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Can diabetes really be prevented with diet, exercise and a normal BMI - despite family history?
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The way one of my medical school lecturers told us to think about type 2 diabetes risk is that genetics basically sets your "trigger weight". That's why some people can be very thin and still develop diabetes, while other patients can become very morbidly obese and avoid it. Your genetics set the weight at which that switch is tripped, and the metabolic processes that make up the disease start.1
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Prevented? Maybe, maybe not. Delayed or successfully managed, definitely. From personal experience I managed to go from high pre-diabetic (115-119 fasting) to low normal (70-75 fasting, up to low 80 when I'm forced to be bedridden) via weight loss alone. No changes to my carbs.
The thing about type 2 diabetes is that it sometimes could actually be misdiagnosed. Adult onset type 1 diabetes is sometimes misdiagnosed as type 2. This type you may not be able to prevent because it's autoimmune in origin, but lifestyle changes make managing it easier. It depends on how lucky you are in the genetic lottery. Good news is that inheriting type 1 is not very common so your chances to never develop it are quite good. If your immediate family are on insulin, and pills don't work for them, it could be a clue that this might be the case, but could only be confirmed by an endocrinologist.
If your parents have true type 2 diabetes, not being overweight or sedentary could really spin the wheels in your favor (especially if they developed it after 50 with and no other family members had it like it is the case for you) and you might be able to completely prevent it or at least delay it to a ripe old age, unless you are one of the unlucky few.1 -
I've only had my levels tested at the doctor, so I can't really say for sure how lifting weights affects my day-to-day numbers. But there was a 2-3 month period at one point in which I was doing some upper body lifting (along with a good bit of low intensity walking), but my long term blood sugar control actually worsened. I will admit, I was eating more carbs during that time, but I had assumed that with my higher activity level I would have been burning them off (it's worth noting my BMI is only around 19 and I have no excess body fat).wisdomfromyou wrote: »ForecasterJason wrote: »Higher than normal blood sugar (not high enough for a diagnosis of diabetes) runs in my family, and I have it to some extent even though I'm only 22. While it hasn't been 100% confirmed that there is no autoimmune component to my family history, one thing I can say is that weight and activity level are mostly irrelevant in my family history. So it appears as though carb intake is more of a factor in my case.
I do think that it would be prudent to keep an eye on your carb intake, which it sounds like you are already doing.
Thank you, Jason . Definitely keeping a tight eye on the carbs.
Do you find weights help?
I wanted to add that I just came back from the gym where I did some slightly more intensive than normal weight lifting, as well as some brisk walking to and from the gym - and after this, I tested my blood sugar on Relion.
I was floored to see it at 76.
It is amazing what weight lifting can do for blood sugar. I had noticed such episodes before after weight lifting - my blood sugar goes down significantly (in the low 80's...and now mid 70's).
I could have watched that number on the Relion screen forever! :-)
There are other factors like stress that could be involved in causing insulin resistance in my case. But I am suspicious that it could be more so an issue with my pancreas having trouble secreting enough insulin. I would say whether that has an autoimmune component to it is questionable.
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wisdomfromyou wrote: »So Midwesterner,
How would I know what type of Type2 is likely in my family hisory ?
With both of my parents, I strongly suspect just lifestyle factors - because there was no trace of diabetes in the family before them.
When diagnosed, my mom had become obese and was eating emotionally (a lot) without any exercise other than some trips to the market. Her mother and sisters were never anywhere close to diabetes.
She also had a terrible doctor who only mentioned the word diabetes when she found her blood sugar in the 300's. She had found it well ino the diabetic range before but all she told my mom at that time was to "watch the bread" - no diagnosis. A year later, with values in the 300's the dr. Panicked and only then she told my mom she had diabetes. In the US, she would have had the living lights sued out of her, but in my home country, the suing thing doesn't work.
My dad comes from great genes, everyone in his family lives close to 100 (father 99, mother 90, aunts 95+). He is 71 now and even with a largely sedentary lifestyle and eating whatever he wants (including sweets and animal fat), he is still only "prediabetic". He also smoked for decades but quit about 10 years ago. I have a feeling that if both had had better lifestyles earlier, they would not have developed type 2 and pre-diabetes, respectively.
So I keep hoping its a type 2 I can avoid, now that we all know better.
