With type 2 diabetes the body is in general less sensitive to insulin, more insulin producing cells won't fix the underlying insensitivity issue, right?
Your typical T1 will prefer insulin therapy over immunosuppressants.
Me and me father both have T1 and he has received transportation of beta cells. Only because he was already on immune suppressants. I'll take insulin every day for the rest of my life happily if I never end up with his general health issues.
Note that beta cells are hardly unique in this regard. High blood sugar is toxic to all tissues, but the affects on some tissues are especially problematic, examples being retinas, kidneys, endothelium, and peripheral nerves.
In my case, my liver seems to emit a virtually endless amount of glucose, This is probably why I'm fat, and oddly, when my diabetes is well controlled, I'm never hungry, when its poorly controlled I'm hungry all the time and gain weight - which is how I was most of my life, being hungry virtually 24/7, even when my blood sugar was normal.
However, limiting your feeding window will naturally reduce the amount of time you spend with elevated blood sugar, without any calorie reduction. Again, that'll lower your HbA1c by definition.
Calorie reduction on the other hand can slow down metabolism
and cause a yoyo-effect.
The real issue is insulin resistance. Even if your blood sugar is "normal", it may take more insulin to achieve those levels. Elevated insulin levels are harmful by themselves. Also, if you go back to your old diet, you will still be insulin resistant.
Intermittent fasting can reduce visceral fat particularly in the liver and improve insulin sensitivity.
> New research suggests that intermittent fasting may raise insulin levels, damage pancreatic cells, and increase the amount of abdominal fat.
Specifically, the new study — led by Ana Cláudia Munhoz Bonassa, a researcher at the University of São Paulo in Brazil — suggests that intermittent fasting may impair the normal activity of the pancreas and the production of insulin, which may, in turn, raise the risk of type 2 diabetes.
> Firstly, it’s important to bear in mind there are important differences between rodents and humans – particularly with regard to diet. For example, a high fat diet causes insulin resistance in rats but it does not appear to in humans.
> The exact method is unclear from the abstract, but if the rats were fasted for one day, this is equivalent to an approximately 3 to 4 week fast in humans! So it’s not applicable to the 24-hour or 48-hour fasts practised by humans on common fasting diets.
(Note: the study made rats fast for 3 days)
Doesn't seem like the study I'd stop at when evaluating the benefits of intermittent fasting. For example, what about the promising ones that study actual humans and only see all markers improve?
I'd certainly stop going around spouting "fasting is bad" if this rat study is all you've got. Reminds me of that political cartoon of a soccer mom digging through a massive stack of studies, finally finding one that says vaccines might be bad, and going "Hah! Knew it!"
The entire "what should I eat" field is so full of bad science that I disbelieve everything. There is so much money to made here it's astonishing and it makes everyone's motives questionable.
I believe in a somewhat closer-to-the-nature approach without going stir crazy.
Moving from very processed foods to their less processed versions felt like a good move. I am playing this by the ear because as our conversation shows there is a study to counter every other study.
I personally believe that general food advice can't exist because surely our genetics play a role in how our body reacts to different foods -- foodstuff itself is very complex chemically, biologically.
In short, intermittent fasting is unnatural and
That can potentially kill a person with T2 through diabetic ketoacidosis(DKA). Please be careful if you refer this to someone else.
He looked me straight in the eye and said, “I wouldn’t publish this anywhere, we still have work to do.”
“What do you mean?” I asked.
“If Nature published every article that purported to cure a human disease based on a mouse model, then I would be next in line for the Nobel Prize,” he replied.
Harsh but true. The challenge of curing human disease cannot be replicated in animal models. At least not yet.
Then there is this thing that bugs me: amount of money spent on finding a treatment vs. preventing type 2 diabetes in the first place. Because 95% of type 2 cases are caused by life style decisions. And as climate change, healthcare costs, covid-19, and other self-inflicted societal crises we prefer to wait until it chronically costs a massive amount of money (add chronic deficit to the list).
Disclaimer: Not every T2D is purely from a bad diet. But many are.
The EBT program here in the US completely distorts the situation.
My local grocery store serves a very poor community, most of the customers pay with EBT. I get to see what kind of things these folks buy, it's idiotic. We could do a lot of good if EBT were only applicable to fresh perishable goods like produce/eggs/milk/fish/meat.
