Welcome to Debate Club! Please be aware that this is a space for respectful debate, and that your ideas will be challenged here. Please remember to critique the argument, not the author.
Can diabetes really be prevented with diet, exercise and a normal BMI - despite family history?
Options
Replies
-
Yes2
-
History of Banting and his research.
https://en.m.wikipedia.org/wiki/Frederick_Banting
One treatment pre-Banting for type 1's was a very strict diet to try and keep rampant sugars under control. It was misery and child patients were turned in to walking skeletons.
There are untreated type 2's to this day. Symptoms include poor blood circulation, infections that do not heal, weight loss, blindness, loss of limbs, coma before death.
There was a teenager in our province who was not cared for by his misguided parents (Type 1) whose teeth had all rotted, he had several septic infections exposing his salivary glands. He was emaciated.
http://calgary.ctvnews.ca/mobile/trial-resumes-for-calgary-parents-accused-in-death-of-diabetic-son-1.3068043
1 -
yes it can, same with blood pressure, you are what you eat2
-
Not completely @KANGOOJUMPS There's a difference between a risk factor and a cause. Skinny people can have high blood pressure. Skinny people can have T2 diabetes.2
-
This is my experience as well. Until my own diagnosis of Type2 diabetes in 2010 and my subsequent research I'd never heard of LCHF. Nor had most of my peers. In Canada, we typically refer those newly-diagnosed to a dietitian. Unfortunately, dietitians in Canada generally do NOT recommend LCHF - as they're taught that it's unhealthy and unsustainable - neither of which are true.geneticexpectations wrote: »Although the absolute number of LCHF minded physicians is still small, the proportion is slowly increasing. It's getting easier by the year to find a physician who is LCHF minded as it's getting increasingly more difficult to deny the literature and more importantly, the real life results.
Usually a physician sees the results in themselves, then pays attention to the combination of the literature and the dramatic reproducable effect on patients.
The other thing that helps when searching for a physician is to find a physician that wants to collaborate with you on your health, rather than simply dispense advice/prescriptions.geneticexpectations wrote: »To be honest, there is no true secret to finding that right physician - you just have to keep looking. But yes, eventually you will find one. The good news from a practical standpoint is that the information that successful physicians dispense is easily available on the internet or in bookstores. Often, physicians get to that point of self discovery when they see that one of their own patients has just proactively done it themselves. Then, the physician reads what the patient read, applies it, experiences the personal success, and the transformation in their practice begins there.
I find the best way to discuss it is with your own successful set of n=1 data. When I was diagnosed, because my HbA1c was so elevated (well-over 12%), my own physician (BTW, yes physicians go see their own physician when need arises) was recommending not-just lifestyle but also pharmacological interventions. When we discussed the matter, she was rather surprised when I suggested only diet/exercise to start. I believe she stated something along the lines of "You know as well as I do that patients with an A1c this high don't control it without pharmacological intervention." I should also mention my c-peptide was VERY low, showing I produce very-little insulin. 3 months later, with an HbA1c of 7.0% (without basal or bolus insulin) she was stunned. We talked only briefly about the diet - as she just isn't overly interested in nutrition (and I tend to get .... wordy) - but after seeing a few other patients in practice do the same, is now quite open to the idea of the diet.geneticexpectations wrote: »In regards to your second question, either you can or you can't. Some physicians are open minded and educated in lifestyle issues, while others prefer to have opinions that are much stronger than their knowledge/success.
That being said - dietitians / nutritionists are a bit-more difficult to convince as to the benefits of a carbohydrate-restrited/high-fat diet, unless you can find one of the EXCEPTIONALLY rare ones that has studied the research in the field, and done a 360-about-face in regards to what they are taught (and rather vehemently believe.)4 -
I'm in a very similar situation in regards to everyone on my dad's side of the family becoming type 2. Honestly, I don't know what the odds are of preventing it completely but I know I'm going to do everything I possibly can!!!1
-
KANGOOJUMPS wrote: »yes it can, same with blood pressure, you are what you eat
At least more often than not.0 -
Not completely @KANGOOJUMPS There's a difference between a risk factor and a cause. Skinny people can have high blood pressure. Skinny people can have T2 diabetes.
Perhaps type 2 diabetes is not actually a disease but a side effect of some other conditions?1 -
I don't think anything would have prevented my type 2 diabetes. My mother, father, uncle, both grandfathers, and one grandmother were diabetic. I have PCOS, insulin resistance from a very young age, and have been diabetic since my late teens. It might have been delayed with proper care, but it was going to happen.
Type 2 diabetes isn't the death sentence some people make it out to be. If you can develop good lifestyle habits before it occurs, it'll be much easier to maintain them after. With care, and proper medication, you can be healthy for a good long time. My mother's started in her twenties, and she's in her sixties now with no longterm complications. It's not easy, but it can be done.2 -
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_sectitle3 -
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
4 -
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
-
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
Categories
- All Categories
- 1.4M Health, Wellness and Goals
- 391.3K Introduce Yourself
- 43.4K Getting Started
- 259.6K Health and Weight Loss
- 175.6K Food and Nutrition
- 47.3K Recipes
- 232.3K Fitness and Exercise
- 387 Sleep, Mindfulness and Overall Wellness
- 6.4K Goal: Maintaining Weight
- 8.5K Goal: Gaining Weight and Body Building
- 152.7K Motivation and Support
- 7.8K Challenges
- 1.3K Debate Club
- 96.2K Chit-Chat
- 2.5K Fun and Games
- 3.2K MyFitnessPal Information
- 22 News and Announcements
- 911 Feature Suggestions and Ideas
- 2.3K MyFitnessPal Tech Support Questions