You wouldn't know which version of type 2 your parents have without them undergoing some rather costly testing... and that is unnecessary because the odds of having the genetic version are incredibly low. I only mention this rare exception because whenever I explain that type 2 is not really genetic, somebody always brings up that there are a few people who have a different form of type 2 that is, in fact, genetic. Even then, most people who think they got diabetes directly from genetics are mistaken... but they also usually don't understand it, so it is an unintentional error (most doctors are not trained on the differences either).0 -
If I understand what you're saying correctly, is it fair to say that for thin people who don't have a buildup of excess fat who are Type 2 or prediabetic Type 2, genetics directly comes into play with not being able to produce enough insulin?midwesterner85 wrote: »wisdomfromyou wrote: »So Midwesterner,
How would I know what type of Type2 is likely in my family hisory ?
With both of my parents, I strongly suspect just lifestyle factors - because there was no trace of diabetes in the family before them.
When diagnosed, my mom had become obese and was eating emotionally (a lot) without any exercise other than some trips to the market. Her mother and sisters were never anywhere close to diabetes.
She also had a terrible doctor who only mentioned the word diabetes when she found her blood sugar in the 300's. She had found it well ino the diabetic range before but all she told my mom at that time was to "watch the bread" - no diagnosis. A year later, with values in the 300's the dr. Panicked and only then she told my mom she had diabetes. In the US, she would have had the living lights sued out of her, but in my home country, the suing thing doesn't work.
My dad comes from great genes, everyone in his family lives close to 100 (father 99, mother 90, aunts 95+). He is 71 now and even with a largely sedentary lifestyle and eating whatever he wants (including sweets and animal fat), he is still only "prediabetic". He also smoked for decades but quit about 10 years ago. I have a feeling that if both had had better lifestyles earlier, they would not have developed type 2 and pre-diabetes, respectively.
So I keep hoping its a type 2 I can avoid, now that we all know better.
You wouldn't know which version of type 2 your parents have without them undergoing some rather costly testing... and that is unnecessary because the odds of having the genetic version are incredibly low. I only mention this rare exception because whenever I explain that type 2 is not really genetic, somebody always brings up that there are a few people who have a different form of type 2 that is, in fact, genetic. Even then, most people who think they got diabetes directly from genetics are mistaken... but they also usually don't understand it, so it is an unintentional error (most doctors are not trained on the differences either).
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I wish! It does most certainly help if there is the control on diet etc. But it is not a given that it will not happen. Nor is it a given if you have a family history you will get type 2. From what II understand there is a genetic factor but ultimately it is a complex system and with higher risk factors, it is risk percetage. No certainties.
If lifestyle was a 100% prevention my MIL would not have developed type 2. MIL is affected form both parents sides. Her parents got it in their late forties, and had died by their mid sixties- I am not sure on exact things as I never knew them, but this is what I heard.
My MIL (@75) only now is starting to have the really bad neuropathy impact, but she still can walk. She is still not in need of insulin. She is not healthy anymore, but she has some serious other health issues too.
I totally credit her diet, walking/cycling and weight dilligence to the fact that she is still with us and still ok-ish.
On the other hand. My mother (now 72) also has some riskfactors but she has managed to stay pre-diabetic for decades without going diabetic She was inactive, obese and not wathcing her diet.0 -
"amusedmonkey wrote: »
If your parents have true type 2 diabetes, not being overweight or sedentary could really spin the wheels in your favor (especially if they developed it after 50 with and no other family members had it like it is the case for you) and you might be able to completely prevent it or at least delay it to a ripe old age, unless you are one of the unlucky few.
Mother got it well after 50, when she was at her most obese and sedentary. Father is still not officially diagnosed because he seems to stay in the barely prediabetic range but then again, after my mom failed to be diagnosed in time, I don't trust their doctor there. I told my mom to change her and be more proactive about my father's diagnosis (is he or is he not diabetic) but they are pretty lax about the whole thing.
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There seem to be so many knowledgeable people here...so I have one more question. I am not sure if anyone has heard of the dawn phenomenon: people experiencing higher fasting blood sugar than what they had the night before - and without snacking in the meantime.
I read a lot about the dawn phenomenon but it all sees to apply to diabetics - when the fasting blood sugar is not only higher than the night before but also abnormal.
My question is: is this something non-diabetics can experience too? Not that the fasting blood sugar would be abnormal, but it would be higher than what they went to bed with.
I seem to have this - for example I went to bed last night with the blood sugar in the high 70's and in the morning was low 80's.
Other times, it would be high 80's at bed and then mid 90's fasting.
Should I be concerned that my fasting blood sugar rises slightly compared to the night before, even if it stays within normal range?
I understood that this is something that the pancreas does naturally...secrete more insulting in the early morning to get the body prepared for the day. But is this something everyone experiences?0 -
20% of the people who die from lung cancer each year are non-smokers. But smoking is the biggest risk factor for getting lung cancer. By quitting smoking, you're improving your odds of not getting lung cancer substantially.
