# Poorest at risk of worst diabetes



## katie (Jul 27, 2009)

http://news.bbc.co.uk/1/hi/health/8167519.stm


----------



## sasha1 (Jul 27, 2009)

Hi Katie,

Thanks for the Link..I've just read it

Heidi
x


----------



## Northerner (Jul 27, 2009)

> ...Numbers have been climbing in recent years due to *increased efforts to find people who were unaware they had the condition....*
> ...the NHS must ensure that appropriate, high quality care is available across the country and that everyone, regardless of their socioeconomic status, is accessing it.



From a lot of the tales on here recently, doctors and nurses are turning away people _*coming to them*_ with obvious symptoms, rather than increased efforts to discover the undiagnosed!

There's still too much of an emphasis towards 'it's your own fault' (lifestyle and obesity) for my liking. My lifestyle and physical appearance is completely the opposite to what they are always emphasising, but some friends still believe that it's something I had in my power to prevent!

And another thing! There's some evidence that diabetes leads to obesity, not the other way around: Cells are resistant to insulin, body produces more insulin, insulin is a growth hormone, people get fatter, people eventually go to/get checked by doctor, found to have diabetes.

Oooo!!!


----------



## Mojo (Jul 27, 2009)

Northerner said:


> There's still too much of an emphasis towards 'it's your own fault' (lifestyle and obesity) for my liking. My lifestyle and physical appearance is completely the opposite to what they are always emphasising, but some friends still believe that it's something I had in my power to prevent!



You're right in thinking that your lifestyle had nothing to do with you developing *Type 1 diabetes*...

Unfortnately with *Type 2 diabetes*, being overweight (especially around the tummy) and incative can predispose people to it i.e. increase their risk of getting it. That's why last year Diabetes UK released a campaign called "measure up" - encouraging people to measure their waists, and if they were too big, going to get tested for diabetes.

Having said that, not every overweight person will get Type 2, as there's no hard and fast rule. And genetics seem to have a big role to play in Type 2. It's all very confusing! 

Mo


----------



## VBH (Jul 27, 2009)

Mojo said:


> Unfortnately with *Type 2 diabetes*, being overweight (especially around the tummy) and incative can predispose people to it i.e. increase their risk of getting it. It's all very confusing!



Wrong.

T2 is genetic.  

The genetic markers that make you T2 also predispose you to be overweight.  Also running high BGs before diagnosis causes people to put on weight as the body is constantly craving carbs.  This is why many T2s put on significant amounts of weight before diagnosis.

I didn't get diabetes because I got fat.  I got fat because I had the genetic triggers for diabetes.

So yes there is a relationship between obestity and diabetes.  The problem is that the media and so many others, including many health professionals have got the cause and effect backwards.

So they blame T2s for their "self-inflicted" condition and the myth keeps being recycled (as above).

Hope that clears up the confusion.


----------



## insulinaddict09 (Jul 27, 2009)

What a fantastic Debate  I do tend to agree that its just too easy to say "oh well you're fat , its your fault you got Diabetes " Grrrrrrrrr


----------



## Mojo (Jul 28, 2009)

VBH said:


> Wrong.
> 
> T2 is genetic.



You might want to google the Finnish Diabetes Prevention Study, or the Diabetes Prevention Program.

These are two very big powerful studies that have shown that people who are on the cusp of having diabetes (impaired glucose tolerance), were able to reverse this and reduce their risk of getting T2DM by *opting for a more healthy lifestyle* and *losing weight - especially around the tummy*

Mo


----------



## VBH (Jul 28, 2009)

Trouble is that it rebounds on T1s as well, as Northerner mentioned.  This myth that T2 is self-inflicted is bad enough for T2s, but to the average punter in the street, there's no knowledge of diabetes, so T1 and T2 tend to get lumped together.  So you get the effect that people think T1 is self-inflicted as well.

I think it all started because of the very obvious correlation between T2 and being overweight but rather than look at the pathways, people started thinking that one caused the other and unfortunately got them the wrong way around.

Incidentally, there seems to be some evidence that T1 is genetic in some cases.  This would make sense being an autoimmune condition.  Not in all cases, but there are some with a family history.

And MODY is quite definitively genetic of course.


----------



## VBH (Jul 28, 2009)

Mojo said:


> You might want to google the Finnish Diabetes Prevention Study, or the Diabetes Prevention Program.
> 
> These are two very big powerful studies that have shown that people who are on the cusp of having diabetes (impaired glucose tolerance), were able to reverse this and reduce their risk of getting T2DM by *opting for a more healthy lifestyle* and *losing weight - especially around the tummy*
> 
> Mo



Now you're talking about the trigger point, rather than the root cause and its an oversimplified view of the mechanics.

If it were that simple, all T2s could be cured by losing weight.

It is possible to delay the trigger point if there is forewarning, but it is not a "cure".  For those who have the genetic markers, it can be a delaying action to prevent the trigger point being reached.

Also obesity-induced diabetes is very real and only slightly related to T2.  Sheer weight can cause insulin resistance and this can be reversed through weight loss, but its not the same thing.

You'll notice that for some people on those studies it made no damn difference.

But thanks for your efforts to blame a serious condition on the sufferers.


----------



## Mojo (Jul 28, 2009)

I agree, VBH, and like I said previously not all overweight people end up with T2DM, so there is no ultimate single cause for T2DM.

This would not be the first time that the media have blown evidence out of proportion. It's up to people like diabetics, health professionals, and charities (like DUK) to re-educate people on the difference between T1 and T2, and that the causes of T2 are multifactorial.

You may have heard about adipose tissue being causing with insulin resistance? This is where the contributing factors come into play.

When I see patients with T2 (or T1 for that matter) who are overweight, I don't use it as a vice to bring them down. I provide them with information which hopefully makes them feel empowered to do something about their weight to gain better control.

Mo


----------



## VBH (Jul 28, 2009)

Incidentally, just on the causes of T2 and the related studies you might be interested in Jenny Ruhl's summary article:
http://www.phlaunt.com/diabetes/14046739.php


----------



## Dizzydi (Jul 28, 2009)

So in theroy  ANYONE really can get T2 fat/thin young/old as it is also genetic ? You would think that Diabetes UK would educate the media properly - someone should.

I must admit it is hard to explain to people that not all T2 were / are overweight/obese when diagnosed 

I went throught the it must be my fault when diagnosed - I was slightly over weight size 14 - but then my GP pointed out Gran and Mum who are T2 as well.


----------



## Steff (Jul 28, 2009)

VBH said:


> Incidentally, just on the causes of T2 and the related studies you might be interested in Jenny Ruhl's summary article:
> http://www.phlaunt.com/diabetes/14046739.php



thanks VBH a very interesting read


----------

