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Can diabetes really be prevented with diet, exercise and a normal BMI - despite family history?
Replies
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Gale you can speculate all you want but unless each theory is tested it's just hot air.
My diabetes went in to remission after significant weight loss and bariatric surgery. This is a known byproduct of the surgery. My metabolism has switched in several significant ways including my production of ghrelin.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208891/#__ffn_sectitle
Hmm. How would you test this theory?0 -
Type 1 cannot be prevented, as it is a genetic disease. My BIL was diagnosed when he was 8. My nephew (his son) was diagnosed as a toddler. I can assure you that his diet and exercise at the age of 2 were excellent
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Type 1 cannot be prevented, as it is a genetic disease. My BIL was diagnosed when he was 8. My nephew (his son) was diagnosed as a toddler. I can assure you that his diet and exercise at the age of 2 were excellent
Right, for type 1, a patient must have both the HLA genes (on chromosome 6) AND a trigger for the autoimmune response. Most (95%) who have the genes are never triggered.
For a type 2, the 'pathway' is much more varied. A huge majority (I would make an educated guess based on scientific and non-scientific literature, as well as observations that this group is >90% of type 2's) have the disease because they are overweight or obese. These patients make enough insulin, but cannot use it efficiently. The diagnosis is used for other pathways as well, including some where insulin production is truly inhibited. There is, in fact, a rare pathway for type 2 that is directly linked to genetics. It is the ONLY pathway for type 2 with a known direct genetic cause as of this time. It is also very rare.
As time goes on, more is discovered about the different pathways involved in a type 2 diagnosis. For example, in the last 10-20 years, we have discovered that many type 1's who have the trigger as an adult have been misdiagnosed as type 2 for a very long time. This is because the autoimmune response is slower in adults, so symptoms are less pronounced and the "honeymoon period" (the time it takes to kill substantially all beta cells) takes much, much, longer. After this discovery, these type 1 patients who would have been misdiagnosed in the past are now diagnosed with LADA.
There will be more to come over time, no doubt, on the various pathways making up the ~10% of type 2's who do not have a metabolic disorder caused by being overweight or obese. However, type 2 patients need self-actualization. If I had a nickel for every time someone told me they have type 2 and it can't possibly be due to weight despite that they are noticeably overweight or obese, I would be a much richer man.3 -
midwesterner85 wrote: »Type 1 cannot be prevented, as it is a genetic disease. My BIL was diagnosed when he was 8. My nephew (his son) was diagnosed as a toddler. I can assure you that his diet and exercise at the age of 2 were excellent
Right, for type 1, a patient must have both the HLA genes (on chromosome 6) AND a trigger for the autoimmune response. Most (95%) who have the genes are never triggered.
For a type 2, the 'pathway' is much more varied. A huge majority (I would make an educated guess based on scientific and non-scientific literature, as well as observations that this group is >90% of type 2's) have the disease because they are overweight or obese. These patients make enough insulin, but cannot use it efficiently. The diagnosis is used for other pathways as well, including some where insulin production is truly inhibited. There is, in fact, a rare pathway for type 2 that is directly linked to genetics. It is the ONLY pathway for type 2 with a known direct genetic cause as of this time. It is also very rare.
As time goes on, more is discovered about the different pathways involved in a type 2 diagnosis. For example, in the last 10-20 years, we have discovered that many type 1's who have the trigger as an adult have been misdiagnosed as type 2 for a very long time. This is because the autoimmune response is slower in adults, so symptoms are less pronounced and the "honeymoon period" (the time it takes to kill substantially all beta cells) takes much, much, longer. After this discovery, these type 1 patients who would have been misdiagnosed in the past are now diagnosed with LADA.
There will be more to come over time, no doubt, on the various pathways making up the ~10% of type 2's who do not have a metabolic disorder caused by being overweight or obese. However, type 2 patients need self-actualization. If I had a nickel for every time someone told me they have type 2 and it can't possibly be due to weight despite that they are noticeably overweight or obese, I would be a much richer man.
A lot of us don't think we are THAT fat. My prediabetes showed up when I was about 165, maybe 170, at 5'8". I was at the high end of normal or just into the overweight BMI. I had extra fat but I din't think of myself as fat yet.
But then I put on weight before I got my BG undercontrol. I put on a good 20lbs in a year... That makes me wonder if some people who are diagnosed T2D while they were fat BECAME fat, or at least fatter, partially due to undiagnosed T2D and high BG and insulin levels.
