The accepted knowledge is that Diabetes destroys gradually over years. Ketosis Prone Type 2 diabetes is an acute form of type 2. This type 2 can reach fasting blood sugars of 300 or higher in months. This blog brings together all the documentation that I could find in the world and my speculation of what it means for KPD’s in specific and diabetics in general. I ask you to leave your stories about what happened to you so that we can all gain a better understanding of what we are dealing with.

Tuesday, September 6, 2011

Thinking about: Western technology, food and the health of people of color and world food production and trade.

I've added, what I think, is an important addition to this post. If you've read this already just skip to the bottom.

Guess whose back? Me! I've finished my latest assignment so it's back to KPD or abrupt type 2 diabetes; however you wish to look at it.

I was working down in Southwest Detroit (One of the few multicultural areas there.) and I was looking at many of the people walking around and many of them were heavy. The thing about this area is that it isn't a "food desert" there are plenty of stores with many types of produce. This is also a working class area so most people do work that requires a certain amount of physical effort. Yet the story remains the same, way too much weight and with all the problems that this portends.

One of the things that helped to keep this in mind was looking at the stats on this blog while I was away. This blog in particular seemed to be getting a lot of those hits. I tried to address this issue further while I was away with this blog. Now I want to go back again and try to put this all a little more together.

In the last thirty years diabetes appears to be surging both in the US and around the world and it seems to affect people of color disproportionately.

You should look at this graph very carefully. Something happened after 1990. One of them is probably a statistical fluke having to do with the change in what is considered diabetic or the fact that the US baby boomer population is entering its mature years but you would expect for that to flatten out eventually. It hasn't.

Here's another fact to consider. Diabetes is a chronic disease that develops overtime. How long this period of time is varies. Even in the case of Abrupt onset T2, there appears to be a long lag before our type of diabetes becomes full blown. You can view that here. My point is that viewing the take off point of diabetes isn't enough. We have to look at the preceding years and what might have occurred in them, if we wish to see some turning point.

The time frame we're looking at is about 30 to 40 years and frankly there are plenty of changes that have occurred in this time that could be correlated with this sudden take off in diabetes. This is diabetes, however, and the dog that hunts best here, at least for me, is diet.

I've talked about the contamination of traditional foods before. Here. You could look at this post as an expansion of that post. My point was that due to economics the constituents of foods around the world are being replaced with cheaper products that I think are problematic.

First up: wheat. Wheat has been around for years. It was first domesticated around the Fertile Crescent and this wheat is Emmer. Later on with get Eichorn wheat and a host of other varieties. Wheat has been bred and bred through out the years for all types of qualities. It has become one of the central characters in the diseases  of civilization. Take a normal healthy society of humans and introduce them to flour and problems tend to arise. Denise Minger on her blog statistically demonstrates a strong correlation between wheat and cardiovascular disease. What should be even more worrying is that 99% of all wheat is of one kind, the dwarf wheat variety. Many people have pointed to this variety as having toxic properties especially as relates to blood sugars. Anecdotally, I've read where people have tried Eikhorn wheat and found no big jump in blood sugars.

My standard answer to any ketosis prone diabetic is to give up wheat. It really doesn't matter what their symtoms are. I say, "Give up wheat." and if they do they always feel better after a month. It makes me appear as if I know what I talking about.The truth of the matter is the giving up of wheat seems to always ease physical problems. Give it a try.

What this has to do with traditional foods is the fact that, due to global trade, a cheaply produced product is easily substituted for a more traditional product that tends to be more expensive. The more plentiful that cheap product is; the more likely it will be used as a substitute. Dwarf Wheat became the dominant variety starting in the late 70's. Unless that traditional food is tightly regulated such as Fasso wheat in Italy, it is more than likely Dwarf Wheat. More Dwarf Wheat If you look at our chart, it was just in time for our diabetes epidemic.

On to seed oils. These have been around since the start of agriculture but except for a few cases like olive oil they could not be produced in great quantity until we had the industrial techniques to do so. These are what we call vegetable oils.

Here's some nice charts.


So what are these graphs about? This is about fats particularly polyunsaturated fats. These typically come from seeds that are processed to get the oil out of them. The fats obtained from seeds tends to be mostly Omega -6's. The body uses Omega-6's and Omega-3's as building blocks. The problem is that the body doesn't distinguish between the two. This really wasn't necessary because in nature they would generally be found in roughly a 1 to 1 ratio. Thanks to modern technology, this has changed. The consumption of seed oils has continues to climb so much so that the ratio is now guessed to be between 10:1 to 25:1. Well what of it?

As noted before, the body does not distinguish much between these two fatty acids. If the body is taking in 6's when it should be taking in 3's then the building blocks for a healthy body are wrong. It sets up a situation of chronic inflammation. This is from Wikipedia.

