The Low Carb Diabetic

Promoting a low carb high fat lifestyle for the safe control of diabetes. Eat whole fresh food, more drugs are not the answer.


Welcome to the Low Carb Diabetic forum,have you signed up yet? if not then sign up and join us in the low carb community today!

    Diabetes: Study proposes five types, not two

    Share
    avatar
    yoly
    Member

    Status :
    Online
    Offline

    Posts : 602
    Join date : 2014-08-14

    Diabetes: Study proposes five types, not two

    Post by yoly on Sat Mar 03 2018, 10:01

    Diabetes: Study proposes five types, not two

    https://www.medicalnewstoday.com/articles/321097.php

    Published Friday 2 March 2018
    By Honor Whiteman
    Fact checked by Jasmin Collier

    Adults with diabetes could benefit from better treatment if the condition was categorized into five types, rather than just two. This is the conclusion of a new study published in The Lancet Diabetes & Endocrinology.

    Researchers say that diabetes should be categorized into five types, rather than two.

    The research was led by Prof. Leif Groop, of the Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine Finland in Helsinki.

    In the United States alone, around 30.3 million people are living with diabetes.

    Excluding gestational diabetes — diabetes that develops during pregnancy — there are two main types: type 1 and type 2.

    In type 1 diabetes, the beta cells of the pancreas — which produce insulin, the hormone that regulates blood sugar levels — are mistakingly attacked and destroyed by the immune system.

    Type 2 diabetes is the most common form, accounting for around 90–95 percent of all cases. This occurs when the body's cells stop responding to insulin, or the beta cells are unable to produce sufficient amounts of the hormone.

    In both forms of the condition, blood sugar levels can become too high — a condition known as hyperglycemia. Unless controlled, this can lead to a number of complications, including kidney disease, cardiovascular disease, and nerve damage.
    The heterogeneity of diabetes

    A diabetes diagnosis is normally made using the fasting plasma glucose (FPG) test or the A1C test. The FPG test assesses a person's blood glucose level at a single time point, while the A1C test measures average blood glucose levels over the previous 3 months.

    When it comes to determining which type of diabetes a person has, healthcare professionals might look for diabetes-related autoantibodies in the blood. These are proteins produced by the immune system that can attack the body's own cells.

    The presence of such autoantibodies is an indicator of type 1 diabetes. If a person does not have these autoantibodies, they are considered to have type 2 diabetes.

    But, as Prof. Groop and colleagues note, the classification guidelines for diabetes have not been updated for 20 years — despite increasing evidence that diabetes has high heterogeneity.

    "Diabetes is a group of chronic metabolic disorders," says Dr. Rob Sladek, of the McGill University and Génome Québec Innovation Centre in Canada, in an editorial linked to the study, "that share the common feature of hyperglycemia, meaning that, in principle, diabetes can be diagnosed via measurement of a single blood component."

    "However, elevations in blood glucose can be caused by a number of genetic and acquired factors that reduce the circulating concentrations of insulin or decrease its effectiveness, leading to heterogeneity in the clinical presentation and progression of the disease."

    Prof. Groop and his team say that a "refined classification" of diabetes based on its heterogeneity could help healthcare professionals better predict which individuals are most likely to develop complications and allow a more personalized approach to treatment.

    In their study, the researchers propose that diabetes should no longer be categorized as two types. Instead, they say that the condition should be classified into five distinct types.
    The five 'clusters' of diabetes

    The researchers came to their proposal by analyzing the data of four study cohorts. These included a total of 14,775 adults from Sweden and Finland, all of whom had been newly diagnosed with diabetes.

    As part of the analysis, the scientists looked at six measures in each subject that each represent different features of diabetes.

    These measures were: body mass index (BMI); age at diabetes diagnosis; hemoglobin A1C (HbA1C), a measure of long-term blood sugar control; beta cell functioning; insulin resistance; and the presence of diabetes-related autoantibodies.

    As well as conducting genetic analyses of the participants, the researchers also compared their disease progression, complications, and treatment.

