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#1
Old 12-22-2013, 01:08 AM
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Is adult-onset diabetes always linked to obesity? (I have type II, aka the "fat and forty" one)

Returned to this question by a current thread on fat people surviving longer on a desert island, particularly:

http://boards.academicpursuits.us/sdmb/...1&postcount=11

Quote:
Quote:
Originally Posted by Vaevictis
I thought when the body self-cannibilizes it dips into muscle more and faster than fat. But I learned that a long time ago, maybe someone can enlighten me? I learned this as the reason a fat person does not get a real advantage in a starvation scenario.
The body generally uses for energy, in order: eaten sugars, eaten complex carbohydrates, eaten fat, stored carbohydrates in the form of glycogen, stored fat, eaten protein and finally stored protein. It will use stored protein if it has to, but because of the number of molecular bonds it has to break to do so, it's metabolically expensive, using up more energy (than other sources) to get energy.

If the body needs amino acids to build new cells or hormones it will break down stored protein to get them. But again, it's easier for your body to make them from food, so as long as you're eating, those proteins will be used preferentially....
I've heard different answers and can't remember the reasons given.


ETA: That's some pretty fine quotin', if I do say so myself.
ETA2: Must remember to start thread in ATMB about why the heck it's so hard to do nested quotes here.
ETA3. It's by WhyNot.

Last edited by Leo Bloom; 12-22-2013 at 01:11 AM.
#2
Old 12-22-2013, 01:18 AM
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No, it isn't. Some Type 1 diabetics are adult-onset, although in adults, the onset is usually much less dramatic than in children or teenagers; in children, it can come on in a matter of hours, whereas adults can develop symptoms over days or even weeks.

There's one subtype that some people have dubbed "Type 1 1/2" because it's not related to obesity, and people who have it use a combination of oral antidiabetic drugs and insulin for optimal control. I've seen it in people as young as their early 20s, and this woman was actually underweight.

Gestational diabetes, which can indicate a predisposition to Type 2 diabetes later in life, is not related to obesity as much as it is to maternal age. The older the woman, the more likely she is to have it, although teenage mothers are not exempt from it. It usually goes away when the baby is born.
#3
Old 12-22-2013, 03:00 AM
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My mother was diagnosed as Type 2 when she was in her 60s. She was petite and somewhat underweight.
#4
Old 12-22-2013, 05:08 AM
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My spouse is considered Type II. He was diagnosed after a bout of pancreatitis that destroyed a good piece of his pancreas. What's left apparently works just fine, there's just not enough of it to entirely do the intended job. No one is sure why he came down with the condition - he entirely lacks the two biggest risk factors: alcoholism and gallstones. Nor is he obese. The only explanation is "sometimes it happens and we don't know why".
#5
Old 12-22-2013, 05:53 AM
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My wife is Type 1, which used to be called juvenile diabetes. For Type 2 / Adult-Onset, it is predominantly caused by obesity but that's not the only cause, as others have already said. Genetics and gender can contribute to the cause of Type 2, and even a lack of sleep and its effect on metabolism.

From https://en.wikipedia.org/wiki/Diabet...pe_2#Genetics:

Quote:
Most cases of diabetes involve many genes, with each being a small contributor to an increased probability of becoming a type 2 diabetic.
... and ...

Quote:
As of 2011, more than 36 genes have been found that contribute to the risk of type 2 diabetes.
#6
Old 12-22-2013, 06:29 AM
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An asthmatic Doper recently mentioned inhaled corticosteroids were causing diabetic symptoms. The further discussion seemed to indicate that these results can be permanent with continued use.
#7
Old 12-22-2013, 07:31 AM
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Quote:
Originally Posted by Broomstick View Post
My spouse is considered Type II. He was diagnosed after a bout of pancreatitis that destroyed a good piece of his pancreas. What's left apparently works just fine, there's just not enough of it to entirely do the intended job. No one is sure why he came down with the condition - he entirely lacks the two biggest risk factors: alcoholism and gallstones. Nor is he obese. The only explanation is "sometimes it happens and we don't know why".
This is very very similar to me. I had a bout of pancreatitis (again, no known cause - possibly genetic) about a decade ago, and it apparently kept up on a slow, asymptomatic burn until my pancreas had almost completely shriveled up and died. In my case, though, I'm much more like type I, because my pancreas is essentially completely gone and not making anything.

