Type 2 diabetes is insulin resistance. insulin resistance is a lack of responsiveness to insulin by the muscle to use glucose and insulin. Insulin feeds glucose to the muscle. When glucose hits the muscle it is used immediately in healthy bodies.
Fatty livers and fat in the pancreas might not be the cause. The correlation is strong. I am not denying that. Hormonally it may play a role.
Being what is called a Tootsy roll means you have fat around your organs and not necessarily a big gut. The mortality rate is high for Tootsy rolls. The correlation to diabetes type 2 has been long known.
The article does not clear up causality. The headline is misleading. There may be several causes. Things are unknowns still.
That’s what the last video I posted about T2 diabetes concluded and was promptly pooh-poohed by… never mind,
The first diet induced fat loss seems to come from the liver and the pancreas.
The Captain
As Denny has mentioned, this is more work from rhe Newcastle unit (and promoting the Newcastle diet) on a manifestation of non insulin dependent diabetes…but still not evidence that T2D can be cured.
On reading through the actual study and the physical characteristics of this small cohort of study subjects, you can see examples of what I (for but one poster) has observed in the past … that “weight” and, as an extension, BMI …doesn’t provide the detail necessary to assess body composition. The proportion of body fat to lean muscle mass. This is not a new idea … or even marginally controversial… i.e the concept of the “skinny fat” individual. More accurately termed metabolically obese:normal weight. Did you see the starting bodyfat % and waist circumferences??? At a BMI close to the upper limit of “healthy” range it sounds to me like these folk have all the trappings of metabolic syndrome…and, in all likelihood, did so for years before the “official” diagnosis of T2D.
For sure insulin resistance appears to be a strong (the?) precursor to metabolic syndrome and its sequelae. And it can start early. I’m going to revisit the podcast being marketed by Peter Attia here…
This guest presented a very convincing case for the role of sedentary behaviour in the early pathogenesis. A few studies cited in the show notes that demonstrate the phenom as early as late teens and early 20s (in lean, but sedentary males with no family history of T2D). One reason why, when casting around early last year for “something” I had to be missing with regard to my dodgy lipid profile, I asked for a circulating insulin test/HOMA-IR …in spite of an A1c and fasting glucose well below the “prediabetes” cutoff.
FWIW, insulin resistance…more specifically the effects of exercise on reducing it acutely…
can be the bane of group exercise instructors, when class members “suddenly” get diagnosed with T2D and start taking themselves in hand all at once. Achieving good glycemic control with their diet and meds…and then throw a wrench in the works by introducing some high-ish intensity exercise with SPINNING classes. I wrote about my experiences in this department on the old Diabetic Fools board a few years back.
The reason and outcome of Metformin working so well in the liver is the cutting of calories the body gets as glucose. Metformin can cut glucose production by up to 30% relieving the body. Some people naturally lose weight on Metformin.
but still not evidence that T2D can be cured.
We need to get our brains in gear. There are various kinds of diseases, diseases from various origins, various pathogens, defective genes, microbes and viruses, accidents, and lifestyles. T2D is a lifestyle disease. Improve lifestyle and it goes into remission. Worsen lifestyle and it comes back. T2D cannot be cured like some other kinds of disease can. The statement “but still not evidence that T2D can be cured” is a meaningless statement.
BTW, the greatest medical advances have not been cures but prevention which creates a huge economic conundrum, preventing a disease is not nearly as profitable as life long treatment of “incurable” conditions. Individual doctors might like to cure patients but the MBAs at the Healthcare Industrial Complex have other goals uppermost in their minds.
Corn flakes is a good example of deviant thinking…
Kellogg was a Seventh-day Adventist until mid-life, and gained fame while being the chief medical officer of the Battle Creek Sanitarium, which was owned and operated by the Seventh-day Adventist Church. The sanitarium was operated based on the church’s health principles. Adventists believe in promoting a vegetarian diet, abstinence from alcohol and tobacco, and a regimen of exercise, all of which Kellogg followed. He is remembered as an advocate of vegetarianism[35] and wrote in favor of it, even after leaving the Adventist Church.[36] His dietary advice in the late 19th century discouraged meat-eating, but not emphatically so. His development of a bland diet was driven in part by the Adventist goal of reducing sexual stimulation.[37]
John Harvey Kellogg - Wikipedia.
One thing led to another, from fairly harmless corn to GMO and hybridized corn to high fructose corn syrup to Metformin and other moneymakers for the Healthcare Industrial Complex. A beautiful example of the path to Hell being paved by good intentions.
The current problem is that once a credo [meme] is institutionalized it is hard to give up. Going back to Dr. Roy Taylor of the University of Newcastle let’s do some logical thinking.
Body fat has a vital function, to store energy for times of famine. Hibernating bears and camels are great examples. Accumulating fat does not make them sick, it helps them survive. It was just as true for humans until humans developed unending streams of high calorie, addictive foods. Humans overwhelmed the energy storage capacity of the fat cells designed for the purpose. The body had to find other places to store the excess, visceral fat, fatty liver and fatty pancreas. It just so happens that the liver and the pancreas are two main organs for regulating digestion and metabolic health.
