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Is Type 2 Diabetes Reversible at Scale?

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Re: Is Type 2 Diabetes Reversible at Scale?

#61

Post by pimeys »

turc1656 wrote: post #53
pimeys wrote: post #35

Earlier quoted context omitted.

> They know french fries are bad, but think it's because they are deep fried. When I tell them that a regular baked potato or red potatoes have glycemic index values of around 85-89 and that potato ships are around 50-55 they are stunned. Having T1D and a CGM I can say the normal potatoes are much easier to control compared to the french fries. The fat is really a huge problem if you dose your own insulin. It is guar…

Yes, fats slow the absorption rate of carbs so that makes sense that you will see a longer, protracted amount of time for the elevated blood sugar levels. You don't get the same spike and subsequent crash because it's more drawn out. I also don't know if the fact that you are Type 1 instead of Type 2 affects anything I said. I don't know enough about Type 1 to comment. Anything I said is specific to Type 2.

That's why I'm trying to comment with care. Just the facts how I can see fatty food with a CGM and a closed loop:

60g of carbs from french fries will mean you take insulin for about 40g of carbs now, then for 60g of carbs starting in one hour and divided to the next 2-3 hours.

For normal potatoes, 60g of carbs, you'd take insulin for the 60g right now and that's it.

You see how a combination of fat and carbs is really tricky when you need to keep a good control of your glucose values. There is good help for us T1 diabetics, algorithms such as oref1 with super micro boluses help to control the delay and additional raise of glucose when eating fatty food.

Ketosis is also something I'd never recommend to a T1D. It can lead to very nasty symptoms; cramps and headache. Can't say anything about T2Ds, people reading these should always consult a doctor before making any decisions of their treatment.

Re: Is Type 2 Diabetes Reversible at Scale?

#62

Post by turc1656 »

magic_beans wrote: post #37
turc1656 wrote: post #31

"...based on highly individualized carbohydrate restriction and nutritional ketosis" That's really the key to what is fixing the diabetes. And it's just a brief mention in the article. Nothing else about the nutritional aspects. This was extremely light on actual, real information. That being said, I'm also not sure why this stuff is still considered news. Many people, myself included, have been saying for some years…

I have a dumb question. Can diabetes actually be "fixed" with a keto diet? What if a T2 diabetic does carb restriction and keto for a year and "reverses" their diabetes. If they eat cakes and cookies for a week at Christmas, does the T2D come crashing back?

Yes and no. I'd say there is a difference between managing and fixing. All the current treatments by doctors are surrounding management. I do fully believe that Type 2 can be fixed in almost everyone with enough time on the proper diet.

From what I have seen/read, it seems to me that Type 2 is caused by a recurring assault on your metabolic processes through significant carbohydrate over-consumption. That damage accrues over time which is why it usually takes decades to become a full-blown Type 2 diabetic. It would therefore take years to fully "fix" it in a person - and that is assuming the accumulated damage is actually reversible. I believe there are some people who have damaged their bodies too much for it to actually be fixed. And on the other hand I rarely ever hear about anyone actually being full keto for years on end, providing the requisite time for their bodies to adapt and heal. It's not a quick process. The less damage, the quicker the improvement and the shorter the total time to "fix".

As to your original, direct question - I doubt it would come crashing back after just one week of bad habits. But that also has to do with the glycemic storage in your body. You muscles hold (I think it was) around 100-200 grams of potential glucose and your liver can hold something like 400-500 grams. If someone is low-carb for even a short amount of time, these "storage tanks" (as I refer to them) in the body are basically empty or close to it. As you consume garbage the excess that is not needed is added to these tanks. Once the tanks are full, the overflow goes into your blood, raising your blood sugar above normal levels. So you would have to consume somewhere between 500-700 grams in excess carbohydrates before you even started overflowing into your blood stream to have elevated levels. That's pretty hard to do in a single week. And the metabolic damage doesn't magically come back overnight. It's kind of like if you had a really bad sunburn and let it heal. The next time you went out into the sun you skin doesn't turn red immediately - the damage has to actually incur/accrue.

Re: Is Type 2 Diabetes Reversible at Scale?

#63

Post by djsumdog »

Numberwang wrote: post #34
devmunchies wrote: post #30

Earlier quoted context omitted.

Fat + Carbs makes you fat. Cut out one and you lose weight. I'm on a plant based diet which is high carb (no highly-refined carbs) and I'm very fit. If your body's glycogen stores are full from carbs then YES fat you consume goes straight to fat. EDIT: and WFPB (whole food plant based) also reverses type 2 diabetes.

Thank you for being a voice of reason in all this. When this ketosis madness ends and we go back to eating plant based like our ancestors did the world will be a better place with healthier humans and no factory farms.