Some medical research suggests that excessive levels of certain n−6 fatty acids, relative to certain n−3 (Omega-3) fatty acids, may increase the probability of a number of diseases.[1][2][3]
Modern Western diets typically have ratios of n−6 to n−3 in excess of 10 to 1, some as high as 30 to 1. The optimal ratio is thought to be 4 to 1 or lower.[4][5]
Excess n−6 fats interfere with the health benefits of n−3 fats, in part because they compete for the same rate-limiting enzymes. A high proportion of n−6 to n−3 fat in the diet shifts the physiological state in the tissues toward the pathogenesis of many diseases: prothrombotic, proinflammatory and proconstrictive.[6]
Chronic excessive production of n−6 eicosanoids is associated with heart attacks, thrombotic stroke, arrhythmia, arthritis, osteoporosis, inflammation, mood disorders, obesity, and cancer.
Here's a listing of the Omega 6 amounts in some of the most used seed oils.

Most of these oils are not bought by people for consumption. They, for the most part, are used in the preparation of foods because they are cheap. Just imagine if your traditional food now made with flour from Dwarf Wheat is cooked in Soy oil.

I was going to throw sugar in this overlong post but if you don't know about that then nothing I'm going to say here is going to change things. I will say this that once again cost is driving cheap substitutes like high fructose corn syrup into more and more foods.

Look back up at the graphs. Look at the times. Does it seem as if we are doing something in our diets that have led to our present problems?

Now back to the problems of people of color and this quiet but possibly toxic mix that has invaded their foods. If we once again look at a graph of the A1c's of KPD's we see a long running period of elevated A1c's.

Normal A1c's should be around 5. These hover at about 6.3 month after month before taking off. I suggest that what we're seeing is inflammation caused by dietary components that over time essentially
damage our bodies. I'm thinking that these elevated numbers are due to a low level hyperglycemia that is a reaction to chronic infection. In this case, I once again bring up the hypothalamus which is an active part of this system and is susceptible to malfunction due to high blood sugar. 

Remember, we are already prone to problems with dealing with carbohydrates, if you throw some fructose in there and cause the liver problems then you can be well on your way to DKA even with a traditional diet.

We are looking at economics possibly overwhelming good sense. Cheap food additives produced thousands of miles away are quietly replacing the traditional healthy foods. I would say simply eat whole foods but under what conditions was this food raised?You should be reading labels on anything that is manufactured but do you know what you're seeing. Did you know that the "emulsifiers" you now see on labels is more than likely a transfat?  Once again I make my usual plea. Get a meter and test the foods that you and your family eats.

This is an addendum to this post. I started thinking that the key to much of what I have said is food production and the trade in food products. A little research found me this graph.

Once again I ask you to look back at the graph of the growth of diabetes. The growth of trade takes off at about 1986. Ten years later in about 1996 diabetes takes off as well and both increase rapidly from there to the present. I don't see this being explained by ideas of food palatability though there is certainly some of that there, nor do I see genetics or behavior explaining this either. Food has not got that much better tasting. Certainly genetics hasn't changed that much and I doubt we have become less industrious in the entire world in the last forty years. This last graph suggests to me that we have done something in the production of our foods that is metabolically traumatic. I well know that correlation is not causation but there seems to be something here and all I can do is nibble around the edges. This calls for a better mind than mine or more specifically some one like a Ned Kock who could possibly tease out what might be going on here.

One could say that this is simply the usual "diseases of civilization" but one has to answer the question "Why does this occur now?". 

I'm at Michigan State University, where some of the best agricultural scientists in the world do their work and though I'm not at liberty to divulge any specifics, world food production is about to seriously take off in the next 10 years. The tests that I have seen suggests we could see a doubling to quadrupling of food production. In other words, an end to famine. More food is good but what if the food isn't?

Thursday, August 4, 2011

Chinese study on Ketosis Prone T2 Diabetes

This is for our Chinese KPD's. Here's a study presently recruiting KPD's in China. Chinese KPT2D Trial One of it's big novel features is that it's recruiting both lean and obese KPD's. This isn't one of those studies showing that KPDM exists in a given population. They quite clearly know it exists. This study is meant to try and understand it.

This is one of the things I've been waiting for. Most of the research on KPD research has been done in the US and Europe even the studies done in African have mostly been carried out by Europeans. What I've been waiting for is for the third world to start picking up the research and expanding it. This is, after all, a growing problem in their countries.

Here it is buried in both bad science and a majority culture which largely ignores it. I talk to Blacks, Hispanics and Native Americans and all of them get this big surprised face when I talk about a diabetes that is prominent in peoples of color in the US.