If the above is true then it should not come as a surprise that as soon as the liver and the pancreas are rid of their excess fat they can go back to doing their job properly, no matter how much fat is stored elsewhere.
The Non-Medical Captain
Absolutely nothing new in this article, but happy to see people getting excited about articles on the problem. Losing weight is good, cutting back carbs, not just calories, is better and when proper food choices are made will both help you lose weight and give your pancreas a rest from the excessive carb load it cannot handle. The typical Mediterranean Diet is too carb heavy for a type 2 diabetic. We follow a low glycemic Mediterranean TYPE diet, in other words focusing on fish for protein, (along with smaller amounts of other proteins to satisfy the soul,) nuts, seeds and low starch veggies such as cabbage, spinach, cauliflower, peppers, as well as a slew of others. Small amounts of fruit, such as berries, with small amount being the key. Simply cannot bring ourselves to limit onions, which can be surprisingly high in sugars, nor do we need to do so.
We have been doing this for around 25 years. Avoiding grains, we use riced cauliflower instead of rice, and nut flours to make our own baked goods. DH has been a Type 1 diabetic for over 50 years, and I used to have wicked carb cravings before going low carb. This way of eating has improved his control over blood sugars immensely, (his endocrinologist stating he is THE healthiest long term diabetic he has ever seen,) and made my tormenting carb cravings disappear. There is both Type 1 and 2 in DH’s family, Type 2 in mine, and I was motivated to make sure our kids were well trained food wise for their future.
Type 2 diabetes is about insulin resistance, so if you minimize the need for insulin via lowering your carbs, you will be putting less stress on the pancreas and hopefully preventing progression to Type 1, which can happen by burning out your body’s ability to produce insulin by insisting it produce more, more, more. Preserve your body’s ability to make insulin. The cost to both your health and wallet of progressing into Type 1 is high, with the answer being food choices, not lower cost for insulin, (with both being good, but avoidance better than treatment.)
IP,
having crispy skin wild salmon filet for dinner tonight
Indeed it is, when a person is accepting of the reality that what Prof Taylor (and others and by other means) have produced is remission in their patients and not cure. This wasn’t your stance initially in the first thread on Prof Taylor’s work so that’s a good clarification.
This current thread has, as its starter, a new study demonstrating something that’s also been recognised for a lot longer than the health and science writers appear to be aware of…the idea of “skinny fat” (mentioned upstream) … even though the the headlines promised a new discovery. Understandable as that’s the key to getting eyeballs on a page.
Now this study was interesting as Prof Taylor’s group is floating the hypothesis of a Personal Fat Tolerance…not an unlikely proposition when you think about it. We’re all everso slightly genetically different with varying predisposition to disease onset (or, for that matter, rude good health regardless of how much abuse a body gets).
It wasn’t everso clear in the primary document if these twenty patients had dieted themselves down to a high end “healthy” BMI…i.e had really done a number on their metabolic flexibility…or if they were like so many older middle aged folk who didn’t overeat dramatically but became steadily more sedentary and schlumpy…accepting that middle age does that to a person and tolerant of the flab and bellyfat, because…(insert whatever excuse folk use).
Thing is, though, as great as it is that it’s possible to achieve this change with “weight loss”, looking at what it took/takes…repeated spells on an 800 Cal/day diet of meal replacement drinks and a few non starchy veggies (not the Mediterranean type diet per the article…that was recommended during maintenance), I think I’d sooner get the results with more modest dietary restraint and some heavy lifting and endurance training, since it appears you have to continue to eat down to what your pancreas can handle since, per the actual study, insulin secretion remained sub optimal.
All more evidence to convince me that being proactive before there’s significant departure from healthy homeostasis is the way to go…whether you’re aware of the genetic hand you’ve been dealt or not
Edit: and per my comment that metabolically obese but “normal” weight isn’t “new” news, here’s but one review article on that topic, chosen for the date…
and here’s a more recent overview withfull article availability…
That is a myth. There is junk protein, junk carbs, and junk fats. Cutting back on calories in a reasonable way is the most valuable thing to do. Cutting out junk is right up there as important.
But carbs are not at all a problem. Regardless of hoards of people constantly believing that.
And yet I have 25+ years of experience that shows that it is not only the number of calories, but the contents of those calories, that matter. Low carb is really low glycemic and counting carbs net fiber. A low carb diet is a high fiber diet, unless you plan to eat only bacon, which I do not advise. For some of us, and yes, we are not all the same, eating high glycemic carbs triggers agonizing cravings for more carbs. I have tried low fat, 2 years vegan, (THE WORST for me, as grains triggers my cravings like there is no tomorrow,) Pritikin, Mediterranean, and just about every way of eating. Low carb really did the trick for me, as is pretty evident after 25 years of being on it.
AMEN!
