# I thought you couldn't reverse diabetes?



## lucy123 (Mar 25, 2011)

HI

I am really confused as I thought we all thought that diabetes could not be reversed. However I recieved the diabetes.co.uk email this week with the following article?
http://www.diabetes.co.uk/reversing-diabetes.html

Have I misunderstood something. I would be very happy if I could reverse mine!


----------



## C*5_Dodger (Mar 25, 2011)

lucy123 said:


> HI
> 
> I am really confused as I thought we all thought that diabetes could not be reversed. However I recieved the diabetes.co.uk email this week with the following article?
> http://www.diabetes.co.uk/reversing-diabetes.html
> ...



Dear Lucy,

Here's the relevent section from the article you quote:

"In some cases, people may find they are able to come off medication, although blood sugar levels should be checked regularly as reversing progression of diabetes is *not a cure*". They really mean you can slow the progression - there is no cure!

Regards  Dodger


----------



## margie (Mar 25, 2011)

Just in case we have any new members diabetes.co.uk and diabetes uk are not the same organisation.

I had a quick look at the article and its talking about reversing progression - which is a totally confusing term.

Diabetes is very complicated and has so many factors. Some people who have gastric band surgery discover that they no longer need any medication and their blood sugar results return to normal (I have a relative in the US where this happened). In their case their weight has been such that it has increased insulin resistance to a point their body could not cope, the removal of the weight means they can. 

However, not everyone who loses weight will be so lucky.

Reversal is a bad term - because people think cure and its not, the issues that caused the diabetes to occur will still be there.


----------



## lucy123 (Mar 25, 2011)

I understand there is no cure - but if you can reverse yourself from type 2 to glucose intolerant and then even further back to normal through good control - that is good isn't it. I understand too that even if you got back to normal, you would still have to maintain good control or would be back where you started.

I thought before once at the type 2 stage you couldn't move backwards into anothe category (if thats the right word)


----------



## Northerner (Mar 25, 2011)

I agree, reversal is a very bad term to use. It is possible for many people to improve their blood sugar levels by improving their insulin sensitivity - making appropriate changes to diet and lifestyle - but this is not possible for many more who, despite their best efforts, may have to continue with medication and eventually increase it. These latter people may feel they have failed if they are unable to 'reverse' their diabetes, but it may be something completely beyond their control.


----------



## chrismbee (Mar 25, 2011)

Lucy, as Dodger and margie have explained, it's not about reversing diabetes, as there is no cure.  It's to do with improving the body's ability to process sugar, mainly through decreased insulin resistance - a significant factor in T2 diabetes.  You are right to assume that, having been diagnosed, one will always be at higher risk of the condition progressing in the future, hence the emphasis on maintaining a healthy lifestyle and diet.  Gestational diabetes frequently all but disappears after birth, but the long term risks remain.

The power of the English language can also be its downfall, in that using the term _reversal _may be perfectly apt, in the context in which it was intended.  However, the meaning may be understood in different ways.  This very fact is often used to great advantage by the media, when condensing original statements into bite-size headlines.


----------



## lucy123 (Mar 25, 2011)

Thanks all, but can you still help with whether a type 2 can through good control move backwards along the so called curve to become glucose intolerant and even further back to become normal as long as maintaining good control.

Sorry if you have already explained this and I have missed it - it is Friday!


----------



## chrismbee (Mar 25, 2011)

If, by "normal", you mean that you can eat any old rubbish and expect your body to deal with it, as if you didn't have diabetes, then the answer is no.
You can enjoy normal BG's, provided that you maintain the healthy eating/life plan.
In essence, the diet/exercise plan is your "medication".
Does this make sense?


----------



## novorapidboi26 (Mar 25, 2011)

I think if its diagnosed quickly, and the diet and lifestyle also changes quickly then the a life free of medication and elevated risks probably could be achieved.......

But with type 2 its often diagnosed much later and so the beta cells have already went through the stresses of supplying more insulin and therefore may start to slowly degrade and therefore the never be able to secrete the insulin normally.....

But I may just be talking rubbish............


----------



## MargB (Mar 25, 2011)

I also received the email and had to read the article closely to pick up the section that kind of said it was not a cure.  

It is confusing as they seem to say you are only type 2 if you take medication but what about all the type 2s who are currently controlling things by diet and exercise?  I can understand someone who is pre-diabetic is able to ward it off but they have been warned and need to control what they are doing.


----------



## donnarob (Mar 25, 2011)

Hi There, 

Define good control? 

Fasting b/g this morning was 6.5

For breakfast, I had a slice of rye bread with a couple of slices of Jarlsberg cheese.  1 hour later I was 8.4 

2 hrs later I was 6.2 

3 hrs later I'm now at 5.4 

About to have some lunch which will be warm roasted breast of chicken with a Greek salad followed by some fruit. 

Will have some nuts or something around 4pm and will probably have something like lamb curry and spiced rice for dinner.  Is this good control? 

Yesterday afternoon I went as low as 4.1 but I kept reminding myself, this is good control - as almost in the "normal" range.   In fact my family were all higher than me and they aren't diabetic?  This can be so confusing at times. 

Diabetes is a constant reminder of that the disease won't reverse itself but you can turn things around to benefit your overall health. By ditching out the crap from your diet, you can get there and, to my absolute joy, I can eat chocolate albeit very dark high cocoa solids!! 

Probably, if you grab diabetes by the b***s, you will become healthier and have a much healthier diet in the long run. 

Hope everyone has a lovely weekend. 

Donna 
Donna :


----------



## everydayupsanddowns (Mar 25, 2011)

Even the most optimistic posts I've read here from T2s who have been able to control their BG levels with careful management of diet, weight and activity have been very cautious about their current 'stability'. There are those who have been approaching insulin, but have managed to gradually reduce oral meds and then seem to be able to control levels with diet and exercise.

Wallycorker (who I've not seen around here for some time) even cautiously suggested that it seemed like he could now 'get away' with occasionally eating carbs which would have previously been difficult, wondering perhaps whether loss of fat around organs was allowing things to work a little more again.

But this is always 'once in a while' and the posters seem fairly clear that if they just went back to eating any old thing they are pretty sure the D would come back with a vengeance.

And there are many others for whom no amount of abstinence and self-control seems able to let their body cope without medication.

Diabetes is a frustratingly fickle and varied beast. YDMV.


----------



## chrismbee (Mar 25, 2011)

A medical condition is determined by the state of the body and its processes - _not _by the medication used to treat it.

Diabetes relates to the body's ability to process sugar from the blood into the cells.

Due to a variety of influencing factors, effective treatment can vary from control of diet alone, to taking medication.  The form of medication depends on the factors that are causing the sugar absorption issues and can range from tackling insulin resistance to giving additional insulin to supplement your body's own requirements.