It almost seems like people on EBT hate themselves for being poor and lean in on being self-destructive while at the store paying for things with EBT. They largely buy processed/prepared junk food, it's unbelievable, but if you view the food they buy as another drug prodding the reward centers of their brains, it's making them feel good in the short-term while giving them diabetes and other ailments in the long-term. EBT enables affording it by being almost equivalent to cash.
On a personal note: I agree with you. It‘s hilarious what people buy even when they are on a tight budget.
Perhaps it's the people with poor impulse control and lack of education that end up economically poor. Maybe they never learned better.
Taking pleasure from those less fortunate than yourself is a trick of the ego. It makes you feel better about yourself by labeling someone else inferior. It comes from a place of insecurity about one's own worth.
By simplifying the problem to a group of people simply being inferior, you miss all the nuance, the complex system of factors that created the result.
It's much easier to dehumanize. But if we don't counter these primitive tribal urges, we are bound to repeat the tragedies of history.
This isn't true, at least in the US. Or maybe we have a very different idea about what "healthy" food is.
Rice, beans and starchy vegetables are problematic for various (different) reasons and non-starchy vegetables generally aren't very nutritious from a macro perspective, which makes them relatively expensive.
Unless you only buy organic, then you might go broke while hungry.
Produce may look cheap, but if you add up the macros (and also some of the micros), it doesn't look cheap at all.
I don't think there's a common understanding of how much time working class people have to spend on work. It's frequently on the order of 50-60 hours across more than one job, plus the attendant transit and pre-work chores. Your job doesn't provide you with cheap, healthy food on-site. You frequently can't eat on the way to or from work, per transit rules or enhanced police presence on your route. Lunch breaks are a strict 30 minutes, and being late can get you fired (hope whatever you're eating doesn't have too much fiber). You may have to go out of your way to shop, if you live in a food desert, and apartment fridges preclude buying in bulk. Oh, and for a racial angle, produce in cities (and, not uncommonly, in majority-minority suburbs) costs more than in white suburbs and rural areas.
We have so many UX experts on here, is it really that difficult to think of this problem as an experiential narrative instead of an engineering problem that can be solved by tweaking a few variables?
That depends on ripeness , I eat a mostly green banana every morning and it doesn't have much sugar at all while keeping my bowels very regular.
It's been my breakfast for decades, I'm quite healthy, and eat a diet almost entirely composed of raw produce. The rest is nuts/seeds/legumes and canned fish. I rarely ever cook, and if I didn't go for organic produce this would be a very cheap diet except for the nuts.
You get virtually all of your macronutrients from the nuts, seeds, legumes and the fish - not the produce.
> I rarely ever cook, and if I didn't go for organic produce this would be a very cheap diet except for the nuts.
So it would be cheap if it was something else, but it's not.
In any event, I consider any diet high in grains/legumes a science experient which may or may not work out. I don't consider it a healthy diet.
By volume most of the "nuts" are roasted unsalted peanuts, which are very cheap, and as you know actually legumes.
I just have a taste for expensive walnuts and cashews, and like organic produce, but I'm not poor.
Everyone can afford peanuts, or peanut butter. I prefer roasted intact peanuts since there's less opportunity for fuckery like replacing peanut oil with palm oil and adding sugar.
People also eat donuts for decades, that means nothing.
People didn't eat beans for hundreds of thousands of years. They're not a "natural" part of the diet. They contain poorly researched plant toxins and anti-nutrients, which can are known to cause issues in sensitive people.
Can you "mitigate" the problem with proper preparation? Apparently, but that doesn't mean we know they are actually healthy as opposed to "sustainable". Populations across the world which have no choice but to rely on grains and legumes as a staple do suffer from malnutrition.
> In observational studies „anti-nutrients“ are mostly associated with better health outcomes.
Observational studies are mostly useless, because anybody who buys into "legumes are healthy" will focus on living a healthy life in other aspects as well. As I said, swapping in legumes in place of donuts is going to be a benefit. That doesn't mean it's optimal.
"More than half of the world populations are affected by micronutrient malnutrition and one third of world’s population suffers from anemia and zinc deficiency, particularly in developing countries."
> I only have to show you that beans are just as much part of human diets as are other foods.
Again, that literally means nothing. Humans can survive on very poor diets.
> For donuts we see a direct correlation between sugary processed foods and obesity, T2D and other diseases. For beans you can not show this.
Of course, I never said beans cause T2 diabetes or any other "disease of civilization". They cause nutrient deficiences in populations that are underdeveloped. As for what it does with those few people in developed nations who choose to adopt a plant-based diet, there's just no good data, yet. That's a recent phenomenon.
