Reversion To Normoglycaemia Occurs More Often Than Progression To Diabetes

Kelj

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This study:

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Finds:


"during a 12‐year follow‐up, 42% older adults affected by prediabetes remain stable, 22% reverted to normoglycaemia, whereas 13% progressed to diabetes or 23% died."

Also, the study, interestingly, has this to say:

"glycated haemoglobin A1c (HbA1c) values increase with age amongst diabetes‐free subjects, and low glucose level may increase mortality in old age 13, 14."

As with cholesterol levels, mortality is found @ lower levels. Why are we lowering it?

I believe this quote from the Eating Disorder Institute explains the effect this study was observing:

Diabetes Mellitus Type 2, Metformin, Disease Risk and You

"we need to reaffirm that the vagaries of blood glucose and insulin levels for those actively in recovery from an eating disorder can mimic the onset of diabetes mellitus type 2 but may not actually represent the onset of type 2 at all. Given that spontaneous adjustment of aberrant blood glucose and/or insulin levels back to the norm will occur for most as recovery from an eating disorder progresses, then we would be stretching diagnostic frameworks to refer to something transient and self-correcting as equivalent to diabetes mellitus type 2 in its usual presentation in old age......

diabetes mellitus type 2 is not a disease— it’s a risk factor for developing disease. That means that not everyone with diabetes type 2 (treated or untreated) will ever develop any disease state that is more strongly correlated with the presence of type 2 than for those who don’t have the condition."

If this study had asked its subjects about anything that had been happening to cause them to undereat, especially carbs, which was corrected over the 12 year span of the study, I believe they would have found that those who corrected the energy deficiency were the ones who reverted to normal glucose levels. I have seen this happen, just as the Eating Disorder Institute explains.
 

LUH 3417

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In my personal experience, a stint with the paleo diet when I was 24 landed me as prediabetic with hba1c of 5.7 even though I was exercising and eating “healthy”. After normalizing my eating and incorporating all foods, it went to down to 5.
 
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Kelj

Kelj

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Me, too. Low carb and intermittent fasting. How many people fool around with some kind of low carb eating and while their body is making the adjustment to provide glucose from the body's tissues at a protectively higher level than normal, they visit the doctor. The doctor sees a high blood glucose level and at the very least, recommends lowering your carb intake, losing weight, maybe (causing typically more restriction and stress), following the glycemic index, etc., and this advice just entrenches the body's up regulation of glucose level.

That's why the Eating Disorder Institute says this in its letter to doctors:

"Advising any patient to diet and exercise to ameliorate morbidity or mortality outcomes is not evidence-based medicine, 2 but to suggest these things to a patient with an eating disorder precipitates increased severity of the eating disorder. 3"
 

LUH 3417

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I also started to wake up to pee multiple times a night around the same time. I wonder if I damaged my kidneys.
 
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Kelj

Kelj

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"Physiological effects of chronic energy deficiency in the body are as follows: anemia, hypoproliferative bone marrow (failure), leukopenia (low white blood cell counts), decreased thiiodothyronine, thyroxine and luteinizing hormone levels (polyendocrine deficiency syndrome), abnormal gastrointestinal motility, atrophy and possible ulceration, constipation/diarrhea, severe liver dysfunction, myofibrillar destruction (damage to heart muscle) and amenorrhea. Also usually present are: low basal metabolic rate, cold intolerance, abnormal calcium metabolism, osteoporosis, serum protein abnormalities (leading to chronic or acute kidney disease), electroencephalographic abnormalities (impaired brain function) and altered skin texture and pigmentation.

Physiological effects of chronic bouts of starvation/reactive eating cycles are as follows: all of the previous list for the most part, although anemia is less likely to be present, and also hypertension, elevated low-density lipoproteins (bad cholesterol levels), artherosclerosis (progressive deposition of fatty deposits on arterial walls, leading to heart disease) and excessive subcutaneous abdominal fat due to long term elevated serum glucocorticoid levels."

BUT, EVEN SO,

"when a patient is actively restricting, both hypothalamic dysfunction and secondary renal (kidney) damage (i.e. damage attributable to restriction of energy intake) can generate results that would indicate a progression towards kidney failure. Yet the anticipated organ failure is not realized when the patient reaches full remission. In other words, you may be told that you have progressive renal disease that will result in kidney failure, but the complete reversal of hypothalamic dysfunction, when you reach remission, may leave you with kidneys that are inherently not in any danger of failing at all.

The above lists are by no means comprehensive, but rather indicative of the scope of restricting energy intake such that the body must make up the deficit with catabolism (destruction of its own cells to release energy).

And, in case applicable:

" a somewhat ominous controlled study suggests that the use of antidepressants (increasingly prescribed for those with eating disorders in the absence of solid clinical data to support their use) exacerbate abnormal osmoregulation (kidney function). 1"
 

haidut

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This study:

Error - Cookies Turned Off

Finds:


"during a 12‐year follow‐up, 42% older adults affected by prediabetes remain stable, 22% reverted to normoglycaemia, whereas 13% progressed to diabetes or 23% died."

