Type 2 diabetes is a chronic disease. The excepted knowledge is that it erodes the body’s systems gradually over years. If you are reading this then you know different. Ketosis Prone Type 2 diabetes is an acute form of type 2. Rather than taking years to reach fasting blood sugars of 300 or much much higher, it can do so in less than a year. A few will even go DKA, a diabetic emergency from high blood sugars that can lead to coma and death. DKA is the only known way to identify KPD but it should be recognized that DKA is KPD at its worst. Measuring it’s prevalence by that is the same as using pneumonia as the best indicator of the prevalence of flu.
This is all made even stranger by the fact that, if treated properly, it can go into a type of remission.
People we need to be noticed. We must tell our stories to save others from what we have experienced and to give researchers an idea of who we are. This is your chance. Please leave as much of your story as you can in the comments section.
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I'm assuming that I have KPT2; what I have certainly isn't normal T2.
ReplyDeleteI was diagnosed about three and a half years ago (A1c 9.6, random BG 364). I immediately started eating low carb (<30 grams of carb/day), but diet and oral meds didn't make much difference in my blood glucose; it dropped to around 200 and stayed there. I tried lots of diets, supplements, medications, etc. Even insulin didn't give me normal BG, and made me gain 20+ pounds.
My BG dropped almost to normal for 4-5 months, then suddenly (with no change in diet or anything I can see) went high again. My hormones are all out of whack, my cortisol is high, and my HS-CRP is high, indicating inflammation. I've eliminated all the toxins I can find from my life, and all potential inflammation-causing foods from my diet (I'm down to eating meat and non-starchy vegetables...no grains, nuts, dairy, soy, PUFAs, starches, etc). Still, my BG is around 200. I also can't lose weight, no matter how low carb/calorie I eat. I believe that reducing inflammation is the key, but where is it and how do I reduce it????
First of all you did not tell your age or sex? Hormonal balance is a delicate dance. If there is even one hormone like the stress hormone Cortisol out of wack, then your healthy sex hormones (that are also responsible for blood sugar control) are low and bound up by SHBG` (sex hormone binding globulin). I am a fan of Natural Hormone replacement (compounded creams) There never is just one missing piece. I think that most of us are under liver distress from all the fructose (1/2 of all table sugar and most fruit) in our diets. Sugar is added to almost every processed food. Our livers are meant to process other things not all this fructose. Even fruit was never to be consumed in the quantities in which we consume it. All foods eventually breaks down into glucose to be used by our cells and is absorbed thru our stomach and intestines. We were created with an innate ability to do this. Sugar in all its forms is the corruptor here, not necessarily carbs, but we have to re-program our bodies back to their normal functions. Good intestinal health is vital for absorption, immunity and proper nutrient balance. Most of us do not get enough fermented foods. Good quality plain yogurt is both blood sugar balancing and healthy. I make my own with goat or sheep milk. It sounds to me as if you are not getting enough quality foods, add lots of veggies, fiber! with every meal and fresh air with walking! also I can add some information about anti-inflammatory herbs if anyone wants to know? Everyone can benefit from Turmeric in capsules New Chapter makes them.
DeleteThis is interesting. This is the reason I want people to write down their stories.
ReplyDeleteHere is the first thing I thought of. Recently I ate something, OK, I'll be honest, it was popcorn. Anyway it just seemed to tear through my stomach. My BG went up and stayed. It was due to injury, of course.
Most KPD's are noted for not having precipitating factors. It seemingly just comes on. You, it seems might have a precipitating factor that you have yet to uncover.
Here's the problem: this might very well be something that happens to plenty of KPD's but I don't know because there is not enough dialogue going on. Hopefully someone reads this and chimes in.
What worked for me was excercise! My blood sugar took about 4 weeks to go from 4-600 down to 100-140. An hour a day of low impact (no heavy breathing) cardio brought my levels down. This scrubs excess blood sugar out of your blood and gives your pancrease a break. Once your levels come down, you should go into remission. Stay away from the carbs for now, but once you maintain normal levels for a month or so, you must add carbs back into your diet (in a very controlled fashion, and I mean low glycemic healthy carbs in small measured amounts) and add more intense excercise to routing in order to turn your body back into a carb burning machine. Remember, never stop your low impact cardio. You must get your metabolism moving. This is probably what caused my systematic failure in the first place. Lethargy and processed carbs. Too much work and sitting all the time. Lots of stress and cortisol. The opposite approach to what got is in this position is logical as the solution. Finally, remember that weight loss can suck key vitamins out of you. Supplement with a good B complex and eat as much non processed vegetables as possible (non stacrchy) as these will have enzymes and vitamins you will need. I can be reached at jedelman@lodgepseed.com for further discussion.
