[JJ]

I have an irrational fear of getting diabetes. can't explain it (my blood sugar is fine.)
if anything, I imagine my heart will take me out.

[Pops]

Heart disease or stroke kills 2/3 of diabetics.

Basically, sugar sticks to protein in the body, same process as browning food. Too much sugar in the blood over too long makes proteins throughout the body unable to do their job. Heart and blood vessels of course are damaged first

HbA1c is a byproduct of the process - called glycation (sp?) - so the A1c test measures exactly the primary cause of complications and how much damage is occurring over time. ADA recommends below 7 so peakoiler kudos to you.

[PeakOiler]

$this->bbcode_second_pass_quote('Pops', 'H')eart disease or stroke kills 2/3 of diabetics.

Basically, sugar sticks to protein in the body, same process as browning food. Too much sugar in the blood over too long makes proteins throughout the body unable to do their job. Heart and blood vessels of course are damaged first

HbA1c is a byproduct of the process - called glycation (sp?) - so the A1c test measures exactly the primary cause of complications and how much damage is occurring over time. ADA recommends below 7 so peakoiler kudos to you.

[Pops]

Being the doomer I am I tried initially to manage as much as possible by limiting carbs. I was somewhat successful at first while I was still making some insulin, I ate no more than 5 complex carbs a day (15 grams carbohydrate less fiber equals one Carb Exchange) and no white bread, etc.

This past spring I think my remaining islets expired and my insulin requirement just about doubled. About the same time I also started to get serious brain fade in the afternoon. After reading about the link between Alzheimer's and insulin - or lack of I've upped my carb intake and of course my regular insulin dose. By experimenting I've kept my A1c down (5.8 post-Cmas) and seem to be able to post almost as coherently (or incoherently) on PO.com in the afternoon as well as the morning. LOL

[Pacoloco]

I have had type 2 diabetes for about 8 years but only recently was put on 6 units of insulin----It sucks but I am determined to wean myself off of this. Diet & exercise---much more needed in this area. I heard marijuana might lower blood sugar---anyone else heard this. Munchies? Surround yourself with nothing but fruits & veggies. You'll be asleep in no time anyway.

[PeakOiler]

I got the results of my latest quarterly blood test today. AIC is still 6.2. It's been 6.2 each of the last 3 quarters. According to the report, the normal range is 4.6 to 6.2, although some medical groups say ~4.6 to 5.7.

Sodium and total protein were just barely on the low side of normal again. I better go eat some steak with a lot of salt.

I rarely eat rice, corn, potatoes, pasta, or breads (wheat), anymore. One fruit a day, or two small fruits, and that includes citrus. I've been eating a quarter of a homegrown grapefruit almost every day since the middle of December.

I've been keeping my daily total carbs under 200 grams/day.

I miss eating chocolate cake. And that was my favorite dessert, especially on my birthday (March 2nd).

[Tanada]

TedMed talk, what if we are wrong about cause and effect for Diabetes?
http://www.ted.com/talks/peter_attia_wh ... betes.html
Good stuff, anyone who has diabetes or knows someone with it should see this.

[Pops]

Thanks Tanada, since you bumped the thread here is an interesting story about a vaccine for Type I.
http://www.medicalnewstoday.com/articles/262559.php

[careinke]

$this->bbcode_second_pass_quote('Tanada', 'T')edMed talk, what if we are wrong about cause and effect for Diabetes?
http://www.ted.com/talks/peter_attia_wh ... betes.html
Good stuff, anyone who has diabetes or knows someone with it should see this.

[AgentR11]

$this->bbcode_second_pass_quote('pstarr', '&')quot;What if we have it backwards?" What if obesity isn't the cause of insulin resistance at all, what if it is a symptom of a much deeper problem?

[Pops]

I eat around 20g of carbs a day, a little more than in one slice of bread. I'm an old Okie and not having biscuits, gravy, fried potatoes and beans was hard at first. I eat lots of protein and good oils, not the high bacon diet unfortunately, what is touted recently as the Mediterranean diet - sans grain.