Perhaps, rather than using terms like "reversing diabetes", it would be more appropriate to consider "reversal of medication dependency", although this doesn't trip off the tongue as easily, and certainly doesn't make a "good" headline.


----------



## novorapidboi26 (Mar 25, 2011)

donnarob said:


> Hi There,
> 
> Define good control?
> 
> ...



That is good control, all that is different to a non diabetic is the 8.4 after your food, this is normal for a diabetic though....

4.1 is on the lower end of the normal range, but still OK, as your type 2 your pancreas should hold back the insulin at this point..........

I tested my 2 year old 2hours after tea and he was 4.2, I was 5.6.....


----------



## mcdonagh47 (Mar 25, 2011)

lucy123 said:


> Thanks all, but can you still help with whether a type 2 can through good control move backwards along the so called curve to become glucose intolerant and even further back to become normal as long as maintaining good control.
> 
> 
> 
> ...


----------



## cazscot (Mar 25, 2011)

By healthy eating/exercise some people can "reverse" their symptoms. Me being an example. Through loosing weight I have come off all my medication and my latest HBA1C was 5.5 which is a "normal" persons range, if you redone all my tests just now you wouldn't be able to tell I was diabetic and I would come out as normal but that doesn't mean I am cured just that I have managed to get my diabetes under control (at the moment)...

So in answer to your question Lucy - yes it is possible for some people to move backwards...


----------



## mcdonagh47 (Mar 25, 2011)

cazscot said:


> By healthy eating/exercise some people can "reverse" their symptoms. Me being an example. Through loosing weight I have come off all my medication and my latest HBA1C was 5.5 which is a "normal" persons range, if you redone all my tests just now you wouldn't be able to tell I was diabetic and I would come out as normal ..



No you wouldn't - if you took an OGTT now you would come out as a Type 2 Diabetic.
By losing the weight ( although its the right thing to do )you are simply masking t2 not reversing it or going backwards. When you reach your ideal weight the real struggle will probably begin.


----------



## lucy123 (Mar 25, 2011)

I am not too sure I agree with that. I have just spoke with my consultant regarding other things and raised this question.

He confirmed as Cazscot says that you can move back as far as normal range and have a normal ogtt if your control is good - but as soon as you eat a doughnut for example you would be on your way very quickly back to t2 range. I am not saying you stop being a t2, but you reverse your symptoms back to normal as long as you are good. Surely if your control is that good that your levels are coming out as normal (as Cazscots are) then that has to be great progress?


----------



## chrismbee (Mar 25, 2011)

mcdonagh47 said:


> When you reach your ideal weight the real struggle will probably begin.



Sorry mcd, don't follow 
Surely, on achieving a medically-good weight (for your height/frame/gender/age etc.) your diabetes treatment becomes easier, more straightforward?
Let us not forget that achieving a good weight helps in so many areas - hardly the beginning of "real struggles"


----------



## HelenM (Mar 25, 2011)

I think that if the diabetes is diagnosed early enough in the process...and it is a linear process,  then some people may be able to stop the process in it's tracks. However, they would still have a tendency to become glucose intolerant and stopping the healthy eating regime, or being unable to continue the same amount of activity might cause more insulin resistance again.
Unfortunately by the time some people are diagnosed the process has been going on for some time with  some loss of beta cell function so they may not be able to 'reverse' their condition. Also, not all people labelled as T2 are overweight, and perhaps there are several variants of T2, some more likely to respond well to diet and exercise than others

Here's a simple report in a Diabetes Journal, they use the word reversal here:


> Reversal of Type 2 diabetes in the context of bariatric surgery is currently of great interest. Discussion of the rapid and dramatic effects of bariatric surgery upon the pathophysiology of Type 2 diabetes has concentrated almost exclusively on surgically induced change in the incretin hormones [1,2]. Little consideration has been given to reversal of Type 2 diabetes by the effects of caloric restriction alone. We report a person with Type 2 diabetes who returned to normal fasting blood glucose and glycated haemoglobin (HbA1c) after reading a notice about a grant award in Balance concerning the effects of a hypocaloric diet on glucose control


Dietary reversal of Type 2 diabetes motivated by research knowledge

http://onlinelibrary.wiley.com/doi/10.1111/j.1464-5491.2010.02992.x/full
Actually the full  story isn't so different to some we read on diabetes forums.The lady lost weight, fasting glucose and HbA1c came down. We don't know about an OGTT


One study back in in 1982 looked at the treatment of T2 on diagnosis by diet alone and did do another OGTT.The subjects were put onto a diet varying between 1000 and 1800 calories a day (individualised according to weight, gender actiivity levels etc) 40% of the diet was carbs. 
  After 3 months they had another OGTT. Of the 182 patients studied, 
  25.4% average  improvement in glucose tolerance,
*37 subjects  "became well-controlled in that the area under the glucose response curve after treatment became normal*
  "29  subjects " were poorly-controlled as the area under their glucose response curves remained at least twice the upper limit of normal.'.

."Those patients whose glucose tolerance became normal were mainly men, and were significantly heavier and had significantly less glucose intolerance before treatment than those patients who remained poorly controlled. On diet therapy the well-controlled patients lost more weight and showed a significantly greater fall in plasma triglyceride levels."

  Did  those people sustain their 'normal' glucose tolerance status?  We don't know. One thing is clear is that the researchers' invested a lot of time and effort in teaching and supporting people in their diets, they weren't just given an instruction sheet to take away with them. 
Treatment of Type 2 (Non-Insulin-Dependent) Diabetic Patients with Diet Alone
http://www.springerlink.com/content/l64x431508p21739/fulltext.pdf

Another paper here is far too detailed to summarise. It  also suggests that reversal is possible by diet  in early diagnosed cases of T2.
  Pathogenesis of type 2 diabetes: tracing the reverse route from cure to cause
http://www.springerlink.com/content/j088876181l3qu55/fulltext.pdf

.


----------



## cazscot (Mar 25, 2011)

mcdonagh47 said:


> No you wouldn't - if you took an OGTT now you would come out as a Type 2 Diabetic.
> By losing the weight ( although its the right thing to do )you are simply masking t2 not reversing it or going backwards. When you reach your ideal weight the real struggle will probably begin.



Ah yes sorry mcdonagh was typing my reply on my mobile during lunch should have clarified it a bit bitter .  Yes you are quite correct if I had an OGTT would indeed come out as Impared Glucose Tolerance after all if I had a normal OGTT I wouldnt be diabetic!  Sorry for the confusion...


----------



## mcdonagh47 (Mar 25, 2011)

cazscot said:


> Ah yes sorry mcdonagh was typing my reply on my mobile during lunch should have clarified it a bit bitter .  Yes you are quite correct if I had an OGTT would indeed come out as Impared Glucose Tolerance after all if I had a normal OGTT I wouldnt be diabetic!  Sorry for the confusion...



