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Can diabetes really be prevented with diet, exercise and a normal BMI - despite family history?
Replies
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No, I don't believe you can always prevent it ... but you CAN control it extremely well with proper diet (especially a VLCKD) and regular (daily) exercise.
Also, to heck with BMI. There's people with BMI of 21 or 22 (normal, healthy BMI range) who have 30-35% body-fat (lots of unseen visceral fat) and are being diagnosed with diabetes. It's an accurate risk predictor for some people, but misses many others and often assume risk where there is none.
Regarding control ... At my current HbA1c levels any physician who doesn't know I'm diabetic would assume I'm not even close. Some would suggest I'm "cured" (sigh.) Yet If I were to change my diet or reduce my exercise, my HbA1c would climb to the moon.
Amazingly, with strict VLCKD there are many Type I diabetics now that are controlling their diabetes quite well without bolus insulin.2 -
albertabeefy wrote: »No, I don't believe you can always prevent it ... but you CAN control it extremely well with proper diet (especially a VLCKD) and regular (daily) exercise.
Also, to heck with BMI. There's people with BMI of 21 or 22 (normal, healthy BMI range) who have 30-35% body-fat (lots of unseen visceral fat) and are being diagnosed with diabetes. It's an accurate risk predictor for some people, but misses many others and often assume risk where there is none.
Regarding control ... At my current HbA1c levels any physician who doesn't know I'm diabetic would assume I'm not even close. Some would suggest I'm "cured" (sigh.) Yet If I were to change my diet or reduce my exercise, my HbA1c would climb to the moon.
Amazingly, with strict VLCKD there are many Type I diabetics now that are controlling their diabetes quite well without bolus insulin.
That's darn impressive.0 -
albertabeefy wrote: »No, I don't believe you can always prevent it ... but you CAN control it extremely well with proper diet (especially a VLCKD) and regular (daily) exercise.
Also, to heck with BMI. There's people with BMI of 21 or 22 (normal, healthy BMI range) who have 30-35% body-fat (lots of unseen visceral fat) and are being diagnosed with diabetes. It's an accurate risk predictor for some people, but misses many others and often assume risk where there is none.
Regarding control ... At my current HbA1c levels any physician who doesn't know I'm diabetic would assume I'm not even close. Some would suggest I'm "cured" (sigh.) Yet If I were to change my diet or reduce my exercise, my HbA1c would climb to the moon.
Amazingly, with strict VLCKD there are many Type I diabetics now that are controlling their diabetes quite well without bolus insulin.
That's darn impressive.
Key word: bolus.
It would also require more consistency than some of us can do. My schedule and foods (split among protein and fat in addition to a small amount of carbs) is too chaotic to completely eliminate all need for bolus insulin. Still, it is much reduced with low carb.1 -
My parents were both type 2 diabetic. Both were able to control it quite well with diet and exercise. My mom is no longer on diabetes meds. My dad just passed away from pancreatic cancer and after he had part of his pancreas, among other things, removed his blood sugars improved as did his also he no longer had high blood pressure.
I think it can be controlled and type 1 is more the genetic kind. My son says he plans on finding a cure for diabetes so watch for this in the future.
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I agree not everyone can do it. It involves a diet that not everyone a) enjoys, or b) is capable of maintaining.midwesterner85 wrote: »Key word: bolus.
It would also require more consistency than some of us can do. My schedule and foods (split among protein and fat in addition to a small amount of carbs) is too chaotic to completely eliminate all need for bolus insulin. Still, it is much reduced with low carb.
And yes, it also involves a schedule that not everyone can maintain. It also means close monitoring and adjusting of the basal insulin as need be - as the need for basal insulin also reduces when T1's adopt a VLCKD.
I'm glad to see you've been able to reduce bolus with low-carb though. It's great to have better control PLUS less risk of hypoglycaemia, etc. that lower-carb diets bring to T1's.
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I tried controlling my blood sugar through diet alone for three days when there were more bills than money. I couldn't do it. The Metformin was doing a marvellous job of keeping my blood sugars stable.
