This evidence suggests that type 2 diabetes does not have to be a progressive

[madyogi]

It is circulatory disease.

I think of T2 Diabetes as a metabolic disease/disorder. The circulatory system is involved, but it's probably more accurate to say it's a problem with the regulation of blood sugar, which is a metabolic (converting raw materials into energy) function. The actual "insulin resistance" is pervasive and occurs in cells of tissues like muscles, fat, liver, etc. Those cells don't take the cues from normal insulin production to turn blood sugar into energy, so (as others have pointed out) excess sugar builds up in the circulatory system, which can create all kinds of havoc.

 

[not2big]

Technically, diabetes is a disease of the endocrine system. The endocrine system controls the release of various Secretions such as hormones, including insulin. As Yogi mentioned, one of the functions of insulin is to aid in metabolism.

 

[CUSP82]

To emphasize as a circulatory disease is important. I know a lot of guys with diabetes and as they're on their 4th piece of cake and I remind them they're diabetic they just tell me they won't eat sweets the next day. When I explain to them that it's a circulatory disease and having that high sugar going through the bloodstream kind of rots out the plumbing they understand better.

 

[madyogi]

To emphasize as a circulatory disease is important. I know a lot of guys with diabetes and as they're on their 4th piece of cake and I remind them they're diabetic they just tell me they won't eat sweets the next day. When I explain to them that it's a circulatory disease and having that high sugar going through the bloodstream kind of rots out the plumbing they understand better.

If that's effective as a deterrent, great. Keep it up. It's just not technically accurate.

The blood sugar building up in the circulatory system isn't really a problem with the circulatory system per se. It's a problem with other tissues not responding properly to the insulin signal (or in the case of T1, no insulin signal to begin with).

I'm not trying to be difficult, but accuracy is important to me. You could simply adjust the language by saying the disease wrecks your circulatory system and talk about plumbing from there, without having to say it's "a circulatory disease." But again, whatever works.

 

[not2big]

The side effect of diabetes not under control is too much sugar in the circulatory system. Excess sugar in the blood system has long term effects as detailed in my previous posts.The diabetic guy eating four services of cake on a regular basis will Eventually suffer with those Side effects.

I have been known to Occasionally eat a second slice of cake; however. I can Bolus enough insulin to Compensate for the resulting Increased blood sugar.

 

[Pegasus]

[FONT=&quot]But the use of fasting to treat diabetes is relatively new.[/FONT]
[FONT=&quot]The idea has been popularized internationally by Dr. Jason Fung – a nephrologist (kidney specialist) at Scarborough Hospital and medical director of the Intensive Dietary Management Clinic in Toronto.[/FONT]
[FONT=&quot]Through a series of books and YouTube videos, Dr. Fung has attracted loyal followers who are convinced he has the answer to their diabetes problems.[/FONT]
[FONT=&quot]Dr. Fung says he decided to experiment with intermittent fasting because he was frustrated seeing so many diabetic patients with kidney failure. “It occurred to me that fasting was an underutilized therapeutic option for losing weight,” he recalls. “I started doing this five years ago, and a lot of people got incredibly good results – it reversed their diabetes.”[/FONT]
[FONT=&quot]Type 2 is the most common form of diabetes accounting for 85 to 90 per cent of cases. It usually develops later in life and it’s often associated with being overweight.[/FONT]
[FONT=&quot]A major feature of the disease is a condition known as insulin resistance. Insulin is a hormone that moves glucose (sugar), from the bloodstream into the body’s cells where it is used for energy. For a variety of reasons that are not fully understood, the body’s tissues don’t respond adequately to insulin and glucose then becomes elevated in the bloodstream.[/FONT]
[FONT=&quot]Poorly controlled blood-sugar levels can lead to a host of medical complications, increasing the risk of heart attack, stroke, kidney failure, blindness and limb amputation.[/FONT]
[FONT=&quot]Diabetes is often treated with medications to make the body more responsive to insulin. Some patients also take additional insulin to top up the amount produced by their own bodies.[/FONT]
[FONT=&quot]Dr. Fung believes the medical community “has been treating type 2 diabetes incorrectly.” In particular, he argues, that the medications used to clear sugar from the bloodstream end up overstuffing cells with glucose, which gets turned into fat. “Even if your blood-sugar gets better, you gain weight and your diabetes is only getting worse.”[/FONT]
[FONT=&quot]According to Dr. Fung, cells are insulin resistant because they are already filled to the maximum with glucose. He compares insulin resistance to a suitcase that’s packed full of clothes. You can’t get more clothes in without taking some out, he explains.[/FONT]
[FONT=&quot]“Periods of fasting allow the body to burn off the excess sugar and then the cells become responsive to the insulin once again.”[/FONT]
[FONT=&quot]He also encourages patients to modify their diets, by cutting back on refined carbohydrates – such as bread and pasta made from white flour – which the body quickly converts into glucose and by adding healthy fats found in avocadoes, nuts and olive oil.[/FONT]
[FONT=&quot]Once glucose stores are depleted, which happens after prolonged fasting, the body shifts to burning fat for fuel.[/FONT]
[FONT=&quot]By fasting regularly, he says, patients tend to lose weight, their insulin resistance is overcome, and they can cut back or even stop taking their diabetes medications.[/FONT]
[FONT=&quot]“Type 2 Diabetes is an entirely reversible disease,” he insists, challenging the traditional notion that’s a chronic and often progressive condition.[/FONT]
[FONT=&quot]Despite his unconventional views, Dr. Fung is winning some converts in the medical profession. “It’s not for everybody, but if someone is motivated, it sure makes sense as a way to lose weight,” says Dr. Martin Strauss, a cardiologist at North York General Hospital.[/FONT]
[FONT=&quot]Over the past two years, Dr. Strauss, who is also an assistant professor at the University of Toronto, says he has referred about 50 patients to Dr. Fung for treatment. “I would say 30 to 40 per cent of them stick with it.”[/FONT]
[FONT=&quot]Dr. Fung agrees that not everyone will succeed at intermittent fasting. He also notes that patients need medical supervision – especially if they are taking diabetes medications. The doses of their drugs will likely need to be adjusted over time.[/FONT]
[FONT=&quot]He says patients with diabetes should at least give it a try. “If you don’t like it, or you feel unwell, you can stop immediately.”[/FONT]
[FONT=&quot]But most doctors are unlikely to recommend intermittent fasting without more scientific evidence that it can produce lasting results.[/FONT]
[FONT=&quot]“We need a proper study with enough patients for a long duration of time to really prove whether this is safe and effective – or harmful,” says Dr. Jeremy Gilbert, an endocrinologist at Sunnybrook Health Sciences Centre in Toronto.[/FONT]
[FONT=&quot]“All diets work in the short-term, but it’s the maintenance phase that’s so difficult,” he says.[/FONT]
[FONT=&quot]There is a risk that those who attempt it and fail could end up worse off, speculates Annie Hoang, a registered dietitian at Sunnybrook. An individual’s metabolism might switch into “starvation mode,” reducing the amount of energy needed at rest, she explains. That means some patients could regain all the weight they lost – and more – if they stop doing intermittent fasting.[/FONT]
[FONT=&quot]Dr. Fung argues that won’t happen.[/FONT]
[FONT=&quot]Whatever the case, Dr. Gilbert says, “this diet has some extreme components some of which makes sense, but it’s not clear how many people can actually do what he (Dr. Fung) is recommending indefinitely.”[/FONT]