You've done great with the weight loss and control. And the party pictures looked good.
Did your A1c fall into line as soon as the weight loss started or was there a gradual fall off in A1c tied to weight loss e.g. one stone off, one % point off A1c ? It would be interesting to plot weight loss and improvements in A1c against each other.


----------



## cazscot (Mar 25, 2011)

mcdonagh47 said:


> You've done great with the weight loss and control. And the party pictures looked good.
> Did your A1c fall into line as soon as the weight loss started or was there a gradual fall off in A1c tied to weight loss e.g. one stone off, one % point off A1c ? It would be interesting to plot weight loss and improvements in A1c against each other.



Thanks , no my HbA1c came right down from 7.1 to 5.8 after a couple of months (but I was on medication at that point).  I have only had one HbA1c whilst off medication at it had only increased .1%


----------



## wallycorker (Mar 25, 2011)

everydayupsanddowns said:


> ............Wallycorker (who I've not seen around here for some time) even cautiously suggested that it seemed like he could now 'get away' with occasionally eating carbs which would have previously been difficult, wondering perhaps whether loss of fat around organs was allowing things to work a little more again............


Yes Mike - the article being discussed describes almost exactly what happened to me. 

More than ten years after diagnosis and after my HbA1c rising to 9.4% and being prescribed 2000mg of metformin per day - i.e. not far away from needing to inject insulin. These days I take no metformin medication at all for around six months now. My last several HbA1c readings have been in the 5s - also, my one hour after finishing eating readings are almost always in what I understand to be normal levels - i.e. between 4.0 and 7.8 mmol/L (around 92% of the time).

Most days, I eat chips with my lunch or occasionally a jacket potato - also loads of fruit. However, I do eat much less starchy carbohydrate than I had been encouraged to eat previously by the various healthcare professonals that I met. I will never go back to eating cereals, bread, pasta and pizza etc in any significant quantities because I believe that it is those foods that caused my problems in the first place.

Tonight, I pushed the boat out by eating a big pile of cottage pie. I expected the worst! My reading one hour after finishing eating that meal was 8.4 mmol/L. Yes - higher than I like these days but nowhere near as bad as I thought that it might have been.

Yes - you are right I don't post much these days - either on this forum or on the many others too. I can't post on several because I've been banned. Why? Because the moderators don't seem to like me talking about what I've achieved simply through slightly changing my diet. All quite weird really!

Please don't worry about me - I'm doing just fine and I don't expect anything to change.

Good luck and best wishes to all.

John


----------



## Northerner (Mar 25, 2011)

Nice to hear from you John, glad to hear that things are still going well for you


----------



## wallycorker (Mar 25, 2011)

cazscot said:


> Thanks , no my HbA1c came right down from 7.1 to 5.8 after a couple of months (but I was on medication at that point).  I have only had one HbA1c whilst off medication at it had only increased .1%


Great stuff Carol! You seem to have seen the light! Keep on going!

The medications will not solve the problem - only changing the diet will do that.

Best wishes - John


----------



## wallycorker (Mar 25, 2011)

Northerner said:


> Nice to hear from you John, glad to hear that things are still going well for you


Hi Northerner,

Yes - I'm at peace with the world after getting 'forumed-out' and getting away from the aggro' that comes about by being on diabetes forums.

I'm even better just now because the winter is behind us and the cricket season is due to start very shortly. I've been riding around the cricket ground most of this week on the roller and grass-cutter taking in the sunshine and at total peace with the world. 

Life is good! Even for a 67 year-old diabetic!

Best wishes - John


----------



## Carina1962 (Mar 25, 2011)

Yes nice to hear from you Wallycorker, was wondering why you haven't posted for a while but glad to hear you are still doing fantastic with your diabetes


----------



## wallycorker (Mar 25, 2011)

lucy123 said:


> HI
> 
> I am really confused as I thought we all thought that diabetes could not be reversed. However I recieved the diabetes.co.uk email this week with the following article?
> http://www.diabetes.co.uk/reversing-diabetes.html
> ...


Hi Lucy123,

If you haven't read it already, you might find something of interest in this thread of mine from quite a long time ago:

http://www.diabetessupport.co.uk/boards/showthread.php?t=6435&highlight=reversal

It is my experience that a great deal is possible for some non-insulin-dependent Type 2s through the power of diet.

Good luck and best wishes - John


----------



## wallycorker (Mar 25, 2011)

carina62 said:


> Yes nice to hear from you Wallycorker, was wondering why you haven't posted for a while but glad to hear you are still doing fantastic with your diabetes


Thanks Carina!

I hope that you are keeping well also.

Best wishes - John


----------



## fruitloaf (Mar 25, 2011)

It is an interesting question. Glucose intolerance and Type 2 diabetes are all part of a sliding scale. The point at which you 'become diabetic' is an arbitrary value really - decided by the risk of developing complications I think. Looking at it from this perspective it is easier to see how someone only just into the diabetic range could 'move back along the scale' following significant weight loss/increased exercise etc. Having said that, glucose intolerance and impaired fasting glycaemia are really the 'mild' form of type 2 diabetes so it's during these stages that the disease is more able to be reversed.

This also brings into question the use of the HbA1c test for diagnosis. It's clear that a person not on medication could have an abnormal OGTT and therefore be diabetic but an HbA1c result within the normal range.


----------



## mcdonagh47 (Mar 26, 2011)

fruitloaf said:


> It is an interesting question. Glucose intolerance and Type 2 diabetes are all part of a sliding scale. The point at which you 'become diabetic' is an arbitrary value really - decided by the risk of developing complications I think. Looking at it from this perspective it is easier to see how someone only just into the diabetic range could 'move back along the scale' following significant weight loss/increased exercise etc. Having said that, glucose intolerance and impaired fasting glycaemia are really the 'mild' form of type 2 diabetes so it's during these stages that the disease is more able to be reversed.
> .



Type 2 Diabetes is diagnosed when Insulin Resistance outweighs Beta Cell Mass when plotted against each other on the Starling Curve of the Pancreas. Its not an arbitrary value. There is no sliding scale ; the diagnosis of Type 2 Diabetes is absolute and the cut off point on the Starling Curve is meant to be, and is, All-or-nothing. Nobody is "only just into the diabetic range" Type 2 diabetic - they are well and truly in it.The suggestion that you might have mild Type 2 diabetes is like suggesting you might be mildly pregnant.
Impaired Glucose Tolerance (IGT) and Impaired Fasting Glucose (IFG) are not forms of mild Type 2 diabetes. IFG shows you are struggling in the battle with Insulin Resistance and it is a strong predictor of Type 2 Diabetes ahead while IGT is not. Many people remain happily IGT for decades without ever being dxed as T2. One medical Actuary calculated that it would take 750 years ( i.e. never) for the average IGT person to be dxed as a TYpe 2.
Once dxed with Type 2 you can't "go back along a sliding scale", but you can establish good control.
____________________________________________________
Denial is not just a river in Egypt.


