The New Diabetes Classification - the next flat-earth battle?

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RalfLott
RalfLott Posts: 5,036 Member
edited September 2016 in Social Groups
Fascinating discussion on the 6 mechanisms for damaging beta cells and implications for treatment:

http://www.diabetesincontrol.com/the-new-diabetes-classification/
Six mechanisms of damage to the beta cell, five downstream events. My simple statement is we have drug therapies even now that can treat all those mechanisms, some of the drugs we have treat multiple mechanisms.
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  • Aquawave
    Aquawave Posts: 260 Member
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    Fascinating yes and informative, but unless I missed something, it's all about pill pushing, not helping with the primary cause, hyperinsulinemia. Thanks for the link.
  • RalfLott
    RalfLott Posts: 5,036 Member
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    It's about keeping beta cells alive and well.

    You've licked T2D and kicked meds si?

    Some of us were too late to the Keto Ball and are stuck with meds, and moi, I <3 the idea of taking as few meds as possible that will curb the various assaults on what's left of my beta cells in the most efficient way possible!
  • Aquawave
    Aquawave Posts: 260 Member
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    The Keto Ball, I like that. Can damaged beta cells make a comeback/healed? I thought I remembered something about that, somewhere I saw it. Would it be so that our generations (baby boomer and silent) is the last to suffer from beta cell damage from hyperinsulinemia. Not to be. I am bitter, my daughter told me her A1C is now 6.2. More public education is needed. The sugar industry revelations, is helping.
  • LowCarbInScotland
    LowCarbInScotland Posts: 1,027 Member
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    It is disappointing that the focus was solely on meds, they're talking about using as few meds as possible to treat the maximum amount of diabetes ailments, but to me, whether you still have some pancreas function left or not, nutrition has to play a role in the remedy and doctors need to start factoring that in when prescribing, otherwise we'll never break the cycle of presuming diabetes is a progressive disease.
  • RalfLott
    RalfLott Posts: 5,036 Member
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    Well, as genuinely individualized medicine takes wing, prevention, diagnosis, and treatment should vastly improve.

    But ensuring and funding access to health care services......
  • cstehansen
    cstehansen Posts: 1,984 Member
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    This is a tough area because we absolutely need proper meds with the fewest side effects and maximum benefits as no two people are exactly alike.

    However, the discouraging part is that the focus of treating pre-diabetes was drugs. We have got to focus on non-drug options early on. Everything I have seen, read and heard is that once drug treatment starts it is almost inevitable that the patient is beginning a slow steady slide downhill where more meds in higher doses are needed.

    Part of that is outdated expectations like keeping a diabetics A1c at or below 7.0 when it seems apparent that sustained levels above 6.0 cause increasing damage. This is one place this guy has it absolutely right where we have to start getting an improvement earlier. Waiting until someone is diabetic (6.5 by most standards) is too late.

    Step one has to be changing the mantra of the politically correct elite pushing LF with lots of grains as the diet to cure everything when that keeps being shown as the culprit in this instance. When I see the food pyramid pushing 6-11 servings of grain and 2-4 servings of fruit, it makes me nuts - up to 15 servings of straight carbs that your body is going to turn into sugar almost immediately upon digestion!!!!

    It doesn't take a rocket scientist to see the obesity and diabetes epidemic started shortly after this *kitten* pyramid was rolled out and started being taught in our schools.

    The definition of insanity is doing the same thing over and over and expecting a different result. "People keep getting fatter and fatter and getting diabetes at younger and younger ages. That must mean we should double down on how we are telling people to eat." Remember when T2D was called "adult onset diabetes?"

    If we get step one accomplished, there will be fewer people like @RalfLott who have damage to the degree that meds become a permanent way of life.
  • RalfLott
    RalfLott Posts: 5,036 Member
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    Well, in all fairness, Dr. Schwartz is not dispensing advice to diabetic patients, nurse practioners, nutritionists, dietitians, etc. Rather, his remarks were made at a professional conference for endocrinologists. (So perhaps he might be excused for failing to insert a footnote saying "try diet and exercise first"...)

    In the clinical context, Dr. Schwartz recommends meds only if diet and exercise fail.
    If a patient is not able to their lower their blood sugars through diet and exercise, he has no hesitation in prescribing 1, 2, or even 3 medications to help them, and notes that, “I think that is where we have to go given the epidemic we are in."