Losing weight and keeping it off is as I understood it the best thing you can do if there's a history of diabetes 2 in your family. You can't do anything about your genes, but you can do something about your weight.
You didn't, by the way, gain some weight back "due to work-related stress". You gained weight back because you chose to deal with your stress by eating. You can change this by developing better strategies for dealing with your stress.
You might find these sites helpful:
http://thecenterformindfuleating.org/Principles-Mindful-Eating
http://www.intuitiveeating.org/content/10-principles-intuitive-eating
http://www.webmd.com/balance/stress-management/stress-management-topic-overview8 -
20% of the people who die from lung cancer each year are non-smokers. But smoking is the biggest risk factor for getting lung cancer. By quitting smoking, you're improving your odds of not getting lung cancer substantially.
Losing weight and keeping it off is as I understood it the best thing you can do if there's a history of diabetes 2 in your family. You can't do anything about your genes, but you can do something about your weight.
You didn't, by the way, gain some weight back "due to work-related stress". You gained weight back because you chose to deal with your stress by eating. You can change this by developing better strategies for dealing with your stress.
You might find these sites helpful:
http://thecenterformindfuleating.org/Principles-Mindful-Eating
http://www.intuitiveeating.org/content/10-principles-intuitive-eating
http://www.webmd.com/balance/stress-management/stress-management-topic-overview
Thank you for the links, vingogly!
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You didn't, by the way, gain some weight back "due to work-related stress". You gained weight back because you chose to deal with your stress by eating. You can change this by developing better strategies for dealing with your stress.
Yep, I typically lose weight when work stress ramps up.1 -
wisdomfromyou wrote: »Thank you for the links, vingogly!
You're welcome!1 -
wisdomfromyou wrote: »There seem to be so many knowledgeable people here...so I have one more question. I am not sure if anyone has heard of the dawn phenomenon: people experiencing higher fasting blood sugar than what they had the night before - and without snacking in the meantime.
I read a lot about the dawn phenomenon but it all sees to apply to diabetics - when the fasting blood sugar is not only higher than the night before but also abnormal.
My question is: is this something non-diabetics can experience too? Not that the fasting blood sugar would be abnormal, but it would be higher than what they went to bed with.
I seem to have this - for example I went to bed last night with the blood sugar in the high 70's and in the morning was low 80's.
Other times, it would be high 80's at bed and then mid 90's fasting.
Should I be concerned that my fasting blood sugar rises slightly compared to the night before, even if it stays within normal range?
I understood that this is something that the pancreas does naturally...secrete more insulting in the early morning to get the body prepared for the day. But is this something everyone experiences?
If the pancreas were getting busy before the day by pumping out more insulin, your blood sugar would be lower in the morning. It's the liver getting busy before the day, pumping out more sugar.
Your longest fast typically is overnight. If the blood sugar drops too low, the liver compensates by releasing it's short term glycogen stores in to the blood stream.
I can only speak for myself. My blood sugar numbers were always highest in the morning (dawn phenomenon) after the long fast. No suggested strategies seemed to have much of an effect. Some suggestions were to reduce the amount of fat I ate the day before, or having a protein/carb snack at bedtime.1 -
I think it was the high risk factors of getting diabetes that helped propel me to stay in shape in the first place. By merely staying in my bmi zone, my blood sugar levels are normal. I have stayed there for over twenty years by always doing something, whether it's the way I'm eating or from running, building muscles, or just yoga and dance. I have not been consistent over time, but It's working for me.1
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I did a little more reading about this. People without diabetes release insulin along with the early morning blood sugar rise so there is no noticeable change in blood sugar.
An effective treatment of this phenomenon (which affects about half of type 2 diabetics) is an injection of long acting (basal) insulin at bedtime.
I never progressed to requiring insulin. The only other strategy I could have tried would be to have dinner earlier in the day, no snack.
http://www.healthcentral.com/diabetes/c/17/164945/phenomenon-diabetes-puzzle/0 -
My fbs was better when I had a small snack before bed than when I didnt.
Again, I'm not sure if it can be termed "dawn phenomenon" if fog is still within normal range, only higher than the night before (no snacking in the meantime).0 -
From this referenced article, normal subjects showed no increase in blood sugar from the night before.
http://care.diabetesjournals.org/content/36/12/3860
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T2D is a disease of high blood glucose. Eating to keep your BG lower and more stable could only help prevent the disease, or help you manage it if you are one of the unlucky few who have a true genetic cause (in which case it would be very common throughout one side, or both sides, of your family regardless of weight and life style.)