----------



## lucy123 (Mar 26, 2011)

wallycorker said:


> Hi Lucy123,
> 
> If you haven't read it already, you might find something of interest in this thread of mine from quite a long time ago:
> 
> ...



Hi John,

Lovely to see you post - and I do see how your diet has helped you. I have just started a low gi diet - am now at the end of week 2 and am feeling fantastic - bounding with energy, so a lot can be said for diet.

I will read your link later - as in a rush to play a tennis match now


----------



## Carina1962 (Mar 26, 2011)

Lucy, what book are you using for your GI diet?


----------



## Northerner (Mar 26, 2011)

carina62 said:


> Lucy, what book are you using for your GI diet?



I believe that it is this one (Lucy can confirm!): The Gi Diet by Rick Gallop. I've just got The Family Gi Diet by Rick and Ruth Gallop out of the library, so I'll write a review of it when I've read it. From what Lucy says, it does sound like Rick knows his stuff!


----------



## cazscot (Mar 26, 2011)

wallycorker said:


> Great stuff Carol! You seem to have seen the light! Keep on going!
> 
> The medications will not solve the problem - only changing the diet will do that.
> 
> Best wishes - John



Thanks John, great to see your post you are such an inspiration .


----------



## Carina1962 (Mar 26, 2011)

oh thanks Northerner  i've already got his 'shopping and eating out pocket guide' which i refer to when i'm writing out my shopping list but didn't realise he has written a book about what to eat, recipes and stuff!


----------



## lucy123 (Mar 26, 2011)

He has written quite a few books Carina - try googling him.
He also has a website.
It takes some willpower to get into but once you are past the first week, it gets easier.
Good luck.


----------



## fruitloaf (Mar 26, 2011)

mcdonagh47 said:


> Type 2 Diabetes is diagnosed when Insulin Resistance outweighs Beta Cell Mass when plotted against each other on the Starling Curve of the Pancreas. Its not an arbitrary value. There is no sliding scale ; the diagnosis of Type 2 Diabetes is absolute and the cut off point on the Starling Curve is meant to be, and is, All-or-nothing. Nobody is "only just into the diabetic range" Type 2 diabetic - they are well and truly in it.The suggestion that you might have mild Type 2 diabetes is like suggesting you might be mildly pregnant.
> Impaired Glucose Tolerance (IGT) and Impaired Fasting Glucose (IFG) are not forms of mild Type 2 diabetes. IFG shows you are struggling in the battle with Insulin Resistance and it is a strong predictor of Type 2 Diabetes ahead while IGT is not. Many people remain happily IGT for decades without ever being dxed as T2. One medical Actuary calculated that it would take 750 years ( i.e. never) for the average IGT person to be dxed as a TYpe 2.
> Once dxed with Type 2 you can't "go back along a sliding scale", but you can establish good control.
> ____________________________________________________
> Denial is not just a river in Egypt.



You don't suddenly become type 2 diabetic. It is a slow development over a period of time. Insulin resistance is progressive. People with IFG and IGT are at risk of developing type 2 diabetes but not all will reach that stage. The cut off point for diagnosis of type 2 diabetes could be lowered - some people have suggested it should be. A lower cut off point for IFG is used in USA. 

HbA1c is now being used for diagnosis of type 2 diabetes. The definition of type 2 diabetes has now changed. Using the HbA1c test for diagnosis, there are some people who have a normal OGTT result but an abnormal HbA1c and visa versa. Therefore whether or not you are diagnosed as being diabetic might depend on the test that your GP chooses to use. 

I wasn't trying to add weight to the argument that diabetes is reversible - I don't think it is except for possibly the use of surgery as mentioned previously. But I do believe that type 2 diabetes is part of a spectrum of insulin resistance that includes IFG and IGT. 

The comparison to being pregnant doesn't work. Pregnancy is a very easily definable condition that happens instantaneously (even though a test result might be incorrect).


----------



## mcdonagh47 (Mar 26, 2011)

fruitloaf said:


> You don't suddenly become type 2 diabetic. It is a slow development over a period of time. Insulin resistance is progressive.
> 
> HbA1c is now being used for diagnosis of type 2 diabetes. The definition of type 2 diabetes has now changed.
> The comparison to being pregnant doesn't work. Pregnancy is a very easily definable condition that happens instantaneously (even though a test result might be incorrect).



You DO suddenly become dxed Type 2 Diabetic when Insulin Resistance outweighs Beta Cell Mass as plotted against each other on the Starling Curve of the Pancreas. The criteria - 11.1 two hours after an OGTT, two FBGs over 7, a random test over 11.1, the new HbA1c measure are all simply surrogate measures of that critical point on the Starling Curve of the Pancreas ( it would be too expensive to give everyone IR tests and Beta Cell Mass evaluations so surrogate measures which equate to that point are used).
Type 2 Diabetes isn't a development over time. When Beta Cell Mass still outweighs IR on the Starling Curve then you will NOT be TYpe 2, the Beta Cell Mass will always win out.
The definition of Type 2 Diabetes hasn't changed and isn't likely to change in the near future.
The comparison with pregnancy works well because Type 2 Diabetes is also an easily definable condition i.e. Type 2 Diabetes is defined/dxed when Insulin Resistance outweighs Beta Cell Mass on the Starling Curve of the Pancreas ( and not before !)
The Starling Curve of the Pancreas is an iconic diagram ( rather like the London Underground Map or whatever) and should be better known amongst Type 2 Diabetics.


----------



## am64 (Mar 26, 2011)

i have noticed over the years that the dx of T2 has lowered ....when i was first dx a level over 7.2 was quoted ...now correct me if im wrong but 6.4 is banded about ?


----------



## Northerner (Mar 26, 2011)

mcdonagh47 said:


> You DO suddenly become dxed Type 2 Diabetic when Insulin Resistance outweighs Beta Cell Mass as plotted against each other on the Starling Curve of the Pancreas. ...



Not according to this, it appears that this is a cause for debate:

http://www.touchendocrinology.com/a...arly-use-glitazones?mini=calendar/2011/4/all&


----------



## mcdonagh47 (Mar 26, 2011)

Northerner said:


> Not according to this, it appears that this is a cause for debate:
> 
> http://www.touchendocrinology.com/a...arly-use-glitazones?mini=calendar/2011/4/all&


Read the first sentence again Northie  ..."Type 2 diabetes mellitus is a result of a progressive and complex inability to maintain normoglycaemia".
It specifically says that Type 2 Diabetes is the RESULT of, not the progressive development itself i.e Type 2 Diabetes is the end product of something else.
Don't what statius that web page has, it looks like an Opinion Piece.


