What is Type 2 Diabetes?

[Pawelk198604]

I live in Poland, today I was at an endocrinologist, I brought also the results of the blood tests that the doctor ordered me.

I am unfortunately obese, I also have autism (Asperger's Syndrome), the doctor said that I was in danger of type 2 diabetes that if I do not begin to take care of yourself so within the next year or maybe two, I can get sick with diabetes,

The doctor advised me to limit the consumption of sugary drinks and bread (she said I should eat only bread with low glycemic index.

The doctor said that my insulin is fine, but it does not work as it should.

As it is thought that diabetes is caused when someone's body does not produce insulin, my supposedly produces and is in excess, I do not understand this ???

[Red Iron Crown]

https://en.wikipedia.org/wiki/Diabetes_mellitus_type_2

[Tex_NL]

You can find the answer right here.

[LordFerret]

http://www.diabetes.org/diabetes-basics/type-2/

[jwenting]

So basically you should restrict your intake of processed carbohydrates.

That means no sugar laden soft drinks and fruit juices.

No candy.

No pasta, very little bread and bread products (including cookies, pie, cake).

Reduce your intake of things like potatoes, peas and beans as well.

Read up on low carb (carbohydrate) diets. You can eat very well that way, no reason to buy special stuff if you're careful.

I've tried low carb bread and couldn't stomach it. Could just have been the variety sold here of course, try for yourself and see if you like it.

[pincushionman]

As is probably apparent already, there are two forms of diabetes:

Type 1 ("juvenile onset"): Pancreas no longer produces insulin. Causes are still poorly understood, but probably autoimmune related. Only possible treatment is supplemental insulin.

Type 2 ("adult onset"): your pancreas still produces insulin, but your tissues don't recognize it. Known to be caused by obesity, age, and genetics. Can be treated by better control of diet or by medication. May require supplemental insulin.

I've had Type1 for the past ten years, so take what I have to say with a grain of salt.

As others have said, avoid sugary foods and drinks. This isn't because refined or processed sugars (including HFCS) are particularly bad compared to other carb sources (despite what some may say) - it's because these sources tend to have lots of carbs, and you need to reduce your total carb intake. As you already recognize you struggle with obesity, you've already realized much of your current carbohydrate intake is unnecessary.

It's not quite as simple as "cut sugar," though it may look like it - you still need a good balance of simple and complex sugars and starches. Simple sugars raise blood glucose more quickly, starches take longer. But starch still has a notable effect. Ultimately it all becomes glucose before it's used. Hopefully your health providers can refer a dietician; they would be more helpful than any of us in determining an appropriate diet for you.

Note this is good advice for everyone, not just diabetics.

One thing I can recommend for certain is to avoid between-meal snacks (particularly candy) and cut soda-pop, juice, or juice-like drinks out of your habits. Those are loaded with simple sugars, and it's a simple step to drastically reduce carb consumption. Note that most "diet" pops usually have no carbs of any kind.

I'm willing to offer any further advice I can, but remember I'm coming from a Type 1 treatment background, and I don't have any experience (specifically) with the obesity.

Good luck, and be open-minded. This will be a lifestyle change - either on your own terms now, or your body will force it on you later.

Edited July 3, 2015 by pincushionman

[Eric S]

Well, since the original question has been answered, I'll just offer moral support, having gone through the same thing about two months ago.

In addition to paying attention to the glycemic index of foods, weight loss helps. I won't push any particular diet because I'm a firm believer that there is no one diet that's right for everyone. I'd recommend looking into nutritional info and a few different diets to find one that works for you, as a diet with perfect benefits that you can't stick to isn't going to help in the long run as much as any diet that helps that you can stick to, because sadly, this is the rest of your life that you're talking about. You need to find what works for you. In my case, it was about finding ways to cut back on calories without feeling like I was depriving myself or eating foods that I didn't want to "just because."