Also, the study, interestingly, has this to say:

"glycated haemoglobin A1c (HbA1c) values increase with age amongst diabetes‐free subjects, and low glucose level may increase mortality in old age 13, 14."

As with cholesterol levels, mortality is found @ lower levels. Why are we lowering it?

I believe this quote from the Eating Disorder Institute explains the effect this study was observing:

Diabetes Mellitus Type 2, Metformin, Disease Risk and You

"we need to reaffirm that the vagaries of blood glucose and insulin levels for those actively in recovery from an eating disorder can mimic the onset of diabetes mellitus type 2 but may not actually represent the onset of type 2 at all. Given that spontaneous adjustment of aberrant blood glucose and/or insulin levels back to the norm will occur for most as recovery from an eating disorder progresses, then we would be stretching diagnostic frameworks to refer to something transient and self-correcting as equivalent to diabetes mellitus type 2 in its usual presentation in old age......

diabetes mellitus type 2 is not a disease— it’s a risk factor for developing disease. That means that not everyone with diabetes type 2 (treated or untreated) will ever develop any disease state that is more strongly correlated with the presence of type 2 than for those who don’t have the condition."

If this study had asked its subjects about anything that had been happening to cause them to undereat, especially carbs, which was corrected over the 12 year span of the study, I believe they would have found that those who corrected the energy deficiency were the ones who reverted to normal glucose levels. I have seen this happen, just as the Eating Disorder Institute explains.

Perfectly consistent with the evidence that diabetes II is driven by environmental factors that tend to be episodic in nature and for many people do pass - i.e. crazy diet, over exercising, stress at work/home, living in a toxic area, etc.
 

CLASH

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True Type II diabetes from what i’ve seen is characterized mainly by increased endotoxin levels and consumption of PUFA.

Also it seems that Heart disease is driven by increased PUFA and endotoxin as well.

Random high blood glucose readings and an increased hemoglobin A1C are associative factors at best from my understanding. Both PUFA and endotoxin directly impact energy metabolism in a very negative way. Low carb causes similar features but I think the mechanisms are different in nature.
 

nbznj

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Ny HbA1c went from 6.2% down to 5.4% within a year (annual checkup) when I started strongly restricting proteins and fats in favor of carbs, mostly fruits rice and tubers. Then I got loose again and started eating more meat and some fats, back up to 5.7% as of February of this year. Haven’t checked back but I’m not deviating from my current macros anymore with two thirds of my calories from carbs and 50-60g of fats per day

Basal temperature is up, mood is good, I don’t train very hard anymore anyway so there’s that too.
 

LeeLemonoil

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Low carb leads to a transient so called physiological insulin-resistance, that’s proven. The body prioritizes glucose suppply to the brain by altering transcription of insulin receptors in the periphery. But hardly any low carver or keto acolytes know or acknowledge that
 

nbznj

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Low carb leads to a transient so called physiological insulin-resistance, that’s proven. The body prioritizes glucose suppply to the brain by altering transcription of insulin receptors in the periphery. But hardly any low carver or keto acolytes know or acknowledge that

That, and Cortisol ramping up glycogen synthase, to keep the liver and brain healthy. Low carb is wrong on pretty much every level, but hey at least it gets some to eat more whole foods so that’s a start somewhat.
 
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Kelj

Kelj

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Low carb leads to a transient so called physiological insulin-resistance, that’s proven. The body prioritizes glucose suppply to the brain by altering transcription of insulin receptors in the periphery. But hardly any low carver or keto acolytes know or acknowledge that
Yes, I have seen this over and over. People often start the low carb regimen with the desire to lower their blood glucose. The initial readings are lower and they rejoice that they've solved their problem. Eventually, if they keep following a low carb diet, their blood glucose levels rise higher and higher, especially the fasting glucose reading. Honestly, it should be very worrying to low carb dieters if their blood glucose levels do not rise. The rise in glucose is an indication that your body is making adjustments to save your life. What does it mean if your body isn't making this and other life-saving maneuvers?
 

mbachiu

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@Kelj I am interested to hear about your particular experience with this refeeding & experiencing diabetic symptoms. Do you have a post or discussion outlining your experiences? I am in active recovery & have been since March of this year. So far, I have felt quite poorly & am experiencing lots of concerning health issues, like symptoms of diabetes. Thanks for any insight.
 
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Kelj

Kelj

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Reassuring on the subject of symptoms in eating disorder recovery are these articles from edinstitute.com:

Pain I: Why Is There So Much in Recovery? — The Eating Disorder Institute

Symptom Questions — The Eating Disorder Institute

Specifically, on the subject of blood sugar readings:

Diabetes 2: Recovery, Insulin, Existential Threat, Bias and Decisions — The Eating Disorder Institute

Quotes from this article:

"We know from the literature....mortality rates for diabetes are almost completely not impacted by the management of blood sugar levels. 1, 2 ... mortality rates for those with diabetes (treated or untreated) are not that much different than for those without it. For the references on all of that, please look out these papers: Diabetes Mellitus Type II, Metformin, Disease Risk and You, Biomarkers and the Fear They Represent, Obesity Basic Facts II and Obesity Science in Context.