That said, with insane amounts of exercise, weight was not my problem. Getting rid of the carb cravings via low carbing eliminated the constant desire to stuff my mouth and the 2 hours a day of exercise that required to keep the weight off. Am still very active, because that’s what I like, but no longer tortured at the thoughts of why I can’t resist stuffing sugar into my body, even though it’s making me feel sick. For some of us, high glycemic carbs are worse than opioids. That’s particularly true for me, because opioids simply do nothing for pain.
Our son also has the same issue with opioids not mediating pain, (which was proven in the hospital with the pain from a compound fracture of the tibia responding better to Tylenol than IV dilaudid, ) and has worse ADHD than I. Co-morbidity of depression, which often goes hand in hand with ADHD. We both found that restricting grains and sugars was huge in improving both our ability to concentrate and our depression, (not to mention staying super active, which did not change along with our diet.)
As has been mentioned on these boards before, microglia have a role in scavenging the brain, sometimes to excess and causing problems. A book titled The Angel and The Assassin indicates that sugars are often a cause of triggering microglia gone haywire, with carb restriction seeming to have a role in bringing them back into check. The book addresses all sorts of chronic conditions caused by these microglia. Sugars also have a negative role in cardiac issues, being highly oxidative.
The body is complicated. Feed it low-glycemic whole foods.
IP
More than fair enough. The measure is plenty of fiber as a marker of better carbs. I kept using the word junk for a reason.
The problem with that is it is “YOU SPECIFIC”, not necessarily valid for anyone else.
Which just means all the other “knowledge”, studies, and exhortations about diets all across the spectrum are wrong and self-cancelling for the same reasons. NO study results can be said to be applicable to any particular specimen. It’s in the nature of studies. They only apply to those to whom they apply. That’s what they need to study. "Who? " And “why” would also be nice since it pretends to be “Science” on the front end. Simply betting and thumping the table on mere study observations are what pass for science these days.
There is no one size fits all when it comes to what is best for humanity. Particularly when it comes to food. Just options for you to consider. However, remember that this thread was about diabetes, and yes, if you need to inject insulin, or are insulin resistant, you should be lowering your carbs. Dr Bernstein’s Diabetes Solution goes into a very complicated explanation of why lower carb intake will result in lower blood sugar swings for type 1s due to the rule of small errors, or something along those lines. That book is super complicated though.
That said, there are many, many books on the subject, detailing the impact of low carb on MANY people. I recommend Protein Power Life Plan, and The Life and Science of Low Carbohydrate Living. Both give a serious nod to the science, without overwhelming the non-scientist. I became a chemist with a concentration in biology because of my interest in nutrition, being tired of one book after another, written by so called experts, contradicting each other. Since I was not a blind follower of what the Gov’t decreed as beneficial, I chose to not become a nutritionist. One nutrition class was enough to know pursuing that degree would result in endless beating of my head against a brick wall.
I can’t tell you what is best for you, but you won’t find what is best for you by closing your mind off to your options. I did just that with low carb while suffering through two years of being vegan. Finally said screw this, I feel lousy, and picked up the book to see why my friend was feeling so good on low carb. Personally, I can’t stand the Atkins books. Am not the cheerleader type.
Also really like The Great Cholesterol Myth, but get the most updated version of this one. These books have been around a while and you are likely to be able to pick them up in your library. Again, get the updated version of The Great Cholesterol Myth. The understanding of the science around cholesterol is still evolving.
Well, isn’t that something that’s actually being done in these studies coming from this research group? Putting small puzzle pieces on the table in an effort to build on past work and clarify the Big Picture?
It’s a shame that these small pearls are gussied up by the press to appear bigger than they are by eyeball grabbing headlines…in the process diminishing their real value as so few readers (and even health and science writers, apparently) seem to put much effort into understanding the nuances of what these studies actually say.
Researchers themselves bear some responsibility for this Science By Press Release as they surely have some veto power over what’s disseminated by their institutions PR department. It wouldn’t hurt, though, if the end point readership put some effort into looking for and understanding the nuances missed in the articles in the press.
In this context … and for anyone interested in the topic … the old Diabetic Fools board was excellent when it came to folk reporting their personal experiences. But, alas, it is no more
It is a constant and endless battle, regardless of the field. Fortunately, I had veto power for the product line I was developing, but that is not necessarily standard. Can’t tell you how often Marketing would send me a mark up of a brochure, followed by my telling them that was NOT what my research said, followed by a much tamer representation of what they wanted approved. Was way more fun being picked apart by my peers from the competition as I presented at conferences, than dealing with Marketing. It’s harder for a researcher to protect their reputation than you would think.
Yes it is … but it’s already come along way beyond what you’ll find in The Great Cholesterol Denialism book (which, even with the superficial nod to the importance of cholesterol particles etc that Jonny Bowden attempts to make, it’s still ultimately a denial of the role of dysfunctional lipids and a hefty dose of statin phobia)
This link gives a reasonable shortish breakdown of the shortcomings of his stance
The lipidology series that a subscription to Peter Attia’s podcasts are a better bet for in depth analysis but, a) require a subscription and b) require a time investment…which I’m mighty glad I made.
Perhaps I am missing it, but when was this written? Could not find the year. This is the book I stated that you need to get the most recent publication. Significant revisions in the newest.