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Offline bezoar

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Type II diabetes
« on: 23/07/2003 06:07:22 »
I have a friend with type II diabetes who tells me that she is struggling to control her weight, because after she takes her insulin, she gets so hungry, which leads me to a question.  
Instead of obesity precipitating the onset of diabetes, maybe the onset of pancreatic dysfunction precipitates the obesity.  Maybe something causes your pancreas to hypersecrete, causing the hunger resulting in the obesity, then your body, in order to help itself, becomes resistant to the insulin as a means of compensating for the hypersecretion of insulin.  Has that avenue ever been explored?


 

Offline chris

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Re: Type II diabetes
« Reply #1 on: 23/07/2003 11:04:00 »
An interesting thought, but probably not true. Obese people usually have a relative insulin insufficiency. That is, they paradoxically have higher levels of insulin than you or I, but then so is their sugar. They effectively become insulin-resistant and require much higher concentrations of circulating insulin to maintain their blood sugar at any level. Weight loss, on the other hand, usually translates into increased insulin sensitivity to the extent that some diabetics can cease to use medications, including injected insulin, if they lose sufficient weight. Of course this does not apply to type 1 (insulin-dependent) diabetics.

Also, a diagnosis of overt 'diabetes' is often preceeded by a period of covert 'impaired glucose tolerance' when sugars run high but not drastically so. This corresponds to the pancreas beginning to reach the end of its adaptive capacity. It's also worth bearing in mind that some women develop 'gestational diabetes' when they are pregnant which usually resolves after the baby is born.

What you have hit on is the interesting relationship between weight, insulin-sensitivity and diabetes and in fact some researchers now refer to this problem as 'diabestity' rather than viewing the two problems in isolation since they are intrinsically linked. The mechanism uniting the two, however, remains obscure.

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« Last Edit: 23/07/2003 11:06:52 by chris »
 

Offline bezoar

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Re: Type II diabetes
« Reply #2 on: 23/07/2003 17:18:52 »
But, could there be a period of time that the pancreas sort of flares before it burns out?  Could this be the time of weight gain?  In other words, when you see a patient gaining weight at an unusual rate, do you automatically do a glycosolated hemoglobin to see what's going on with the pancreas?

A long time ago I read an article describing the treatment of juvenile diabetes with immunosuppressant drugs with a good response, so there was speculation that juvenile diabetes could be an autoimmune disorder.  And, when I worked home health, I noticed that three of my patients were diagnosed with diabetes, and within a year were diagnosed with cancer.  Might have been a coincidence, but if you cosider cancer a breakdown of the immune system, could diabetes be the same thing.  And don't women who have gestational diabetes have a higher rate of diabetes later in life?
 

Offline chris

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Re: Type II diabetes
« Reply #3 on: 23/07/2003 23:43:20 »
Type 1 diabetes (juvenile onset DM) is, without doubt, an autoimmune condition caused by inappropriate destruction of the pancreatic insulin-secreting cells by the immune system, perhaps as a result of an antecedent viral infection.

I don't think that anyone has looked at people who suddenly gain weight to see if they are becoming hyperinsulinaemic. I'll ask around...

Chris

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Offline bezoar

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Re: Type II diabetes
« Reply #4 on: 24/07/2003 05:55:33 »
Thanks, Chris.  Seems something is being missed with diabetics, but I can't quite put my finger on it.  The explanation of obesity being the cause of the adult onset is just too simplistic.  The cause of the obesity needs more exploration.
 

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Re: Type II diabetes
« Reply #4 on: 24/07/2003 05:55:33 »

 

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