Did you hear on the news tonight a possible cure for Type 2, but they don't know why it happens.
Some Type 2 diabetics that had Bariatric surgery and diabetes, a few days or even few hours after the surgery, they no longer were diabetic and no longer needed medication, even before any weight loss.
That shows how some of the myths of obtaining Type 2 are so false.
I believe that type 2 diabetes is a problem with insulin resistance, I've heard recently that it is a certain type of fat that gets in the way of insulin making it into the cells, In any case I don't see how bariatric surgery can change insulin resistance no matter what the cause. I agree with Helen, that a patients reduced ability to absorb the food they eat and greatly restrict their calories, gives the body a chance to stay on top of the sugar,
But you can do that with out surgery. Just eat less. I bet if they did a study of 2 groups, one that has had surgery and one that simply eats the same diet as the first group. You would find the results would be similar.
The fact that anyone can say " a few hours later the patient was not diabetic " is really laughable because any type diabetic can appear normal with normal sugars. Especially when fasting for surgery.
I know I can sound like a real pessimist, but this sounds like a media statement that the Bariatric surgeons of America put out,
This was on the ABC network news and they did state they don't know why it happened and it had nothing to do with weight loss, as it happened right after the surgery.
Insulin resistance is the key in this mess and has to do with glucose saturation of the temporary storage sites of the skeletal muscle cells. The bariatric surgery as well as staravation diets all do something in common and that is to get the saturated sites unloaded from glucose by dropping quickly the amount of glucose being supplied by the system. Pancreas goes back to work in many cases.
Its only logical in a distibuted glucose storage system where cells will have various levels of loading and to prevent poisoning from excess glucose and oxidation products, these cells shut off their response to insulin to stop nay futher glucose transfer.
Medical science presently has this myopic view of the medical infinite energy machine that keeps storing and using more glucose for ever - if only one can up the insulin levels sufficiently or use the actos crowbar to ram more in. No machine, biological cell on this planet works that way. They usually self destruct at some point. Rot out.
Yes, I have heard about this and I do think it's very interesting. I know that I have been able to fast for hours (I've gone as long as 36 hours on nothing but water during surgery prep) while still maintaining very high blood sugars (over 250 mg/dl.) This was before I started on the short-acting insulin. I also know that I have been able to walk for seven miles while fasting without seeing any drop in my BGs -- then they would drop like crazy the next day. Insulin resistance is so...weird.
I have always found it interesting that my liver is dumping out glucose faster than I can burn it up even while fasting and exercising for very extended periods.
Then when I read that people were seeing normalized BGs directly after surgery (long before seeing any weight loss) it made me scratch my head even more.
There's something going on there with the stomach and small intestine that is counter to the whole "being fat makes you diabetic" meme.
Ghrelin, leptin, insulin, etc. are all interacting in an intricate Kabuki dance.
I also find this interesting. I work with a woman who had weight loss surgery of some sort a few years ago. Prior to the surgery she was on metformin although I don't know what her official diagnosis was. Immediately after the surgery, she no longer needed metformin.
She lost about 100 pounds over the next year but then fell back into bad eating habits after a traumatic event in her life (the loss of a child). Her recent bloodwork still showed normal bg levels. She was surprised because she said the way she's been eating, she would have expected to have elevated numbers. Her father was Type 2 so there is a family history.
Weird. I don't have any of her exact numbers but this is just how she describes it.
I think this just points out how little we understand about what is going on in T2. I take Victoza which mimics GLP-1 a hormone secreted by the small intestine. It had an immediate positive effect on my blood sugar and also decreased my appetite so that I am eating significantly less. The weight should be coming off fast considering my decreased caloric intake. Instead it is coming off very very slowly.
What I have learned from this is that my metabolism is damaged in more ways than just an insufficient insulin response. I also think it means I did not cause this by being fat, instead I got fat because of my condition.
I never did beat myself up about getting T2, instead I focused on what I needed to do going forward. But the constant drumbeat in the media about people giving themselves T2 by self satisfied people who have never had to deal with it does no one any good.
I hope the opinion makers will read articles like this and realize their implications in regards to the treatment and prevention of T2. It's time to ditch the blame game.
Well said BadMoon. I strongly agree.
See Salk Institue and St Johns Childrens on work on metformin and liver and knocking back glucose overloading. It is ery interesting.
Although the popular press takes the conclusions of these studies in peer reviewed journals to be the Gospel, Jenny always starts from the viewpoint of a skeptic.
Here's her conclusion:
"Do you really want to risk your life for a surgery that would give you results no better than you could get by getting serious about cutting down on your carbs? The same people who warn you it is 'dangerous' to lower your A1c by cutting your carbs urge you to have this potentially fatal surgery to 'cure' your diabetes. Shame on them!"
The standard treatment should be to give up the sugar, bread, pasta, fruit and potatoes etc. see what happens and go from there. It's not a cure all and many will require more aggressive treatment but every escalation in treatment carries some additional risk. Getting good results that minimize risk to the patient, not putting money in someones pocket should be the aim of treatment. If mega bucks could be made from carb restriction this argument would already be over.
Well, I did that: no starch in my diet since December. Three months with no bread, pasta, crackers, flour, thickeners (no corn starch, potato starch, tapioca starch, or the like), no potatoes or starchy veggies of any kind, and a drastic reduction in fruit intake (no fruit juice or dried fruit, maybe two pieces of whole fruit per week.) My total carb intake yesterday was 36 gm, for example, and almost all of that was from low-glycemic veggies. I am trying to keep it under 50 gm/day.
Despite injecting 66 IU total of Levemir every day (in two injections, twelve hours apart) and giving myself bolus/correction shots of Novolog, I still wake up every morning between 135 and 175. Regularly drop into the nineties by afternoon and if I go much higher on the Levemir I drop hypo in the wee hours while I sleep, e.g. 53-54 mg/dl.
Most importantly for my long-term well-being, restricting carbs REDUCES to about 10% the relentless craving for carbs that I normally have when I indulge.
Carb restriction is KEY to my diabetes management, along with regular, gentle exercise. To me there is no question that T2's should all give a good, solid try to carb restriction before they do something drastic like bariatric surgery.
all most interesting comment.
Funny thing was; I was on diet of 1200 calories and 2 miles walking for 2 years and couldn't lose an ounce ( got to 330 pounds) till liver excess release shutdown and after that lost weight to sub 240 on same diet and exercise.
I do not believe everyone suffers from excess liver games as I do but shows the complexity of this T2 fracas and in fact it truly is multi-organ, multi-hormone fracas needing some in depth research and inspection.
I never did beat myself up about getting T2, instead I focused on what I needed to do going forward. But the constant drumbeat in the media about people giving themselves T2 by self satisfied people who have never had to deal with it does no one any good.
I also agree BadMoon. I used to be ashamed to be diabetic because I heard so much about it possibly being my fault. That is so inconsiderate of those that do not have to deal with Diabetes. How could something passed to me based on my father's family background be my fault. Also how can this surgery remedy insulin resistance?
LaGuitariste, have you tried Lantus? Some of us do better on Lantus, some are better on Levemir. If one or the other isn't working well, it might be best to switch. I did, Lantus works better for me, lower dose, and better control. Just an idea.