What worked for me was spending a week tracking what I eat, including weighing things so that I knew just how much I was eating, then looking up the basic nutritional and glycemic information for what I ate. At the end of the week I started categorized foods into a few categories ranging from "this is good and I like it, let's eat more of it" to "I like it but it's bad for me, I need to eat it less often" to "OK, that food is really bad for me and I don't like it enough to make up for that, it's gone."

Another big thing I noticed when I started paying more attention is that I tended to eat more than necessary. Why stop when the food still tastes good, right? This tended to be a bigger problem on foods that I really liked, but I found that most of the enjoyment I got from a favorite meal came early on, so that shifting from "eat till it doesn't taste good" to "eat till I'm not hungry" really didn't leave me feeling like I was depriving myself much.

I didn't get things right immediately. I had a few meals that were low enough in protein that the first time I lined up one low protein meal with a low-to-medium protein meal in the same day, I didn't get enough protein and was feeling off during the late evening. Still, I'm losing a pound or two a week most weeks while maintaining decent energy levels and not missing my favorite foods much, which means it will take a long time to get my weight back down where it should be, but after all, it took a good 30 years to gain it.

[Stargate525]

As is probably apparent already, there are two forms of diabetes:

Type 1 ("juvenile onset"): Pancreas no longer produces insulin. Causes are still poorly understood, but probably autoimmune related. Only possible treatment is supplemental insulin.

My cousin's been doing research on this, as he was recently diagnosed with it (at 28 or so, no less). There are studies and trials going on for imbedded insulin injectors, and pancreas transplants. So there is movement for a 'cure.' Or at least treatment that doesn't involve daily needle sticks.

[pincushionman]

My cousin's been doing research on this, as he was recently diagnosed with it (at 28 or so, no less). There are studies and trials going on for imbedded insulin injectors, and pancreas transplants. So there is movement for a 'cure.' Or at least treatment that doesn't involve daily needle sticks.

Oh, I'm aware of some of those, but right now they're not ready for prime time. I only brought it up at all to point out that if Pawelk's condition does turn into Type 2, it doesn't necessarily mean insulin injections, whereas a Type 1 diagnosis given right now is always going to be inject or pump, which is ultimately the same concept.

- - - Updated - - -

…and I misspoke. It's been closer to 20 years. My, time flies…when you're old.

[Hcube]

Oh i thought that it was 100% admitted that type1 was an autoimmune disease caused by genetic factors...

Anyway OP, i don't have any of those, but many of my friends do and showed that the earlier and the more seiously you deal with type2 at first, the easier it will be : so have a lot of courage and avoid it if you can !

[softweir]

@ Pawelk: Sorry to hear you are at risk of diabetes.

Something nobody else has mentioned is exercise: Part of the reason people develop type 2 diabetes is they eat more fat and sugar than their muscles burn up, and as a result their muscles start to ignore the insulin. Taking more exercise AND eating less sugar and fat will give your muscles a chance to become less insensitive to insulin. Eating less sugar and fat helps, exercise helps, but you really have to do both.

Don't exercise too heavily at the start: build up the exercise slowly so you have a chance to improve your fitness.

Foods made from unmilled grains are very low-GI and are very useful for treating early-stage type 2 diabetes. Examples are boiled rice, porridge made from whole grains such as rolled oats, and boiled barley are the sort of thing you need to look at. A lot of traditional dishes across Europe used to be cooked with unmilled grains, I assume Poland must have had some! So look out for traditional cookery books.

It may help to avoid artificial sweeteners. This is because when you taste anything sweet, your brain tells your pancreas to manufacture insulin: if it is an artificial sweetener, then you get the insulin but no sugar, so your blood sugars drop, and you get hungry and eat too much.

However, the important things are exercise, eating less, and trying to eat unmilled grains.

Good luck!

[Eric S]

Something nobody else has mentioned is exercise:

Agreed. I didn't go into that because I really don't have much advice there, my exercise plan experienced RUD due to unrelated medical issues. :-)

However, the important things are exercise, eating less, and trying to eat unmilled grains.