I am sure many T2Ds became diabetic after they were fat - really fat - but I wonder how many got fat (fatter) BECAUSE of their T2D status. Some doctors seem to be looking into this now. I wonder if it will be supported or disproved in the future.1 -
I have a sneaking suspicion it's not 100% either way for 90% of T2Ds....0
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I have two good friends who are brothers and both have Type II diabetes even though they are active and very thin. Their parents didn't develop diabetes until they were 60+ yrs (also active and thin) but they both developed health issues around 30 yrs of age. I know it's becoming increasingly common even in non-obese populations. Many have suggested that it is largely undiagnosed in nonobese populations due to the focus placed on metabolically unhealthy obese populations which are studied within established animal models. I suspect that the truth is that metabolic disorders become more pronounced when compounded with obesity and less pronounced when subjects with metabolic disorders lose excess weight. There are many metabolically healthy obese people who don't develop diabetes. The layman often incorrectly associates a "risk factor" with causality. Anyone who has performed medical research understands that relationships are nearly always for more complex.
At any rate, with a double dose in genetics I would stay on top of my fasting glucose for sure and know that even though the genetics of metabolic disorders can't be avoided, the severity of complications can be managed by maintaining a healthy weight and active lifestyle...of course that goes for any disorder or disease.2 -
midwesterner85 wrote: »Type 1 cannot be prevented, as it is a genetic disease. My BIL was diagnosed when he was 8. My nephew (his son) was diagnosed as a toddler. I can assure you that his diet and exercise at the age of 2 were excellent
Right, for type 1, a patient must have both the HLA genes (on chromosome 6) AND a trigger for the autoimmune response. Most (95%) who have the genes are never triggered.
For a type 2, the 'pathway' is much more varied. A huge majority (I would make an educated guess based on scientific and non-scientific literature, as well as observations that this group is >90% of type 2's) have the disease because they are overweight or obese. These patients make enough insulin, but cannot use it efficiently. The diagnosis is used for other pathways as well, including some where insulin production is truly inhibited. There is, in fact, a rare pathway for type 2 that is directly linked to genetics. It is the ONLY pathway for type 2 with a known direct genetic cause as of this time. It is also very rare.
As time goes on, more is discovered about the different pathways involved in a type 2 diagnosis. For example, in the last 10-20 years, we have discovered that many type 1's who have the trigger as an adult have been misdiagnosed as type 2 for a very long time. This is because the autoimmune response is slower in adults, so symptoms are less pronounced and the "honeymoon period" (the time it takes to kill substantially all beta cells) takes much, much, longer. After this discovery, these type 1 patients who would have been misdiagnosed in the past are now diagnosed with LADA.
There will be more to come over time, no doubt, on the various pathways making up the ~10% of type 2's who do not have a metabolic disorder caused by being overweight or obese. However, type 2 patients need self-actualization. If I had a nickel for every time someone told me they have type 2 and it can't possibly be due to weight despite that they are noticeably overweight or obese, I would be a much richer man.
A lot of us don't think we are THAT fat. My prediabetes showed up when I was about 165, maybe 170, at 5'8". I was at the high end of normal or just into the overweight BMI. I had extra fat but I din't think of myself as fat yet.
But then I put on weight before I got my BG undercontrol. I put on a good 20lbs in a year... That makes me wonder if some people who are diagnosed T2D while they were fat BECAME fat, or at least fatter, partially due to undiagnosed T2D and high BG and insulin levels.
I am sure many T2Ds became diabetic after they were fat - really fat - but I wonder how many got fat (fatter) BECAUSE of their T2D status. Some doctors seem to be looking into this now. I wonder if it will be supported or disproved in the future.
Right - many don't think they are overweight. Even 20 lbs. extra for American standards is enough for some people to start seeing insulin resistance.0 -
Gale you can speculate all you want but unless each theory is tested it's just hot air.
My diabetes went in to remission after significant weight loss and bariatric surgery. This is a known byproduct of the surgery. My metabolism has switched in several significant ways including my production of ghrelin.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208891/#__ffn_sectitle
Hmm. How would you test this theory?
My diabetes went in to remission shortly after bariatric surgery. That's a fact, not a theory.
