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Why are long standing type 2 diabetics at risk for developing type one diabetes?

Answered on August 19, 2014
Created October 16, 2011 at 5:55 PM

I'm developing a theory based upon the science I am reading, but I am wondering if anyone else here has another point of view.

I think this maybe an area where a Paleo diet may have to be re-thought.

27361737e33ba2f73ab3c25d2699ad61

(1880)

on October 17, 2011
at 03:41 PM

Maybe Dr. Rosedale will weigh in. He has undoubtedly followed many type 2 patients who via his diet have maintained tight glucose control. It would be interesting to know how many under tight glucose control progress to insulin dependency? My guess is the typical type 2 progresses to insulin dependency because they follow the ADA recs which do not result in tight glucose control for many (dare I say most) type 2 diabetics.

3c6b4eed18dc57f746755b698426e7c8

(5147)

on October 17, 2011
at 02:45 AM

Or a T2 who has burnt out his pancreas?

3c6b4eed18dc57f746755b698426e7c8

(5147)

on October 17, 2011
at 01:08 AM

Well, what do you call a LADA after the honeymoon period?

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on October 17, 2011
at 01:03 AM

I was not talking about LADA's who have their own specific issues.....I am talking about clear cut t2D that become T1D over time.

0dbd7154d909b97fe774d1655754f195

(16131)

on October 16, 2011
at 11:51 PM

Autophagy? ....

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 16, 2011
at 09:09 PM

This is my understanding too. Such that you burn out the pancreas beta cells...

6670b38baf0aae7f4d8ac2463ddc37c0

(3946)

on October 16, 2011
at 08:22 PM

Dragonfly edited The Quilt...wow!

64433a05384cd9717c1aa6bf7e98b661

(15236)

on October 16, 2011
at 06:06 PM

Someone was talking to me about this just a few days ago and explained it very well, I'll get back to you with their reasoning...

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2 Answers

6
510bdda8988ed0d4b0ec0b738b4edb73

(20898)

on October 16, 2011
at 06:01 PM

I thought (as a simple picture) type 2 is "your pancreas can't keep up with demand because you're insulin resistant" and type 1 is "your pancreas is broken and doesn't make (enough) insulin". So running your pancreas at full throttle while type 2 wears it out and it becomes type 1. There's probably a lot more to it, but I like simple physical pictures to get the initial understanding.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 16, 2011
at 09:09 PM

This is my understanding too. Such that you burn out the pancreas beta cells...

0
3c6b4eed18dc57f746755b698426e7c8

on October 17, 2011
at 12:57 AM

Quilt, as much as 25% of T2 diabetics are T1.5s or LADAs. That's because their doctors didn't bother to test for T1 antibodies, unless they look obviously thin or T1 diabetes run in their family. So some of them are just misdiagnosed and eventually have to go on insulin. (Now, it's also possible for such people to test negative initially and test positive later.) These people's diabetes are driven by autoimmunity, just like T1s, only that they have a longer honeymoon period, and do not start administering insulin while they're juveniles. The issue is not so much insulin resistance (high insulin) as insulin depletion (low C-Peptide and low insulin) for these people. How do these people know? Unless you have a dedicated endo, you won't know: you will know when, overnight, you lose BG control and your fasting is at 200, even though you're ketogenic. Then, you start scratching your head and go to your endo and he tests u and your C-Peptide or Insulin has hit rock bottom.

Obviously, some T2s go on insulin because of the pancreas burn out, as the 70% beta cell decimation upon T2 diagnosis progresses ever closely to 100%. This is a progressive disease, so if you can "stop the progression", as your beloved Dr. Neal Barnard says, you've "reversed diabetes." Also, some T2s go on insulin voluntarily to "preserve their beta cells", not because they're under autoimmune attack but either they can't abide by a low-carb diet or they think pancreas is close to being burnt out.

Now, the open issue is that these are just assumptions. We still do not know whether the so called beta cells are simply dormant or dead. U start reading some emerging research out of Israel and u will realize that it may be possible to "revive" these beta cells that are presumed dead. Or read some research out of UK regarding HCG diet being administered to fledgling T2s, and it may be possible to restore functionality to some beta cells.

My hunch: they're not "dead". It's possible to bring them back. And our BG control is not at the mercy of the depleting pancreatic beta cells. We just don't know how to revive them. Going back to your original query, T2s do not have to become insulin-dependent or T1s. But some T2s were never T2s to begin with. That's the reality of the situation because of the national shortage of endocrinologists and untrained internists treating diabetics.

3c6b4eed18dc57f746755b698426e7c8

(5147)

on October 17, 2011
at 02:45 AM

Or a T2 who has burnt out his pancreas?

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on October 17, 2011
at 01:03 AM

I was not talking about LADA's who have their own specific issues.....I am talking about clear cut t2D that become T1D over time.

3c6b4eed18dc57f746755b698426e7c8

(5147)

on October 17, 2011
at 01:08 AM

Well, what do you call a LADA after the honeymoon period?

27361737e33ba2f73ab3c25d2699ad61

(1880)

on October 17, 2011
at 03:41 PM

Maybe Dr. Rosedale will weigh in. He has undoubtedly followed many type 2 patients who via his diet have maintained tight glucose control. It would be interesting to know how many under tight glucose control progress to insulin dependency? My guess is the typical type 2 progresses to insulin dependency because they follow the ADA recs which do not result in tight glucose control for many (dare I say most) type 2 diabetics.

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