My doctor said that technically, I'm not considered type I or type II. To be "real" type I, you need to have the autoimmunity that is what usually causes it.

So, anyway, I am a case of adult-onset diabetes that is not type II or linked to obesity.

Last edited by Smeghead; 12-22-2013 at 07:31 AM.
#8
Old 12-22-2013, 09:08 AM
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You might be interested in this past thread.

12% of newly diagnosed diabetics have a "normal" BMI at diagnosis. They have a distinctly worse prognosis than those who are overweight or obese at diagnosis, a situation sometimes referred to as "the obesity paradox."
#9
Old 12-22-2013, 09:33 AM
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As has already been amply said, but I'll back up with more anecdotal evidence: No, DMII is not always linked to obesity, but if you're a betting man, that's the way to bet.

I wasn't aware that the prognosis was poorer, but it doesn't surprise me much. It seems that my normal or underweight by BMI patients with DMII (I've had five, out of a couple hundred patients with DMII) have a lot more difficulty with blood sugar control, even when they eat "right." And they just cannot seem to "cheat" like the obese patients can - even a little splurging sends their sugars wonky, and they report a greater number and more bothersome symptoms of hypoglycemia at higher numbers than obese patients, and also a greater number and more bothersome symptoms of hyperglycemia at lower numbers. So it's harder for them to stay in their safe window, and that window is smaller. Major suckage. Major anecdotal suckage, I hasten to reinterate. I don't know if studies have looked at or borne out my "narrowed window" hypothesis.

On the other hand, at least most of them can get their own shoes on to protect their feet, and can look at their feet to pay attention to and keep an eye on any cuts or nicks they get. The obese patients often have trouble physically reaching their feet for diabetic foot exams, and that's bad for keeping all your limbs.
#10
Old 12-22-2013, 11:24 AM
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On top of that, the disease process can often be reversed if an obese person loses enough weight (although how often does that happen? Essentially never). A person who's of normal or under-weight doesn't have that option.
#11
Old 12-22-2013, 12:41 PM
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My mom was diagnosed with Type II when she was in her mid 40s and she told me it was because her pancreas had been producing too much insulin and then suddenly stopped. I have no idea, I was around 17 then and didn't do much research on it. Is something like that possible? I could try looking that up. She's not obese, but does have fat in her abdominal area which is know is considered to be worse than having a more even distribution of fat.
#12
Old 12-22-2013, 02:15 PM
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Suddenly? No. But inexorably, yes.

You describe her as what are clearly one segment of those referenced in my post above - metabolically obese normal weight (MONW); overlapping with thin outside fat inside/skinny fat - BMI may be fine, percent body fat even possibly (although often not) but the where they have their fat is intra-abdominal including in the liver. That pattern is associated with increased and increasing insulin resistance. Consequently the pancreas has to produce more and more insulin to keep blood sugar in range and eventually it can't keep up and at some point after that begins to burn out. Maybe she progressed from "can't keep up" to "burn out" pretty quickly.

It is not clear that all MONW have central fat with normal BMI but clearly it is at least a common pattern.
#13
Old 12-22-2013, 04:00 PM
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Unless I missed it, why again is fat around the belly different than fat around your butt/thighs, say, different as far as your endocrine system cares?
#14
Old 12-22-2013, 04:15 PM
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I was diagnosed with Type 1 at age 38, and the doctor who eventually diagnosed me told me she'd diagnosed people in their 80s with Type 1. So no, it's not always linked to obesity.

Also relevant: although I was a regular exerciser, ate fewer carbs and more vegetables than they told me a diabetic should, and had a BMI of around 24, I was first diagnosed as Type 2. I've also talked to more than a few fit, thin Type 2s. It happens.