Basically, this is the one area were I most agree with the diet buzz about eating minimally processed foods. Basically, processing or overcooking food tends to make the carbohydrates in the food more readily available to your body, causing the glycemic index of the food to spike. Minimally cooked pasta has a low glycemic index, overcook it and the GI triples, if I remember correctly.

[softweir]

One quick mention about pasta: the starch in pasta which is cooked and then cooled changes so it is harder to digest. If the pasta is then reheated it changes further, making it even harder to digest. The same, apparently, goes for potatoes as well. If it wasn't for the fat they are cooked in, twice-fried chips (fries in America, frite in France and posh restaurants) would be an excellent low-GI food!

But yes, freshly overcooked pasta is high GI and not good.

I believe the worst is the very soft French breads such as is used in croissants - they have a GI higher than sucrose!

[kiwi1960]

I have type two diabetes... but mine wasn't caused by being obese, it was caused because I cannot exercise enough due to having related issues, such as MS, a heart condition and now, arthritis.

I disagree with the advice given here, to not eat sugary foods... the fact is, you cannot escape it in today's world, they even put sugar in peanut butter for heavens sake.

What I will advise you is this... eat what you want, but in strict moderation. Instead of having two jam sandwiches, for example, have one.

Then idea is to not eliminate sugar (etc) from your diet, but to reduce it, restrict it.

I use two types of insulin, because given my circumstances, mine was harder to get under control than most other peoples.

I take two shots of a slow acting insulin a day, to slowly lower my blood sugars over the entire 24 hours.

The other kind, I take 15 minutes before each meal, or snack, its a fast acting insulin.

You can still eat pasta, but rather than a large helping, have a small one, and don;t eat constantly.

I was proven right when my nurse told me that when I take insulin, I should eat.... to me, that was just wrong...

You take insulin to lower your blood sugars then eat to raise it? What was the freaking point... and then, recent studies confirmed what i had been saying.

My diabetes nurse confirmed that you don't have to eat constantly to keep your blood sugars at a safe level... but you should eat if your blood sugars go too low.

Its a hard game, and its not too late for you, you are only at risk of getting it. But keeping the levels between 4 and 8 is very very hard. The highest readings I have even had were in the 20's... heart attack territory. The lowest was about 3.5 .... a tea spoon of sugar or chocolate fixed that.

If you can change your lifestyle before you "get" it.... then do so. Its no fun having to walk a constant tightrope between 4 and 8 ... too low, it can kill you, too hight it can kill you.... but even if its moderately high.... it can damage you, they don't call it the silent killer for nothing... even at 5 or 6 for many months can cause you to go blind... or have a foot amputated... but at those levels, you feel fine... the silent killer is the one that gets you.

Good luck.

P.S. as for potatoes? REALLY.... they do NOT need to be deep fried. You can boil them and mash them.... no wonder the USA is mostly obese.. they think there is only one way to cook taters....

[Eric S]

I disagree with the advice given here, to not eat sugary foods... the fact is, you cannot escape it in today's world, they even put sugar in peanut butter for heavens sake.

What I will advise you is this... eat what you want, but in strict moderation. Instead of having two jam sandwiches, for example, have one.

Then idea is to not eliminate sugar (etc) from your diet, but to reduce it, restrict it.

I didn't make it clear, but that's really what I focus on as well. There are very few things I've actually removed completely from my diet. Fish and chips being one of the few things that I removed that I'll miss. 2500 calories for a single meal just isn't worth it. I tend to describe it as making myself aware of the decisions I'm making and trying to make the better choice more often, but not to the exclusion of all the bad choices. I gained the weight slowly and my HbA1c isn't too serious yet, so I didn't need to make drastic choices to start losing weight. I won't know how my HbAIc is changing until I get retested in a few months, but both my doctor and I expect to see some positive changes there as well.