 

[Pegasus]

So here is a central concept I would like to discuss.

Quote
According to Dr. Fung, cells are insulin resistant because they are already filled to the maximum with glucose. He compares insulin resistance to a suitcase that’s packed full of clothes. You can’t get more clothes in without taking some out, he explains.

 

[Pegasus]

So here is a central concept I would like to discuss.

Quote
According to Dr. Fung, cells are insulin resistant because they are already filled to the maximum with glucose. He compares insulin resistance to a suitcase that’s packed full of clothes. You can’t get more clothes in without taking some out, he explains.

If the above is correct then that leads to this .
Quote
Diabetes is often treated with medications to make the body more responsive to insulin. Some patients also take additional insulin to top up the amount produced by their own bodies.
Dr. Fung believes the medical community “has been treating type 2 diabetes incorrectly.” In particular, he argues, that the medications used to clear sugar from the bloodstream end up overstuffing cells with glucose, which gets turned into fat. “Even if your blood-sugar gets better, you gain weight and your diabetes is only getting worse.”
Unquote \
So in this scenario diabites 2 is progressive and incurable.

 

[Pegasus]

So the medical people sem to be going with the idea that complete remission for 5years is operationaly a cure .

Quote
[FONT=&quot]Remission of type 2 diabetes could be attained, for example, after bariatric/metabolic surgery or with lifestyle efforts such as weight loss and exercise. Nondiabetic glycemia resulting from ongoing medications or repeated procedures (such as in the dynamic phase of band adjustment after laparoscopic gastric banding) would not meet the definition of remission, as these interventions are considered treatment. Remission can be considered an outcome of devices (e.g., gastric banding, endoluminal devices) only after the patient has achieved a steady state and no longer requires repeated adjustments and/or replacements of the device. For type 1 diabetes, remission could potentially be attained after immune modulating or islet-replacement therapies that do not require ongoing immunosuppression but not with transplants that require ongoing immunosuppression or future therapies such as an implanted artificial pancreas.[/FONT]
[FONT=&quot]Prolonged remission is complete remission that lasts for more than 5 years and might operationally be considered a cure. The 5-year period was chosen arbitrarily, since there are no actuarial data indicating the likelihood of relapse over various periods of time from the onset of normoglycemia. It is recognized that the risk of relapse likely remains higher for people with diabetes in remission than for age-, sex-, BMI-, and ethnicity-matched individuals who have never had diabetes.[/FONT]

 

[not2big]

According to a study in coordination with Johns Hopkins. the “mechanics“ of insulin resistance is very complex but essentially a result of excess sugar attaching itself to specific proteins inside liver, muscle and fat cells. [FONT=&quot]The scientists found that at least two proteins involved in passing along insulin's message were unlikely to work properly when coated in extra sugar. According to the study, when excess sugar Is coated on the specific protein controlling the conversion of sugar into either energy or stored as fat, the protein can’t receive the message delivered by insulin so when sugar is introduced into the blood by the liver in the form of glucosamine, some of it tends to remain in the blood where it can cause havoc.