Now, with significant weight loss, the diabetes is in remission.3 -
I highly recommend the book, "The Obesity Code" by Dr. Jason Fung. He also has a Youtube channel with many lectures on the true cause of obesity and diabetes. All the info in his book can be found in those lectures. He sites numerous long term human studies and the evidence is overwhelming. He works mainly with diabetic patients and has helped many of them reverse their diabetes. The current recommended protocol for treating diabetes actually makes it worse. Diabetes in actually insulin resistance, developed over years of eating too much sugar and refined/processed carbs. To reverse diabetes you must reverse the insulin resistance and he explains how to do this. Doctors today continue to prescribe increasing doses of insulin to diabetics which only makes the insulin resistance and the disease much worse. Blood sugar does go down but this does not translate into making the diabetes better. You most certainly can prevent and even reverse diabetes through a low carb, high fat diet and also intermittent fasting (he explains all about that also). There are a lot of fit, normal weight people becoming diabetic. Losing weight will not prevent or reverse diabetes. It's not a weight or calorie issue. It's an insulin issue. You must address the insulin resistance. Again, I highly recommend that you check out Dr. Fung's book and/or Youtube channel.2
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In answer to OP's title, I have found through clinical experience that Diabetes can easily be reversed regardless of family history with whole food low carbohydrate dieting combined with fasting. Pure calorie reduction (without attention to other variables) seems to work to a much less dramatic extent when it does work, and it only seems to work temporarily. Just my observations.2
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geneticexpectations wrote: »In answer to OP's title, I have found through clinical experience that Diabetes can easily be reversed regardless of family history with whole food low carbohydrate dieting combined with fasting. Pure calorie reduction (without attention to other variables) seems to work to a much less dramatic extent when it does work, and it only seems to work temporarily. Just my observations.
Thanks. Are you a clinician?0 -
geneticexpectations wrote: »In answer to OP's title, I have found through clinical experience that Diabetes can easily be reversed regardless of family history with whole food low carbohydrate dieting combined with fasting. Pure calorie reduction (without attention to other variables) seems to work to a much less dramatic extent when it does work, and it only seems to work temporarily. Just my observations.
Thanks. Are you a clinician?
yes, a phycisian2 -
geneticexpectations wrote: »geneticexpectations wrote: »In answer to OP's title, I have found through clinical experience that Diabetes can easily be reversed regardless of family history with whole food low carbohydrate dieting combined with fasting. Pure calorie reduction (without attention to other variables) seems to work to a much less dramatic extent when it does work, and it only seems to work temporarily. Just my observations.
Thanks. Are you a clinician?
yes, a phycisian
If you regularly treat T2 diabetics, there are many here who would be intetested in your experiences and observations....
Among the questions that tend to come up are:
"How can I find a LCHF-minded PCP/endocrinologist/nutritionist to help me fine-tune my diet?";
"How can I productively discuss my diet with my PCP/endocrinologist/nutritionist?"; and
"Is genetic testing worthwhile for some or all T2 diabetics at this point?"
Thanks for any insights you'd be willing to share!1 -
geneticexpectations wrote: »geneticexpectations wrote: »In answer to OP's title, I have found through clinical experience that Diabetes can easily be reversed regardless of family history with whole food low carbohydrate dieting combined with fasting. Pure calorie reduction (without attention to other variables) seems to work to a much less dramatic extent when it does work, and it only seems to work temporarily. Just my observations.
Thanks. Are you a clinician?
yes, a phycisian
If you regularly treat T2 diabetics, there are many here who would be intetested in your experiences and observations....
Among the questions that tend to come up are:
"How can I find a LCHF-minded PCP/endocrinologist/nutritionist to help me fine-tune my diet?";
"How can I productively discuss my diet with my PCP/endocrinologist/nutritionist?"; and
"Is genetic testing worthwhile for some or all T2 diabetics at this point?"
Thanks for any insights you'd be willing to share!
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.
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.
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.
I think genetic testing can be helpful, but we have had experience with massive quality of life improvements with major chronic diseases in general (not just diabetes) regardless of how genetically predisposed the individual is (to a point of course, but this is the exception, not the rule).3 -
I'll tell you what my endo. told me: the root cause of type-2 diabetes is insulin resistance, or the body's inability to process sugar effectively. I inherited mine from my father, and he from his. I was pre-diabetic (and had gestational diabetes with both my children). But then I lost 80 lbs, I now run regularly, and am no longer considered pre-diabetic.
However...I take 500 mg of Glucophage/day and try to eat less than 30 g. of sugar/day, because I am still, and will always be, insulin resistant. I will develop type-2 diabetes someday--all this work and taking the meds, though, should push it down the road quite a bit. There's nothing wrong with being proactive, OP. 2 -
@geneticexpectations -
Thanks for sharing your thoughts.
Here's an unrelated T2D question:
I developed a GI war zone after my pharmacy switched generic versions of metformin XR last year (which led me in a roundabout way to this group...) I happened to catch Dr. Bernstein advising people with such issues to switch to name-brand Glucophage XR, and voilà! this resolved my GI complaint in short order.
