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Diabetes Is Actually Five Separate Diseases, Research Suggests (bbc.com)
An anonymous reader quotes a report from the BBC: Scientists say diabetes is five separate diseases, and treatment could be tailored to each form. Diabetes, or uncontrolled blood sugar levels, is normally split into type 1 and type 2. But researchers in Sweden and Finland think the more complicated picture they have uncovered will usher in an era of personalized medicine for diabetes. The study, by Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine Finland, looked at 14,775 patients including a detailed analysis of their blood. The results, published in The Lancet Diabetes and Endocrinology, showed the patients could be separated into five distinct clusters:
Cluster 1 - severe autoimmune diabetes is broadly the same as the classical type 1 -- it hit people when they were young, seemingly healthy and an immune disease left them unable to produce insulin
Cluster 2 - severe insulin-deficient diabetes patients initially looked very similar to those in cluster 1 -- they were young, had a healthy weight and struggled to make insulin, but the immune system was not at fault
Cluster 3 - severe insulin-resistant diabetes patients were generally overweight and making insulin but their body was no longer responding to it
Cluster 4 - mild obesity-related diabetes was mainly seen in people who were very overweight but metabolically much closer to normal than those in cluster 3
Cluster 5 - mild age-related diabetes patients developed symptoms when they were significantly older than in other groups and their disease tended to be milder
Cluster 1 - severe autoimmune diabetes is broadly the same as the classical type 1 -- it hit people when they were young, seemingly healthy and an immune disease left them unable to produce insulin
Cluster 2 - severe insulin-deficient diabetes patients initially looked very similar to those in cluster 1 -- they were young, had a healthy weight and struggled to make insulin, but the immune system was not at fault
Cluster 3 - severe insulin-resistant diabetes patients were generally overweight and making insulin but their body was no longer responding to it
Cluster 4 - mild obesity-related diabetes was mainly seen in people who were very overweight but metabolically much closer to normal than those in cluster 3
Cluster 5 - mild age-related diabetes patients developed symptoms when they were significantly older than in other groups and their disease tended to be milder
There is more and more information coming out that Alzheimerâ(TM)s may be its own form of diabetes. https://www.ncbi.nlm.nih.gov/p...
Curiously enough, all forms of diabetes are amenable to at least partial treatment with one simple mechanism: stop eating sugar and and easily-digested starches. Some will require supplemental insulin, of course, but that small step will work wonders even for them.
It really irritates me how much the press can misinterpret scientific results. This is more a matter of classifying Type 2 as four new subtypes (since Type 1 is an autoimmune disease and "cluster 1" is the only cluster to contain autoimmune markers). If you're really interested in this, go check out the Medscape article about this (https://www.medscape.com/viewarticle/893305), which goes into a bit of detail and even calls them out for completely ignoring Type 3c (which though only recently classified, represents roughly 10% of those currently diagnosed as Type 2). There are actually 8+ currently recognized forms if you consolidate them as much as possible: * Type 1, which in turn breaks down into 1b (idiopatiic) and 1a (which has both rapid-onset and slow-onset aka LADA or Type 1.5) * Type 2 * Type 3c (pancreatogenic) * Gestational (both "normal" and autoimmune) * MODY (actually 12 separate genetic disorders) * Neonatal * Mitochondrial (Diabetes and Blindness) * Cystic Fibrosis Related Diabetes And as others have pointed out, it's been proposed that a form of Alzheimers relating to insulin resistance within the brain be reclassified as "Type 3".
Do you really need reason for beer? Wingman Brewers
Where does gestational diabetes fit into all this?
that's because doctors here treat the symptoms and not the root cause. the patient doesn't care a lot of times about making themselves better, why should the doctors? and there is money to be made
go into a food court or starbucks and you will see the problem. people binging on sugar daily and then wondering why they get sick. some cultures eat nothing but carbs and think it's good to be overweight
That beats non-Western medicine by an amount roughly equal to categories and statistics.
Confucius say, "Find worm in apple - bad. Find half a worm - worse."
go into a food court or starbucks and you will see the problem. people binging on sugar daily and then wondering why they get sick. some cultures eat nothing but carbs and think it's good to be overweight
Well it's more the latter than the former, nothing wrong with carbs if you intend to burn them. It's eating lots of sugar with your ass firmly planted in your car seat, office chair and living room couch that's the problem. And you can get plenty fat on pizza with all the toppings, overeating is a much bigger problem than sugar... though of course it doesn't help.
Live today, because you never know what tomorrow brings
So after decades of treating diabetics as either type 1 or 2, they wake up to the idea that things might be a little bit more complicated than that.
Yet, I an insulin-dependent diabetic am still nowhere to be found in their expanded categorisation.
I was ~35 when I was diagnosed with diabetes. This was well over a year after almost dying from acute pancreatitis.
It's well known in the literature (if not by common sense) that if the pancreas goes bonkers then there is a reasonable chance that the patient will probably become diabetic to some extent, since the pancreas is where insulin is produced. It was seemingly unknown to the cock holsters who treated me, though.