----------



## Northerner (Mar 26, 2011)

mcdonagh47 said:


> Read the first sentence again Northie  ..."Type 2 diabetes mellitus is a result of a progressive and complex inability to maintain normoglycaemia".
> It specifically says that Type 2 Diabetes is the RESULT of, not the progressive development itself i.e Type 2 Diabetes is the end product of something else.



But reading further:



> Moreover, it becomes clear that the disease process is continuous and starts very early in the NGT range. The point along this continumm where glycaemia, fasting or postprandial, is to be called ?diabetes? is completely arbitrary. The threshold for diabetes mellitus has more to do with increasing risk of complications, census or reimbursement issues but not with something pathological suddenly happening.


----------



## mcdonagh47 (Mar 26, 2011)

Northerner said:


> But reading further:



The second quotation is Opinion Northie and individual interpretation. the use of the term "arbitrary" in a pejorative sense tell us that. And what does it mean by "glycaemia", does the writer mean hyperglycaemia ? The article seems to be simplistic dumbing down ; there is no "continuum" IFG - IGT -Type 2 Diabetes. Most of the People who test out as IFG on an OGTT very rapidly progress to Type 2 Diabetes within a year without passing through IGT. The majority of people who test out as IGT (60%) will never be dxed as Type 2.   50% of people who test out as IGT in one OGTT subsequently revert to normal in further tests. So there is no smooth progress to Type 2 Diabetes through these stages.


----------



## am64 (Mar 26, 2011)

please translate into plain english ?


----------



## wallycorker (Mar 27, 2011)

am64 said:


> please translate into plain english ?


Hear! Hear! Am64 - that's all much too complicated for me too even though I have a scientific background!

By the way, I was diagnosed more than ten years ago on the basis of a fasting blood glucose level of 7.2 mmol/L. I've never had an oral glucose tolerance test.

Certainly, I've never even heard of some of the stuff in this thread before never mind having been tested for it.


----------



## veganlass (Mar 27, 2011)

I havent read all the posts, but according to recent news on TV they interviewed a chap who was diagnosed T2 and he changed his lifestyle around did more exercise  and managed to reverse it.

My Gp suggested my T2  maybe due to the pancreas wearing out due to old age!!.

This may be true but I am jolly well going to try to reverse it by diet and lifestyle changes if i can. Lost 6lb in weight in less than a fortnight  so far.


----------



## Ellie Jones (Mar 27, 2011)

The proof of the pudding of reversal is eating the pudding!

To reverse you taking the condition back to a previous state and the same criteria but you've only improved because you've changed the criteria, if you return to the same criteri it soon return...

As we for T2's there is phrases like pre-diabetic and glucose intollerance these were brought in many years ago when organisations such as WHO were deciding at what point T2 is offically diagnosed! The bar was slightly raised and pre-diabetes and glucose intollerance placed, as to give somebody the diagnosed with T2 it effects their life insurance and medical insurance etc!


----------



## veganlass (Mar 27, 2011)

Ellie love that first line, so appropriate.


----------



## HelenM (Mar 27, 2011)

> Originally Posted by mcdonagh47
> You DO suddenly become dxed Type 2 Diabetic when Insulin Resistance outweighs Beta Cell Mass as plotted against each other on the Starling Curve of the Pancreas.



Beta cell death is  certainly a major factor in T2 and there has been a big reduction in beta cells by the time someone has developed impaired fasting glycemia.(prediabetes)

At the Mayo clinic they looked at  pancreases (pancreata?) of a number of subjects  immediatley after death. http://diabetes.diabetesjournals.org/content/52/1/102.full

People who were *obese, but not T2 had a 50% greater beta cell volume  *than people who were lean and not diabetic. So obese non diabetics have the capacity to produce more insulin. 

 Those  who were obese and had *T2 had 63% less  beta cell volume *than non diabetic obese controls
 Those who were obese and had *impaired fasting glycemia had 40%  less  volume *than  non diabetic obese controls.
Those who were *lean and had T2 had 41% less *volume than  lean non diabetic controls.
(it was the number of cells, not the size of the cells that made the diffference in volume)

They looked at  the *apoptosis,( programmed cell death)* and *replication (increase following division)* of the beta cells.

*Apoptosis *was slightly, but *not  significantly greater in obese diabetics *than obese non diabetics. It *was  significantly greater in lean diabetics *than lean non diabetics.
*BUT*  as those with diabetes had a smaller volume of cells in the first place. 
 There was a relative *3 fold increase in the frequency of apoptosis in obese diabetics *compared with obese non diabetics

There was a *10 fold increase in the frequency of apoptosis in lean diabetics *compared with lean non diabetics.

*Replication was the same in all cases, obese or lean, diabetic or non diabetic* , it occurred but it was *slow and it declined with age.*

Reversal as well as increasing insulin sensitivity would  have to include being able to stop this  rate of death and increase the number of beta cells so sufficient insulin can be produced at all times, not just with a reduced carbohydrate intake.  Otherwise when there was a big demand on insulin as for example in  some illnesses there might not be enough production capability. 
 A major problem is that  cell replication is slow and declines with age. 

It is possible that new islets are formed elsewhere and when this paper was written in 2003 they were optimistic as the site they thought new cells were produced was normal.  They  said that they had  found  the the presence of islets budding from exocrine ducts  in all pancreata irrespective of obesity or diabetic status. As I understand it, they thought  new cells were able to be formed in these ducts.
Unfortunately, the juries out on this one.  Recently other researchers have found what they say is proof  that new beta cells are not formed in the exocrine ducts after birth


----------



## wallycorker (Mar 27, 2011)

Ellie Jones said:


> ..........The proof of the pudding of reversal is eating the pudding!............


I like that first line too Ellie. Brilliant!

However, I am coming to the conclusion that maybe we should never have been eating the "pudding" that you refer to in the first place?

Maybe it was the "pudding" - or "starchy carbohydrate" as I call it - that caused my diagnosis with Type 2 in the first place more than ten years back - and it's progression for eight years after that? 

Anyway, I'm very happy indeed with what has happened to me since I cut back on eating the "pudding" - or "starchy carbohydrate"!

I'll stick mainly with the fruit for my carbohydrate intake. Oh! and the chips too that I eat with my meat because, these days, rather surprisingly I find that they too seem to be OK, at least, in sensible amounts as served with the pub meals that I buy!

People can call it what they want but I'm very happy indeed that today all my health indicator numbers (HbA1c, post-prandial blood glucose levels, blood pressure, TC, LDL, HDL, creatinine - and in particular triglycerides are all very much better than they have ever been. Also, that the many diabetic symptoms that I had experienced to varying degrees have disappeared virtually altogether. 