Moderation in everything, as the saying goes. I can't think of a single thing that the body needs to function well that it can't get too much of, and that includes water. And no, I'm not talking drowning, there is such a thing as water poisoning. Same for salt. Some salt in your diet is necessary, but it's easy to get too much of it, especially if you're sensitive to it. At least some people have a harder time losing weight if they cut fat out of their diet completely instead of limiting it to a small amount. Seems the human body doesn't want to give up what fat it's got if it's not getting any new fat.

As I said before, I don't think that there is any one diet that's optimal for everyone, especially when you take into account what diets different people can stick to. My favorite hamburger is something like 900 calories and the fries that come with it are even worse, but as long as I know that I'll make room for that every few months, I'm fine. If I say that I'm giving up that hamburger for good, I'll feel like I'm depriving myself and the diet won't last two weeks, even though I probably wouldn't have eaten that burger during that same two week period even without being on a diet.

I haven't stopped eating candy, but I eat it a lot less often and in smaller quantities when I do. Chips and cookies fall into the same category. I haven't even given up fried chicken, but I limit the frequency and portion size when I do eat it.

So yes, focusing on moderation can work for some people, even those that don't have the best self-discipline.

[Napaeozapus]

At least some people have a harder time losing weight if they cut fat out of their diet completely instead of limiting it to a small amount. Seems the human body doesn't want to give up what fat it's got if it's not getting any new fat.

What type of fat you eat is more important than eliminating it since it is something your body actually needs to function. Felt I should add something to this topic.

[pincushionman]

...I haven't stopped eating candy, but I eat it a lot less often and in smaller quantities when I do. Chips and cookies fall into the same category. I haven't even given up fried chicken, but I limit the frequency and portion size when I do eat it...

Baby steps, man. Eliminating or reducing the unnecessary parts of your diet is the most effective step you can take.

[Dangerous_Beans]

since no one else has mentioned it: there is also gestational diabetes, which occurs when hormones from the foetus mess up a pregnant persons glucose regulation. this can trigger type 2 diabetes, or make it worse.

worth being aware of if pregnancy is something you are planning or have to worry about.

[PB666]

As is probably apparent already, there are two forms of diabetes:

Type 1 ("juvenile onset"): Pancreas no longer produces insulin. Causes are still poorly understood, but probably autoimmune related. Only possible treatment is supplemental insulin.

Type 1 diabetes is an autoimmune disease in which two HLA types DRB1*03:01, *04 and DQB1*03:02, *02:01 mediate a response to several proteins including bovine insulin in milk, proinsulin, GAD65, and several Beta-islet cell surface proteins. The autoantibodies themselves do not cause disease, but the B-cells and plasma cells are attracted to beta-islet cell surface and attract the CD8+ T-cells (killer cell phenotype) which kill the islet cells. The how of the B-cell homing to islet cell and cytokine/lymphokine attraction to islet cells has not be fully worked out. Risk factors are maternal (lack of sunlight, excess blood sugar, lack of vitamin D in diet, infection), neonatal (HLA class II antigens, non-HLA autoimmune gene risk factors, birthweight, Age of wheat consumuption onset-dubious, presence of gluten sensitivity 'Coeliac disease', neonatal viral infections of the GI tract including coxsackie virus, enterovirus, influenza, and via coeliac risk rotavirus) and adult (Type II diabetes, obesity, HLA DR3-DQ2/DR4-DQ8 genotype, aracidonate, another autoimmune disease). Conversion of autoantibody profile from one to two specificities predicts future disease and more than two autoantibodies correlates with type 1 diabetes. IN essence it means if you have 3 kinds of B-lymphocyte/plasma cell specificities you have enough to attract sufficient programmed cell death cell types to kill the b-islet of the pancrease.

Type 2 ("adult onset"): your pancreas still produces insulin, but your tissues don't recognize it. Known to be caused by obesity, age, and genetics. Can be treated by better control of diet or by medication. May require supplemental insulin.