So another set of overpaid cock holsters come up with this staggering finding. /s
When I was diagnosed ~20 years ago, I grovelled around the 'net via Excite! and found a paper where the author identified maybe a dozen different types of diabetes including mine. Some 20 yrs later, they produce a considerably crappier paper and are lauded like they've split the fucking atom...
WTF? Read my sig.
The Machine stops.
It's not the carbs. It's the (mostly dry) PROCESSED carbs + unnatural levels of fat.
A good sized 8 oz potato is 170 calories. 2 from fat. An 8 oz bag of chips is 8oz has 1,280 calories, 720 from fat but has only a similiar amount of satiety. If you go the more "responsible" route with baked potato chips, with 85% less fat, 8oz will still net you 960 calories, 144 from fat. Doubling on the potato (without sour cream, butter, etc) is no big deal , 340 calories, 4 from fat. Doubling either bag of chips is a ~2,000-2,560 binge.
You won't get fat from potatoes as grown. Japan had very low diabetes in the 1950s. Since then, meat consumption rose 7x, milk consumption 9x, eggs 3x, and fish 1.25x.... rice consumption has declined by 1/2, as has potatoes/sweet potatos. And diabetes has skyrocketed. So tell me it's the carbs, again.
Fat used to be rare in nature. Domesticated animals have 7x the fat wild animals do. It takes 1000-1400 olives to make a liter of olive oil, 10-12 heads of corn to make corn oil -- when the Medieval farm was ekeing out a mere 10% caloric surplus (meaning they could feed 10 extra non-farm hands besides internal consumption from a 100 man farm) where was all this fat supposed to come from before the industrial revolution? The modern avocado has 10x the meaty flesh the wild ones do and those were only in season 2 weeks of the year.
Again, where is all this fat sourced? We lived on carbs. The further we go back with more advanced techniques, we see humans lived on carbs. We just didn't see it before because bones survive the ages to dig up, corn kernels do not. We now see it in ancient tools and by analyzing ancient teeth, etcetera.
It seems worthwhile to put this in perspective of general medical science and progress. In every age, doctors and scientists try to understand disease within the framework of contemporaneous knowledge. When new discoveries are made, everyone scrambles to reevaluate what they know with respect to their primary field of interest. This then propels extensive new nomenclatures of disease, new therapeutics, and new clinical treatment schemes. This is the normal flow of progress in medicine, since forever, but especially easy to trace the waves of discovery and development over the past two centuries.
As example, consider breast cancer, another disorder which, like diabetes, is of profound incidence, morbidity, death, and public health interest and funding. Before the 1850's, it was described by features on physical exam, and doctors knew and named them as "medullary", "scirrhous", and "ulcerated". After the 1850's, we best understood tissue pathology by what we saw under the microscope, and clinical histology became the mandatory standard by which diagnoses were made and treatments decided. Breast cancers were then designated as "ductal" or "lobular" depending on cell or structure of origin. In the past 30 years, discoveries from the proteomics and genomics world have identified genes and receptors which govern tumor behavior. What the cells look like under the microscope is not so prognostic as how they behave, and hormone and cytokine receptors and genes (ER, PR, HER2, BRCA) now rule the diagnosis. Whenever such new discoveries force a rethinking of diagnostic and treatment paradigms, there are usually international nomenclature conventions or committees which organize to bring some sense of logic and order and common language to the new and old systematics.
That is what this new diabetes research is about, getting more refined, more focused, more granular in understanding the pathogenesis of the disease. It makes up for profound deficiencies in the adequacy of old nomenclatures. Eons ago, there was just "diabetes", recognized by profuse urination (with a multitude of later complications). By the Middle Ages, distinction was made between diabetes in which the urine was either sweet or tasteless (yes indeed, taste test was the chem lab of its day). Sweet urine was then called diabetes mellitus (honey like), versus diabetes insipidus (tasteless) which we now know is due predominantly to ADH deficiency from the pituitary.
Diabetes was relatively uncommon before the 20th century. By mid century, increasing prevalence forced everyone to start rethinking the nature of the disease, inasmuch as various clinical subtypes and profiles were easily discerned. Anomalous forms such as "adult onset diabetes" and "non-insulin-dependent diabetes (niddm)" and then "obesity related diabetes" were obviously different than classical "true" diabetes, so a distinction had to be made with a more robust vocabulary. Thus, "Type 1" and "Type 2" diabetes, but these terms were adopted only circa 1990. But those two designations alone do not cover the spectrum of clinical presentations, for instance is niddm really the same as obese diabetes? Also, these designations do not address underlying physiological mechanisms. In a patient whose diabetes, blood sugar control, and life itself are dependent on exogenous therapeutically delivered insulin (iddm), is his disease because his pancreas not make insulin, or because it actually does make insulin, but peripheral cells do not have receptors to bind the insulin?
