Is Type 2 Diabetes Your Fault?

Good point. I wonder if anyone has ever tested postprandial BG levels in obese people with ravenous hunger but no diabetes.

Oh I wondered where that doctor had gone!

My situation was even worse, I had all the metabolic markers of obesity (high postprandial BG, rubbish lipids, high BP) without putting on a pound. Plus my FBG was and still is normal. The postprandial hungers, which I know now to be caused by reactive hypoglycemia - a glucose spike followed by a rapid drop - were put down to "neurosis".

The dietician worked hard and patiently at eliminating fats from my diet and eventually succeeded in causing me to gain weight, at which time I was accused of "failing to comply" with the diet.

It took a change of doctor to finally discover what was occurring, and a total reversal of the prescribed diet to control the BG, BP and lipids and make the weight go away again.

It took genealogical research to discover this syndrome is not uncommon in one line of my family, and the internet to discover it also hits unrelated people.I suspect insulin resistance somehow decoupled from leptin.

IMO there are a whole bunch of candidate genes which are probably adaptive in famines but not in today's continuous feast and the secret is to find how NOT to express them. Not eating sufficient carbs to spike my BG, and especially avoiding wheat, has hugely improved the insulin resistance but I doubt anything will bring back my Phase 1 insulin. We're genetic throwbacks who thrive on meat, fish, fat and vegetables so long as we avoid Healthy Whole Grains.

Trinkwasser, it's sad that this attitude of dieticians persists. I have a quote in my T2 book from a patient who had a similar experience. She was told to add raisins to her morning oatmeal "to get the carbs up," and when her BGs got worse, the dietician said she had to get serious about following the prescribed diet.

I do think there are different types of metabolism. Some people can tolerate low-fat, high-carb diets. Most of us with diabetes can't.

Our Government is working on the premise that 30% of the population WILL become diabetic, quite likely on the prescribed diet.

ISTR a paper by Gerald "Metabolic Syndrome" Reaven suggesting as much as 75% of the population may be carbohydrate-intolerant.

On the other hand I'm pretty convinced that probably less than 1% of Type 2s actually do make a high carb diet work - and boy don't they make a lot of noise on forums!

Frank, if you have constant hunger but there's no food around, you won't eat it. People in concentration camps don't usually put on weight. But if you have constant hunger and your employer serves doughnuts at 10 a.m., your restaurant serves huge portions, and there are snack machines by the water cooler, then you're going to eat more than you need to maintain your weight.

I feel sad that a nutritionist thinks his clients have "weakness of the will."

Try this experiment. Go for 4 days without eating anything but water. Then go out to a restaurant with some friends and order a side salad without dressing while all your friends eat huge meals. You might get through one meal. But could you have the same willpower for 3 meals a day, 365 days a year?

actually, your experiment accentuates my point about weakness of will- we are social by nature, and so we help eachother achieve our goals- this leads to the concept of social will (developed by Marx, but that's another one of my crackpot theorys).  So, when you construct someone who's friends eat big meals, thereby eroding the will of one in the group who opts to eat salad, you are highlighting the fact that social will can increase (or erode) personal will- after all, this is what you and i are doing- we are public advocates for helping people increase their will to eat healthy and to thereby become advocates for a healthier environment- again, just watch the biggest loser- whether or not the contestants blame themselves for their weight gain, they work together to develop a stronger will power to effect change in their lives- through diet and exercise

I think you missed my point that different people have different levels of hunger. Why should one person have to eat salad (and salad isn't necessarily low calorie) while everyone else is eating pizza? Why did that one person get fat eating the same stuff that his/her friends did?

I forgot to add. People talk about the "obesity epidemic" as if 50 years ago everyone was thin. They weren't. There have always been fat people and thin people. What is different today is that people who used to be "pleasingly plump" are now obese, and people who used to be slightly rounded are now fat.

I agree that the genes haven't changed. But do you really think there's been a major change in willpower?

I think what has changed is the environment, which allows the genes that predispose people to easy weight gain are given free rein.

When I was a kid, we weren't allowed to snack between meals. If we complained we were hungry, and asked, we were allowed a piece of fruit. We got 10 cents a week allowance, which even in those days didn't go very far (one comic; one candy bar). A soda or a Good Humor bar was considered a big treat. Schools didn't have any snack machines.

Today's kids seem to have unlimited access to snacks and sodas. Kids with thin genes can cope. Others can't.

Blaming people just makes them feel bad, and they'll eat more to compensate.

Thanks for the laugh, Alan.

You have a good weekend too, Ann.

Hi Gracie. It's sad that so many don't understand that carbs are poison for some people. And this is true in a high proportion of Native Americans.