ReplyDeleteThis is definitely a one size does not fit all disease. I was riding a bike when I was diagnosed as a matter of fact I rode the bike to the doctor's office to be told I was a serious diabetic. Obviously, exercise was not getting it done. For me, it was a diet and rather specifically looking at my 1 hour after dinner blood sugars. This testing indicated to me that all the "healthy grains and fruit" that I'd been eating were the problem
ReplyDeleteMy blood sugars came down and stayed down even as I, intentionally, cut way back on exercise. My A1c got down to 4.7. I've since tried adding back some carbs and now my A!c is 5.2 even though I've let my rate of exercise go up. This maybe due to the fact that I'm thin, I don't really know.
I should note that I didn't go into remission until I rejected the diet advice of my diabetic team. They wanted me to take in 300 g of carbs a day. They didn't seem to recognize that an abrupt onset diabetes requires and immediate and sharp reduction in carbs. I suspect that If I'd followed their advice there would have been no remission and I would have stayed on insulin and been considered a LADA or T1.
Frankly, I don't know what Type of diabetes I have; only that it is not a currently recognized form of Type 1. KPD is a definite possibility. I do not believe in "Type 2." From what I've read, observed and experienced, there are many unrecognized variants, and not much work being done to identify them.
ReplyDeleteI was diagnosed while in DKA, several hours after a routine blood test in April 2011. BG at the time was 513, A1c was 13.5. I'd been feeling steadily lousier and lousier since 2005(!) -- but the subject of diabetes never came up.
ER staff put me on insulin immediately. Within a couple of months, I was able to attain and maintain near-normal levels, but only through continued insulin and a low-carb, high-fat diet -- both are necessary. There has been no remission. It seems I will be on insulin and low-carb, high-fat for the rest of my life, and I'm content with that.
My health plan did all the right things when it same to insulin. Not so, however, with diet. Docs, nurses and educators all urged me to eat 45g of carb with each meal, and 15g with each snack. For me, this is utterly impossible, which, I've learned since, is equally true for a whole lot of us.
In addition, my health plan "diagnoses" all adult-onset diabetics as "presumed Type 2." Later, in diabetes class, I found that many of my classmates weren't even told that much. The only term they were given was "diabetes." We were told, however, that adult onset is always Type 2, and that we should eat lots of carbs! I graduated myself early.
I did get type testing, after I insisted. No antibodies were found. But my wonderment at such lax diagnostic procedures, and deep concerns about their effect on research, remains.
Hi Shalynne
ReplyDeleteThanks, I don't get many comments part of the reason is that this blog is very international and I guess non-native english speakers don't feel comfortable expressing themselves.
From your description, you would be classified as T1b. Which means basically you don't have antibodies and they don't have a clue as to why your body isn't producing insulin. One thing you didn't say was where your c-pep was. Is it low or nonexistent?
The reason I ask is because the literature, at this time, doesn't make a difference between beta cell destruction and beta cell dysfunction.
This is to say that dysfunction would be intact beta cells that, for what ever reason, have been turned off. I bring this up because the cases that I've read have occurred so quickly and resolved so quickly that it can't be beta cell regeneration. I've also had the experience of turning my 1st phase back on by using an NSAID.
I have come to the thinking that abrupt type diabetes that isn't involved with antibodies is more a response to some sort inflammation that effects signaling in the body that blunts or stops altogether beta cell response until the inflamed system returns to the point where its signal can once again be expressed.
Of course, this maybe hooey but it certainly seems better than most of the advice I see flowing out medical. I had the exact same advice on carbs and decided to graduate early as well.
Right now, in an attempt to ameliorate some of this, I'm with a group of researchers in Michigan writing translational briefs to try to get information to medical practitioners which is a bit more up to date.
My c-pep was 6.2. Normal range!