Quote:
Originally Posted by WhyNot View Post
It seems that my normal or underweight by BMI patients with DMII (I've had five, out of a couple hundred patients with DMII) have a lot more difficulty with blood sugar control, even when they eat "right." And they just cannot seem to "cheat" like the obese patients can - even a little splurging sends their sugars wonky, and they report a greater number and more bothersome symptoms of hypoglycemia at higher numbers than obese patients, and also a greater number and more bothersome symptoms of hyperglycemia at lower numbers. So it's harder for them to stay in their safe window, and that window is smaller. Major suckage. Major anecdotal suckage, I hasten to reinterate. I don't know if studies have looked at or borne out my "narrowed window" hypothesis.
Are you/they sure they're Type 2? I ended up having to go to Joslin Diabetes to get my proper diagnosis. What I dealt with in the 6 month prior to that was very much like you describe: I was on Lantus (long acting insulin, for those who don't know. 1 shot a day). and Metformin, yet still could not eat more than about 10 carbs at a time without having a major spike in blood sugar that took forever to get down. It was even worse pre-Lantus. I had a strong feeling I'd been misdiagnosed, so managed it by just not eating carbs until I could get to a specialist.

Anyway, the point I was trying to make is that once I got to Joslin, they told me they saw lots & lots of people who were diagnosed incorrectly. Most docs don't see ketones and immediately say "Type 2", but it's more subtle than that, according to the Endos at Joslin.
#15
Old 12-22-2013, 04:29 PM
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Quote:
Originally Posted by Leo Bloom View Post
Unless I missed it, why again is fat around the belly different than fat around your butt/thighs, say, different as far as your endocrine system cares?
Here's an excerpt from the Wikipedia article on abdominal obesity:

Quote:
There are numerous theories as to the exact cause and mechanism in Type 2 Diabetes. Central obesity is known to predispose individuals for insulin resistance. Abdominal fat is especially active hormonally, secreting a group of hormones called adipokines that may possibly impair glucose tolerance.

Insulin resistance is a major feature of Diabetes Mellitus Type 2 (T2DM), and central obesity is correlated with both insulin resistance and T2DM itself.[43][44] Increased adiposity (obesity) raises serum resistin levels,[45][46][47][48] which in turn directly correlate to insulin resistance.[49][50][51][52] Studies have also confirmed a direct correlation between resistin levels and T2DM.[45][53][54][55] And it is waistline adipose tissue (central obesity) which seems to be the foremost type of fat deposits contributing to rising levels of serum resistin.[56][57] Conversely, serum resistin levels have been found to decline with decreased adiposity following medical treatment.[58]
#16
Old 12-22-2013, 04:35 PM
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By the way, if you do a Google image search for "obesity" and "diabetes risk," you will see pictures which show a pretty strong relationship between obesity and diabetes. And which seem to bear out what Whynot said about the odds.
#17
Old 12-22-2013, 07:05 PM
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It may even be that subcutaneous fat, at least the superficial componant of it (SSAT), compared to the deeper subcutaneous componant (DSAT) is protective, resulting in total subcutaneous fat as neutral. Apparently subcutaneous fat outside the fascia superficialis is specifically associated with lower risks. The person with washboard abs is not the ideal from the health perspective.

Who knows if the compounds that the Wiki article are the whole story or not? I'd doubt it. What we can say is that we have to think of fat tissue as part of, a huge part of, the endocrine system. And different adipose tissue behaves differently in that role. Different portions of adipose tissue respond differently to different stimuli (foods, exercise, etc.), produce different stuff, so on.
#18
Old 12-22-2013, 08:42 PM
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Quote:
Originally Posted by DSeid View Post
It may even be that subcutaneous fat, at least the superficial componant of it (SSAT), compared to the deeper subcutaneous componant (DSAT) is protective, resulting in total subcutaneous fat as neutral. Apparently subcutaneous fat outside the fascia superficialis is specifically associated with lower risks. The person with washboard abs is not the ideal from the health perspective.