Are you familiar with the work of Kibbe Conti and Jay Wortman?

Kibbe is a Lakota nutritionist who has developed a relatively low carb diet called the Four Winds Model and is trying to get people of Plains background to adopt it. It's based on the Medicine Wheel and the four directions. The West is water. The North is lean meats. The East is nonstarchy vegetables and fruits. And the South is starchy vegetables.

It has more starch than you or I would want to eat, but it's much better than the high soda and bread diet so many are eating now.

Wortman is a metis MD who was Dx'd with type 2 and is now supporting a low carb diet.

Not familiar with them, but I can certainaly support them. They are probably more carbs than I can eat, but lower is a step in the right direction!

HUgs,

G

Why was your mother controlling food and portion sizes? Were people in her family overweight and/or diabetic?

She controled the food due to budget and family size i suppose, I used to be so hungry that I would offer to drink my sisters milk, which she hated , if she let me eat her green beans which she also hated. We discussed this last year and determined that we must have allways been out of milk at suppertime or the milk man was running late. Its interesting to note that when my kids were little I allways had at least 3 gallons of milk in my fridge. Both my mothers parents were rail thin.So were my parents and myself and my sisters were also rail thin.

If you were really hungry with adequate food, it suggests something wrong with your appetite control, and when you were able to eat what you wanted to eat, you ate a lot.

You might have been rail thin not because of thin genes but simply because there wasn't enough food around to allow you to gain weight.

However, if you were really hungry because food was quite limited in your household, that's a different situation, and perhaps the overeating when you were on your own was a typical rebellion against one's upbringing.

I think the later of the two is true . We were extreamly  active kids and food was limited, I never thought of it as rebellion but that sounds about right.I think there must have been enough food. Just not as much as we wanted . My older sister is also struggling with weight issues, but Im the only one in my family to have diabeties.

Thanks. Just make sure your friends don't use the idea that being overweight isn't their fault to avoid doing anything about it.

If we're given faulty genes, it makes our job much more difficult, but that doesn't mean we shouldn't try to do whatever we can. I think removing the burden of guilt makes the challenge a tad easier.

I agree. As I stated..."they struggle...", yet they continue to change their life styles. One of them has lost about 40 pounds, but is still obese. She has maintained a good attitude, and continues in her efforts. I don't think your article will make them think it is ok to be over weight. I expect it will cause them, and me, to realize that they must be more patient in their endeavour to lose weight, as well as determined.    

Your friend should be congratulated for success against the odds. Here is a recent review article discussing "the homeostatic mechanisms important for weight control, such that exposed individuals are predisposed to weight gain, despite normal diet and exercise." Unfortunately, you have to pay to read the full text, and I haven't done so and so I don't know if it's worth buying. But they could get a sense of it from the abstract, which is free.

Here is a slightly older article by the same guy, who coined the term "obesogen." This one is free full text.

I've read that diabetes tends to appear at a younger age with each generation. This might be because high BG levels during pregnancy predispose the child to problems.

So don't feel it's your fault. Instead, put your energy into making sure your children take care of themselves. One hopes that their father's genes will dilute out the diabetes genes from your side of the family, but just in case, make sure they're tested regularly.

At what age do you think they should begin being tested?

Thank you!

I don't know how old your children are. But because testing blood sugar is so simple, and relatively cheap, I'd say it wouldn't hurt to start now. Ask your doctor if s/he could include blood sugar test with every physical. That could be either fasting or random.

If you start testing early, then it will be easier to detect any increasing trend. If there never is an increasing trend, then they won't need to worry about it.

In adult children of people with diabetes, I'd suggest getting their own meter (maybe one you're not using anymore) and testing themselves after meals once every 6 months or so. Or establish a family tradition of testing everyone after Thanksgiving dinner, which is sort of a worst-case scenario.

I didn"t have diabetes with my first 2 children, I did however develop gestational with the 3rd and had full blown type 2 with the birth of my 4th but kept tight control during both. Do my children all have the same risk or are the 3rd and 4th at higher risk? There is so much guilt not only being diabetic and passing it to your children but also that we don't have enough info to help. Thank you so much for helping others!

I don't think anyone knows for sure if all your kids would be at the same risk. And
"risk" is only statistical. You can be at very high risk for something and never get it.

Children who are born underweight and who gain weight very quickly in their first years are also at increased risk. There is so much that can affect risk, and so much we don't know.

Don't feel guilty. There's nothing we can do about our genes. If you want, blame it on your grandparents <G>. And when we get bad medical advice, that's not our fault. Furthermore, medical understanding keeps evolving. Perhaps what is considered prudent today will be considered a bad idea in the future.

Just make sure your kids understand they're at increased risk so they do what they can to avoid getting it.