> The only thing you can show is some mechanistic data, where we can speculate.
Of course we have to speculate, because we don't know. You can always ask for more evidence that this-and-that is or isn't harmful in some dose. Somehow, people are very wary about synthetic toxins or pesticides, but when it comes to natural toxins that plants produce to defend themselves, we don't really pay the same kind of attention.
What's the evidence that heavy metals, or dioxin, or any of the other pollutants are harmful in the doses that we allow them in? There isn't any, that's why we allow them. Does that mean harmful effects don't exist? No. It means we don't know any better.
Legumes just happen to be the biggest offenders of natural toxins in our diet. They all have a rich history of requiring preparation to become digestible at all. We're not evolutionarily prepared to handle them, we haven't eaten them as a staple for more than a few thousand years. That's a red flag.
> In my personal opinion you are the victim of an industry that wants to sell stuff like Gundrys supplements like „Lectin buster“ and the like.
I don't care about Gundry opinions or his supplements, he's no better than your nutritionfacts guy. Also, it's not like there isn't a whole industry behind selling the plant-based diet. A much bigger industry in fact, also fueled by ideology, ethics and virtue signaling. Red flags.
Also, in the west, a lot of the culture of preparing these foods (such as fermenting or vigorous soaking) is bypassed.
> Bean consumption is typically a good predictor for survival in elderly people.
That data suffers from the usual issues related to nutritional studies. Consuming beans in place of donuts may be a good predictor of health, that doesn't mean that beans themselves are healthy relative to other healthy foods.
I don't know if poor Americans are doomed to diabetes, but it is certainly orders of magnitude easier for the poor to eat poorly compared to the rich. Boosting morale in the poor is difficult without cheap fatty/sweet food and drugs, other poor people have nearly nothing else to get by excessive stressors except exercise. Running a perfectly clean life is admirable and very difficult with limited resources, social standing and spare time.
Rice in itself is a healthy food, especially when it is brown. I read a study some years ago where a doctor even cured mild forms of diabetes with high loads of rice instead of junk food. Don‘t have a link handy though.
Americans are not doomed to diabetes. Diabetes T2 is one of the easiest diseases to prevent. Vegans for example have 60-70% less diabetes according to observational studies like Adventist Health II.
I would say we spend way less on food than your typical American. It's really THAT cheap. Also we have a lot of food for CoViD-19 as we store a lot of food in our cellar all year around (lentils, whole oats, canned beans, etc.).
Ah, and we are not poor in any way. I'm among top 5% in Germany. I think it's just healthy and sustainable (for the same reason we don't own a car).
You also probably get way too much sugar from sugary fruits which you overindulge in because your diet otherwise is so "healthy". Instead of soft drinks you have fruit juices, which have effectively the same amount of sugar. Again, just a guess.
You probably got your nutrition advice from ideologically based publications, or you're just "winging it" based on what makes sense to you, in which case you're likely going to be wrong as well.
Heme iron is associated with disease in all major studies. I don‘t see a reason to ingest it.
I have a great O3/O6 ratio. I don‘t use oil at all and avoid foods that are filled with plant oils. My breakfast contains lots of flax seeds. Our usual foods contain hemp seeds. All good sources of O3. And all without pollutants from fish.
I get a lot of information from nutritionfacts.org. Dr. Greger offers free information as in free beer. No ads, no sponsors, even the earnings from his books are given to charity. I highly recommend you check him out. He certainly has his biases but still way less than most other doctors.
If you didn't have any animal foods, you're going to be missing out on B-vitamins, because of low bioavailability.
> Heme iron is associated with disease in all major studies. I don‘t see a reason to ingest it.
An excess of many essential nutrients and vitamins is associated with disease, that doesn't mean you should cut them out. Non-heme iron is way less bioavailable, especially in combination with plant antinutrients, so you can end up iron-deficient.
> I have a great O3/O6 ratio. I don‘t use oil at all and avoid foods that are filled with plant oils.
You probably should be using oil, just not plant oils.
> My breakfast contains lots of flax seeds. Our usual foods contain hemp seeds. All good sources of O3.
Unfortunately not, because those sources also have low bio-availability.
> And all without pollutants from fish.
Pollutants are unfortunate, but when it comes to nutrition, you have to pick your poisen. Salmon roe is a good source of Omega 3 that is low in pollutants.
