peptide in the UK is a specialist test and only requested by consultants/endocrinologists.
I’ve managed to get a consultant app in 4 weeks who will refer to on to endo if required hopefully.
@RigbyT Good Luck to sorting everything out. It sounds like you are doing what you can to find out what is going on. You should be okay for a time. I’m not a doctor but with high antibody tests and blood sugar problems it just seems like it could be type 1. Just watch for lows, type 1’s have been known in the early stages to get them without insulin because their body doesn’t regulate blood sugars right. But also highs where you end up in DKA. So you need to be aware of the symptoms and get immediate help if you get them.
False. Type 2 diabetes can be reversed. There are studies and diet protocols that have proven it
It was shown as far back as the 70s that a vegetarian and vegan diet reversed type 2 diabetes.
Dr Walter Kempner reversed type 2 diabetes and diabetic retinopathy with a rice and fruit only diet.
He kept meticulous records and his diet protocol was validated by Duke University.
“His numbers also showed how a high-carbohydrate diet improved blood sugars and often cured type-2 diabetes.”
Back in 2013 Newcastle University ran a study that showed a low calorie diet reversed type 2 diabetes.
The NHS is using that diet now for type 2 diabetic patients.
My advice is to read and resesrch before coming at me with nonsense
I was diagnosed as T2DM 35 years ago. If you want to call it reversed, I reversed achieving normal BG levels wit a carb restricted diet and exercise.
That worked for 10 years, then my BG started to rise that fasting and increased exercise would bring down.
My doctor said to not beat myself up and that T2DM tends to progress. It is overworked Beta cells attempting to overcome my cells resistance to accept insulin on receptors.
This required metformin then long insulin and finally rapid meal time insulin.
My C-Peptide is very low. I don’t have antibodies. I still am following proper diet and regular exercise.
You can lower your sugars and get them beneath the threshold of diabetes, and some call that remission and some call it reversed or cured, but really you are buying time.
insulin resistance can be mitigated but it cant be reversed.
it will always get worse with time.
eating less and finding a heathy diet is great and we should all do that, making diabetes less impactful.
Wow. Thanks for this detailed explanation. Makes so much sense. Have been LADA for 20 years and misdiagnosed for two of those years. Second Endo did a c-peptide and confirmed type 1. It was so frustrating because I was never overweight with low blood pressure and normal cholesterol. Keep my A1c around 5.8 which my Endo thinks is too low.
The overall focus seems to be going more towards TIR. Making sure there is not too many lows, definitely under 4%, but preferably under 3%, keeping that percentage lower is even better in their eyes. Then overall percentage control of TIR. My endo once said to me she will never try to tell anyone what to do if they have a 96% TIR. My A1c is 5.1-5.3, 95-98% TIR and generally my lows are between 0-2%. But endos do vary.
I do remember about 8 years ago my prior pcp saying my A1c was too low. But she changed her view after a few years, now my doctors always say you have great control.
Totally agree but my TIR is 97-98%. He probably doesn’t look at that. Some Endo’s go by rote. Never think outside the box. I just go for supplies and labs. It’s a crazy disease.
Actually the American Diabetes Association recognizes over 70 causes of diabetes.
And T2DM is really many diseases. The variety of demographics shows it. Even more, the variety of responses to treatments shows that it’s many diseases.
A few years ago, I read a review article that included a discussion of causes. It’s now thought that T1DM is about half environmental (specifics unknown) and about half genetic. Eight gene loci have been identified which together account for about half the genetic component.
T2DM is also split half/half (though that varies with age of onset), and 100 gene loci have been identified which account for about 10% of the genetic component.
I’d say thats a pretty good indication of how complex it is. T2DM is a disease of the entire metabolism, with hundreds (at least) of dimensions.
@Edward_Reid I think they might have identified 11 genes? Several involved the immune system. But they also think there might be a lot more that involve risks. The majority of people in type 1 and type 2 involve genes you inherit. Then the predominant idea in type 1 seems to be it is set off by a virus, but probably not in all cases. Several different viruses seem to be at fault, Covid was one. Interesting note, you are more likely to inherit type 2 than type 1.
If you ask people on this sight an awful lot of type 1’s got it after a high stress time/event. That makes a lot of sense as our immune systems don’t function well during stress.
As I wrote, my info was a few years old. I’m not surprised that more genes have been identified. I expect there will be a lot more, since the most important ones were likely identified first.
I did simplify one part of that review that I mentioned. It said that t2dm in middle age is about 50% genetic, but in old age is 80% genetic. I have not followed up for more details, but that’s one more indication that it’s really many diseases.