Who knows if the compounds that the Wiki article are the whole story or not? I'd doubt it. What we can say is that we have to think of fat tissue as part of, a huge part of, the endocrine system. And different adipose tissue behaves differently in that role. Different portions of adipose tissue respond differently to different stimuli (foods, exercise, etc.), produce different stuff, so on.
Everything you say here is amazing and ignorance fought.

Also, just to be clear--to myself also, because I was starting to forget--the "fit/not fit" thing we're talking about is the predispositive case. Getting fit, ie exercising, hasn't nearly so many open questions.

Ummm, right?
#19
Old 12-22-2013, 09:06 PM
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Not sure if I understand the question but there is no question that regular exercise makes DM easier to control and helps delay or even prevent it by several means -

Within a period of time it increases insulin sensitivity (and needs to be kept up regularly to do that).

Over time it changes body composition, increasing fat free mass and preferentially decreasing visceral abdomninal fat.

It lowers the risk of a host of potential complications and comorbidities of diabetes.

Odds are a combination of both aerobic and resistance exercise is most effective in treating, delaying and preventing T2DM. Details here.

A recent BMJ article put it into some perspective:
Quote:
Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study
... Across all four conditions with evidence on the effectiveness of exercise on mortality outcomes (secondary prevention of coronary heart disease, rehabilitation of stroke, treatment of heart failure, prevention of diabetes), 14 716 participants were randomised to physical activity interventions in 57 trials. No statistically detectable differences were evident between exercise and drug interventions in the secondary prevention of coronary heart disease and prediabetes.
NYT had a nice summary of it.
Quote:
The results consistently showed that drugs and exercise produced almost exactly the same results. People with heart disease, for instance, who exercised but did not use commonly prescribed medications, including statins, angiotensin-converting-enzyme inhibitors or antiplatelet drugs, had the same risk of dying from — or surviving — heart disease as patients taking those drugs. Similarly, people with diabetes who exercised had the same relative risk of dying from the condition as those taking the most commonly prescribed drugs.
(Bolding mine.)

You gotta exercise. Gotta gotta gotta. Don't worry about the scale as the goal. The exercise itself is key to control your diabetes, as important as medicine is.
#20
Old 12-22-2013, 09:11 PM
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Well, $360 ago I signed up for monthly membership at a gym after the most recent time the riot act was read to me by my endocrinologist. It would have been simpler, and I would have gotten more exercise, to walk past it once a month and tear up a $50 and four $10s.

His office just called, coincidentally. Time to face the music again.

Last edited by Leo Bloom; 12-22-2013 at 09:12 PM.
#21
Old 12-22-2013, 09:25 PM
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You don't need a gym membership. You need to exercise.

Jumping jacks, burpees, jumping rope. Fill up some old plastic gallon milk bottles with water and do squats holding them, or thrusters (that's just holding the bottles by the handles against your chest, squating down and in one motion explode up and thrust the bottles over your head, squat repeat.) You don't need to spend lots of money; just a fairly small amount of time.
#22
Old 12-23-2013, 11:55 AM
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... burpees?
#23
Old 12-23-2013, 12:04 PM
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Originally Posted by purplehorseshoe View Post
... burpees?
Burpees
#24
Old 12-23-2013, 12:04 PM
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Article about virus link to diabetes:

http://sciencedaily.com/releases...1022091721.htm
#25
Old 12-23-2013, 03:26 PM
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Quote:
Originally Posted by Leo Bloom View Post
--the "fit/not fit" thing we're talking about is the predispositive case. Getting fit, ie exercising, hasn't nearly so many open questions.

Ummm, right?
Quote:
Originally Posted by DSeid View Post
Not sure if I understand the question...
It took a bit but I think I understand what confused me about your question. The fit/not fit that you initially refer to is about weight and how the normal weight individuals with a new diagnosis have a worse prognosis than those who are overweight or obese at diagnosis! I didn't get that because to me those who are normal weight are not necessarily fit and those who are fat may be fit.
#26
Old 12-23-2013, 04:52 PM
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Quote:
Originally Posted by DSeid View Post
It took a bit but I think I understand what confused me about your question. The fit/not fit that you initially refer to is about weight and how the normal weight individuals with a new diagnosis have a worse prognosis than those who are overweight or obese at diagnosis! I didn't get that because to me those who are normal weight are not necessarily fit and those who are fat may be fit.
Yes, thanks for both your interest, and for your explanation, which adds another fact against ignorance.