I think you can do either, and I should have added that to my post. Veganism isn't a health diet straight out; it's a political diet. But you can be very health (lots of plant, plant carbs and very little fat) or very unhealthy (nothing but Oreo cookies).

I agree with the poster that a high carb/low fat diet can also be pretty healthy, but you pretty much do have to do one or the other.

Both approaches are difficult, because the food supply/industry isn't really setup for it. There are a ton of unhealthy vegan meals in vegan restaurants as well, where they load up on refined sugar and not as many plants.

They keto stuff isn't madness though. It's just a different approach and it works for some people.

Re: Is Type 2 Diabetes Reversible at Scale?

#64

Post by turc1656 »

bena wrote: post #60
turc1656 wrote: post #47

Earlier quoted context omitted.

There are some healthy and natural oils, but yes the vast majority of the oils we use are cheap, processed garbage. The real issue is that our bodies aren't designed to consume, for example, vegetable oil in mass quantity because the amount of actual vegetables you would need to consume to get that same amount of the oil is simply impossible to do. Those refined oils aren't handled in the same way the healthy, natura…

Plain old lard contains over 100 calories per tablespoon. It's not really a battle between processed and unprocessed. It's just simple math. Oil and sugar pack a lot of calories in a very small package. We eat multiple times every day. We have the entire variety of food at our disposal multiple times every day. I can have a feast for every meal. Most people eat like royalty of the past. This is new. Most of us live p…

I respectfully disagree. Calories are not created equal.

https://www.health.harvard.edu/blog/theres-no-sugar-coating-...

https://www.webmd.com/diet/news/20120626/all-calories-not-cr...

"That’s just not what the unbiased studies have shown. Looking only at calories ignores the metabolic effects of each calorie; the source of the calorie changes how you digest it and how you retrieve energy from it."

Re: Is Type 2 Diabetes Reversible at Scale?

#65

Post by mindcrime »

I'm starting to believe that calorie restriction is the key, with carbohydrate restriction playing a role as well.

For context, I'm a T2 diabetic, whose diabetes has "progressed" to the point that I take insulin. I'd recently had to adjust my dose to 100U / day (I only use a once a day, long-acting insulin at the moment).

Then a buddy of mine mentioned a book on fasting[1] and said that some diabetics had had great results from fasting. I ordered the book, but haven't read it yet. But I did start a sort of psuedo-fasting routine of my own design. Basically, I allow myself a normal sized meal, and then for the next 48 hours I an aggregate total of maybe 1000 calories. A typical meal during that time is a thin soup made of chicken broth, jalapeno peppers, banana peppers, cherry peppers, cactus and onion, with some spices thrown in for flavor. Note that jalapeno peppers, banana peppers, and cherry peppers, and cactus share a common trait: extremely low calorie content, and low carbohydrate content.

Anyway, after doing this for about 2 weeks, I can already see a pronounced difference (for the better) in my blood sugar numbers. And that's even after lowering my insulin dose a bit.

I don't know that the protocol I'm using is anything close to what the experts recommend or not. But it definitely seems to be having a positive impact. I'm really looking forward to seeing how this works out long-term. Especially once I can start lifting weights again (I hurt my arm a few weeks ago doing some bench presses and haven't been able to lift for a while). Resistance training has been shown to help with insulin resistance, so I'm hoping the combination of regular lifting and this dietary approach will yield some good results.

[1]: https://www.amazon.com/Complete-Guide-Fasting-Intermittent-A...

Re: Is Type 2 Diabetes Reversible at Scale?

#66

Post by hyoogle »

Dr. Eric Berg has a great Youtube channel where he explains his take on how a ketogenic diet and also intermittent fasting (and the two together) can help to reduce insulin resistance (and type 2 diabetes) and improve metabolism. I personally find his explanations very helpful:

His channel: https://www.youtube.com/channel/UC3w193M5tYPJqF0Hi-7U-2g

One video: "Can Diabetes be reversed?" https://www.youtube.com/watch?v=NdpnAkYlWwo

Re: Is Type 2 Diabetes Reversible at Scale?

#67

Post by turc1656 »

nradov wrote: post #55
turc1656 wrote: post #31

"...based on highly individualized carbohydrate restriction and nutritional ketosis" That's really the key to what is fixing the diabetes. And it's just a brief mention in the article. Nothing else about the nutritional aspects. This was extremely light on actual, real information. That being said, I'm also not sure why this stuff is still considered news. Many people, myself included, have been saying for some years…

Boiled potatoes are becoming more popular as fuel for competitive endurance athletes specifically because they have a high glycemic index. https://gearjunkie.com/bike-team-race-food

Yes, but those people are taking it because they have a specific, immediate need to use the energy. Starches are quick energy, so it's fine for these people to use because it's being put to immediate use and will not end up sloshing around in their blood stream, raising their blood sugar. Also, because of the nature of what they do, these athletes almost certainty have a near-zero store of glucose in their bodies at any given time. The muscles and liver combined can store anywhere between 500 and 700 grams of glucose for immediate use in the average person. But these athletes are consistently using it up, thereby having the ability to consume these starches with no ill effects.