I am especially perturbed by the advice given them by their local medical people. These people have no idea about this and so treat it just like a regular type 2, type 1 or LADA. This is probably one of the reasons DKA's have doubled in the last thirty years in the US.

Graph showing Number (in Thousands) of Hospital Discharges with Diabetic Ketoacidosis as First-Listed Diagnosis, United States, 1980-2005. Links for data figures, sources, methodology and data limitations, and detailed tables follow this figure.

Good for you China and let's hope the rest of the world gets going too.

Monday, April 18, 2011

Caution on NSAIDS

I've pointed out a NSAID as the drug I was using to effect my 1st phase insulin response but anyone who is thinking about trying this should be aware of the risks involved. Beyond the usual issues of stomach and intestinal distress, there are other issues. You can read about many of them here.  Jenny's Blood Sugar 101

One thing that she doesn't cover is that NSAIDs are NOT recommended for those who are G6PD deficient because of the chance of hemolytic anemia. If you've been reading this blog you should know that KPD's have a very high rate of this deficiency. So I do urge caution in their use.

Monday, April 11, 2011

How I got normal blood sugars for 60 cents a week

Being that I'm still on assignment, I've decided to let you in on the experiment that I did on myself to try to understand the nature of Ketosis Prone Type 2 diabetes or as I call it Abrupt onset type 2 diabetes.

Okay, a bit of a review. Ketosis prone type 2 diabetes is an abrupt onset type 2 diabetes though highly prevalent in people of color it can and does pop up in any group. The fact is that KPDM is actually a subset of this form of diabetes. I know LADA's that have gone DKA. There is a real question in my mind whether Abrupt onset T2 (AOT2) is a type of diabetes or simply a mechanism through which diabetes is expressed.

At any rate, this is a diabetes that comes on very strong because the body simply quits producing insulin. It is therefore classified as a type 1 diabetes, T1b. It comes out of nowhere. In 6 months time a person can go from near normal blood sugars to DKA. I talk about this process in these posts. Relapse

It has also been shown to vanish just as quickly, if handled correctly. In the space of a year, a person can go from near normal blood sugars  to close to death from DKA and then back again. This not a regular diabetes and so far has failed serious classification. It is so fantastical that most people don't know it exists, even those most susceptible to it such as people of Latin, African and Asian descent.

I, however, got lucky. About six months ago, I found myself with a revived 1st phase insulin response. I wasn't content with this. I had to find out what happened and how this could be and I kept experimenting until I not only found it but was able to manipulate it. I could turn it off and on with a simple manipulation. You can read about this process through this link, This is a dialogue on diabetesforums where I talk about this experiment

Here are some of the citations that I dug up to back up what I believed to be the cause of my suddenly restored 1st phase insulin response.
Non-steroidal anti-inflammatory drugs increase insulin release from beta-cells by inhibiting atp-sensitive potassium channel


Effect of selective cyclooxygenase-2 (COX-2) inhibitor treatment on glucose-stimulated insulin secretion in C57BL/6 mice

Use of Salsalate to Target Inflammation in the Treatment of Insulin Resistance and Type 2 Diabetes

Targeting INflammation using SALsalate for Type 2 Diabetes.

Potential Role of Salicylates in Type 2 Diabetes

This got me to thinking about KPDM and its quick rise and fall which you can read here. Here

Now you know. It was a NSAID called Sodium Naproxen taken as needed. The net cost was about 60 cents. More when I have the time.

Thursday, April 7, 2011

Roux-en-Y gastric bypass

I, in no way, endorse this procedure but it does have some bearing on Abrupt T2. It was orignally thought that much of the gains from this surgery was due to the limiting of / and types of food that people could eat once this surgery was performed. The citation below, however, shows that, in this case, there are far ranging effects on the hypothalamus that suddenly take effect. These effects proceed weight loss and involve the whole series of hormones that influence metabolism.

My point for Abrupt T2 is that this shows that the hypothalamus is a higher order mechanism that can certainly effect, if not control, the whole insulin cycle. Once again, there is no change in the underlying beta cell structure. The change isn't there but higher up. 

Facebook Page for Abrupt Onset Type 2 Diabetes

People have suggested that I put up a Facebook page so that people can easily comment and add information.

Okay, I've done this and I'll be adding more in the future. Hopefully, while I'm off on this project, this will keep the dialogue going.

Abrupt Onset Type 2 Diabetes

Obviously, I just got this set up before I went off on my latest assignment. I really didn't know what it was going to be but now I think I'm getting it. I don't have time to seriously go through scientific papers at this moment. I still am thinking about things and interesting citations still come across my desk. What I plan to use facebook for are these clues about Abrupt Onset that keep arising. 