> I get a lot of information from nutritionfacts.org. Dr. Greger offers free information as in free beer. No ads, no sponsors, even the earnings from his books are given to charity. I highly recommend you check him out. He certainly has his biases but still way less than most other doctors.
A plant-based diet is ideology that is cherry-picking and misrepresenting some insights of nutrition science while sweeping others under the rug. With his exaggerated claims, Greger isn't any more credible than certain people on "the other side".
Your thoughts on bioavailability are also outdated. It has been shown for protein, iron and some vitamins that bioavailability in practice is very good for plant sources. E.g. iron is converted as good as heme iron when combined with vitamin C. And it‘s hard to avoid C on a plant based diet.
May I ask where you get your information from?
Perhaps, but we're talking about nutritional deficiencies, have you tested for all of those? A vitamin deficiency can take up to a decade to manifest in symptoms.
> If you want to believe that animals are essential for human health, go on.
I don't want to believe that, I would prefer not to have to believe that. On the other hand, many people want to believe that animals are not necessary, for ethical reasons. That causes distortion and misrepresentation, because it would be inconvenient if a plant-based diet was not entirely healthy and nutritionally complete.
> Your thoughts on bioavailability are also outdated.
Those aren't "my thoughts", that is scientific data. Show me yours.
> It has been shown for protein, iron and some vitamins that bioavailability in practice is very good for plant sources. E.g. iron is converted as good as heme iron when combined with vitamin C. And it‘s hard to avoid C on a plant based diet.
> May I ask where you get your information from?
I get it from all available sources. If Doctor So-and-so claims this-and-that, I look at the scientific publications supporting that.
On top of that, I try to look at what's plausible from an evolutionary history perspective. A plant-based diet doesn't seem plausible. That doesn't mean it's not good, of course - especially compared to a junk food diet. However, there's a lot of "ethical incentive" to misrepresent it as better than it is. You gotta watch out for that.
The problem with B12 is more with low cobalt in the soil and genetically low absorption. There are now even bioactive plant forms of B12 like water lentil.
That's why I say a plant-based diet is science experiment with no plausible basis in evolutionary history. I'm not saying it's bad per se, I'm saying we don't actually know if it's good.
Looks like you have done your homework and are not in fact deficient, at least in terms of those biomarkers and reference values. A lot of plant-based dieters are not that diligent, affluent or educated.
You just have to get off your ass and actually go buy perishable fresh groceries regularly and plan for the week ahead.
Laziness and convenience prevails.
If it's a lack of time, then it's a lack of time to even hit the grocery store. Which depending on where you live, if it's a food desert situation, may be valid.
A well known joke in the diabetes community: the soonest way to find a cure for diabetes is to figure out how to turn humans into mice.
Do you have a source for that claim? My understanding is that genetics is the primary risk factor for diabetes.
In my world this is called cancer. So yeah interesting how they're actually able to tell cells how to grow. But you don't want liver cells mixed into your pancreas, do you?
> But if a quarter of the cells you make are actually liver cells or other pancreas cells, instead of needing a billion cells, you’ll need 1.25 billion cells. It makes curing the disease 25% more difficult.
I'd assume the reason they try to get clean cultures is that otherwise they'd be implanting tumors. Optimizing by 25% sounds like something they'd do after having proven it on the human model.
It's a known problem though and not an insurmountable one. There's been a lot of work with encapsulation of these cells in a barrier that will prevent the barely controlled tumor that is an artificial pancreas from breaking out and wrecking havoc. And methods that are getting better at controlling these cells like the one in this thread are promising ways of mitigating this risk moving forward as well.
All of everyone’s cells are derived from stem cells. The issue is still how prone to uncontrolled proliferation they are, not so much having a population of a particular cell type in the wrong place.
It isn't cancer unless it continuously reproduces.
Mutation is how one gets cancer. If only they knew how to detect mutated cells! They might just cure cancer!
Relies on currently quite expensive hardware (continuous glucose monitors / insulin pump / iPhone / Bluetooth to radio device) but that could all be combined into 2 cheap devices easily. Regulation and inertia just seems to be making that process very slow.
You should be careful using that word around type 1 diabetics. Incidentally I was on medtronic's loop system for about a year and a half, but you couldn't pay me enough to go back to it. Not saying it doesn't work for some people (often people with very stable hormonal systems who don't have large variations in their physical activity levels), but even in the best case calling it a cure is rough claim to hear being familiar with the reality of dealing with these things. I'm glad that it was a success for your friend though.