That idea has been around for decades, but never with adequate proof. Being fed cow’s milk in early childhood was a popular hypothesis for a while. I expect there are dozens or hundreds of environmental factors involved, including viral infections of several kinds.
Anecdotes are never proof. Anyway, if such a correlation exists, it’s far more likely that stress revealed an existing, developing condition rather than caused it. What is well established is that stress raises bg, so stress could bring on symptoms.
But t1dm is caused by an over-exuberant immune system.
In any case, I believe that the immune system is far, far too complex to be judged in a single dimension from weak to strong. I think there are dozens if not hundreds of dimensions. Someone whose immune system has destroyed their beta cells may very well be particularly susceptible to the common cold, etc. Many researchers are interested in the immune system precisely because it is so complex.
From what I understand it’s more complicated and a lot of factors need to line up.
I was diagnosed in 1987, and I was still sick from an upper respiratory infection that is likely the trigger for my Type 1.
I had coxsackie B, and it’s been known as a common trigger for Type 1 since the 1970s.
My doctor at that time also diagnosed me with pancreatitis because my pancreas was inflamed.
The thought behind that is my pancreas was infected with this virus directly, and my immune system went overboard attacking the virus and also my islet cells.
There were no genetic markers nor antibody tests at that time.
But it makes sense why some people have the markers and some do not. In my case I wouldn’t have had to have antibodies for my islets to be destroyed in the mayhem.
I’ve since been tested for GAD and it was negative, but I’ve had no islet function for 40 years so, it also makes sense that I would not have antibodies now as they can decrease with time.
I never had the others run, because I feel like it hardly matters.
However I also have eczema and Allergies.
I also had cancer twice. These are all failures of the immune system to recognize self from non self.
So I’m certain my immune system has some issue in that regard.
Exactly; so it is not a disease, it’s a symptom. T2s get thrown into a big bucket along with a few T1s, accidentally of course. The symptom is high HbA1c; if someone has low HbA1c but high BG (quite possible) the first thing the docs do is check if they are pregnant.
T2 is a big, really big, cheap, really cheap, bucket to throw someone into.
It’s not a disease, it’s not a condition it is, in fact, barely a symptom. It’s just a dumping ground!
Thank you, I have managed to get an appointment with the endo, and my GP has written to them asking for clarification of my antibody tests as I was pushing him for. Breakdown. The lab said they don’t give a triple islet breakdown as the gas was positive it just serves as clarification of positive antibodies. I will see what they say on the 19th August.
The nhs app shows me as type 2, it’s a fairly good system allowing access to plenty of information.
As someone who has dealt with T2DM for 35 years, I respectfully disagree. The symptoms of Tt2DM are high cellular resistance to innsulin attachment on skeletal and liver cell recceptors. Over time this can lead to other symptoms such as high triglycerides causing obesity, non achoholic fatty liver disease and excessive fatigue.
The excessive secretion of insulin by the Beta cells to combat insulin resistance ultimately causes those cells to weaken and die. This is how T2DM progresses.
I was diagnosed with very high fBG and HbA1c which is a sign of quite advanced T2DM. I was able to normalize BG with a carb restricted diet and daily exercise, for 10 years. This was the point that the disease progressed to needing drug therapy.
I’ve gone through 3 stages of progression that have occured regardless of my diet and exercise. 1st - Metformin, 2nd Lantus, 3rd MDI and then a pump.
I am not obese, I still restrict carbs and exercise. Those things are essential keys to T2DM. Restricting carbs limits the glucose from digestion and exercise is the #1 way to increase cellular acceptance of insulin.
Most people with DM are ignorant of the mechanism of their own type to some extent and are generally completely ignorant of the mechanism of the other types. I on the other hand have terminal malignant curiosity, I read scientific papers about all types of DM..
My interest in T1DM came about from working with a non-complaint T1DM on the miidnight to 8A shift. She lived 2 blocks away and would inject insulin at home and then spend the night eating cookies. I know that those with T1DM can bolus for sweets but this was extreme. The result was her BG would rise and fall at extraordinarily levels. Once we were out of town for a company school when she called me. Her BG dropped to 27mg/dl in the night, she was able to treat it with some soda. What happened is that she sprained her ankle which was twisted in the sheets.
The hotel had breakfast so I would make us each a plate of food and make her eat. I insisted that I drive us to classs in her car, that she give me her spare door card and her husband’s phone number. This went on for 2 weeks, me watching over this idiot.
Another time we had to go to another central office 26 miles away. She was driving the company pickup, when she went into some sort of trance. Pedal to the metal, speed ever increasing and me yelling trying to break the trance. Fortunately the highway was very straight with no traffic and I finally got through to her. I never let her drive us again.