Personally, I've seen this in myself when doing strenuous physical labor on hot days - for example, doing yard work in 90 degree heat or moving lots of heavy boxes when helping someone move. On these days, I can consume quite literally anything I want and my blood sugar will not budge an inch (I regularly test myself even though I don't have diabetes). It's essentially impossible for me to crack 110 on those types of days even if I consume a gigantic soda, gatorade, etc, with a garbage meal. I've actually tested this theory several times on myself and it has consistently held true.

Re: Is Type 2 Diabetes Reversible at Scale?

#68

Post by aaavl2821 »

turc1656 wrote: post #31

"...based on highly individualized carbohydrate restriction and nutritional ketosis" That's really the key to what is fixing the diabetes. And it's just a brief mention in the article. Nothing else about the nutritional aspects. This was extremely light on actual, real information. That being said, I'm also not sure why this stuff is still considered news. Many people, myself included, have been saying for some years…

Lack of information is certainly a problem but food insecurity and habits are also very important. A lot of people would have a really hard time, logistically, maintaining a ketogenic diet [0]

I'm also somewhat skeptical of the evidence that the ketogenic diet can cure diabetes (or cancer / autism etc). I haven't looked into it in depth, so may be wrong, but all I've seen in the way of evidence are 1) anecdotal cases 2) hypotheses about a supposed biological mechanism (haven't seen any good studies validating this mechanism) and 3) appeals to evolution, i.e. "People ate low carb for most of human history etc", again with no rigorous science (that I've seen) to support this, just logical sounding claims

You'd need large randomized controlled trials to really test 1) whether it works, 2) whether it's safe and 3) whether the benefit is attributable to a low carb diet or to people just being on a diet in general. Unfortunately those are expensive so will probably never be done because no one requires them (like FDA for drugs)

Proponents of keto diet also cite the entrenched corporate financial interests that led the low-fat wave based on shoddy science. The same dynamic is at play with low carb. I asked a very well funded company marketing keto diet products about their clinical research efforts, and they said they don't have a clinical research arm -- all the clinical studies fall under the marketing department

I'm not saying it's pseudoscience, but based on the limited data I've seen I don't think we can rule that out

[0] https://www.google.com/amp/s/www.citylab.com/amp/article/560...

Re: Is Type 2 Diabetes Reversible at Scale?

#69

Post by jklinger410 »

deno wrote: post #20
jklinger410 wrote: post #15

This is just a native ad for Virta, a company operating in the diabetes technology space.

Someone writing about something they’re involved with or excited about on their personal blog is a “native ad” now? The article even contains a disclaimer.

I do get what you are saying. I was at a startup operating in this space, so I want to counter your defense of this particular post.

You can read Virta's press releases and find all of this information. You can read many of Virta's competitor's press releases and also find similar information.

There isn't much he is adding here except his personal perspective on already well-promoted information.

This comes across a bit as using your own employees for some light "influencer marketing."

I have no problem with the author, the article, the writing, anything, other than to put out that its inclusion here in Hacker News is a bit off, considering the points I made above.

Re: Is Type 2 Diabetes Reversible at Scale?

#70

Post by deno »

jklinger410 wrote: post #69
deno wrote: post #20

Earlier quoted context omitted.

Someone writing about something they’re involved with or excited about on their personal blog is a “native ad” now? The article even contains a disclaimer.

I do get what you are saying. I was at a startup operating in this space, so I want to counter your defense of this particular post. You can read Virta's press releases and find all of this information. You can read many of Virta's competitor's press releases and also find similar information. There isn't much he is adding here except his personal perspective on already well-promoted information. This comes across a…

Within the confines of his own blog, the author should have every right to make this kind of post. Promoting any company to your audience means putting your reputation on the line. Any recommendation you make yourself is within this social contract, which is why it’s non-controversial.

“Native Ads” OTOH present themselves as something they are not. They are controversial precisely because they break the contract the author or editor have with their audience.

As to the inclusion on HN I suppose it is a little weird, but I think it can be explained by name recognition, for example from a recent Joe Rogan’s podcast, which I think is quite popular here.

I suppose your point is that the article doesn’t quite deliver on the title. I would agree, but my contention is with the pejorative connotation of calling something a “native ad”, which I think is undeserved.

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