Recall a few basics about sugar and insulin. Cells use glucose as their primary fuel. The body has a complex multi-control system to regulate glucose levels in the blood so that cells get it when they need it, so that dietary sugars can be stored for later use, and stored carbon can be mobilized between feedings or during high demand. Insulin is central in this process, having multiple aspects of control and regulation within this complex machine. Its most immediate and profound function is, by bindi
You know that 75-80% of your example potato is water, while the bag of chips is nearly free of water? A fair comparisation thus would be to compare 40 oz of potato to 8 oz of chips + 32 oz of water.
He wasn't talking about children stricken with Type 1 diabetes. He was talking about 'adult onset' or Type 2 diabetes, which is a totally different condition.
If you think I voted for Trump because of this post, you're wrong. I voted for Dr. Jill Stein of the Green Party. Again.
There are too many self-appointed who have simple solutions for every complicated problem.
Thank you for setting the record straight.
1. Not all potatoes are equal. Some have much higher glycemic loads than others. Russets are the worst common ones. Sweet potatoes aren't even comparable to what most Americans are eating.
2. You're right about the processing of carbs, in that it mostly removes fiber, which means you're getting the glucose from those carbs faster after you eat them. And purified sugar is the worst.
3. The fat was coming from animals. Meat, eggs, milk. (Bearing in mind there are human populations that only recently evolved adult tolerance to milk...so yeah, it was a big part of at least some diets.) Inuit/Eskimo diets didn't have a lot of carbs until recently, and then their health went to hell along with everyone else. They were eating mostly fat and protein and it wasn't hurting them. Fat isn't the problem; at least not for diabetes.
Um, yeah, that's the entire point. A potato has a very high satiety in the Holt satiety index. Potatoes were in the top spot, with the INHERENT water draggin down calories per serving. Inherent water is very different from water outside the food like drinking water with chips. Just like an average person eating hanfuls of grapes will predictably consume much less calories in a sitting than if they ate handfuls of raisins (here the difference is 19 vs 86 calories per ounce respectively - a 4.5 fold difference).
So, okay, try eating 5 8oz potatoes and see if you want more. I know plenty of people who go through a bag of chips and still hungry. And the fat intake of 5 potatoes is 10 calories vs 720 on chips.
High water content foods drag down caloric density and eating low caloric foods typically drag down the caloric intake of meals. That's the entire name of the game.
Learn about caloric density and role in keeping thin.
Glycemic index and glycemic load is not an index of healthiness, it's just one characteristic of food.
An average Chocolate Cake has an index of 30 while Shredded Wheat has 83 and Carrots have 92. Is carrots going to give you diabetes?
The Inuit were healthy myth was propragated by researchers Band & Dyerberg:
"The fact is they never examined the cardiovascular status of the Eskimos; they just accepted at face value this notion that coronary atherosclerosis is almost unknown among the Eskimo, a concept that has been disproven over and over starting in the 30s. In fact, going back over a thousand years, we have frozen Eskimo mummies with atherosclerosis. Another from 500 years ago, a woman in her early 40s – atherosclerosis in her aorta and coronary arteries. And these aren’t just isolated cases. The totality of evidence from actual clinical investigations, autopsies, and imaging techniques is that they have the same plague of coronary artery disease that non Eskimo populations have, and actually have twice the fatal stroke rate and don’t live particularly long."
The fact is the Eskimo died relatively young, had high rates of atherosclerosis, heart disease, and strokes.
"Such dismal health that the Westernization of their diets actually lowered their rates of ischemic heart disease. You know your diet’s bad when the arrival of Twinkies improves your health."
Even today they live 10 years shorter than the surrounding population.
Look up diabetes and lipotoxicity. Dietary fat converts readily to body fat with somewhere around 97% conversion rate. Carbohydrates do not (very low conversion even on moderate overfeeding) but an excess of carbs will signal to the body to story any dietary fat. Important thing is to eat carbs as grown, and less from a package, since it's more calorie dilute. Pasta with it's water content is the one exception I know, although whole foods still is better. Try to minimize fats, vegetable or animal, as they're much more rare in nature.
go into a food court or starbucks and you will see the problem. people binging on sugar daily and then wondering why they get sick. some cultures eat nothing but carbs and think it's good to be overweight
Nothing like Slashdot to find someone with no medical training telling the 'simple' answer to something that has been extensively studied by actual professionals...
Yes, but I was responding to another AC who specifically was talking about his child who had Type 1, and it not being caused by Starbucks.
If you think I voted for Trump because of this post, you're wrong. I voted for Dr. Jill Stein of the Green Party. Again.
This would be true for #3 and #4. Not so much for #1, #2, and #5 above.
SJW: a person who perceives an injustice, and while correcting it, commits a greater injustice.
I agree. I'm either cluster 2 or cluster 3 (onset at age 47, overweight, responding well to change in diet and taking my metformin)
SJW: a person who perceives an injustice, and while correcting it, commits a greater injustice.
I'm Type II, Cluster 3 or 4. A good sized 8 oz BAKED POTATO has a Glycemic Index of 30 for me.
SJW: a person who perceives an injustice, and while correcting it, commits a greater injustice.