Dr Bernstein's Diabetes Solution is a really great source for helping to keep BG under control.wisdomfromyou wrote: »There seem to be so many knowledgeable people here...so I have one more question. I am not sure if anyone has heard of the dawn phenomenon: people experiencing higher fasting blood sugar than what they had the night before - and without snacking in the meantime.
I read a lot about the dawn phenomenon but it all sees to apply to diabetics - when the fasting blood sugar is not only higher than the night before but also abnormal.
My question is: is this something non-diabetics can experience too? Not that the fasting blood sugar would be abnormal, but it would be higher than what they went to bed with.
I seem to have this - for example I went to bed last night with the blood sugar in the high 70's and in the morning was low 80's.
Other times, it would be high 80's at bed and then mid 90's fasting.
Should I be concerned that my fasting blood sugar rises slightly compared to the night before, even if it stays within normal range?
I understood that this is something that the pancreas does naturally...secrete more insulting in the early morning to get the body prepared for the day. But is this something everyone experiences?
Sure, but it is dawn phenomenon is less noticeable in those who have no insulin resistance.
Everybody expereineces a bit of extra glucose in the blood via gluconeogenesis in the very early hours of the morning. Your body makes more corticosteroids and the liver makes glucose as part of an effort to help you wake up and have some energy in the morning. Those with T2D will not effeciently use insulin to keep blood glucose at a steadier sate so BG rises. Those with T1D may experience high FBG because they did not use enough insulin to take care of that rise - tricky since FBG fluctations are not unusual.
I have prediabetes or maybe T2D now. My BG last night was a 5.4 (98?) but I woke up with a 6.7 (120). That is what DP can look like in T2D (as an aside, I'm beginning to wonder if it is actually LADA). It's more of an extreme fluctuation. Usually. Healthy people will often not have much of a rise but it is often still there. DP can happen with everyone.1 -
@wisdomfromyouwisdomfromyou wrote: »There seem to be so many knowledgeable people here...so I have one more question. I am not sure if anyone has heard of the dawn phenomenon: people experiencing higher fasting blood sugar than what they had the night before - and without snacking in the meantime.
I read a lot about the dawn phenomenon but it all sees to apply to diabetics - when the fasting blood sugar is not only higher than the night before but also abnormal.
My question is: is this something non-diabetics can experience too? Not that the fasting blood sugar would be abnormal, but it would be higher than what they went to bed with.
I seem to have this - for example I went to bed last night with the blood sugar in the high 70's and in the morning was low 80's.
Other times, it would be high 80's at bed and then mid 90's fasting.
Should I be concerned that my fasting blood sugar rises slightly compared to the night before, even if it stays within normal range?
I understood that this is something that the pancreas does naturally...secrete more insulting in the early morning to get the body prepared for the day. But is this something everyone experiences?
No clue if T1's deal with it.
I have had it happen on occasion and definitely wondered what it was, it can give you the sweats and then you get the chills and wake up drenched. I would wake up and think what the hell is happening and have to get a blanket. It's often times part of being a T2 diabetic.
I had never dealt with it or so I thought until I read more on Diabetes and came upon the term "Dawn Phenomenon". It's a normal part of having T2, but not everyone gets the chills and sweats, some get other middle of the night symptoms. It mimics Menopausal hot sweats at times the article shares (not having gone through it yet I don't know personally)
"The dawn phenomenon, also called the dawn effect, is the term used to describe an abnormal early-morning increase in blood sugar (glucose) — usually between 2 and 8 a.m. — in people with diabetes."
https://www.google.com/search?biw=1280&bih=889&q=dawn+phenomenon+non+diabetic&sa=X&ved=0ahUKEwjSuMLlwfjNAhVq54MKHW3FA3IQ1QIIcCgD
Does dawn phenomenon happen in normal people? :
Dr.Bernstein ...
"NO. A non-diabetic does not have the dawn phenomenon. The reason is as follows: Yes the liver releases its early dose of morning glucose."
[http://forum.lowcarber.org/showthread.php?t=380708_green]
forum.lowcarber.org/showthread.php?t=380708
Lots of great info on Google and the links above. Happy reading, some really fascinating reading to learn more about how to avoid certain things..
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Nvmomketo,
This is reassuring. As I have been monitoring my bg a bit more closely lately, I have taken it at different times of the day, several days in a row, just to see how it is behaving after various situations (carb, exercise, fasting/morning, etc). Again, I'm not diabetic or even prediabetic, but I'm obsessive due to family history and having spent my teen years, as well as my early 20's, and a good part of my 30's....pretty much drowning in refined carbs.
Last evening inhad 76 after a relatively active day (in leucine weight lifting) and this morning it was 82.
I suppose that's ok.
Question is how to keep THIS active all the time.
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