  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
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    I confess I didn't read the article but it is my understanding that in T2D, the beta cells crap out because of fatty pancreas and burnout but once you eliminate the fatty pancreas condition they spring back into action. And this is all talking about very late stage T2D anyway, because earlier on, they are not only functioning but making lots and lots of insulin.
    Maybe I'm misunderstanding what's being asked
  • RalfLott
    RalfLott Posts: 5,036 Member
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    <spike>
  • GaleHawkins
    GaleHawkins Posts: 8,160 Member
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    It is disappointing that the focus was solely on meds, they're talking about using as few meds as possible to treat the maximum amount of diabetes ailments, but to me, whether you still have some pancreas function left or not, nutrition has to play a role in the remedy and doctors need to start factoring that in when prescribing, otherwise we'll never break the cycle of presuming diabetes is a progressive disease.

    @LowCarbInScotland I agree with you but keep in mind MD's deeply in student loan debt are not paid to break the cycle. They are ONLY paid if the cycle is NOT broken. I am only talking about Type 2 Diabetes in this post.

    In the USA we are about to joint the world it seems with a single payer health care system. Then the MD's will be paid staff then we will see cycles of poor health better addressed. We can start to see that trend in the USA with the Veterans Administration (VA) health care system which is supported mainly with tax dollars.
  • RalfLott
    RalfLott Posts: 5,036 Member
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    Great vid.
  • nvmomketo
    nvmomketo Posts: 12,019 Member
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    @maureenkhilde congrats on your success so far! It sounds like you've found the path that works well for you. :)
  • GaleHawkins
    GaleHawkins Posts: 8,160 Member
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    I am a type 2 Diabetic now for 15 plus years. And now see a specialist yes a Endocrinologist
    And have been told you really need to eat better, would you like to see a dietician asked once in the 7 years I have been going there. The answer increase medications, give me more medications. Some with intense side effects. That caused me to stop taking. This year I decided enough is enough I am killing myself, eating too much, and much of the wrong foods. Three prong goal, take way less medications, actually stop some, which will improve my health. And lose some weight. I do not have a long term goal. Starting with the well known one for Diabetics. Loose 5% it will help, I have done that. So next goal going for 10%. I need to find someone who can help me, get on the correct train tracks. So I started on MFP and started tracking and reading and being accountable to myself daily. And was told no white sugar, and no grains for you for now. I am kind of being cycled with proteins, carbs and fats changed every three weeks by the Dr I am seeing who specializes in weightloss, and knows so much about the food, carbs, proteins, fats, sugar etc. And what impacts what, and yes had me watch the videos listed in this topic. And I for one am seeing the huge direct impact that dropping carbs has on my insulins. I started on 5/6/2018 using 70 ML of Lantus, now I am down to 56, Humalog total per day was 36 ML (divided into 3 times) now is 12 ML per day. I am checking BG first thing in morning before lunch and before bed. Or if I start to feel like it is going to low. I am keeping all Dr,s in the know of what is going on and results. As this is a journey I have started on. Carbs could go lower and most likely will but from uncontrolled to 45C per day all coming from Vege and Fruits has been a big jump for me.

    @maureenkhilde I have been keeping my daily carbs just under 50 grams daily for four years and it has done so much good for my BG readings and all my other health markers.

    Carbs seems to be the major way to develop Type 2 Diabetes, low HDL and high triglycerides.

    Keep learning your way forward and you will come up with your own Way Of Eating that works best for YOU. It is cool to read about what the WOE of others can do for them but in the end it is finding your own WOE that requires no real effort to do for the rest of your life.

    Best of success.
  • DiabeticDer
    DiabeticDer Posts: 21 Member
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    I am a type 2 Diabetic now for 15 plus years. And now see a specialist yes a Endocrinologist
    And have been told you really need to eat better, would you like to see a dietician asked once in the 7 years I have been going there. The answer increase medications, give me more medications. Some with intense side effects. That caused me to stop taking. This year I decided enough is enough I am killing myself, eating too much, and much of the wrong foods. Three prong goal, take way less medications, actually stop some, which will improve my health. And lose some weight. I do not have a long term goal. Starting with the well known one for Diabetics. Loose 5% it will help, I have done that. So next goal going for 10%. I need to find someone who can help me, get on the correct train tracks. So I started on MFP and started tracking and reading and being accountable to myself daily. And was told no white sugar, and no grains for you for now. I am kind of being cycled with proteins, carbs and fats changed every three weeks by the Dr I am seeing who specializes in weightloss, and knows so much about the food, carbs, proteins, fats, sugar etc. And what impacts what, and yes had me watch the videos listed in this topic. And I for one am seeing the huge direct impact that dropping carbs has on my insulins. I started on 5/6/2018 using 70 ML of Lantus, now I am down to 56, Humalog total per day was 36 ML (divided into 3 times) now is 12 ML per day. I am checking BG first thing in morning before lunch and before bed. Or if I start to feel like it is going to low. I am keeping all Dr,s in the know of what is going on and results. As this is a journey I have started on. Carbs could go lower and most likely will but from uncontrolled to 45C per day all coming from Vege and Fruits has been a big jump for me.