This happens with a lot of T2 post bariatric patients and even though the mechanism is not fully understood you can be sure post surgery patients are followed closely. I was monitored for two full years after surgery, including a whole battery of blood tests.1 -
Gale you can speculate all you want but unless each theory is tested it's just hot air.
My diabetes went in to remission after significant weight loss and bariatric surgery. This is a known byproduct of the surgery. My metabolism has switched in several significant ways including my production of ghrelin.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208891/#__ffn_sectitle
Hmm. How would you test this theory?
My diabetes went in to remission shortly after bariatric surgery. That's a fact, not a theory.
This happens with a lot of T2 post bariatric patients and even though the mechanism is not fully understood you can be sure post surgery patients are followed closely. I was monitored for two full years after surgery, including a whole battery of blood tests.
Sorry, I meant the chicken and egg question Gale raised, as it wasn't clear to me what you were characterizing as an unproven theory.
Couldn't one person could develop high BG simply as a result of being dealt bad genes, while in another it might come about as a consequence of a distinct metabolic snafu, insulin resistance?0 -
Gale you can speculate all you want but unless each theory is tested it's just hot air.
My diabetes went in to remission after significant weight loss and bariatric surgery. This is a known byproduct of the surgery. My metabolism has switched in several significant ways including my production of ghrelin.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208891/#__ffn_sectitle
Hmm. How would you test this theory?
My diabetes went in to remission shortly after bariatric surgery. That's a fact, not a theory.
This happens with a lot of T2 post bariatric patients and even though the mechanism is not fully understood you can be sure post surgery patients are followed closely. I was monitored for two full years after surgery, including a whole battery of blood tests.
Sorry, I meant the chicken and egg question Gale raised, as it wasn't clear to me what you were characterizing as an unproven theory.
Couldn't one person could develop high BG simply as a result of being dealt bad genes, while in another it might come about as a consequence of a distinct metabolic snafu, insulin resistance?
For the 1st possibility: No, it isn't possible. At least not directly. High BG can be caused by too little or no insulin production or insulin resistance. Some of the reasons for too little or no insulin production or insulin resistance could be directly or indirectly caused by genetics. Type 1 is caused by genetics. Type 2, in rare cases I mentioned above, is caused by genetics. For the most common pathway, genetics have no direct input.
Having said that, I see articles on occasion that continue to try to blame genes for common obesity-related type 2. When reviewing the detailed explanation of how this is caused by genes, it always suggests that people with particular genes have difficulty maintaining weight for various reasons. By explaining that genes make it easy to be overweight or obese, the expectation is that genes can then be blamed for conditions resulting from being overweight or obese. It's a very indirect relationship, then, between genes and type 2 diabetes.1 -
Gale you can speculate all you want but unless each theory is tested it's just hot air.
My diabetes went in to remission after significant weight loss and bariatric surgery. This is a known byproduct of the surgery. My metabolism has switched in several significant ways including my production of ghrelin.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208891/#__ffn_sectitle
Hmm. How would you test this theory?
My diabetes went in to remission shortly after bariatric surgery. That's a fact, not a theory.
This happens with a lot of T2 post bariatric patients and even though the mechanism is not fully understood you can be sure post surgery patients are followed closely. I was monitored for two full years after surgery, including a whole battery of blood tests.
Sorry, I meant the chicken and egg question Gale raised, as it wasn't clear to me what you were characterizing as an unproven theory.
Couldn't one person could develop high BG simply as a result of being dealt bad genes, while in another it might come about as a consequence of a distinct metabolic snafu, insulin resistance?
Kinda like, does obesity cause diabetes or does diabetes cause obesity?
Like i mentioned in my above post, my uncle was never overweight and he is the only person in our family to have had diabetes. His unhealthy lifestyle, smoking and OTT sweets likely contributed to it..1 -
I find it very interesting that there is no direct genetic component for Type 2 diabetes. My mother and at least 2 of her brothers have type 2 diabetes. They are all overweight or obese. BUT my aunt has type 1 (acquired or diagnosed or triggered during or after her first pregnancy, I'm not sure of the details). She is very slender. I always just thought that my family had a genetic predisposition to diabetes...
