Diabetes Is Actually Five Separate Diseases, Research Suggests (bbc.com) 114
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
And Potentially Alzheimerâ(TM)s as an additio (Score:3)
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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
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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.
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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.
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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.
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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)
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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
Re:Modern science treat the disease not symptom (Score:4, Interesting)
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Um, yeah, that's the entire point. A potato has a very high satiety in the Holt satiety index [mendosa.com]. 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 diffe
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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 ev
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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. [drmcdougall.com] Is carrots going to give you diabetes?
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I'm Type II, Cluster 3 or 4. A good sized 8 oz BAKED POTATO has a Glycemic Index of 30 for me.
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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...
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This would be true for #3 and #4. Not so much for #1, #2, and #5 above.
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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
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That beats non-Western medicine by an amount roughly equal to categories and statistics.
And yet... (Score:2)
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Wish I had mod points. My laugh for the day.
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Yep.
My type-1 diabetic (category 1) teenager ran out of Insulin and came home from school over 500BG. We ran/speed walked for 5 miles and came home with them @ 220BG. We had them eat meat and cheese for dinner and picked up the insulin in the AM when the pharmacy finally got their delayed shipment in.
I told my teen, if the apocalypse happens, just run everywhere. Which won't be hard, since we will be running for our lives anyway...
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And you are an expert on this because...
Certified internet WebMD doctor here, can vouch for demonlapin.
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I see so much arguments over this that boils down to having completely different conditions having the same name. It would be similar if all kidney issues were lumped into one category of "kidney failure", when one is from a treatable bacterial infection, one is from a genetic birth defect, one is from a severe car accident, and three are from different types of tumors or cancers. Calling them all "kidney failure" because the kidney isn't working would be senseless from a treatment or prevention point of vi
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Hepatitis is another one. It can be caused by an infection, severe alcoholism, genetic disorders, etc. It's really a few different diseases that cause the same symptoms.
I think the reclassification for diabetes makes sense, but I'm going to hate to have to explain to people that I'm now Cluster 1. The general populace already had a hard enough time understanding it, and this will just confuse them more.
It's even more of a shame to see the folks here on this site confuse the matter.
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"So why have two conditions named the same thing, when they are only related by the word "insulin"?"
They don't have the same name. One is called type 1, the other type 2.
Furthermore, people who matter aren't confused by this, even if you are.
Also, this "research" does not suggest that diabetes is "actually five separate diseases", it "showed the patients could be separated into five distinct clusters". Those are not remotely the same thing.
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"So why have two conditions named the same thing, when they are only related by the word "insulin"?"
They don't have the same name. One is called type 1, the other type 2.
Types of what disease? Diabetes. Yes, they have the same name.
Furthermore, people who matter aren't confused by this, even if you are.
I didn't say I was confused, I said people argue semantics because different conditions have the same name.
Also, this "research" does not suggest that diabetes is "actually five separate diseases", it "showed the patients could be separated into five distinct clusters". Those are not remotely the same thing.
This research still wants to call different and unrelated conditions with the same name. It just has a different grouping than Type I and Type II.
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Have you actually done any reading on this, or dealt with the problem yourself? It's pretty straight forward.
MANY people with 'diabetes' or 'pre-diabetes' can cure it without pills, you just reduce weight, significantly reduce sugar / carbs, preferably exercise.
Done.
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I agree with the diet plan. My experience dropped over 1 whole number on the sugar measure since my first diagnosis, from a test, rather then from symptoms and no time spent with doctors relating to it, since the first diagnosis, to another test years later. Just adjusted diet and exercise. I still put one teaspoon of raw sugar in my tea and coffee and that is pretty much it for sugary stuff and I did swap to wholemeal bread and diluted diet drinks (the flavour became way too strong over time, hence half to
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"Just lose weight" has a 95% failure rate as a treatment. It is so bad the FDA would have rejected it.
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No, keeping weight off, is a 95% failure rate.
The weight loss itself very much helps with diabetes, in fact, even if you don't keep it off, assuming the dietary changes are kept (you're just over eating "healthier" food) you're still very likely to be in much better shape.
Concentrated calories like carbs / sugar, are the devil
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"Concentrated calories like carbs / sugar, are the devil"
How are carbs concentrated calories?? Butter has twice the calories per gram as refined sugar.
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"Just lose weight" has a 95% failure rate as a treatment. It is so bad the FDA would have rejected it.
The Food and Drug Administration often questions any treatment that doesn't generate massive profits.
Don't pretend for a fucking second they're not biased. They know which side their bread is buttered on. Artificially propping up a multi-billion dollar diabetes industry by only recognizing solutions that come from a prescription bottle is exactly what has been established.
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But to be fair "just lost weight" can be tried multiple times and many anecdotal evidence suggest that there are millions of people who managed to lose weight and improve health that didn't succeed the first time.
There is almost no down side to an overweight person to lose weight, unlike most medicines whose have a % of people with side eddect.