I'm quite content to contine to consider what has happened to me as being "reversal" - i.e. things are much better than they were in the first place. Or, as my dictionary defines the noun reversal - "a change to an opposite direction, position or course of action". That sounds to describe my current Type 2 diabetic situation quite admirably! 

Long may it stay that way!

Best wishes - John


----------



## everydayupsanddowns (Mar 28, 2011)

HelenM said:


> ...Reversal as well as increasing insulin sensitivity would have to include being able to stop this rate of death and increase the number of beta cells so sufficient insulin can be produced at all times, not just with a reduced carbohydrate intake. Otherwise when there was a big demand on insulin as for example in some illnesses there might not be enough production capability.
> A major problem is that cell replication is slow and declines with age....



Crikey there's a lot to take in there Helen!

Did you catch the report on Joslin50 T1s (type 1 for over 50 years) a few years back which showed that some still had signs of insulin production, functioning islet cells (creation? not sure now) and continuing autoimmune destruction of islet cells long after it would be expected for them to have run out. Seem to remember there was a thought about looking into ways of supporting the insulin production of those cells.


----------



## lanzlady (Mar 28, 2011)

I feel as though I am reading some script from medcial notes in some replies
as AM quotes plain English please some replies are so long I can't be bothered reading them

This is only my opinion



Lanz


----------



## everydayupsanddowns (Mar 28, 2011)

lanzlady said:


> I feel as though I am reading some script from medcial notes in some replies
> as AM quotes plain English please some replies are so long I can't be bothered reading them
> 
> This is only my opinion
> ...



Tee Hee! Yes there are a few *very* technical posts here, along with the more general anecdotal ones.

Here's my summary:

Q: Can you 'reverse' diabetes?
A: Yes*. And no*.

* it depends on what you consider to be meant by the term 'reverse'.


----------



## HelenM (Mar 28, 2011)

lanzlady said:


> I feel as though I am reading some script from medcial notes in some replies
> as AM quotes plain English please some replies are so long I can't be bothered reading them
> 
> This is only my opinion
> ...



Yes, my post was long, I'm sorry for that and realised when I'd posted it  that  not every one will want to read it (maybe no-one )  Indeed I almost cut the whole thing when I saw the final post.
It was a summary, it took a very long time rewriting it to the fewest possible word yet still be accurate.


----------



## Northerner (Mar 28, 2011)

HelenM said:


> Yes, my post was long, I'm sorry for that and realised when I'd posted it  that  not every one will want to read it (maybe no-one )  Indeed I almost cut the whole thing when I saw the final post.
> It was a summary, it took a very long time rewriting it to the fewest possible word yet still be accurate.



Don't apologise Helen. I find your research very interesting. I can see that not everyone has the time or inclination to read the technical stuff, but it does provide useful information to those that do  Often what starts out as a particular question can turn into quite a wide-ranging discussion, and of course this is one of the key topics in diabetes today, so all input is welcomed


----------



## everydayupsanddowns (Mar 28, 2011)

Absolutely Alan. (and thanks for your post Helen!)

M


----------



## mcdonagh47 (Mar 28, 2011)

everydayupsanddowns said:


> Here's my summary:
> 
> Q: Can you 'reverse' diabetes?
> A: Yes*. And no*.
> ...



Here's my summary ;
You can no more reverse Type 2 Diabetes than you can ride to the Moon on a bike.
And using the term "reverse" in relation to Type 2 Diabetes is irresponsible because it misleads Newbies about the fundamentals of their condition.
IMHO


----------



## Andy HB (Mar 28, 2011)

mcdonagh47 said:


> Here's my summary ;
> You can no more reverse Type 2 Diabetes than you can ride to the Moon on a bike.
> And using the term "reverse" in relation to Type 2 Diabetes is irresponsible because it misleads Newbies about the fundamentals of their condition.
> IMHO



My summary is that some T2 diabetics can reverse the diabetic symptoms if they diet and exercise regularly resulting in improved insulin sensitivity.

But I think you're right, once a diabetic, always a diabetic (for now).

Andy 

p.s. And your post was interesting to me too Helen.


----------



## everydayupsanddowns (Mar 28, 2011)

I understand what you mean mcdonagh47, but for some newbies who are crushed by the thought that there is nothing they can do to improve their condition who might be wondering 'does this mean I'll have to take these tablets forever?' the answer based on several members' experience would seem to be 'not necessarily'. And if that person considers the 'not taking tablets' to be in some way an improvement in their condition then they might think of that improvement as a form of reversal. I'm not saying you have to think it is so, but I'm just saying that some people might. I'm also not saying that _everyone_ can improve their symptoms without the support of medication, but that _some people_ can.

Andy's line of an improvement in 'diabetic symptoms' is perhaps more accurate.


----------



## Mark T (Mar 28, 2011)

You could describe it as a form of regression, you have regressed the disease back to the point where you can avoid taking medication.  However, if you re-adopt a unhealthy lifestyle the disease will re-emerge.

I'm not sure if that would also cause confusion because regression is used for cancer also.


----------



## lanzlady (Mar 28, 2011)

HelenM said:


> Yes, my post was long, I'm sorry for that and realised when I'd posted it  that  not every one will want to read it (maybe no-one )  Indeed I almost cut the whole thing when I saw the final post.
> It was a summary, it took a very long time rewriting it to the fewest possible word yet still be accurate.



Helen please do not be sorry for your long post of course it was interesting just long posts are not for me.


Lanz


----------



## lanzlady (Mar 28, 2011)

Northerner said:


> Don't apologise Helen. I find your research very interesting. I can see that not everyone has the time or inclination to read the technical stuff, but it does provide useful information to those that do  Often what starts out as a particular question can turn into quite a wide-ranging discussion, and of course this is one of the key topics in diabetes today, so all input is welcomed



That's correct I am one of those people who do not have the time to sometimes read the technical stuff but I do have the inclination of reading the posts


Lanz


----------



## oldun (Mar 29, 2011)

*No meds*

T2 last Hba1c 6.1 overweight!
Diag 2005.  On medication since 2005 Hba1c varied from 6.1 to 6.9
Despite being prescribed alternate medication, I felt better without meds and so earlier this year, having consulted with both my GP and diabetes nurse, plus a desire to lose weight, I stopped medication and relied on a controlled diet.
After 10 weeks my Hba1c (last week) was 6.1 and I have shed 11 pounds weight, 'lost' a skin rash on my arms and reduced red rashes on my feet (top) and feel more alive.  My afternoon sleeps are also less frequent.
I'm merely recounting my personal experience and NOT making any recommendations for others.