In any case, I'm very high risk for developing it. BMI of ~34 (down from 43 about 15 months ago), family history, and personal history of gestational diabetes. As of my most recent bloodwork I have evidence of insulin resistance but good fasting glucose levels and normal HbA1c, which I attribute to eating LCHF. Interestingly enough, my previous GTT results were perfect... and that was when I had a BMI of 43.2 -
I find it very interesting that there is no direct genetic component for Type 2 diabetes. My mother and at least 2 of her brothers have type 2 diabetes. They are all overweight or obese. BUT my aunt has type 1 (acquired or diagnosed or triggered during or after her first pregnancy, I'm not sure of the details). She is very slender. I always just thought that my family had a genetic predisposition to diabetes...
In any case, I'm very high risk for developing it. BMI of ~34 (down from 43 about 15 months ago), family history, and personal history of gestational diabetes. As of my most recent bloodwork I have evidence of insulin resistance but good fasting glucose levels and normal HbA1c, which I attribute to eating LCHF. Interestingly enough, my previous GTT results were perfect... and that was when I had a BMI of 43.
There is one on one genetic link for diabetes type 2, but there is definitely a genetic link which increases the likelihood Environmental factors are important though. It is the reason why people that have type 2 in the family are urged to live a healthy lifestyle
From American Diabetes AssociationType 2 Diabetes
Type 2 diabetes has a stronger link to family history and lineage than type 1, although it too depends on environmental factors.
Studies of twins have shown that genetics play a very strong role in the development of type 2 diabetes.
Lifestyle also influences the development of type 2 diabetes. Obesity tends to run in families, and families tend to have similar eating and exercise habits.
If you have a family history of type 2 diabetes, it may be difficult to figure out whether your diabetes is due to lifestyle factors or genetic susceptibility. Most likely it is due to both. However, don’t lose heart. Studies show that it is possible to delay or prevent type 2 diabetes by exercising and losing weight.
In my husband's family type 2 occurs a lot. His maternal parents both had it. My MIL is one of 7 and 4 of them have it, one of them currently dying of the damage it caused in his body.
MIL is one of those that has it, it is now catching up on her. She kept it at bay with diet, walking and weight control (she is obsessed with keeping her weight down) well into her sixties. She is 75 now and combined with other health issues the neuropathy side effects are really getting to her.
We know that my husband paternal grandparents did not have it. The doctor's estimate is that my husband therefore has about a 25% chance of getting it. Which also means a 75% of not, So he lives a healthy life to at least keep the environmental factors at bay. He loves sports and we love healthy living His weight is within BMI and that is really all we can do.
As it is statistics it will not guarantee to prevent diabetes type 2, but we give it the best shot to aim for 75% instead of the 25%.
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Always amazes me that the ADA simply will not include "restrict your carbs and calories" among recommendations for avoiding T2D - perhaps because it sees "low carb" as synonymous with "low revenue" from sponsoring companies, whose profits depend on continued consumption of sugar or a steady supply of new diabetics....
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I was diagnosed T2 around 13 years ago at the age of 40. Initially they advised me to modify my diet ( I didn't!), then they put me on gradually increasing levels of drugs until around 5 years ago (weighing in at 270lb) they wanted me to try a daily self-injection of some sort into the stomach area. I really didn't fancy the idea of that! I'd read somewhere that rapid weight loss could 'shock' the pancreas into behaving. It may have been rubbish research, but I gave it a go and through diet and exercise I lost 50lb in four months (using MFP religiously). I'd also built up to jogging 3.5 miles every day. I've kept the weight off by eating sensibly and I've kept on jogging every day. Since I lost the weight my blood sugar levels, which are checked every 6 months, have been 'normal'. Not sure if my methods to get there would suit everyone, but in my mind the relationships between excess weight, poor lifestyle and T2 are pretty clear. I also think half an hour's exercise a day is a big factor in general health, as well as T2. Never felt fitter than I do now.3
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Onset, yes. Inherited, no. Diabetes can be controlled with the right programs in place, but even then it's no guarantee that it won't the the demise of someone.
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Onset, yes. Inherited, no. Diabetes can be controlled with the right programs in place, but even then it's no guarantee that it won't the the demise of someone.
A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition
That's definitely the case with any internal organ issues, diagnosed or otherwise. How many examples do we have of otherwise healthy and "fit" individuals dropping dead out of nowhere from heart, liver, kidney, failures, blood clots, etc.?1 -
Christine_72 wrote: »Gale you can speculate all you want but unless each theory is tested it's just hot air.