To be even simpler, my thought was even before that, pre-diagnosis: "aah, you're fat and forty, you're gonna get diabetes." That epidemiological kettle of fish.
#27
Old 12-28-2013, 04:03 AM
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Well at least one study found that diet and exercise did not help Type 2 diabetics:

http://nytimes.com/2012/10/20/he...ics.html?_r=1&

Quote:
The study randomly assigned 5,145 overweight or obese people with Type 2 diabetes to either a rigorous diet and exercise regimen or to sessions in which they got general health information. The diet involved 1,200 to 1,500 calories a day for those weighing less than 250 pounds and 1,500 to 1,800 calories a day for those weighing more. The exercise program was at least 175 minutes a week of moderate exercise.

But 11 years after the study began, researchers concluded it was futile to continue —the two groups had nearly identical rates of heart attacks, strokes and cardiovascular deaths.
#28
Old 12-28-2013, 09:39 AM
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Quote:
Originally Posted by Leo Bloom View Post
Unless I missed it, why again is fat around the belly different than fat around your butt/thighs, say, different as far as your endocrine system cares?
To add to what's already been said, I'll offer two (more) 'explanations':

(as background, please note that when people use the term "fat", they are actually referring to triglycerides)

1. Fat (triglycerides) around the belly is inherently more metabolically active than fat around the hips (e.g. although tough to do, you can lose fat around your belly by "lifestyle measures" whereas once fat is deposited around the hips, it is almost impossible to lose).

By "metabolically active", I am referring specifically to the equilibrium that exists between fat (i.e. triglyceride) and its breakdown components called fatty acids and glycerol (here is a clear picture).

So, fat (triglyceride) around the belly is constantly breaking down into its core constituents of fatty acids and glycerol, but fat (triglyceride) around the hips tends not to breakdown nearly as much and thus doesn't produce as much fatty acids and glycerol.

But here's the thing: fatty acids released from fat, as occurs from fat in the belly, leads to insulin resistance and also signals the liver to start making sugar. In other words, it's a double whammy - insulin is made less effective by fatty acids and fatty acids also signal the liver to produce sugar. The net effect is a tendency to high blood sugar. (Fatty acids also have other effects which, as you guessed, also lead to high blood sugar).

2. Not only is belly fat more likely to generate the sugar-elevating fatty acids than hip fat, but any fatty acids so released tend to go directly to the liver, with the liver being a central player is sugar metabolism. Phrased differently, even if hip fat did break down into fatty acids to the same extent as belly fat, any fatty acids so released would not go directly to the liver and thus have a more modest impact on sugar metabolism - i.e. belly fat 'drains' into the liver but hip fat drains away from it. (For those with a physiological background, belly fat drains into the portal system, but hip fat goes systemically).

Last edited by KarlGauss; 12-28-2013 at 09:42 AM.
#29
Old 12-28-2013, 10:01 AM
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Originally Posted by CatherineZeta View Post
My mom was diagnosed with Type II when she was in her mid 40s and she told me it was because her pancreas had been producing too much insulin and then suddenly stopped. I have no idea, I was around 17 then and didn't do much research on it. Is something like that possible? I could try looking that up. She's not obese, but does have fat in her abdominal area which is know is considered to be worse than having a more even distribution of fat.
Sounds like she may have had polycystic ovary syndrome. The disease process with that involves the pancreas dumping too much insulin, until eventually it burns itself out. It's incidental that insulin is so similar to an ovulation-inducing hormone that it binds to the same receptors and interferes with ovulation, though that's usually the symptom that gets women diagnosed.
#30
Old 12-28-2013, 11:27 AM
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By the way, if anyone wants to learn more about the relationship between fatty acids and (rising) blood glucose levels, it's described by the Randle Cycle.
Quote:
Originally Posted by me View Post
To add to what's already been said, I'll offer two (more) 'explanations':

(as background, please note that when people use the term "fat", they are actually referring to triglycerides)

1. Fat (triglycerides) around the belly is inherently more metabolically active than fat around the hips (e.g. although tough to do, you can lose fat around your belly by "lifestyle measures" whereas once fat is deposited around the hips, it is almost impossible to lose).

