StemCell Therapy

OpinionType 2 diabetes is not an inevitable life sentence. In 2020, the condition looks very different

Wednesday, 12th February 2020, 7:00 am

The idea that type 2 diabetes is a lifelong disease has been ingrained for so long. But the research explained in my new book, Life Without Diabetes, shows this is not necessarily true. As this is a condition that costs 10 per cent of NHS expenditure, that is good news.

Return to normal health is possible for almost everyone in the first few years of type 2 diabetes. Some people can achieve this even after many years of diabetes. Our research in Newcastle has shown exactly what causes type 2 diabetes for the first time and has traced both the underlying processes of returning to normal and the gruesome processes of developing the disease.

The role the liver and pancreas play

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We measured the critical items in the two important organs of type 2 diabetes - liver and pancreas. In liver, we measured the fat content and the response to insulin control of sugar production. In the pancreas we developed new techniques to measure the fat content and the production of insulin. We were amazed to see that the hypothesis we tested was exactly correct: in the liver, fat content and insulin response were normal within seven days (so blood glucose first thing in the morning dropped to normal); and in the pancreas there was a gradual fall in fat content over eight weeks which was mirrored by a return to near normal insulin production.

The nub of the matter is removing the damaging effects of excess fat delivered to the insulin producing cells of the pancreas. Excess fat builds up first in the liver. Then the liver supplies excess fat to all tissues of the body including the pancreas. Not everyone is susceptible to this fat induced damage to the pancreas, but for those unlucky enough to be so disposed, the major hormone insulin can no longer be produced rapidly enough.

And the solution? Weight loss of about 15kg sounds impossible, but by developing a humanly possible, effective method we have been show that this can be done in a matter of weeks by anyone with motivation to return to health.

The greater challenge is preventing weight regain in the face of the slings and arrows that are part of everyday life. This is not easy, but many people have demonstrated that by following simple changes to habits it can be done. There is no magic diet individuals suit different approaches but a long term way of living life to the full can be successful.

Type 2, obesity and BMI

It's widely believed type 2 diabetes is due to obesity.But a glance at the hard information shows that this is simply untrue. One in two people developing the disease have a body mass index (BMI) under 30 and are not obese. So if half are obese and half are not, maybe there are two different diseases? Not so, as the underlying mechanisms have been shown to be the same over the range of BMIs. In fact one in 10 people have a normal BMI at the time of diagnosis and in contrast around three quarters of people with BMI over 45 do not have type 2 diabetes.

The truth is that we are all individuals, and simple statistical categorisation by BMI is inappropriate. Those of us with a genetic set to live in a body of BMI 25 may well get type 2 diabetes if their weight rises to 28. And those who have normal metabolism with a BMI of 34 may get the disease if they put on weight to say, a BMI of 37. The reverse process is useful to consider, as it is now very clear that someone with a BMI of 37 can return to normal sugar control and normal blood fats with a BMI of 34. That is why the 15kg weight loss target is appropriate for most people: as everyone has a personal threshold above which they will develop type 2 diabetes. It is nothing to do with the fixed BMI concept of obesity.

In other words, we all have a personal fat threshold above which mischief will start happening. This has been rather obscured by the present popularity of population level information to drive beliefs about what is relevant for individuals. But there is a clear bottom line: if a person has true type 2 diabetes, then they have become too heavy for their body.

Eating sweet things and high blood sugar

It's also widely believed that eating sweet things is the cause of high blood sugar. When you wake in the morning, all the sugar in your blood has been made by you by your liver. No molecule of sugar in the blood will have come directly from what was eaten yesterday. In type 2 diabetes the normal restraint on overproduction of sugar by the liver is lost, because the liver becomes resistant to the action of insulin. In turn, that is because there is too much fat inside the liver preventing insulin working normally. When you eat you get a double whammy: all your carbs are turned into sugar during digestion, and this load is additional to the outpouring of sugar from your liver which continued throughout the 24 hours. Certainly eating a lot of sugar or carbs with type 2 diabetes will make the blood sugar even higher, but the basic problem is lack of normal functioning of the hormone insulin. Loss of fat from liver and pancreas restores this.

So type 2 diabetes is not all doom, gloom and an inevitable life sentence. In 2020, the condition looks very different.

Life Without Diabetes by Professor Roy Taylor is published by Short Books, 9.99

See the original post here:
Type 2 diabetes can be reversed even after years of having the condition - this is how - inews

This entry was posted on February 16, 2020 at 7:44 pm and is filed under Diabetes. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed. |