My diabetes went in to remission after significant weight loss and bariatric surgery. This is a known byproduct of the surgery. My metabolism has switched in several significant ways including my production of ghrelin.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208891/#__ffn_sectitle
Hmm. How would you test this theory?
My diabetes went in to remission shortly after bariatric surgery. That's a fact, not a theory.
This happens with a lot of T2 post bariatric patients and even though the mechanism is not fully understood you can be sure post surgery patients are followed closely. I was monitored for two full years after surgery, including a whole battery of blood tests.
Sorry, I meant the chicken and egg question Gale raised, as it wasn't clear to me what you were characterizing as an unproven theory.
Couldn't one person could develop high BG simply as a result of being dealt bad genes, while in another it might come about as a consequence of a distinct metabolic snafu, insulin resistance?
Kinda like, does obesity cause diabetes or does diabetes cause obesity?
Like i mentioned in my above post, my uncle was never overweight and he is the only person in our family to have had diabetes. His unhealthy lifestyle, smoking and OTT sweets likely contributed to it..
We see the same situation in several hormonal diseases as well. I spend a great deal of time countering the convention that hypothyroidism causes weight gain. Hormonal shifts will cause a dramatic initial weight gain, but this is due to increased cellular uptake (water weight), but only ~5-10 lbs which is similar to the weight gained from a high salt meal.
Obesity dramatically increases risk factors which can lead to other diseases. I wouldn't go so far as to say it is the primary cause, but it simply makes the body work harder to maintain balance, which increases the chance of disease.0 -
This is an interesting article about how T2D may be quite possible in normal BMI people. NAFLD and NASH. Not good.
https://www.dietdoctor.com/insulin-fatty-liver-disease2 -
I have been diabetic for years; parents were type 2. For many years, doctors told me I was "prediabetic"...now I laugh at that because to me, there is no such thing. You either are or you aren't. That said, my battle with weight, exercise and food (emotional eating) have taken their toll on me through my own choice. However, at 63, I am finally on recovery road! I read everything I can on this horrible disease and IMO if your parents have it and you are genetically predisposed on the short end of the stick, you will find out soon enough that you have diabetes no matter how thin you try to be, or how much exercise you try to do. The key word for me is "sustainable". Is all that I am doing to keep my #s in check sustainable? If not, you will be on the rollercoaster ride I have been on for so many years. So, if you can sustain your exercise routine and sustain your eating habits (low carb) you will keep things in check.0
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wisdomfromyou wrote: »My mother is diabetic and my father is borderline (pre-diabetic).
Both became quite sedentary after they retired from their comparatively active jobs (agronomists, walking up and down green-house alleys a good part of the day).
My mother acquired diabetes a few years after that. My father just plain sits on the couch and watches the news a good part of the day. They both live overseas (not in the US).
My mom was almost obese when she was diagnosed and she was a major emotional eater due to some problems related to my brother - but she lost weight ever since. My father is overweight too.
What are my chances of NEVER getting diabetes if, unlike them:
1. I will work to keep my BMI at a normal level.
2. I exercise daily and make sure to get in at least 10,000 steps a day (not just the hour of intense exercise).
3. I stay on top of diet and do low-carb, avoid sugar, take blood sugar lowering supplements, whatever.
Last year I had a BMI of 24.8 but I have put on some weight over the past few months due to work-related stress. I am on my way back down to 24.9 which would make me "normal".
My fasting blood sugar varies from upper 80's to mid 90's on a home testing device (Relion) which, in my experience, shows higher values than doctor's lab.
I have 13 lbs to lose to be back to a normal BMI - and I am 43.
I am so terrified of getting this illness given my family history.
Please someone tell me I can avoid it altogether if I BEHAVE long term - per diabetes guidelines.
Thank you all.
What you spell out sounds like me talking back some 33 years ago ... and I was able to stave off the disease until 13 years ago. I was 59 when the diagnosis of Type 2 Diabetic was put on my medical chart, the last of my siblings to be so diagnosed. Surprisingly, it wasn't my weight which triggered it for me, but some medication I was taking for another condition. ... So ... keep on staying active and eating well. You may be able keep it at bay ... because, after all, it's not set in stone that if your family has it in their line that you will definitely have it ... it's a toss up of how your body will react to everything it's exposed to.
PS ... I am a healthy T2 Diabetic ... with the help of medication, food plan, life style.2
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