ReplyDeleteMy glucose at the time was 146, perhaps not high enough to test properly. But I do seem to have some beta cells left. Obviously, I've also got a huge degree of insulin resistance. Dysfunction, not destruction, as you say.
Everyone in my family, both sides, is diabetic. My elders, however, developed it in their 60s and 70s, and in a form more like "classic Type 2." No one went on insulin. For me, it hit at 54, and was doubtless present years before diagnosis, and I'm on insulin. I keep myself at or, preferably, below, 30g of carb per day. Yet, no insulin = spike, no matter what.
Many thanks for your work! Political and economic factors stand in the way of progress, but knowledge shared can break down a lot of walls.
Hi Michael,
ReplyDeleteI would like to thank you for putting down such great information. There seems to be a real dearth of stuff on improving first-phase insulin response.
Now my story. I am not diabetic but almost pre-diabetic but I’m being proactive.
I’m a 45 year old male, pretty good health, quite lean at 150 lbs / 5’6” now (not a 6-pack but a 4-pack plus a bicycle tire) . Mixed race (about 25% European, 25% Chinese and 50% Filipino). The most I ever weighed was 176 lbs from about 2002 through 2006. Desk job. Regular weight in the gym. Was lean until my late 20s. Never felt good after a soda, so I never had much, and I always preferred having meat or other fat in my meals. 1 uncle and 1 grandma had Type 2 diabetes, both overweight.
My fasting blood sugar was always in the high 90s, as far back as I can remember. So of course no doctor told me anything.
In 2006 I got an oral glucose challenge test when I complained of always having reactive hypoglycemia. Result:
Start: 97
1 hr: 91 peak was obviously missed
2 hr: 50 reactive hypoglycemia
Unfortunately no insulin measurements.
After some reading I decided to reduce my starch and sugar intake, and cut out snacks and eat 3 meals most days. (“Leptin rules of eating”) I lost weight, from 176 to 160 and stayed there for a long time. Reactive hypoglycemia cured.
Then I started testing my A1c about every other year. It varied between 5.5 and 5.7. Again no flagging from the doctor.
A year ago I bought a glucometer and started gathering data.
FBG: 90-105
Pre-meal: 85-95
Post meal peaks: 150-170 with modest amounts of starch (e.g. 2 hamburger buns, or 2 thick crust slices of pizza).
I tried a “yam challenge test” at lunch time – use an 8 oz microwaved yam instead of a glucose drink. Typical results:
start: 90
45 mins: 175
60 mins: 147
2 hrs: 85
So I decided to go low carb and paleo. I dropped almost all starches, fruit and omega6 sources and ate veggies and pastured meat instead. With low-carb meals post meal BG peaks usually below 110-120. I did the Jack Kruse “Leptin Reset” for a while, then moved on to occasional intermittent fasting (skipping breakfast). My weight dropped down to 152.
Started supplementing with cinnamon, VitD, Cod Liver Oil, GTF Chromium.
Kept this up for a while. My sensitivity to starch did not seem to improve.
But fasting insulin test: 0.5 (!). I hope it wasn’t a fluke.
Jason
ReplyDeleteThen in December I stumbled on Richard Nikoley’s blogs on Resistant Starch. So I worked my way up to 4 tbsp/day of Bob’s red mill unmodified potato starch. I dropped another 2 lbs to 150 lbs today. 4-pack came out.
3 weeks later:
FBG: 80-95
I tried some starchy meals. Meals what would have peaked at 130 were 110. Peaks at 150 are 120-130.
I then tried an 8 oz yam test:
Start: 85
35 mins: 130 (Wow!)
41 mins: 125
1 hr: 121
I was stunned. And ecstatic. I now had excellent starch tolerance. So I started eating more “safe starches” as per Paul Jaminet, typically ½ cup of Uncle Ben’s Parboiled Rice or ½ cup of a sweet potato. I kept this up for a few months.
And then I went through a stressful period in my life – a family member passed, another family member was diagnosed with Hashimoto’s, and I started hating my job. This was also about the time I started a bunch of prebiotics (Sauerkraut, AOR and Prescript Assist). After a few weeks of this, I did a spot check of my FBG. 95. Hmmm. So I did a few more tests:
FBG: 92-99
I tried taking ALA. 900 mg at bedtime will drop my FBG into the 80s.
