It's such an extraordinary video, Holger!!
Thanks for sharing it. I cannot watch it enough times.
Which reminds me... have you all done the Big Blue Test today?
What are you waiting for? We need to reach 20,000 tests and only have 656! Come on, people!!! ;)
I am taking today off as I have a 10 miler tomorrow. I'll turn that into 3 (hoping to be able to run 9:00/ mile...) and put in the CGM data. Sorry for the lapse but I have a plan...;-)
Awesome, Mike!
Manny, it' good to get this info out and publicized. I even had to agrue the point with my endocrinologist recently - he did not want to consider the likelihood of decreased beta cell function! I should point him to the study - which I would have expected he'd seen already!
Thanks
Sarah, it seems like you didn't look at the chart presented in the original post. T2s DO lose beta cells and DO become insulin dependent, and no amount of diet and exercise and weight loss is going to change that.
You also seem unaware of all the enzyme systems in the gut, adipose tissue and brain that are messed up in T2, and that it's NOT so easy as popping a pill, losing weight and forgetting about it. You apparently have never been overweight, nor do you seem to understand how frickin' HARD it is to lose weight when your body hangs on to every ounce as if it were gold.
You are also making gross overgeneralizations about T2 lifestyles AND T1 lifestyles. How do YOU know T2s aren't eating well? How do YOU know that T1s don't have weight issues?
And yes, the grass is always greener on the other side of the fence, but you haven't experienced that side of the fence, so your perceptions may be FAR off!
here is another study looking into type 2 islet and liver insulin resistance recovery by separate group in UK .
Title is :
Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol
Summary says:
However, type 2 diabetes is clearly reversible following bariatric surgery [7]. The normalisation of plasma glucose concentration follows within days of surgery, long before major weight loss has occurred, and it has become widely assumed that the protective effects of gastrointestinal surgery are mediated by altered secretion of incretin hormones [8, 9]. Improved control of blood glucose in type 2 diabetes by moderate energy restriction has been demonstrated by others [10]. We have hypothesised that the profound effect of a sudden negative energy balance on the metabolism could explain the post-bariatric surgery effect [11] and, specifically, that the decrease in the intracellular fatty acid concentrations in the liver would lead to a lower export of lipoprotein triacylglycerol to the pancreas, with the release of beta cells from the chronic inhibitory effects of excess fatty acid exposure.
and:
Discussion
This study demonstrates that the twin defects of beta cell failure and insulin resistance that underlie type 2 diabetes can be reversed by acute negative energy balance alone. A hierarchy of response was observed, with a very early change in hepatic insulin sensitivity and a slower change in beta cell function. In the first 7 days of the reduced energy intake, fasting blood glucose and hepatic insulin sensitivity fell to normal, and intrahepatic lipid decreased by 30%. Over the 8 weeks of dietary energy restriction, beta cell function increased towards normal and pancreatic fat decreased. Following the intervention, participants gained 3.1 ± 1.0 kg body weight over 12 weeks, but their HbA1c remained steady while the fat content of both pancreas and liver did not increase. The data are consistent with the hypothesis that the abnormalities of insulin secretion and insulin resistance that underlie type 2 diabetes have a single, common aetiology, i.e. excess lipid accumulation in the liver and pancreas [11]. This provides a unified hypothesis to explain a common disease that previously appeared to require separate disease processes affecting the pancreas and insulin-sensitive tissues.
Thank you Natalie! You said what I so wanted to say....It sounds to me as if several T1's want it to be "ours is worse than yours" and a bit of a childish "my dad can beat up your dad" attitude. I don't think any T2's can understand what the T1's go through and vice versa. I don't think it should be a matter of comparison but each accepting the other and understanding each other. As a T2, I know how hard I work at eating healthy and both of my "borrowed" sons are T1's and we both eat about the same only because they are totally insulin dependent, they can fudge a bit on their diet and "fix" it with insulin. I can't. There are few luxeries in the eating dept. for a T2. This should not be a competition.
Sarah, you sound so very judgmental and angry. A bit like "my disease is worse than yours" and it is certainly not fair. I would gladly trade places with you....I will take your T1 and you take what I have.. the brain tumor, the two types of cancer, the Sjogren's, the A-Fib, the drug allergies and the 25+ surgeries in the last 12 years.....and tell me you can control the T2 with diet and exercise. You can't! My new endo said I will be lucky to get close to normal. Do you know what cancer does to a BG?? Or all the rest? I would love to be able to go for a walk...and not drop over from lack of oxygen! I have learned to be grateful for what I have and not wish more or worse on others. Instead of complaining about "why me" start thinking "why not me?". You will be happier in life.....
Why would you think T1s and T2s can’t understand what the other flavor goes through? There are always good testimonials from all types here that illuminate experiences of all types.
My first question from this is how long foes this effect last? Is it permanent, or will it wear off in several months or years (even assuming there is no return to unhealthy habits) ? The study's time frame seems too short to draw any conclusions in this.
How does this - or even just DOES this - have any application for non-obese T2s? From casual observation, it appears that many T2's have tried extreme diets - an as many have claimed little or no success in "reversing" the condition as have claimed success. In addition, there are many T2's that are normal or below normal weight. Is their condition completely different?