Also, it (should) cost almost nothing, and can be safely used in conjunction with other inteventions, which unlike medicines, would most likely have no negative c
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except in cases of type 1 and clusters 1 and 2 in the article summary.....but yeah....
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My grandmother has type 1 diabetes and manages it primarily with diet and exercise.
It's worked quite well for her for over 50 years. She's in her 80's now is going strong.
Re: And yet... (Score:2)
Which leads me to suspect that her case could be cluster 2 - too little insulin but there's a little and that's enough for her to cope with it that way.
Without a thorough check it's hard to tell though.
But one big problem many of us have is all that hidden sugar in a lot of products that has been added for taste purposes. Even sweeteners is a problem. The type of sugar may also be a factor.
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"except in cases of type 1 and clusters 1 and 2 in the article summary.....but yeah.."
I was going to say much the same thing. Even for Type 1, Carbohydrate management is probably advisable as it should make guessing proper insulin dosage a lot easier. The consequences of getting the dosage wrong can be serious or even fatal. And the $#@% blood glucose test strips don't seem to work anywhere near as well in practice as experimental results say they should.
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all forms of diabetes are amenable to at least partial treatment with one simple mechanism: stop eating sugar and and easily-digested starches
I know that reading the whole article might be too much for you but reading the summary seems to be as well. The summary says this:
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
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He could just be American, where we insist on our right to express outrage at a story after only reading the headline.
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You could just read my second sentence, you know. Cluster 1 will always need some insulin, but can cut their needs substantially. Cluster 2 might not, if they can get their insulin demand below the level that their pancreas can supply. And that's primarily determined by diet.
This is what you wrote:
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.
So let me rephrase your wording so you understand how silly you sound:
Curiously enough, all forms of cancer are amenable to at least partial treatment with one simple mechanism: stop eating sugar and and easily-digested starches. Some will require supplemental chemotherapy, of course, but that small step will work wonders even for them.
Also let me edit your words to be accurate:
Cluster 1 will always need some^H^H^H^H insulin for the rest of their lives regardless of diet. Cluster 2
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Umm, no. Some of us have diabetes because our pancreas is sitting in a jar of formaldehyde on a surgeon's desk....
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Do you understand where insulin comes from?
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I'm afraid it's not a good classification system, for exactly the reason you've described. I've done some investigation lately, due to colleagues who handle their diabetes or who've family with diabetes. And since I've become older, it's more common among my older peers, and I've gotten to know a few children with diabetes in my lifetime.
I've found it helpful to segregate by pathology, such as "juvenile onset" which described the auto-immune problem that destroys insulin producing cells. I was also informed
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The far more common form of diabetes, aka Type 2 diabetes, is tied to insulin resistance. This makes it more difficult to exercise, since normal use of glucose is impeded, and the resulting raised insulin level also raises hunger. Between the lethargy, and the hunger, it' can be difficult to avoid weight gain. The weight gain reduces the effect of available insulin several distinct ways. This creates positive feedback. It also lets people blame the victim, thinking that the weight gain is the cause of the d
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This only looked at the most common adult-onset (Score:2)
Gestational? (Score:2)
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But if you quit being a fatty and lost weight, you wouldn't keep going to your doctor and he'd stop getting paid (by you or your insurance).
More medical failure isn't news (Score:2)
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
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So you had a shitty doctor and in your view that makes the entire profession bad?
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Doctors don't throw up their hands because they suck. Doctors fall out of line with the established policies and procedures their malpractice insurance won't kick in and protect them when little Timmy has a reaction to a treatment and doesn't survive due to a secondary ailment. They have to do all the boring tests first to establish that the risk is worth it for the fun tests for the insurance companies and the lawyers.
Don't like it? Make tort reform a campaign issue. There's an enormous difference between
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Same here. Got acute attack of pancreatitis and then got diagnosed as diabetic. Never ate sugar even in coffee as both parents had adult onset. Doctor keeps prescribing meds but nothing works except insulin. I have a weight of 170 pounds on a 5 7 frame so not morbidly obese but the general advice is lose weight. Hell I am taking Insulin 50 units a day and insulin makes you fat. How are you supposed to lose weight when you are barely 10 pounds above normal for the height and the insulin injections you take m
Thank you for making known your story (Score:2)
There are too many self-appointed who have simple solutions for every complicated problem.
Thank you for setting the record straight.
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Insulin is made in the pancreas. After pancreatitis or pancreatectomy (such as for trauma or cancer), you no longer have the islets of Langerhans in which the insulin is made. No insulin, thus you have diabetes. Type 1 and Type 2 (and this new nomenclature) refer to endogenous disorders for which some disease, understood or otherwise, is at work. Post-pancreatic diabetes is not related to the endogenous Types. Its pathogenesis, diagnosis, and treatment are all clear cut. Your insulin making machine ha
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Can we choose which one we self-identify as having?
Medical systematics and nosology - a good example (Score:2)
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, bu