For many T2s, diet and probably fasting can reduce the amount of sugar/glucosamine coating on the special proteins such that they can now receive the appropriate messages Delivered by the insulin produced by the pancreas.

[/FONT]

 

[Pegasus]

So here is a central concept I would like to discuss.

Quote
According to Dr. Fung, cells are insulin resistant because they are already filled to the maximum with glucose. He compares insulin resistance to a suitcase that’s packed full of clothes. You can’t get more clothes in without taking some out, he explains.

Ok so according to Fung the excess blood sugar is caused by the body stores being constantly full . This results in constant overflow into the blood stream stressing the insulin system over long periods of time leading to system breakdown . Of course some people system are more robust or fragile depending on genetics etc .

The implications are straightforward and 2 fold firstly the body stores can be lowered and second the amount of sugar reaching the blood can be limited in total amount and by speed .

 

[boof]

Hello

I've been type 1 diabetic for over 20 years and have tried almost every diet and exercise program I could come across. I thought I would explain what works for me. My HbA1c has been consistently at 5.8% for years now.

For Diet
Carb: Carbs pretty much just get converted into blood glucose. Can get into low GI etc but in the end it doesn't really matter. Any carbohydrate will impact blood sugar (same for all those ingredients in so called health bars that end in "ol", "ose", "ace".
Protein: Some does get converted into blood glucose, but it is really slow.
Fat: No impact on blood glucose.

The key for me was to extremely limit carbohydrate intake and only get carbs through fibrous vegetables (leafy greens, cabbage, etc). Also not over stuffing myself in each meal helps a lot. I've gone as low as zero carb but my sweet spot is around 30-50g a day.
Eat some protein (it will have fat in it).
Have some healthy fat.
More or less a healthy low carb/keto type diet.

Eating this way also reduces the error in calculating how much medication to take per meal. The more carb's that are in a meal, the more medication. There is a a higher chance for error here. More error = larger swings in blood sugar.

Exercise
A walk every day is key (30 - 60 mins). Walking after meals also helps.
A mixture of strength training and cardio seems to be perfect. No HIIT type training - that seems to just increase blood glucose. Slow and steady Maffetone/LSS type cardio. But again, nothing too crazy, strength and cardio sessions tend to last for 30-60 mins.

I think it goes without saying that any extra weight on my body makes it more difficult to manage sugars. So not being overweight has also helped, that required the weighing of food (and cutting down on food) for a while. But most people eat way more than they need anyway, diabetic or not.

Stress
Limiting stress as much as possible has also helped. Sleeping 7-9 hrs helps with that, so does the walk each day. Also when work/family etc is stressful then the workout that was barbell training gets changed to body weight training which is a lot less stressful on the body but still gets a workout in.

There are a few doctors out there who have success with themselves and their patients. Dr Bernstein and Dr Runyan are two that seem to have good results.

Anyway that is what works for me.

 

[Pegasus]

thanks for the input boof

 

[Pegasus]

So what are the thoughts on lowering body stores through exercise?

 

[not2big]

Exercise is a primary technique to reduce excess blood sugar along with taking steps to improve diet.

 

[boof]

Exercise does help to lower blood glucose (very intense exercise does raise it though - my understanding is the body reacts to high intensity exactly the same as a high stress response and the liver releases a lot of stored glucose to help with energy). I think this is predominantly due to the muscles needing some glucose for repair/energy.

That being said if the diet is full of carbohydrate then the amount of glucose used in exercise will be completely offset by the amount of sugar being ingested. I've been told by a good trainer (who trains people for marathons, triathlons etc) that unless I've done a minimum 2hr cardio/exercise session (likely not walking) then I've not earned any carbohydrate apart from what is in low carb fibrous vegetables (that was not from a diabetic point of view either). Whatever is behind that statement may point to how much exercise is actually needed to lower body stores - but eating carbohydrate after would bring those stores back up?

 

[not2big]

When I was swimming laps daily and injecting insulin, I noticed that after 20 minutes of swimming, my blood sugar started increasing. After 30 minutes, it would peak and level off And after 45 minutes it would begin to decline.If I Continued for an hour, I would have to consume carbs in order to bring it back up to a normal level.

 

[Pegasus]

Hmm .

Ok so Fung uses diet to lower body stores and he uses fasting . It seems to me this is also a blunt instrument and a combination of diet and training could be used .

 

[Pegasus]

I thought this might be worth reading for those interested .

https://www.pegym.com/forums/exercise-health-forum/131558-energy-substrate-useage.html?highlight=

 

[Pegasus]

So does this sound right?
Quote?

According to Iowa State University, a healthy adult body can store about 500 grams of carbohydrate. Skeletal muscles store about 400 grams or glycogen, the liver stores 90 to 110 grams of glycogen and your blood circulates roughly 25 grams as glucose.Nov 30, 2017