Saturday, December 8, 2012

What can keep type 2 diabetes from coming back?

Q. My mom has type 2 diabetes and the doctor said it was resolved after she lost over 100lbs but now she broke her ankle. She can't really move for 6 to 8 weeks and we live on the second floor in a studio. Is there anything we can do to make sure her diabetes doesn't come back?

A. Type 2 diabetes is control by lifestyle change -- proper diet, proper exercise, and weight control.

You mom may not be able to exercise right now, but she CAN control her diet and her weight. Being pretty much inactive, she will need to REDUCE her calorie intake by eating less food.

She also needs to get up an exercise that broken ankle (as the doctor permits) so that she can get back to physical activity, and thus increase her food intake.

"Resolved" is the wrong word. "Controlled" is correct. Diabetes will NEVER leave you -- you can only CONTROL IT, WIC it seems as though you Mom has done. She must now work harder on the diet since she is temporarily inactive. in the mean time, work the necessary Physical Therapy to get the ankle back in shap so that she can resume her previous exercise level, thus KEEPING the diabetes under control.


Can I join the military if I have type 2 diabetes?
Q. I realize that if you have type 1 diabetes you are automatically disqualified, but I control my type 2 diabetes simply by consuming a diet low in sugars and this works fine for me.


What is the militarys stance on this?

A. No. http://usmilitary.about.com/od/joiningthemilitary/a/intmedstandards.htm


What are some risk factors for type 1 and type 2 diabetes?
Q. What are some risk factors for type 1 and type 2 diabetes? What went wrong with the insulin production and how does that affect the body�s ability to fuel itself with blood sugar? This is a bit confusing to me so I would appreciate any help. Thank you.

A. Type 1: In majority of cases, the causes is unknown (idiopathic diabetes). In other cases, immune disorders can cause type 1 diabetes. Factors that precipitate the diabetes onset include certain bacteria, viruses and some food chemical toxins. Other factors include: family history; ethnicity (non-Hispanic population such as Americans, Caucasians); auto-immune disorder (celiac or thyroid diseases); when your mom has stopped breastfeeding you in the first three months; being a men.

In this case your body recognizes its cells as "stranger" and begins to fight them. Therefore, beta cells of pancreas are destroyed and cannot produce anymore insulin.

Type 2: Risk factors are divided in a) those you can control (weight; diet; alcohol intake; smoking; stress; malnutrition), and b) those you can't control (family history; age; being part of high-risk population).

In this case, beta cells of pancreas can still produce insulin; however for the above-mentioned factors, this insulin is not effective in the periphery (muscle or fat cells).

In both cases (type 1 and 2 diabetes); what we have inherited in our genes is a major factor.


Why do healthy people get Type 2 diabetes? How is this caused?
Q. I've seen a few type 2's that have a healthy diet, are fine in weight etc. How did they get Type 2 diabetes?

A. Well there are some theories about it.

For most type 2's, there is usually a genetic tendency in their family to be predisposed to diabetes. However, you can also have pancreatic damage through viruses, surgery and other events.

Type 2 diabetes is NOT caused by weight gain. Its caused by increased insulin resistance. In most type 2's, insulin resistance itself contributes to weight gain and rising blood sugar, which in turn aggravates the insulin resistance. This leads to a viscous cycle of weight gain, and increasing blood sugar and worsening insulin resistance. This is why most type 2's are overweight.

They can diet and exercise and still not be able to lose much weight, because their insulin, pancreas and cells just don't work together optimally. And they put the weight back on very quickly, and more besides.

Eventually, this leads to the pancreas burning out and being unable to produce enough insulin, and in fact can eventually stop producing insulin altogether. This is called insulin dependent type 2. If your body can't make enough insulin for its needs, (even if it can still make some), it still isn't enough for good blood sugar control. At this point you have to start injecting insulin, just like a type 1 does.

Some type 2's are lucky and don't have the weight gain, but start making less insulin than their body needs, and their blood sugar rises. This is more similar to type 1 diabetes but it happens slowly, not quickly, like type 1. (Sometimes this is called type 1.5, but its not a correct medical term). It can be caused by a virus attacking the pancreas, or some other trauma to the pancreas, such as surgery, or it can even be induced by medications such as beta blockers, etc.

Another reason some type 2s do not gain weight is because they "spill sugar". Their blood sugar is too high and the kidney's spill the excess sugar in the urine. This is very unhealthy, and damages the kidneys. It also leads to nerve damage and circulation problems.

Type 2 diabetes is usually about insulin resistance and the subsequent weight gain, but can also be caused by reduced insulin production.

Sometimes type 2 comes on because an older person's pancreas just gets worn out as they age, (usually in their 70's, 80's, or even their 90's.

Another possible factor is faulty insulin. You might produce enough insulin, but it may not work very well, leading to overproduction, insulin resistance, weight gain (or not, if you spill enough sugar) and rising blood sugar.

Type 2 diabetes is not studied nearly as much as type 1, even though type 2 makes up around 80% of the cases. Its not a popular topic, and doesn't seem to be as well understood.

There are a lot of misconceptions about type 2 being caused by weight gain, but we now know that insulin resistance and faulty insulin production are responsible for rising blood sugar AND weight gain.





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