Simply stated excess glucose effects metabolism. Chronic excess the body absorbs more glucose that it can readily convert to saturated fat on the liver. Whereby it is also known as fatty liver diabetes. As glucose levels rise the body produces more insulin [increasing the risk for LADA type 1 diabetes (of adults, type 1 diabetes is not just a juvenile onset disease)], but as time goes by it knows less what to do with that glucose.

I've had Type1 for the past ten years, so take what I have to say with a grain of salt.

As others have said, avoid sugary foods and drinks. This isn't because refined or processed sugars (including HFCS) are particularly bad compared to other carb sources (despite what some may say) - it's because these sources tend to have lots of carbs, and you need to reduce your total carb intake. As you already recognize you struggle with obesity, you've already realized much of your current carbohydrate intake is unnecessary.

It's not quite as simple as "cut sugar," though it may look like it - you still need a good balance of simple and complex sugars and starches. Simple sugars raise blood glucose more quickly, starches take longer. But starch still has a notable effect. Ultimately it all becomes glucose before it's used. Hopefully your health providers can refer a dietician; they would be more helpful than any of us in determining an appropriate diet for you.

Note this is good advice for everyone, not just diabetics.

One thing I can recommend for certain is to avoid between-meal snacks (particularly candy) and cut soda-pop, juice, or juice-like drinks out of your habits. Those are loaded with simple sugars, and it's a simple step to drastically reduce carb consumption. Note that most "diet" pops usually have no carbs of any kind.

I'm willing to offer any further advice I can, but remember I'm coming from a Type 1 treatment background, and I don't have any experience (specifically) with the obesity.

Good luck, and be open-minded. This will be a lifestyle change - either on your own terms now, or your body will force it on you later.

It is quite fortunate for you that T1D is quite livable now. They are currently undertaking a large decadal epidemiological study in Europe (largely norther Europe) to find the causes and best treatment strategies for type 1 diabetes. Hopefully we will finally get some answers on the environmental factors that cause this terrible disease. The causes appear at present to run in cycles, with viral infections playing a big wild-card in children, and vitamin-D and sunlight levels in female parents of diabetic children.

Other risk factors include saturated fat versus poly-unsaturated (alpha-linoleic acid derivatives) fat in diet. Common to all diabetes appear to be the role of gastrointestinal sensitizing agents such as NSAIDS, wheat and other big 8 allergens, glutamate, benzoate, tartarazine. It is not clear why but elements of the innate immune system may respond to GI stress by sending signals to the ducts that connect to the gall bladder, pancrease and liver and alter their function. This can cause fatigue and make diabetes worse. Bread is a good thing to back off of for several reasons, packaged drinks have alot of benzoate and sugar.

Glucose in its linear form is an aldehyde, it reacts with -NH2 (protein amino moieties) to form schiff bases, and this can cause permanent damage to the bodies non-regenerative tissues (brain, eyes), but also leads into metabolic syndrome. Its damage over time. It also reacts with hemoglobin forming A1C. A1C is a measure of spikey glucose which often occurs because people do not eat regular meals but a large dinner and then go to sleep. The primary goal is to reduce glucose spikes. This means 3 healthy meals and one snack a day. Dinner (classically a big meal) should not be the largest meal, should be low in carbs and should not be eaten 4 hours before sleeping.

Excercise is very effective at treating type 2 diabetes, but if the diet is messed up the individual may feel depressed and not feel like exercising. Chronic subacute inflammation of the bowel is frequently undetected in diabetics and is often the result of a bad diet. Changing the diet increasing vitamin B and omega-3 fats (cold-water fish, flax seed oil and canola oil) increase the energy levels and help to reduce inflammation. In Northern Europe vitamin D also appears to be a common deficiency and this is known to affect risk for 2 forms of diabetes.