    The study revealed five distinct forms of diabetes, three of which were severe and two that were mild. The team categorized these as follows:

    Cluster 1: severe autoimmune diabetes (currently known as type 1 diabetes), characterized by insulin deficiency and the presence of autoantibodies. This was identified in 6–15 percent of subjects.
    Cluster 2: severe insulin-deficient diabetes, characterized by younger age, insulin deficiency, and poor metabolic control, but no autoantibodies. This was identified in 9–20 percent of subjects.
    Cluster 3: severe insulin-resistant diabetes, characterized by severe insulin resistance and a significantly higher risk of kidney disease. This was identified in 11–17 percent of subjects.
    Cluster 4: mild obesity-related diabetes, most common in obese individuals. This affected 18–23 percent of subjects.
    Cluster 5: mild age-related diabetes, most common in elderly individuals. This was the most common form, affecting 39–47 percent of subjects.

    The researchers note that each of these five types "were also genetically distinct," meaning that there were no genetic mutations that were shared across all five clusters.
    A 'step toward precision medicine'

    When the researchers assessed the treatment received by adults in each of the five clusters, they noticed that some were being treated inappropriately.

    As an example, the team points out that just 42 percent of patients in cluster 1 and 29 percent of patients in cluster 2 received insulin therapy from the point of disease onset.

    They say that this indicates that the current classifications of diabetes fail to target the underlying features of the disease.

    As such, Prof. Groop and colleagues propose that diabetes should be categorized into five distinct types.

    While further research is required to refine these five clusters — by using biomarkers and genetic risk scores, for example — the team believes that this study is a great stride toward tailored treatments for diabetes.

    "Existing treatment guidelines," concludes Prof. Groop, "are limited by the fact they respond to poor metabolic control when it has developed, but do not have the means to predict which patients will need intensified treatment.

    "This study moves us towards a more clinically useful diagnosis, and represents an important step towards precision medicine in diabetes."

    Prof. Leif Groop

    avatar
    graham64
    Member

    Status :
    Online
    Offline

    Male Posts : 3730
    Join date : 2014-08-10
    Location : Lancs

    Re: Diabetes: Study proposes five types, not two

    Post by graham64 on Sat Mar 03 2018, 22:57

    Hi Yoly
    Perhaps they may take this on board and stop using a one size fits all for T2 diabetes, that said I don't fit into any of the categories, diagnosed with a normal BMI and no belly fat trigs and HDL good no indicators at all, it's only through an annual check up T2 came to light 

    One not mentioned was drug induced diabetes steroids in particular and statins and there may be other drugs too


    _________________
    I'm a skinny T2 diagnosed 4/4/2008, a high calorie LCHF diet and one metformin a day A1c 6.2 and no complications.

    Proving the LowCarb sceptics wrong for over ten years

    Not all cherubs are Angels  Wink nor all diabetics Bonkers  Rolling Eyes
    avatar
    chris c
    Member

    Status :
    Online
    Offline

    Posts : 4520
    Join date : 2015-07-26

    Re: Diabetes: Study proposes five types, not two

    Post by chris c on Sat Mar 03 2018, 23:26

    Another paper I couldn't find on Sci-Hub.

    Yes it is NOT a one size fits all disease. Mine is somewhat related but not the same as one of the MODYs. A recent finding of a gene deletion affecting GLP-1 came close but this is found predominantly in women

    I know one person with a similar symptom set who has it mostly in women in her family, but in mine it is predominantly in males, and in most of the others it is distributed between the sexes/among the genders.

    The pattern seems to be a lack of Phase 1 insulin starting in childhood but progressing slowly. Meanwhile I have seen other Type 2s who progress faster than some adult onset Type 1/LADAs.
    avatar
    yoly
    Member

    Status :
    Online
    Offline

    Posts : 602
    Join date : 2014-08-14

    Re: Diabetes: Study proposes five types, not two

    Post by yoly on Sun Mar 04 2018, 09:45

    There have to be many types and causes for diabetes. If at least they used the insulin and glucose profile "aka Kraft" at diagnosis they could better treat the individual patient. I think I have been "insulin deficient" since a child I remember other eating cake and sweets, but I will get nausea and feel bad eating them. It just progressed with age.

    I have been thru two hurricanes with out power and communications for 5 months. Had to eat a lot of canned crap but I survived.