    @maureenkhilde congratulations on your progress! My story is very similar to yours. I have reduced my carbs beginning in April and went from 9.2 A1C to 5.5 in 3 months! I went from 88 units of lantus to 55 units. Can't wait for my next visit with my MD in 2 weeks to get my next A1C!. I've lost 35 lbs in just under 6 months and I feel so much better! Keep up the great work!! We can do this!!
  • nvmomketo
    nvmomketo Posts: 12,019 Member
    Options
    I am a type 2 Diabetic now for 15 plus years. And now see a specialist yes a Endocrinologist
    And have been told you really need to eat better, would you like to see a dietician asked once in the 7 years I have been going there. The answer increase medications, give me more medications. Some with intense side effects. That caused me to stop taking. This year I decided enough is enough I am killing myself, eating too much, and much of the wrong foods. Three prong goal, take way less medications, actually stop some, which will improve my health. And lose some weight. I do not have a long term goal. Starting with the well known one for Diabetics. Loose 5% it will help, I have done that. So next goal going for 10%. I need to find someone who can help me, get on the correct train tracks. So I started on MFP and started tracking and reading and being accountable to myself daily. And was told no white sugar, and no grains for you for now. I am kind of being cycled with proteins, carbs and fats changed every three weeks by the Dr I am seeing who specializes in weightloss, and knows so much about the food, carbs, proteins, fats, sugar etc. And what impacts what, and yes had me watch the videos listed in this topic. And I for one am seeing the huge direct impact that dropping carbs has on my insulins. I started on 5/6/2018 using 70 ML of Lantus, now I am down to 56, Humalog total per day was 36 ML (divided into 3 times) now is 12 ML per day. I am checking BG first thing in morning before lunch and before bed. Or if I start to feel like it is going to low. I am keeping all Dr,s in the know of what is going on and results. As this is a journey I have started on. Carbs could go lower and most likely will but from uncontrolled to 45C per day all coming from Vege and Fruits has been a big jump for me.

    @maureenkhilde congratulations on your progress! My story is very similar to yours. I have reduced my carbs beginning in April and went from 9.2 A1C to 5.5 in 3 months! I went from 88 units of lantus to 55 units. Can't wait for my next visit with my MD in 2 weeks to get my next A1C!. I've lost 35 lbs in just under 6 months and I feel so much better! Keep up the great work!! We can do this!!

    Wow! Congratulations! :)
  • G0ldengirl68
    G0ldengirl68 Posts: 43 Member
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    I didn't watch the OPs link because I wanted to share something I didn't see in the thread yet, but I do see the last post was in 2018. I didn't start my journey with T2 until Jan. 20, 2021. I jumped into youtube videos, and googled articles, joined a couple forums to learn what I could from those that experience Diabetes, specifically T2 of course.

    I like to listen to Dr. Ben Bikman's info. I get most of what he teaches since he graciously puts it in terms layman's terms, and he is so brilliant in my opinion. He has one "product" I only heard about one time, oh, and his book but I didn't even know he had anything. This guy is just into getting the truth out, as he sees it, again, my opinion.

    https://youtube.com/watch?v=XQZKwCbWWZE

    I do eat (lean towards keto) low carb, macros are Fat highest, Proteins next, and carbs lowest. I still don't have my macros exactly right (well, can't be perfect) so I need to readjust them on MFP, but I'm still learning and discovering what works the best for me. I'm glad to find the group thanks to help from @springlering62 :D

    Hope to meet many of you!


  • RalfLott
    RalfLott Posts: 5,036 Member
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    Whew, what a difference a couple years make. Dr. Bikman was not on my radar at the time, but he is a terrific resource. His book, like his lectures, is outstanding.