Bread is not as essential as Europeans make it out to be, the Mesolithich peoples of Europe did not eat bread, they lived on Fish meats, hazelnuts, fruits and tubers, compared to their neolithic counterparts they were alot healthier. The bread/Cow diet is suitable for settled peoples but mesolithic peoples need energy because they are constantly moving about. The basic analogy here is that Finland has the highest diabetes rates in the world, particularly type 1, the same peoples on the other side of the border in Russia have 10 fold lower type 1. Finland unfortunately is one of two peoples that have high composite levels of DR3-DQ2 and DR4-DQ8. The other comparable is Jalisco Mexico. Oddly type 1 diabetes in Jalisco is lower, restricted to mainly peoples of European primary descent (DR3-DQ2 bearers largely from Basque) even though the levels of DR4-DQ8 is much higher in mestizo derived and in Europe and the US is DR4-DQ8 is a much higher risk factor for type 1 diabetes. Corn tortillas versus bread. Think global food alternatives. I am fortunate because I was brought up between two food cultures (Mexican and American) and I live close to one of the biggest outdoor food markets in the southern United States. So I can pick the best of food cultures that span the Americas and most of the European foods. I don't even think about bread anymore, the more you find the good stuff the less you want to eat junk.

Whole grains bind the starch up in fiber, it takes time for gut amylases to reach the starch and for the sugars to diffuse out and reach the lamina propria of the small intestine. Wheat flour is 95% starch finely ground, it takes no time in the stomach for amylases to reach the starch and turn it into glucose, the same is true for white rice (99.5% starch). This sugars goes into the blood stream as soon as it finds a surface it can be absorbed through. In essence bread and white rice are akin to eating their dry weight in sugar. The best sources of sugar in whole grains are those with fiber content over 8%, these are whole oats, buckwheat (chopped), and Quinoa. Chopped or nixtzmalized corn (nixtmalized corn has no free sugar) are a cheep alternative. I would not say beans are particularly bad, but refried beans may have the same release rate as wheat flour and alot of saturated fat. But there are lots of alternative grains, chopped malted barley, millet, etc. Just about every culture has a cheap readily available whole grain alternative.

In other words its not the thing so much as what is done to the thing after it goes into processing, highly processed foods release their payload quickly, and unprocessed foods need the process of diffusion over time to get their goodies out. Gluten-free since 2003.

[LordFerret]

since no one else has mentioned it: there is also gestational diabetes, which occurs when hormones from the foetus mess up a pregnant persons glucose regulation. this can trigger type 2 diabetes, or make it worse.

worth being aware of if pregnancy is something you are planning or have to worry about.

Certain anti-inflammatory drugs and steroids (such as Decadron) used to curb brain swelling related to tumors and brain cancer can induce diabetes mellitus also, an issue I had to deal with in my dad's (RIP) late stage cancer treatments. He required (as kiwi1960 mentions) two types of insulin, fast acting and slow release. Due to the severity of his condition and fragility of his health, I had to constantly monitor his blood levels, 6 to 8 times a day... he would tell me "I feel like a pincushion."; Add to that the required insulin injections for maintenance.

Not fun.

[PB666]

@ Pawelk: Sorry to hear you are at risk of diabetes.

Something nobody else has mentioned is exercise: Part of the reason people develop type 2 diabetes is they eat more fat and sugar than their muscles burn up, and as a result their muscles start to ignore the insulin. Taking more exercise AND eating less sugar and fat will give your muscles a chance to become less insensitive to insulin. Eating less sugar and fat helps, exercise helps, but you really have to do both.

Don't exercise too heavily at the start: build up the exercise slowly so you have a chance to improve your fitness.

Foods made from unmilled grains are very low-GI and are very useful for treating early-stage type 2 diabetes. Examples are boiled rice, porridge made from whole grains such as rolled oats, and boiled barley are the sort of thing you need to look at. A lot of traditional dishes across Europe used to be cooked with unmilled grains, I assume Poland must have had some! So look out for traditional cookery books.

It may help to avoid artificial sweeteners. This is because when you taste anything sweet, your brain tells your pancreas to manufacture insulin: if it is an artificial sweetener, then you get the insulin but no sugar, so your blood sugars drop, and you get hungry and eat too much.