    My numbers have gone up I am thinking of using half a milligram of glimepiride a day . It doesn't increase insulin much and has other extra pancreatic effects.

    https://www.slideshare.net/iyerbk/glimepiride

    I may die sooner but it will help better control and maybe die less painfully without other complications.


    avatar
    graham64
    Member

    Status :
    Online
    Offline

    Male Posts : 3730
    Join date : 2014-08-10
    Location : Lancs

    Re: Diabetes: Study proposes five types, not two

    Post by graham64 on Mon Mar 05 2018, 21:32

    @yoly wrote:There have to be many types and causes for diabetes. If at least they used the insulin and glucose profile "aka Kraft" at diagnosis they could better treat the individual patient. I think I have been "insulin deficient" since a child I remember other eating cake and sweets, but I will get nausea and feel bad eating them. It just progressed with age.

    I have been thru two hurricanes with out power and communications for 5 months. Had to eat a lot of canned crap but I survived.

    My numbers have gone up I am thinking of using half a milligram of glimepiride a day . It doesn't increase insulin much and has other extra pancreatic effects.

    https://www.slideshare.net/iyerbk/glimepiride

    I may die sooner but it will help better control and maybe die less painfully without other complications.

    Wow 5 months is a long time I can understand your problems with the non-availability of fresh food supplies, in your case needs must you've got to eat 

    I don't really know much about glimpride but a half mg is low, if you do decide to go down that route hope it works out for you.


    _________________
    I'm a skinny T2 diagnosed 4/4/2008, a high calorie LCHF diet and one metformin a day A1c 6.2 and no complications.

    Proving the LowCarb sceptics wrong for over ten years

    Not all cherubs are Angels  Wink nor all diabetics Bonkers  Rolling Eyes
    avatar
    chris c
    Member

    Status :
    Online
    Offline

    Posts : 4520
    Join date : 2015-07-26

    Re: Diabetes: Study proposes five types, not two

    Post by chris c on Mon Mar 05 2018, 23:19

    Yoly you sound like another one! I know a small but significant number of such people, none as far as I know related to me, or to each other.

    A very small dose of bolus insulin would probably be useful, but what the hell, I don't seem to have suffered much from not eating the carbs. Oh except that I am thirteen years older . . .

    Sorry to hear of your ongoing problems, I wondered where you had gone. Welcome back!
    avatar
    yoly
    Member

    Status :
    Online
    Offline

    Posts : 602
    Join date : 2014-08-14

    Re: Diabetes: Study proposes five types, not two

    Post by yoly on Tue Mar 06 2018, 10:03

    I am back to eating full low carb, no matter how you try to avoid it even canned or processed meat have carbs. It just not keeping my numbers normal, it helps a lot even even if you are type 1 but I can no longer be on the normal range.

    Sadly metformin nor is natural version berberine work for me. They have no or little impact on my numbers. Insulin is a hassle to keep 24hrs control and no doctor here will prescribe them unless you are in the upper 7% A1C numbers and you had to have tried all the expensive bad for you medications first. Glimepiride it can cost here as little as $7 for a two month supply and I can buy without prescription in a local pharmacy. So I am seriously considering taking it, higher numbers will just produce a faster decline and more possible complications. That is the doctors approach but that is no good as we know.
    avatar
    graham64
    Member

    Status :
    Online
    Offline

    Male Posts : 3730
    Join date : 2014-08-10
    Location : Lancs

    Re: Diabetes: Study proposes five types, not two

    Post by graham64 on Wed Mar 07 2018, 21:37

    @yoly wrote:I am back to eating full low carb, no matter how you try to avoid it even canned or processed meat have carbs. It just not keeping my numbers normal, it helps a lot even even if you are type 1 but I can no longer be on the normal range.

    Sadly metformin nor is natural version berberine work for me. They have no or little impact on my numbers. Insulin is a hassle to keep 24hrs control and no doctor here will prescribe them unless you are in the upper 7% A1C numbers and you had to have tried all the expensive bad for you medications first. Glimepiride it can cost here as little as $7 for a two month supply and I can buy without prescription in a local pharmacy. So I am seriously considering taking it, higher numbers will just produce a faster decline and more possible complications. That is the doctors approach but that is no good as we know.