----------



## Northerner (Mar 29, 2011)

oldun said:


> T2 last Hba1c 6.1 overweight!
> Diag 2005.  On medication since 2005 Hba1c varied from 6.1 to 6.9
> Despite being prescribed alternate medication, I felt better without meds and so earlier this year, having consulted with both my GP and diabetes nurse, plus a desire to lose weight, I stopped medication and relied on a controlled diet.
> After 10 weeks my Hba1c (last week) was 6.1 and I have shed 11 pounds weight, 'lost' a skin rash on my arms and reduced red rashes on my feet (top) and feel more alive.  My afternoon sleeps are also less frequent.
> I'm merely recounting my personal experience and NOT making any recommendations for others.



That's a great weight loss and improvement oldun, well done! Nice to hear from you again


----------



## wallycorker (Mar 30, 2011)

oldun said:


> .............I'm merely recounting my personal experience and NOT making any recommendations for others..............


Great stuff oldun!

Don't be shy! Maybe you ought to be making recommendations to other Type 2s?

In my opinion, you sound to be well down the right pathway.

Best wishes - John


----------



## veganlass (Mar 31, 2011)

Oldun, thats what I am trying to do, control it by diet. My diabetic care nurse on first visit said "I can see I am going to have trouble persuading you to have tablets"

I said yes. 

You prove it can work. Medics are quick to prescribe tablets etc,. as its an easy option.


----------



## C*5_Dodger (Mar 31, 2011)

veganlass said:


> Oldun, thats what I am trying to do, control it by diet. My diabetic care nurse on first visit said "I can see I am going to have trouble persuading you to have tablets"
> 
> I said yes.
> 
> You prove it can work. Medics are quick to prescribe tablets etc,. as its an easy option.



Dear veganlass,

Have you tried following (left click it) *this* dietary method of lowering your blood sugar?

Regards   Dodger


----------



## veganlass (Mar 31, 2011)

Thanks will look. I did do a food diary a week before I saw the diabetic care nurse and she said there was nothing to alter.

Even though I have just dropped down my quantity of carbs now.

Its a good link. I had thought of doing that after seeing my yesterdays readings.


----------



## Cliff (Mar 31, 2011)

Very interesting thread.  The whole concept of diabetes reversal is obviously controversial but perhaps easier to understand if you think of glucose intolerance as a continuum rather than something that has fixed diagnostic points.  Take an example to illustrate why fixed point diagnosis is unreliable - you give two fasting readings of 7 or over and you're diabetic.  You give two fasting readings of 6.9 and you have impaired fasting glucose.  What's the difference in those terms between 6.9 and 7.0?  Nothing at all, except the diagnosis.  On one day you might be over 7, the next under.  Sometimes, you might hit the 5s.  If you were to have been tested and gave two readings in the 5s, you wouldn't be diabetic or have impaired fasting glucose - well, officially you wouldn't.

I'm convinced some of us can move position on the glucose intolerance scale and drive our levels down.  For what it's worth, I finally got round to taking an OGTT last week after my doctor said it was unlikely I would match the diagnostic criteria for diabetes given my recent HbA1cs (bearing in mind that when I was first diagnosed, I had a fasting reading of over 9).  And the result?  5.8 fasting and 8.2 two hours after the lucozade frenzy.  So now I officially have impaired glucose tolerance, 'normal' fasting glucose (don't know any normal people that hit 5.8 on fasting though) and have had the diabetic label taken away.

On that basis it seems to me that movement along the continuous scale is possible.  I don't think it makes you non-diabetic though, and I don't think once you've improved your position you should ease off from the measures that led to your improvement.


----------



## veganlass (Mar 31, 2011)

Cliff  I was beginning to think, yesterday that I would revert back to just doing a pre BG test before meals. 

You can easily get paranoid with the testing. I will continue doing pre and post testing till the weekend (Going away for a few days then) . Then reconsider next week.

I will continue losing my excess weight.


----------



## Cliff (Mar 31, 2011)

veganlass said:


> Cliff  I was beginning to think, yesterday that I would revert back to just doing a pre BG test before meals.
> 
> You can easily get paranoid with the testing. I will continue doing pre and post testing till the weekend (Going away for a few days then) . Then reconsider next week.
> 
> I will continue losing my excess weight.



It's a combination of serious carb control and the consequent weight loss arising from that carb control that's done it for me.  From being quite a big lad, I am now 4 stones lighter and positively skinny!

With regard to testing, I don't do all that much now.  The most useful thing I found was to target likely food suspects and see how they affected me, and either eliminate entirely or reduce quantities depending on the results.  Once I knew what foods and how much of them sent me high, I decided I didn't need to test on that food again, apart from the occasional check.  Fairly quickly you can see what works and what doesn't, so if the cost or availability of strips is an issue for you, a targeted approach might be best.


----------



## veganlass (Mar 31, 2011)

Yes Cliff thats my reasoning too.

I have lost 7lbs in weight now since the 16th march and my pre meal BG at lunchtimes are running at anything from 7.6 to 8.9 now. 

I will continue to monitor till I have got down to 9 stone, which is 1st 3oz o go.
As i am 61 I dont want to look scrawny if I go down further.

If by then I am still showing signs of being diabetic then I will agree to medication.


----------



## mcdonagh47 (Mar 31, 2011)

Cliff said:


> Very interesting thread.  The whole concept of diabetes reversal is obviously controversial but perhaps easier to understand if you think of glucose intolerance as a continuum rather than something that has fixed diagnostic points.  Take an example to illustrate why fixed point diagnosis is unreliable - you give two fasting readings of 7 or over and you're diabetic.  You give two fasting readings of 6.9 and you have impaired fasting glucose.  What's the difference in those terms between 6.9 and 7.0?  Nothing at all, except the diagnosis.



Mmols are a complicated Logarithmic Scale, like the Richter scale for Earthquakes, don't know the exact maths but 7.0 is a whole lot worse than 6.9 ( possibly 10 times as bad ???). Its an exponential increase not a simple arithmetical on.
Of course anyone persistently scoring 6.9 should be sent for an OGTT to clear up whether they are IGT or Type 2 Diabetes.


----------



## mcdonagh47 (Mar 31, 2011)

Cliff said:


> I'm convinced some of us can move position on the glucose intolerance scale and drive our levels down.  For what it's worth, I finally got round to taking an OGTT last week after my doctor said it was unlikely I would match the diagnostic criteria for diabetes given my recent HbA1cs (bearing in mind that when I was first diagnosed, I had a fasting reading of over 9).  And the result?  5.8 fasting and 8.2 two hours after the lucozade frenzy.  So now I officially have impaired glucose tolerance, 'normal' fasting glucose (don't know any normal people that hit 5.8 on fasting though) and have had the diabetic label taken away.



It doesn't sound as if you were Type 2 in the first place, Cliff, and should have had an OGTT right at the start.


----------



## Cliff (Mar 31, 2011)

mcdonagh47 said:


> Mmols are a complicated Logarithmic Scale, like the Richter scale for Earthquakes, don't know the exact maths but 7.0 is a whole lot worse than 6.9 ( possibly 10 times as bad ???). Its an exponential increase not a simple arithmetical on.