Then I realized my post meal peaks were up at 150-160 with only half a cup of rice. So I repeated the 8-oz yam challenge:
Start: 90
40 mins: 177
45 mins: 155 <- fluke?
60 mins: 172
67 mins: 157
75 mins: 148
90 mins: 116
130 mins: 74
I was chagrined.
I repeated the yam test, but this time with a 4-oz yam:
Start: 90
30 mins: 121
40 mins: 137
50 mins: 151
60 mins: 142
75 mins: 123
I thought back on what may have changed, so I restarted a new blood sugar supplement which contains Chromium, cinnamon, and a bunch of herbs. It has been 2 weeks, and so far no improvement.
So I started reading up again, and discovered the concept of the “first phase insulin response”, and your page.
I’m a bit lost right now. The questions in my mind are:
How did I lose the plot?
Did my increase in “safe starch” intake “break” my system?
Was it the stressful period? That has mostly passed and I feel about 75% back to normal.
Was it the AOR and Prescript Assist (soil) probiotic? But that’s helped a lot of people. Here is a very dramatic testimonial:
http://freetheanimal.com/2014/05/resistant-problems-ignorance.html
What tests can I try? A proper OGTT with insulin? My beef with that test is they only test at 1 hr. 30-45 minutes would be more useful for me, and not 3 hours.
Thanks for the bandwidth.
-Jason
Just started reading this blog and I find it phenomenal!!! There are so many points that seem to be resonating...I don't know definitively if I am KPT2, but there is something in this particularly dialogue that seems to be exploring a larger conversation about the layers that can exist in a diabetes diagnosis than the usual blanket diagnosis of such a complex and impacting condition...thank you for this...luna
ReplyDeleteThanks for commenting!
ReplyDeleteYou're right, this is a very complex disease. I doubt there are any pure cases of a single type of diabetes. It's really shades of grey going from T1 to T2. The problem is finding out where you are on that spectrum so that you can find a good protocol that works for you. Medical science really has not found a way to make this differentiation except in broad categories.
I'm happy to be a part of this dialogue...I've been recently trying to really embrace the dea that the presence of diabetes in my body is a living and breathing part of what is my unique ecosystem instead of seeing it solely as disease/illness/pathology...I just sense something to be gained from not seeing it solely as something that has "attacked" my body versus something that was born from my body based on my body's ability to survive and cope and sustain with absolutely all things considered...I'm just feeling there is a clarity to be gained from going into and identifying my own unique narrative relative to this part of my experience...ultimately I think the diabetes has provided me with a lens to observe my own unique physiology et al...if this makes sense ...luna
ReplyDeleteThough I might couch it in a different way, this is largely my view.
ReplyDeleteI've never thought of diabetes as a disease but this is how the language is couched in medicine. For me, diabetes is the physical behaviour of my body over time given certain sensitivities.
Now a lot of things, even mental, could go under this definition. The point, however, is to learn how you specifically fit in all this and not simply take some ones word for it.
Diabetes stopped me cold and forced me to evaluate myself and habits. It might have saved me from an early grave.
Bit of back story:
ReplyDeleteI am a white male living in the UK and was diagnosed about 18 months ago in my early 40s having been sent to hospital because of all the typical quick onset symptons; weight loss, high blood sugar and high ketones etc etc. First they thought type 2 due to age but then type 1 and put on insulin. About 6 weeks later my blood sugar was in normal range and taken off of insulin and placed on metformin whilst antibody tests have come back negative. In the 18 months since I have been through various consultants who couldn't fathom things out as my A1C has been excellent, which in my opinion has mainly been down to controlling the number of carbs and sticking to a low GI diet. The latest consultant believes that I am most likely a T2 Ketosis Prone Diabetic which I had looked into and kind of agreed with, although as the antibody tests have not been for all known antibodies just the usual ones I do wonder whether it may be LADA.
The trouble is that when I asked about data on how long remission lasted and whether it would be a sudden increase in blood sugar or a gradual one the consultant couldn't help admitting that T2 Ketosis Prone Diabetes hasn't been studied in a way to provide this sort of information. So what I would like to know is what have others diagnosed as T2 KPD experienced when it came to the progression of their diabetes. Were they able to maintain control for years and then suddenly find things getting worse or was it a gradual increase in blood sugar. And how many months were they able to keep things under control.