Blood glucose level is a biomarker......
close management of blood glucose levels leads to macro and microvascular complications, pancreatitis in some, and increased risk of cancer in others. 8, 9, 19, 11 The most serious risk from insulin treatment will be a single hypoglycemic event (low blood sugar) which can lead to seizures, unconsciousness and death. Any hypoglycemic episode increases risk of cardiovascular death and stroke. 12 In fact, some research investigation now suggests that risks of cardiovascular death correlated with the presence of diabetes mellitus type 2 is confounded by a greater risk of cardiovascular death correlated with management of diabetes mellitus type 2 through the control of blood glucose levels triggering episodes of hypoglycemia. The risk of cardiovascular disease due to hypoglycemia was found to be greater in one systematic review and meta-analysis than that of the presence of hyperglycemia/diabetes mellitus type 2. 13"

A personal comment here:
When we began to view the body from a different perspective in my family, we began to see the rise of blood glucose as a life-saving maneuver on its part. Low blood sugar, hypoglycemia, is what will kill you quickly. It occurs as a result of even temporary starvation. Our bodies have the life-saving ability to turn the tissues making up our bodies into the glucose which is absolutely vital for the survival of our cells. If we starve our bodies, especially of carbohydrates, this life-saving emergency response is triggered until we provide enough calories, especially carb calories, in our diet. The brain selects the glucose level. It uses our tissues to keep the glucose coming in abundance, until we run out of tissue. That is why the results of treating "high" blood glucose are as outlined in the above scientific references. To treat it and force the glucose down is going against what the body is trying to do for itself to survive the starvation.

The article goes on to say:

"Unfortunately, there is little research data on the presence of hyperglycemia during recovery from an eating disorder. Pancreatic function is impaired due to starvation and its ability to return to full function is a work in progress during recovery. 16, 17 And such limited research as there is on the topic suggests that many metabolic anomalies resolve with continued recovery efforts in the absence of any treatment intervention. 18"

Some quotes from this article:

Diabetes Mellitus Type 2, Metformin, Disease Risk and You — The Eating Disorder Institute

"diabetes mellitus type 2 is not a disease— it’s a risk factor for developing disease. That means that not everyone with diabetes type 2 (treated or untreated) will ever develop any disease state that is more strongly correlated with the presence of type 2 than for those who don’t have the condition."

"we need to reaffirm that the vagaries of blood glucose and insulin levels for those actively in recovery from an eating disorder can mimic the onset of diabetes mellitus type 2 but may not actually represent the onset of type 2 at all. Given that spontaneous adjustment of aberrant blood glucose and/or insulin levels back to the norm will occur for most as recovery from an eating disorder progresses, then we would be stretching diagnostic frameworks to refer to something transient and self-correcting as equivalent to diabetes mellitus type 2 in its usual presentation in old age."

And back to this one:

Diabetes 2: Recovery, Insulin, Existential Threat, Bias and Decisions — The Eating Disorder Institute

"It is not my job to tell you how to address any specific symptoms or how to arrive at developing your decision-making list for treatment. It is my job to try, to the best of my ability, to provide you with the research and the strengths and limitations of that research so that you can determine, alongside the advice from your actual medical advisers, whether the benefits of treatment outweigh the risks in your specific case—to develop your own decision-making list that works for you.

Secondly, you own your treatment decision. If you are influenced by my writing, or conversely anecdotal suggestion, or heaps of drug-company-supported illness associations and foundations and their “informational” materials, or your own medical practitioner’s reasoned advice…no matter how you arrive at your treatment decision it’s yours and no one else’s."

I concur with this. We did, indeed find, however that blood glucose eventually normalizes when we stop starving ourselves. Also, when we stop starving ourselves, kidneys function properly, nerves are not cannibalized and repair, eyes repair and function normally and wounds heal quickly. All these things are symptoms of a body without the energy to repair itself. They and everything else fixes with enough energy. Calories are the energy. Glucose is the fuel.
 

mbachiu

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@Kelj thank you for providing those articles. I found them very helpful to read. I also appreciated you sharing the change in your family’s thinking about high blood sugar. When I was younger I would have a lot of hypoglycaemic attacks & I didn’t really think much of them. Throughout this whole process of recovery, I’m starting to realize that I was probably never fueling my body properly, which is likely what lead to so much dissatisfaction & abuse of my body in the first place. Thanks again. I very much appreciate you sharing those articles.
 

Sofia

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Thank you, extremely usefull. I can merge this with Peats ideas, the whole picture gets more clear.
 

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