I'm sorry to contradict you mcdonagh but there's a simple linear relationship between glucose concentration in the blood and its expression in mmol/l - it's not logarithmic.

Glucose has a molecular weight of 180g.  1mmol is therefore 0.18g.  So if your level is 6.9mmol/l, then you have 1.242g of glucose in every litre of your blood (0.180 x 6.9).  If your level is 7.0mmol/l, then you have 1.26g of glucose in every litre of your blood (0.180 x 7.0).

PS I'm a Chartered Chemist so really hope I've got this right


----------



## C*5_Dodger (Mar 31, 2011)

Cliff said:


> I'm sorry to contradict you mcdonagh but there's a simple linear relationship between glucose concentration in the blood and its expression in mmol/l - it's not logarithmic.
> 
> Glucose has a molecular weight of 180g.  1mmol is therefore 0.18g.  So if your level is 6.9mmol/l, then you have 1.242g of glucose in every litre of your blood (0.180 x 6.9).  If your level is 7.0mmol/l, then you have 1.26g of glucose in every litre of your blood (0.180 x 7.0).
> 
> PS I'm a Chartered Chemist so really hope I've got this right



Dear Cliff,

You explanation is exactly my understanding, nice to see you posting.

Warmest Regards  Dodger


----------



## Copepod (Mar 31, 2011)

Glad to see my understanding that mmol/l was a linear scale, unlike logarithmic scale such as Richter magnitude scale earthquakes and dB for sound, is correct. 
Not a chartered chemist like Cliff, but got Chemistry & Physics A levels nearly 30 years ago.


----------



## mcdonagh47 (Mar 31, 2011)

Cliff said:


> I'm sorry to contradict you mcdonagh but there's a simple linear relationship between glucose concentration in the blood and its expression in mmol/l - it's not logarithmic.
> 
> Glucose has a molecular weight of 180g.  1mmol is therefore 0.18g.  So if your level is 6.9mmol/l, then you have 1.242g of glucose in every litre of your blood (0.180 x 6.9).  If your level is 7.0mmol/l, then you have 1.26g of glucose in every litre of your blood (0.180 x 7.0).
> 
> PS I'm a Chartered Chemist so really hope I've got this right



LOL - Thanks for the heads up on the maths Cliff.
I must have read somewhere that Millimoles per mol were a logarithmic scale and misunderstood it.

So the actual difference in glucose beteen 4.9 and 5.0 represents an increase of 2% (0.018/0.882). While with the difference between 6.9 and 7.0 the rate of increase slows to 1.4% (0.018/1.242). And (9.9 compared to 10.00 represents an increase in actual glucose of only 1.0% (0.018/1.782). So the 0.1 steps in bgs we measure aren't of equal value ? The significance of each 0.1 step up decreases as bgs get higher ?

So as bgs drop  the significance of a 0.1. drop increases, hence helping to explain hypos ? The difference in actual glucose per litre between 2.9 and 3.0 is 3.3%.


----------



## wallycorker (Apr 1, 2011)

veganlass said:


> Cliff  I was beginning to think, yesterday that I would revert back to just doing a pre BG test before meals.
> 
> You can easily get paranoid with the testing. I will continue doing pre and post testing till the weekend (Going away for a few days then) . Then reconsider next week.
> 
> I will continue losing my excess weight.


Hi again veganlass (and Cliff),

It's great to hear that Cliff is still doing OK. Like him, despite being diagnosed over ten years ago on the basis of fasting readings of 7.2 mmol.L, I've never had an OGTT either. I've wondered about having an OGTT myself just to see what happened.

Also, just like Cliff - I don't do much less testing these days. I do very few tests before eating because they tell me very little simply because I know that they are going to be OK - usually in the 4s or 5s. 

These days when I do test, I test mainly one hour after finishing eating to see how a particular meal affects my blood glucose levels. Once I know what happens, then I rarely test that particular meal again.

Keep on going because you sound to be moving well down the right pathway!

Best wishes - John


----------



## veganlass (Apr 1, 2011)

Yesterday I only did prior to food and it was better than I thought.

fasting 11.9  prior to lunch 8.6 , prior to tea 10.2 and at bedtime 11.1

Fasting this morning was 11.2 after brekkie 12.9 prior to lunch 7.8 so, so far much better.

Just had 2 veggies burgers (3.7 gram each carbs), salad and 4 tiny oatcakes (2.6gram carbs)
So I will see what the BG is at 1.30pm.

So fingers crossed its improving


----------



## Cliff (Apr 1, 2011)

mcdonagh47 said:


> LOL - Thanks for the heads up on the maths So the actual difference in glucose beteen 4.9 and 5.0 represents an increase of 2% (0.018/0.882). While with the difference between 6.9 and 7.0 the rate of increase slows to 1.4% (0.018/1.242). And (9.9 compared to 10.00 represents an increase in actual glucose of only 1.0% (0.018/1.782). So the 0.1 steps in bgs we measure aren't of equal value ? The significance of each 0.1 step up decreases as bgs get higher ?
> 
> So as bgs drop  the significance of a 0.1. drop increases, hence helping to explain hypos ? The difference in actual glucose per litre between 2.9 and 3.0 is 3.3%.



An incremental increase of 0.1 is aways identical in absolute blood sugar terms, no matter where you start from.  However, when you look at a 0.1 increase starting at 6 say, and a 0.1 increase staring at 7, it will be a difference %.  Percentages are just odd - an increase from 1 to 2 is a 100% increase.  However, when you go from 2 back to 1, it's only a 50% decrease.  That's because you're starting point is different.  Go figure lol


----------



## C*5_Dodger (Apr 1, 2011)

Cliff said:


> An incremental increase of 0.1 is aways identical in absolute blood sugar terms, no matter where you start from.  However, when you look at a 0.1 increase starting at 6 say, and a 0.1 increase staring at 7, it will be a difference %.  Percentages are just odd - an increase from 1 to 2 is a 100% increase.  However, when you go from 2 back to 1, it's only a 50% decrease.  That's because you're starting point is different.  Go figure lol



Dear Cliff,

You are just describing a property of real numbers, every thing you say is true, but why should it be relevent 

Regards   Dodger


----------



## Northerner (Apr 1, 2011)

C*5_Dodger said:


> Dear Cliff,
> 
> You are just describing a property of real numbers, every thing you say is true, but why should it be relevent
> 
> Regards   Dodger



He was clarifying an earlier comment made by mcdonagh47, Dodger


----------



## C*5_Dodger (Apr 1, 2011)

Northerner said:


> He was clarifying an earlier comment made by mcdonagh47, Dodger



Dear Alan,

Exactly!

Regards  Dodger


----------



## Robster65 (Apr 1, 2011)

100% correct ? 

Rob


----------