This will give me a chance to talk about and hopefully get feed back on ideas that you might find interesting.

Who gets KPD T2? Everybody!

I've decided to keep updating this with citations as they come in.



Adult-Onset Atypical (Type 1) Diabetes: Additional Insights And Differences With Type 1a Diabetes In A European Mediterranean Population. Http://Www.Ncbi.Nlm.Nih.Gov/Pubmed/15111529

Clinical characteristics of Korean patients with new-onset diabetes presenting with diabetic ketoacidosis.

Ketosis-onset diabetes in Tunisian adults: immunological markers and β-cell function 

High Frequency of Type 1B (Idiopathic) Diabetes in North Indian Children With Recent-Onset Diabetes

A Subtype of Markedly Abrupt Onset With Absolute Insulin Deficiency in Idiopathic Type 1 Diabetes in Japanese Children

South Asian version of flatbush diabetes mellitus- A case report and review article

Ketoacidosis in Apache Indians with non-insulin-dependent diabetes mellitus

Cetoacidosis diabética:una complicación frecuente de la diabetes tipo 2 en hispanoamericanos

The Occurrence of Diabetic Ketoacidosis in Type 2 Diabetic Chinese Adults

Characteristics of Caucasian type 2 diabetic patients during ketoacidosis and at follow-up

The prevalence of ketosis-prone type 2 diabetes is not known, but observational studies suggest that this type of diabetes accounts for a substantial number of patients with diabetic ketoacidosis. In the United States, the prevalence has been estimated to be between 20% and 50% in African-American and Hispanic patients with new diagnoses of diabetic ketoacidosis . In addition to ethnicity, clinical features predictive of future near-normoglycemic remission are obesity and a family history of type 2 diabetes. Among 154 consecutive African-American patients admitted to the hospital with diabetic ketoacidosis, we observed that obesity was present in 29% and that the prevalence of obesity was higher among those with newly diagnosed diabetes (56%). More than 80% of patients have a family history of type 2 diabetes. The mean body mass index at presentation in African-American patients with ketosis-prone type 2 diabetes has ranged between 28 kg/m2 to 37 kg/m2 . A high rate of obesity is also reported in Hispanic and Chinese persons and in sub-Saharan black African immigrants to Europe. Obesity in persons with diabetic ketoacidosis from minority ethnic groups is more common than in white persons, in whom the rate of obesity is less than 20%.

Balasubramanyan and colleagues reviewed the clinical profiles of 141 adults admitted to the hospital with diabetic ketoacidosis. At presentation, 39% of patients were considered to have type 1 diabetes, 53% were considered to have type 2 diabetes, and 8% were not classified.Twenty-eight percent of patients had newly diagnosed diabetes, 93% of whom were reassessed at least 2 years after their initial episode of diabetic ketoacidosis and were considered to have type 2 diabetes. More recently, Pin˜ero-Pilon˜a and Raskin  reported that the incidence of this type of diabetes among persons with new-onset diabetes with diabetic ketoacidosis was approximately 60%. In agreement with the U.S. experience, African studies have reported that 42% to 64% of patients with diabetic ketoacidosis initially treated with insulin therapy do not have classic type 1 diabetes and may experience prolonged remission. The prevalence of ketosis-prone type 2 diabetes seems to be lower in Asian and white persons and may represent fewer than 10% of cases of diabetic ketoacidosis.

Narrative Review: Ketosis-Prone Type 2 Diabetes Mellitus

The extent of the prevalence of this syndrome really isn't known. As far as I know, there is no ready test for KPD T2. What we have is hospital admittance records for DKA. The numbers quoted for Mexican and African Americans is about 60% of all the DKA cases. What this means in terms of the general Mexican and African American population is in question but you have to recognize that for every case where it is bad enough to cause hospitalization there has to be many multiples of it in existence.


Sunday, February 6, 2011

Contamination of traditional foods

I'm still off on assignment but this subject came up and I thought that it would be good to drop a brief note on it.

We tend to think that if we stick to traditional foods that we can expect to be safe from problems with blood sugar. What needs to be recognized is that traditional foods were typically raised by the consumer or the farmer was near to the consumer. Preparations were carried out by the person eating the food.

The modern world is different, however. You might very well be eating a traditional diet but what are its constituents? Is that wheat the traditional wheat which was used in the preparation of that bread? How was it prepared? This is important. Traditional preparation will do nothing to offset problems of diet, if the underlying food is problematic.

If you look at our "diabetes epidemic", you will note how much it has taken off in peoples of color across the world in the last few decades. I suspect that some of the reason has to do with newer varieties being substituted for old traditional foods. I know I keep harping on this but the only way to truly know is to test your blood. Don't be complacent. The world isn't very dietarily safe for you or me.