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Cricket 07-05-2017 02:26

Type 2 Diabetes Is A Progressive Disease?
 
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Is diabetes 2 a progressive disease? Does that mean no matter how good my control is, that one day I will end up on insulin anyway?

I would love to find some studies on folks living a keto lifestyle over an extensive amount of time to know if the disease continued to be progressive.

Quote:

Because A1C will increase by ∼1% every 2 years even with most therapies (Fig. 2), patients with diabetes require repeated and vigorous intervention. Failure to implement such interventions, owing to “clinical inertia” or patient noncompliance, results in worsening glucose control and perpetuates a vicious circle of hyperglycemia and glucose toxicity. Importantly, failure of β-cell function in the late stages of the disease is further compounded by the complications of diabetes and by the likelihood of significant comorbidities in elderly patients. Defining and Characterizing the Progression of Type 2 Diabetes
Quote:

When people who take oral diabetes medications progress to needing insulin, they often feel as if they've done something wrong to prompt this transition. Unfortunately, it's just the progression of diabetes and can't be avoided in those instances. Insulin is a hormone and generally doesn't interact with other medications; the primary side effect is hypoglycemia. Hypoglycemia can occur with some of the oral diabetes medications, too. But insulin does not cause diabetes complications; it's high blood glucose levels that are responsible for complications. Insulin is a helpful and necessary tool in the management of type 2 diabetes. Type 2 Diabetes Is A Progressive Disease

hftmrock 07-05-2017 03:03

Personally my mind will not rap itself around that.

if I dont eat carbs and carbs is what causes insulin response and insulin response is what gets damaged (not enough or cells not listening ) , then how can it be progressive?

But I dont have scientific studies so I cant say for sure. I want to believe if I dont eat anything to cause the insulin to produce, it cant continue to make it worse.

its a great question and I would love to know more scientific answers on it as well.. it should be asked to the doctor that made the video we share all the time. she might have scientific evidence.

Cricket 07-05-2017 03:20

@hftmrock that is also my line of thinking. As an example, if people were following the ADA nutrition guidelines I can see the disease being progressive, but I am seriously not wrapping my brain around it always being progressive, regardless of carb intake.

This is the part that made the least sense to me.

Quote:

Because A1C will increase by ∼1% every 2 years even with most therapies (Fig. 2), patients with diabetes require repeated and vigorous intervention. Failure to implement such interventions, owing to “clinical inertia” or patient noncompliance, results in worsening glucose control and perpetuates a vicious circle of hyperglycemia and glucose toxicity. Importantly, failure of β-cell function in the late stages of the disease is further compounded by the complications of diabetes and by the likelihood of significant comorbidities in elderly patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811457/
I am not seeing an A1C increase of 1% every year. Are you?

Cricket 07-05-2017 03:20

@hftmrock that is also my line of thinking. As an example, if people were following the ADA nutrition guidelines I can see the disease being progressive, but I am seriously not wrapping my brain around it always being progressive, regardless of carb intake.

This is the part that made the least sense to me.

Quote:

Because A1C will increase by ∼1% every 2 years even with most therapies (Fig. 2), patients with diabetes require repeated and vigorous intervention. Failure to implement such interventions, owing to “clinical inertia” or patient noncompliance, results in worsening glucose control and perpetuates a vicious circle of hyperglycemia and glucose toxicity. Importantly, failure of β-cell function in the late stages of the disease is further compounded by the complications of diabetes and by the likelihood of significant comorbidities in elderly patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811457/
I am not seeing an A1C increase of 1% every year. Are you?

moon 07-05-2017 03:20

I've no answer, nor scientific study to share. Would be surprised if there is one on this vs theories.

Used to think that it wouldn't progress if I did everything right. That might or might not be true, but letting go of the fear of insulin has made it a non-issue.

I was terrified of insulin! Then I needed to use it last year, and found that while not having to carry it around and think about it is definitely easier, using it is no big deal.

moon 07-05-2017 03:28

I haven't had an A1c in several years, but in the beginning certainly it didn't increase by 1% since it kept going down with low-carb.

With A1c fluctuations (so many variables), it would take several years to see if that was happening over time (5.5 would be only 5.55 ...)

Cricket 07-05-2017 03:52

Quote:

Originally Posted by hftmrock (Post 1222105)
...
its a great question and I would love to know more scientific answers on it as well.. it should be asked to the doctor that made the video we share all the time. she might have scientific evidence.

I am not sure if she monitors her own Twitter account or not, but I sent her a message there, just in case...

mbuster 07-05-2017 19:25

JMO, diabetes is progressive, if you let it. Also JMO, the first quote in the OP is basically true, diabetes does require vigorous intervention. If the correct intervention is taken, one that stops the increasing of BG numbers (which increases A1c) no further action would need to be taken. Doing so in the first place, eliminates the need for repetitive changes. Figure 2, showing that A1c increases about 1% point every two years is talking 6%->7%->8%->9%. That just supports my belief that the ADA approach to continue to maintain as many carbs in the diet as they do and then throw meds, then more meds, then more meds at the ever increasing BG is totally "whack". By their means, I was diagnosed (officially in 2012 but I know now that it had been growing since 2003) with an 8.8% A1c. By their statistics, following their methods, my A1c should be 10-12% now. My last A1c was 5.3%, how do they explain that.

Following the ADA recommendations, the second quote in the OP, is also true. Sad, because it doesn't have to be.

If and when they do the studies of controlled BG, it will be interesting to see if they include LCHF in those studies.

Cricket 07-05-2017 19:32

@mbuster the more research I have done, the more convinced I am that the disease if progressive if you keep damaging the cells. If you are living a LCHF or KETO lifestyle you are NOT continuing to further damage the cells. Just my opinion, but my A1C is getting better, not progressively worse.

alamogirl 07-05-2017 19:34

My mother was diagnosed when she was in her early to mid 40's. She was insulin dependent (and following ADA guidelines). She watched her diabetes like a hawk. Back then, there wasn't internet or support groups such as ours. She didn't have a meter. Eventually, she graduated from insulin to oral medication, where she remained for the rest of her life. She passed away at 65 years old due to an unrelated illness. Even during her other illness, she never experienced any kind of organ failure (kidney, liver, heart). She didn't need glasses except for reading. I look at my mother at how healthy a diabetic can be if you take care of yourself. So, I respectfully disagree with the ADA.


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