However, the important things are exercise, eating less, and trying to eat unmilled grains.

Good luck!

One of the reasons some professional athletes age faster than the general population is that they do exactly this eat more calories to sustain a heightened fitness and strength. The problem is that excessive calories is a tax on the liver. From an excercise point of view the body really wants to burn fat, fat burns in pure O2 but glucose undergoes the alanine cycle and produces lactic acid. So the liver likes to convert sugar to fat and send it off to the muscles in LDL bodies. This ages the liver more rapidly than if one has a balanced diet of protein, fat and carbohydrates. The problem with consuming fat to solve this problem is the cheapest source of fat is animal fat (generally the fat of animals that have been raised in feed lots) and is not healthy because of the high levels of saturation and arachidonate. As long as you are very athletic, meaning you are not accumulating fat, the arachindonate burns. But if you are not this the arachidonate rises and causes inflammation (increasing risk for rhuematoid arthritis and type 1 diabetes), but also increasing risk for prostate cancer and putatively (base on animal studies) breast and ovarian cancers. So there is no fast remedy to deal with excess calories. There is also the believe that steroids can help you pack on muscle and this will help deal with excess calories in the diet. Muscle is made of protein from dietary amino-acids, and for this to work you actually have be be working out before taking them, otherwise all the excess calories are added as weight, a small amount of muscle increase and alot of fat.

I suspect the OP had a finding from his doctor that he had borderline Hb A1C. This is a common finding in young people and it will lead to diabetes over years, but it is so easily remedied because the spike of glucose often occurs (even in fit individuals) because they eat something sweet like ice-cream before going to bed. If glucose spikes are the problem (meaning A1C is borderline or high) then simply removing the spikes corrects the problem, its relatively easy.

_However_ as one ages one becomes more susceptible to the effects of glucose, metabolism slows down, and so we also need to eat less. There was a recent study from New Zealand suggesting that at 38 years of age some individuals are aging 3 times faster than others. I suspect that sugar intake is part of this equation. The second easy remedy is to remember that 3 meals a day and a snack, with the lion share of the calories in the breakfast and lunch can really take the head off the spikes. They also make your metabolism work more efficiently and keep the vital organs from aging too fast and declining. Third fat burns in a small stream of sugar, and so if you want the body to burn fat nominally you should not have glucose swinging up to 200mg/dL and then down to 60.

[Jesrad]

Lots of useful info here I've not seen mentions of the role of iron enrichment of food in dabetes/obesity trends though so I thought I'd add it.

Excercise is very effective at treating type 2 diabetes

Actually, that hypothesis was tested and turned out wrong. Exercize is either not very effective, or not effective at all, depending on the stage of metabolic disorder in the patient. Exercize is still healthy for all kinds of other reasons though.

The one thing that really does work with diabetes type 2 is dietary adaptation by eating a lot less carbohydrates or switching to carbohydrates that are resistant to human digestion.

From an excercise point of view the body really wants to burn fat, fat burns in pure O2 but glucose undergoes the alanine cycle and produces lactic acid.

Yup, very important detail here. It seems that sustained glycolysis in slight hyperglycemic state with presence of certain (oxydized ?) fatty acids causes cumulative damage to the mitochondria and all kinds of enzymatic machinery around them, that might be the central cause of insulin resistance in muscles (then causing obesity, diabetes type 2, fatty liver, etc.) and onset of Alzheimer's disease in neurons.

Edited July 8, 2015 by Jesrad

[PB666]

Lots of useful info here I've not seen mentions of the role of iron enrichment of food in dabetes/obesity trends though so I thought I'd add it.

Actually, that hypothesis was tested and turned out wrong. Exercize is either not very effective, or not effective at all, depending on the stage of metabolic disorder in the patient. Exercize is still healthy for all kinds of other reasons though.