By "metabolically active", I am referring specifically to the equilibrium that exists between fat (i.e. triglyceride) and its breakdown components called fatty acids and glycerol (here is a clear picture).

So, fat (triglyceride) around the belly is constantly breaking down into its core constituents of fatty acids and glycerol, but fat (triglyceride) around the hips tends not to breakdown nearly as much and thus doesn't produce as much fatty acids and glycerol.

But here's the thing: fatty acids released from fat, as occurs from fat in the belly, leads to insulin resistance and also signals the liver to start making sugar. In other words, it's a double whammy - insulin is made less effective by fatty acids and fatty acids also signal the liver to produce sugar. The net effect is a tendency to high blood sugar. (Fatty acids also have other effects which, as you guessed, also lead to high blood sugar).

2. Not only is belly fat more likely to generate the sugar-elevating fatty acids than hip fat, but any fatty acids so released tend to go directly to the liver, with the liver being a central player is sugar metabolism. Phrased differently, even if hip fat did break down into fatty acids to the same extent as belly fat, any fatty acids so released would not go directly to the liver and thus have a more modest impact on sugar metabolism - i.e. belly fat 'drains' into the liver but hip fat drains away from it. (For those with a physiological background, belly fat drains into the portal system, but hip fat goes systemically).
#31
Old 12-28-2013, 12:29 PM
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Originally Posted by Surreal View Post
Well at least one study found that diet and exercise did not help Type 2 diabetics:

http://nytimes.com/2012/10/20/he...ics.html?_r=1&
First off the discussion here was asking about the cause of diabetes and preventing it. That study was designed to analyze preventing the complications of in people who already have it.



What is buried in the actual data is what was hinted in the NYT article. Odds are the exercise and improved diet group needed much less medicine to achieve the same results (Insulin, other injectable hypoglycemics, statins, BP meds, etc.).
Quote:
Originally Posted by the NYT article
Dr. Nathan, though, said the results meant that people with diabetes might have a choice. The group assigned to diet and exercise ended up with about the same levels of cholesterol, blood pressure and blood sugar as those in the control group, but the dieters used fewer medications.

“That may be the choice we are highlighting,” Dr. Nathan said. “You can take more medications — and more, I should say, expensive medications — or you can chose a lifestyle intervention and use fewer drugs and come to the same cardiovascular disease risk.”
Quote:
Originally Posted by the NEJM article
... the increased use of statins in the control group, as compared with the intervention group, may have lessened the difference between the two groups. In addition, the intensification of medical management of cardiovascular risk factors17 in routine medical care in the two study groups may have made the relative benefit of the intensive lifestyle intervention more difficult to demonstrate. ...

... Patients in the intervention group had clinically meaningful improvements in glycated hemoglobin levels, which were greatest during the first year but were at least partly sustained throughout follow-up. This positive effect may explain why patients in the intervention group were less likely to be treated with insulin during this period. Furthermore, we recently reported that patients in the intervention group were more likely to have a partial remission of diabetes during the first 4 years of the trial than were those in the control group.19 Other benefits that were identified during the early years of the trial included reductions in urinary incontinence,20 sleep apnea,21 and depression22 and improvements in quality of life,23 physical functioning,24 and mobility.25 Intensive lifestyle intervention has also been shown to prevent or delay the development of type 2 diabetes in other studies.15,26
Not listed but also previously found, less risk of erectile dysfunction as well. Also
Quote:
... a 31% reduction in the risk of advanced kidney disease ... a significant 14% reduction in the risk of diabetic retinopathy
Concluding that it "did not help" is not accurate. It reduced the need for medications, reduced some signficant complications, and improved quality of life. Compared to intensive medication management coupled with standard exhortations to eat right and exercise (which resulted n some gradual weight loss in the control group as well) it was no better in reduction of cardiovascular complications. People are disappointed by that. Go figure.