    Same here with insulin doctors would only prescribe it as a last resort though for us cost is not an issue as all drugs are free to diabetics, however doctors do have to consider budgets and will resort to the cheapest available drugs were possible.


    _________________
    I'm a skinny T2 diagnosed 4/4/2008, a high calorie LCHF diet and one metformin a day A1c 6.2 and no complications.

    Proving the LowCarb sceptics wrong for over ten years

    Not all cherubs are Angels  Wink nor all diabetics Bonkers  Rolling Eyes
    avatar
    chris c
    Member

    Status :
    Online
    Offline

    Posts : 4520
    Join date : 2015-07-26

    Re: Diabetes: Study proposes five types, not two

    Post by chris c on Wed Mar 07 2018, 22:57

    Yes it's scary just how much "food" has added sugar, and/or wheat, and let's not even mention the soy/oil.

    Give it a go, one of the MODYs is especially sensitive to sulphs.
    avatar
    yoly
    Member

    Status :
    Online
    Offline

    Posts : 602
    Join date : 2014-08-14

    Re: Diabetes: Study proposes five types, not two

    Post by yoly on Wed Mar 14 2018, 09:54

    So far so good. With 1/2 a milligram taken at lunch my numbers in the morning are around 86 which is great and after eating low carb meal never pass 115. A little more hungry at lunch. I am increasing my eggs and cheese at breakfast but not anything that can't be managed.
    avatar
    Jan1
    Member

    Status :
    Online
    Offline

    Female Posts : 4929
    Join date : 2014-08-13

    Re: Diabetes: Study proposes five types, not two

    Post by Jan1 on Fri Mar 16 2018, 18:31

    @yoly wrote:So far so good. With 1/2 a milligram taken at lunch my numbers in the morning are around 86 which is great and after eating low carb meal never pass 115. A little more hungry at lunch. I am increasing my eggs and cheese at breakfast but not anything that can't be managed.

    Pleased to read that it's 'so far so good' ...

    All the best Jan
    avatar
    yoly
    Member

    Status :
    Online
    Offline

    Posts : 602
    Join date : 2014-08-14

    Re: Diabetes: Study proposes five types, not two

    Post by yoly on Sat Mar 17 2018, 15:13

    Thanks Jan. Sad that diabetic care is so bad we have to try to do better on our own. Most doctors know anything about diet and good care. They just follow the official line of pharmaceuticals.
    avatar
    chris c
    Member

    Status :
    Online
    Offline

    Posts : 4520
    Join date : 2015-07-26

    Re: Diabetes: Study proposes five types, not two

    Post by chris c on Sat Mar 17 2018, 19:57

    http://www.diabetesgenes.org/

    Andrew Hattersley has done some excellent work which most doctors have never heard of
    avatar
    yoly
    Member

    Status :
    Online
    Offline

    Posts : 602
    Join date : 2014-08-14

    Re: Diabetes: Study proposes five types, not two

    Post by yoly on Mon Mar 19 2018, 09:39

    @chris c wrote:http://www.diabetesgenes.org/

    Andrew Hattersley has done some excellent work which most doctors have never heard of

    Thanks Chris interesting site. There is a long road ahead before good diabetes care reach the masses.
    avatar
    Eddie
    Member

    Status :
    Online
    Offline

    Male Posts : 3805
    Join date : 2014-08-13
    Age : 68
    Location : London

    Re: Diabetes: Study proposes five types, not two

    Post by Eddie on Tue Mar 20 2018, 17:15

    Yoly you hit the jackpot almost 2000 reads, a record for this place, nice one.


    _________________
    Type two diabetic-low carb diet (50 carbs per day) and two 500mg Metformin pills per day. Apart from diagnosis HbA1c almost 12-all HbA1c results none diabetic. For over eight years my diabetes medication has not changed. My weight has remained stable, I have suffered no ill effects from my diet whatsoever. Every blood test has proved, I took the right road to my diabetic salvation. For almost seven years, I have asked medical professionals and naysayers, how do I maintain non diabetic BG levels on two Metformin other than low carb ? The silence has been deafening !

    Sponsored content

    Re: Diabetes: Study proposes five types, not two

    Post by Sponsored content


      Current date/time is Sun Dec 16 2018, 16:16