My last A1c was 5.1 which translates to 99.7mg/dl average, which is pretty good for a type one without a pump. Most long term ill effects happen above 110 and the rise in complications is pretty dramatic even levels in the 110-160 range if long term. An additional motivation was to get out of the in-between area where I was ketoacidotic at time which left my brain kinda foggy, now I'd guess I have lots of ketones in my blood all the time and the brain, being the remarkable thing it is, can adjust after a couple of days to running to a large extent on ketones for fuel instead of glucose - voila, no more fog...

Guess I'll have to come up with some other excuse, LOL

[PeakOiler]

Pops, glad to read that your glucose is under control.

My type II diabetes is relatively under control as well. Here's my latest data:



My body can tolerate ~200 grams of total carbs per day with the help of three meds:
Janumet (aka. metformin-Janumet includes a diuretic), pioglitazone, and glipizide.

I'm still learning how to modify my diet to minimize my dependence on pharmaceuticals.
I still "cheat" too much! Fresh peaches (when I have some) don't help. Pecans, however, are excellent. I still may get some this season.

btw, I've never considered myself obese. I've never needed to wear a pair of pants greater than 34" waist. I'm 5' 11.5" tall. Diabetes is in the bloodline. Genetics is still a big factor in whether one develops diabetes.

Skinny people get diabetes too.

[John_A]

Diabetes. Ah yes...well....it got me about a year ago. Failed two A1C's at 10.5

My doctor was unhappy. So was I.

Lost some weight, changed the diet slightly (primarily downsized processed sugars) and got the doc off my back. Then I missed a winters exercise, gained 10 pounds back due to proximity to the kitchen at the new job, paid less attention to the processed sugar intake and bingo...back to crappy numbers. <sigh>

So I am resigned to a new lifestyle to keep as much control over bg as possible without touching the drugs. Never liked any of them.

What has been most fascinating about this process is the reaction of the doctor. As I began to quiz her regularly, she revealed that everyone gets the first A1C back, they go forth swearing to do better, and then come back 3 months later with the same numbers. Another 90 days, same numbers, they ask for the drugs. And then they regulate the dosage to make sure they can do double dip ice cream and cake at birthday parties. Filed that as a fascinating example of "normal" human behavior from her perspective.

[Subjectivist]

FDA finaly getting close to approving SLGT-2 inhibitors for type 2 diabetes. These ones work via the kidney instead of the liver so it spreads out the effects over more organs lowering the risk of over stressing any single organ during treatment.

$this->bbcode_second_pass_quote('', '.') Dec. 12: Forxiga FDA panel review
If at first you don't succeed, try, try again! AstraZeneca and Bristol-Myers Squibb are attempting again to get their revolutionary SGLT2-inhibiting type 2 diabetes drug, Forxiga, approved in the U.S. -- but first it'll face a date with the firing squad known as the FDA's advisory panel on Dec. 12.

A quick refresher: Efficacy was never the issue with Forxiga, as AstraZeneca and Bristol-Myers Squibb actually managed to get their drug approved in the European Union late last year. However, Forxiga was turned away in the U.S. because of potentially elevated risks of liver damage, as well as bladder and breast cancer, associated with the drug.

After nearly two years, the companies come back to the table with some 26 mid and late-stage safety trial results spanning roughly 12,000 diabetes patients, which they believe will help demonstrate once and for all that the benefit profile of Forxiga far outweighs any prospective risks. Also working in Forxiga's favor is that Johnson & Johnson's Invokana, another SGLT2 inhibitor, was approved earlier this year; that may help loosen the FDA panel's safety concerns a bit.

The allure of SGLT2 inhibitors is that they work in the kidneys as opposed to the pancreas and liver, allowing patients to get rid of excess glucose that is blocked from absorption through their urine. Furthermore, while DPP-4 inhibitors -- the most commonly prescribed type 2 diabetes mellitus medication -- are weight-neutral, SGLT2 inhibitors have been shown as a side effect to cause weight loss! Obesity is a common ailment that often goes hand in hand with type 2 diabetes, so Forxiga could offer blockbuster sales potential as a next-generate type 2 diabetes drug.