I did mention that once an individual has entered the metabolic crisis phases they may experience such physiological depression they may be unable to exercise their way out. Exercise for borderline diabetes is effective, and it has an added benefit that it can reduce blood pressure by 10mmHg so it reduces the risk of other complications.

Speaking of physiological depression, excess iron intake, particularly in individuals with hereditary hemochromatosis can make physiological depression much worse, and it can exacerbate all kinds of problems. The physician needs to rule out other causes of physiological depression before recommending iron suppliment (unfortunately typical PCP are not very good at doing this), individuals may actually fair better by getting rid of iron if their saturation is above 72% (good ole fashion blood letting). Individuals should have a blood profile done to see what the hematocrit and hemoglobin levels are before packing alot of iron. About 1 in 50 mid-aged European males carry carry potential hereditary hemo. And increased consumption of lean red meat is sufficient to trip the switch on HC induced depression.

"Insulin resistance (often patients have already been diagnosed with diabetes mellitus type 2) due to pancreatic damage from iron deposition"-WP-Hereditary hemochromatosis.

There are other conditions also, like polycystic ovary syndrome that one needs to be aware of. So you know, can tell a story of a PCP who tested iron saturation and had a high level but forgot he did the test or tell the patient, and the patient walks into his office 4 years later with a 96% (the limit for ferritin test) saturation and spiralling physiological depression. It goes without saying that if there is another underlying cause for insulin resistance, and exercise and diet are not working the physician and patient should work together to find out what the cause is.

- - - - - - - - - - - - - - - - - - - - - - - - - -

Editorial addition to response: Although I thought the point previously made clear; I should point one area of agreement to Jesrad. For borderline diabetes or prediabetes (people with high A1C and normal fasting glucose), exercise may not be of benefit. Hemoglobin A1C is also seen in athletes and long distance runners, borderline and high A1C with normal fasting glucose is not the fault of lack of exercise although exercise will help to burn fat off the liver that the spike that creates the A1C creates. A1C is indicative of accumulating damage (independent of mitochondrial damage mentioned by Jesrad). This state is almost entirely due to glucose spikes, a result of modern processed foods and drinks and therefore the cause of the spike should be reduced or eliminated from the diet.

The one thing that really does work with diabetes type 2 is dietary adaptation by eating a lot less carbohydrates or switching to carbohydrates that are resistant to human digestion.

Yup, very important detail here. It seems that sustained glycolysis in slight hyperglycemic state with presence of certain (oxydized ?) fatty acids causes cumulative damage to the mitochondria and all kinds of enzymatic machinery around them, that might be the central cause of insulin resistance in muscles (then causing obesity, diabetes type 2, fatty liver, etc.) and onset of Alzheimer's disease in neurons.

But mitochondria can proliferatively replace themselves, there are 50 or so copies per cell, much more in a muscle 'cell'. Their are a whole host of problems of burning sugars instead of fats. Lactic acid build up damages neurons and other tissues. Its best to exercise before a meal than after. If you track a long distance runner from the beginning to the end of training for a marathon, the muscles demonstrate they are very good at responding to increase demand. There is an increase of blood flow, increase in myoglobin levels, and increase in mitochondria. The way to get a marathon like muscle mass good at burning fat and indirectly the fat that sugar produces is to excercise. To build muscle however a good source of lean meat is much better for fat, iron and low glucose. You will find yourself however at some outdoor market buying bison meat out of an ice-chest because most of the meat sold at grocery stores is loaded with bad fat (the only exception I can think of trimmed beef heart) and for certain individuals the high levels of arachidonate in in lot fed meat can exacerbate cramping and pain issues.

I think I am inclined to follow the believe that a person who regularly engages in vigorous exercise including vigorous walking has a trained muscle that will upon increased demand principally burn fat high, sugar or high fat diet aside. If a person does not reach this level of exercise, their bodies will prefer to burn sugars even if they occasionally vigorously exercise.

Edited July 8, 2015 by PB666