Finally, this was a small study, and as such there are likely many variables that haven't been touched upon at all in so small a sample. It seems to me that the claims are grander than should be drawn from such a study.
-- I want to hope for a reversal, too - but I want to see a much more complete researh before I let myself hope that a path is being opened.
There is no greener grass. My lawn is less green than my neighbors, but their is less hardy than mine. Does it matter? Each has its challenges.
I am T2 (I think). I am also insulin dependent and will stay that way unless some new discovery allows that to change. Regardless, listening to the challenges that T1's have, I am thankful that I don't have those challenges. Similarly, there are many issues and concerns that I have that I wouldn't wish on anyone. In addition, I have to fight insurance to get the insulin and tools I need (aside from actuarial "reasons," why does a T2 need these, anyway?). It's all one big mess, really.
Neither is good. Both are hard to manage. Many of these (both sides) have been listed elsewhere, so I will not rehash. In the end, however, there is one challenge that we all have: there is not enough funding for the research that may make all our lives better. Combined, the number of PWD of all types is staggering, though resources are not available relative to those numbers. In part, this is because of some of the misconceptions vocalized here. None of us are helped by this lack of public awareness and funding. All of use would be better served by the presentation of a clear and unified message that this - OK, maybe THESE - disease(s) have to be addressed. The long-term cost of diabetes in all forms and complications, when they occur, is astronomical. Results, treatment, that (those) elusive "cure(s)" will pay off BIG TIME.
... but only if the message is clear -- starting with unity within our community.
So true. Despite our differences we have a lot in common. One time I was looking at what the MDA (Jerry Lewis) considers one of their diseases. There are actually about a dozen but they all are muscle control diseases that have similar problems and solutions so they grouped them all together so they could raise awareness and funds.
Yesterday and today! Finally over the flu bug and getting active again.
I was diagnosed as T2. For a short while (months), diet and exercise worked. Then they stopped working and I was sequentially put on 2 different sulfonylureas (all that was available), neither of which worked at all. I have since found out, by genetic testing, that I SHOULD have been extraordinarily sensitive to sulfs. No deal. So the diagnosis was changed to LADA. And I went on insulin, which worked wonders.
But during that time, I studied up intensively on T2, and I remain convinced that there are more similarities than differences, and when T1s look down their noses and WISH they had T2, it only means that they don't know what they're talking about. If they knew anything at all about T2, they'd wish for a cure for ALL of us, even though a cure for T1 is MUCH more likely than a cure for T2, since they don't even know just what's wrong with T2s, let alone how to fix it. Sorry, but this one is a hot button for me, because of the agony I suffered by the misdiagnosis, and because I feel so much empathy in my heart for T2s.
Type 2 diabetes is indeed very serious and quite complex, and charts like this (and the video that Holger posted) may help to dispel myths and most importantly lead to better treatment for T2s (so many T2s see exogenous insulin as failure, which is completely untrue). The "blame game" does no good and is really detrimental to people's health including mental health. I think that the medical community contributes to the T2 problem in that T2 is not taken seriously enough--there is so much blame heaped on the person with T2, when what is needed is appropriate care (for example, enough test strips, exogenous insulin if needed, the full arsenal of treatments).
Finally, and noting that it is the last day of LADA Awareness Week (latent autoimmune diabetes in adults, aka slow-onset Type 1 diabetes), I think it is important to consider that many/most people with adult-onset T1 are misdiagnosed (for example, Manny Hernandez, Donna H, me) as having Type 2 diabetes. If you were given the T2 diagnosis, T2 meds don't work, and you require exogenous insulin early on, there is a possibility that you are misdiagnosed and may be LADA/T1 (another possibility is monogenic diabetes/MODY). It's important to get a correct diagnosis to get appropriate treatment. I write about medical misdiagnosis of insulin deficient diabetes in this blog.
I'm actually starting to believe that it isn't that people get misdiagnosed, it is that they are "undiagnosed." There are no diagnostic tests to confirm T2, it is just a diagnosis by exclusion. I think the term T2 should probably be eliminated and we should just call it diabetes, of which T1/LADA and MODY are specific diagnosed forms of diabetes. We should actually be advocating for proper diagnosis for all patients with diabetes, appropriate antibody tests and c-peptide tests to determine whether a patient with diabetes is insulin deficient even if they don't have antibodies (which is apparently my case).
... and mine (with two C-Peptide tests taken 5 months apart demonstrating apparently rapidly diminishing production). Though I started taking insulin before those tests, due to an intolerance to oral meds (which were, otherwise, somewhat effective), the test indicate that it would probably have been necessary, anyway - despite my negative GAD65 antibody test.
The fact that many doctors use insulin as a threat to scare T2 patients into "compliance" with other regimens is just plain awful. I'm fairly well-informed, but even with that, had it not been that I was having very frightening side-effects from orals when my doctor suggested that I "try" insulin, I would have felt those same feelings of "failure" - apart from my fear of needles. I've been on insulin for a year, and I don't doubt that it has been the right course for me.
Thanks much, Manny!
I'm wondering if you aren't actually LADA. Not all LADAs show antibodies, just as not all children presenting in DKA show antibodies. There may be antibodies that have not been discovered yet, or other reasons for the rapid destruction of beta cells.
At any rate, I'm glad you're doing the right thing for your body -- it's not the method of treatment, but the results that count! :-)