[Tanada]

That is interesting, I just watched a lecture by Dr. Jason Fung, a Nephrologist (kidney doctor) who specializes in diabetic patients trying to keep them healthy and avoid kidney dialysis treatments from lack of function. He is a Canadian doctor and one of the things he discusses is focusing treatment for Diabetes on drugs like Metformin and Forxiga because they work in ways that reduce insulin resistance which improves Type II diabetes over the course of treatment as opposed to insulin injections and Sulfonylurea type drugs that cause increasing insulin resistance over time.

He also talks about how you have to give Type I diabetics a maintenance dose of insulin or they will waste away because without insulin the fat, muscle and organ tissues do not grow enough to preform the necessary self repair needed to sustain weight or even life indefinitely. He mentioned a phenomenon (diabulemia) in some type I diabetics where they deliberately skip insulin doses in order to lose weight.

Anyhow you can see his lecture http://www.youtube.com/watch?v=dimP7IdM2Og which is part 2 of a six part series. Part one is mostly about obesity, part 2 is mostly about diabetes.

[Pops]

fwiw
The liver can create 100-150g of glucose per day from protein and fat either from food intake or the body itself, which is more than enough for normal business. This is the reason there is no Minimum Daily Requirement for carbs.

Insulin is the signal to the liver that there is plenty of sugar-energy available and to not convert protein and fat into glucose. Uncontrolled type 1s get skinny because without insulin the liver thinks the body is starving so tries to convert muscle and fat into food energy - glucose. Even if I (a type 1) eat zero carbs, I still need 25-30u of insulin per day to control my liver function.

[Subjectivist]

Watched the video, interesting stuff. Diabetes scares me, it is one of the diseases I really want to avoid so I read news about it to see what's new. Did you know the ancient greek name for diabetes roughly translates to "honey urine" ? The doctors even back then recognized that type I diabetics excreted lots of sugar in their urine, they noticed that ants would gather up the sweet soil in places where diabetics urinated. Under normal conditions this only happens when your blood sugar is very high because the kidneys are good at pulling glucose out of the urine as they filter the blood. These new drugs, Forxiga and Invokana work by preventing the kidney from pulling the glucose out of the urine and this allows patients to excrete 70 to 90 grams of glucose per day.

Would that help you hold your glucose level steady Pops? You said you eat very low carb, and if your liver can only make 150 grams while your kidney can excrete 90 grams would that reduce your insulin need, or would you still have to use a lot to slow your liver ketone production down? I had two great aunts who were insulin dependent when I was a kid but they passed away in the early 1980's. I am fascinated that a Canadian kidney doctor has so much advise for how to prevent diabetic kidney failure. Why don't American doctors put out lectures like the one Tanada linked above? Everyone complains about the Canadian health care but this guy seems pretty smart and concerned about what is the best treatment instead of what is the 'conventional' treatment.

[Pops]

I think you meant to say the drugs increase the kidney's ability to remove glucose?

High blood sugar causes the long term complications because glucose reacts with proteins and they get "sticky" and cause all sorts of problems gumming up the works. It's called the Maillard reaction and it results in lots of diabetic complications so especially for T2 diabetics who have no way to "manually" adjust their blood sugars (like T1s do with insulin) this drug might be great. Coincidentally the Maillard reaction is the same process that causes foods to caramelize - browning.

But insulin also allows glucose to be stored locally in cells throughout the body and it's this stored energy that allows bursts of activity. So I think (guess) that it isn't really all that beneficial to T1s, especially since low blood sugar is the numero uno problem T1s deal with when trying to keep their glucose levels within the normal range.

[Pops]

Looking at This page, the drug isn't for T1s because of hypoglycemia (low sugar).

It works by preventing the reabsorption of glucose which the kidneys filter out. Of course it depends on functioning kidneys but it could be great for T2s who aren't doing well with the other drugs.