Q - Is the GI side effect more likely attributable to a filler/inactive ingredient in that particular generic or to a quality-control problem with the specific formulation of the active ingredient?
(I've never had that sort of reaction to generic versions of other drugs)
Thanks again!0 -
I'll tell you what my endo. told me: the root cause of type-2 diabetes is insulin resistance, or the body's inability to process sugar effectively. I inherited mine from my father, and he from his. I was pre-diabetic (and had gestational diabetes with both my children). But then I lost 80 lbs, I now run regularly, and am no longer considered pre-diabetic.
However...I take 500 mg of Glucophage/day and try to eat less than 30 g. of sugar/day, because I am still, and will always be, insulin resistant. I will develop type-2 diabetes someday--all this work and taking the meds, though, should push it down the road quite a bit. There's nothing wrong with being proactive, OP.
Nice going!
A quick aside about Metformin/Glucophage...
If you can tolerate it, the effective dose is said to be higher in the FDA product info for clinicians - 1500-2000mg/daily, if memory serves.
PS. I don't think you're condemned to develop T2D if you stay the course!
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@geneticexpectations -
Thanks for sharing your thoughts.
Here's an unrelated T2D question:
I developed a GI war zone after my pharmacy switched generic versions of metformin XR last year (which led me in a roundabout way to this group...) I happened to catch Dr. Bernstein advising people with such issues to switch to name-brand Glucophage XR, and voilà! this resolved my GI complaint in short order.
Q - Is the GI side effect more likely attributable to a filler/inactive ingredient in that particular generic or to a quality-control problem with the specific formulation of the active ingredient?
(I've never had that sort of reaction to generic versions of other drugs)
Thanks again!
Short answer - who knows. As physicians we just do what works (so changing medication worked, which is good). That being said, Metformin has GI side effects in all versions really, just depends on the person.
What seems to work better is getting patients off all meds entirely. Less side effects 2 -
@geneticexpectations -Thanks for the added information. 1
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From my reading on this subject after hubby was diagnosed, if you're going to get Type 2, you're going to get it. Whether you end up with at 40 or younger vs. 65+ and how well it's managed are where weight and lifestyle come into play. Even those who reverse it with lifestyle will eventually find it returning and requiring more medication and changes as they age. Complications can be avoided until you're very, very old if you manage it well.3
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Kind of random question: What happened to those with diabetes before the age of modern medicine. I mean, I know they *died*, but what did it look like? In other words, how fast was the downward progression, and what did people think was happening? Or, was it not well understood that this was a singular disease? I am interested in the sociological-ish history of disease.1
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Kind of random question: What happened to those with diabetes before the age of modern medicine. I mean, I know they *died*, but what did it look like? In other words, how fast was the downward progression, and what did people think was happening? Or, was it not well understood that this was a singular disease? I am interested in the sociological-ish history of disease.
I don't really know the answer with type 2, but it was not as common when obesity was less common.
For type 1 diabetes... which I will add is a totally different disease with a different pathway than type 2... they knew what was happening at a point. Before they knew, it would have been that someone got sick and died at a very young age. By the late 19th century and early 20th century, it was somewhat understood that blood sugar was going high. The ketone breath and sweet, ketone-smelling urine was a symptom. So they would give diabetics alcohol constantly and make them eat low carb since those things seemed to help. I'm not sure if they understood why it helped at the time, but we know today that our liver does not release glycogen while processing alcohol. We also know that net carbs become glucose directly and quickly, unlike proteins and fats. Alcohol suppressed glucose from being added to blood from glycogen and eating low carb limited glucose added from food. This could keep type 1's alive through part of the "honeymoon" stage, so it extended life expectancy by months and sometimes even a year or two. When a researcher in Canada discovered that injections of animal insulin made such a marked difference (1920's or 1930's if my memory of history serves me right), it quickly became the new standard for treatment.
Now, we have advanced synthetic insulins, high-tech precision delivery systems (insulin pumps), and patient-use CGM's. Even compared to when I was first diagnosed with type 1 diabetes, therapy has come a very long way. There was a time when I took beef insulin, and then pork insulin. I mixed my own injections then (with bolus and basal insulin). Now I take a rapid-acting synthetic through a pump for both bolus and basal insulin needs, through precise dosing and timing.5 -
Yes2
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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
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yes it can, same with blood pressure, you are what you eat2
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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
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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
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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
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