Poking around here's someone else's analysis (HuffPo):
Quote:
Look AHEAD resulted in reduced rates of kidney disease, eye disease, and depression in the intervention group. There was also improved overall quality of life, fewer hospitalizations, enhanced mobility, and reduced medication use. And all of these benefits were seen despite the modest between-group differences noted above.

There is another point I emphasized when this story broke in the fall, worth reiterating now. The intensive intervention of Look AHEAD was based on the methods of the Diabetes Prevention Program. That study showed this lifestyle intervention, producing an average weight loss of 7 percent, could prevent the onset of diabetes in nearly 60 percent of high-risk individuals. Look AHEAD does nothing to invalidate those findings. It just may be that a lifestyle intervention works better when applied earlier. Once diabetes is established, perhaps the returns diminish somewhat -- although Look AHEAD indicates there clearly are still returns.

A number of important messages issue from Look AHEAD. One is that very small intervention differences are apt to produce very small outcome differences. Another is that medicine of great value early may be of less value when administered late. Medication that can prevent asthma flairs is useless in treating an acute one. Ditto for migraine. This phenomenon is more common than not. If weight loss is medicine, the timing of its application may matter enormously. Yet even so, there was clear, and almost surprising, evidence of intervention benefit in Look AHEAD.

Yet another message is the importance of how, and even how often, medical news is reported. If headlines say "weight loss is of no benefit in diabetes," that is apt to be all readers take away. If the very same data could be reported as showing that "novel benefits are attached to weight loss in diabetics," then perhaps a bit too much of what we think we know comes down to how things get spun.

We may also be doing a disservice to the power of lifestyle interventions by focusing excessively on weight. While weight loss was a study goal, the real medicine was lifestyle. In the aggregate, the evidence is overwhelming that the same basic lifestyle prescription does prevent heart disease, and diabetes, along with every other major chronic disease.
#32
Old 12-28-2013, 02:57 PM
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Originally Posted by DSeid View Post
First off the discussion here was asking about the cause of diabetes and preventing it. That study was designed to analyze preventing the complications of in people who already have it.
No, it isn't. The thread title states:

[quote]I have type II, aka the "fat and forty" one)[quote]

So my comments are completely relevant here.

But the details of the Look AHEAD study you presented are duly noted. I suspect, however, that most diabetics would rather simply take more meds than make the effort to restrict calories and exercise regularly.
#33
Old 12-28-2013, 03:21 PM
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Fifth grade KneadToKnow just emailed me to say that "burpees" are more accurately described as "vomitees."
#34
Old 12-29-2013, 12:20 PM
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Surreal on review the conversation had certainly moved into what to do about it now that he has it and the importance of exercise. Still I do think clarifying that that article was talking about prevention of complications, not prevention of diabetes, was im[portant to make.

As far as taking more of more expensive meds (so long as they are covered) rather than serious diet and exercise, possibly. Increased risk of kidney failure, of going blind, of depression, of decreased mobility ... yeah probably willing to live with those in many cases than actually eat well and exercise regularly. But erectile dysfunction! That might get a few to work at it some!
#35
Old 12-30-2013, 12:56 AM
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Join Date: Aug 2010
Posts: 1,027
Quote:
Originally Posted by Sattua View Post
Sounds like she may have had polycystic ovary syndrome. The disease process with that involves the pancreas dumping too much insulin, until eventually it burns itself out. It's incidental that insulin is so similar to an ovulation-inducing hormone that it binds to the same receptors and interferes with ovulation, though that's usually the symptom that gets women diagnosed.
Hmm, as far as I'm aware though she doesn't have any of the other symptoms of that. I would assume a gynecologist or the doctor she went to when she was pregnant with me would have noticed if she had it.
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