… just to add to that, around 10% of the entire NHS budget (!) is now spent on type2 diabetes, so it’s a huge problem. And, mostly, that is down to lifestyle - poor diet leading to weight problems, and lack of regular exercise.
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Exercise seems to be a bit of a cure-all for many things…
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… until your knees, hips and or back start to complain 
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Interesting reading. I got hit with Type 1 out of nowhere on my 29th birthday seven years ago now. Never been over 10 stone in my life and cycling 150 miles a week. I always say it was better to get Diabetes than finding a lump and being dead inside three months.
You are offered a lifeline if you can make the lifestyle choices needed to stall Type 2 but it isn’t easy. Neither is five insulin shots per day. The Freestyle Libre sensors are great for monitoring (and better still if you get them on prescription).
It’s a disease you live with and it is the worlds most tremendously annoying affliction but you can get on top of it without it taking over.
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Which is why I was swimming; no repetitive impact load on the joints, and the variety of movement from several different strokes helps a lot with minimising arthritis
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Hi Posters
I hope I’ve 
every one of you 
Both my late fathers older brothers developed ‘Adult Onset’ Type 2 Diabetes and lived well into their late 70’s early 80’s [their demise being ‘heart failure’ (after a Quadruple Bypass) and ‘Pneumonia’ ] both unrelated to Type 2 Diabetes
So given my genetics and high cholesterol…could be potentially joining your Type 2 Club in future 
But then my optician told me ‘my levels were too high’ and he suspected I had ‘Glaucoma’ [because my late father did] which can lead to ‘blindness’ and I required ‘further tests’
Well…did me research and pretty certain I don’t have ‘Glaucoma’…yet
There is a thing called ‘genotype’ [genetic inheritance] and ‘phenotype’ [basically environmental factors] and it’s how the two interact that can result in illness
Plus we have a massive amount of ‘naturally occurring’ pharmaceutical drugs in our systems without resorting to their ‘chemically’ produced brothers [which all come with side effects]
e.g. most anti-depressants fool the brain to produce more ‘serotonin’ [naturally occurs in our brains already]
Rambling some what here
BUT what I wanted to ‘Applaud’ you all for is for you starting chat on the matter on Type 2 and talking about it openly and honestly amongst ‘chaps’ [as a female raised by a chap to ‘think like a chap’]…that ain’t easy at all
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If you have average intelligence or above it’s not too difficult to sort out the wheat from the chaff.
For those that haven’t and are on the wrong side of average, life will get even more impossible.
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No, you have it wrong about what “phenotype” means. Your phenotype is the result of your genotype interacting with the environment. In many cases (but not all), your genotype doesn’t doom you. External factors influence gene expression.
My phenotype is that I am a diabetic. My genotype has conspired with external factors (lifestyle, personal tragedy/stress etc) to result in this, in a way that doesn’t have the same outcome to someone else in the same circumstances. This is probably what Prof Roy Taylor means when he rejected the concept of BMI, and indicated that some people simply carried too much weight for their body (meaning, their own genotype defined some ideal weight unique for them, rather than baed on a crude population analysis). Of course that doesn’t really help, beyond lose some weight. His suggestion is that T2Ds need to lose 15kg, regardless of whether they are classified as obese or not, based on an understand of fat on the liver and pancreas. He has gone further by suggesting that the only difference in T2D and non-T2D is 500mg of fat on the Pancreas. The 600kCal starvation plan has come under scrutiny; the trials data conclusions might be a bit thin. The 600kCal target was based on a regimen intended for pre-surgical preparation, and was really only used in a clinical trial to prove a point, rather than a plan that was sustainable, or really any different to any other crash diet. Some suggest Taylor is not really saying anything different than some research from the 1950s
Some work was being performed just before COVID to understand why some people became very ill or died following influenza infector, but for others, it was a mild illness. Its not simply a case of age or co-morbitidies. The work is close to identifying biomarkers that will help doctors identify who will end up in ICU and who won’t.
In some case, the phenotype is so strong and obvious, there is no need for genotyping, an example is Li Fraumeni syndrome, and inheritable set of mutations, that presents with a history of cancers, mostly breast, but also gastric, within a family.
T2D is likely a range of syndromes, with different etiology and approaches to therapy. T3D has been suggested, which is a form of Alzheimers, how insulin production impacts the brain. T4D is a suggested term for T2D diagnosed in the elderly with no obvious factors.
For years, in my field, I have been a firm proponant of pre-natal chromosomal mapping. Right now, foetus can undergo chromosomal screening for upto 100 conditions, that are helped to inform parents. There is very little genetic counselling before testing (explaining to people the ramifications of such a test, in the way people are counselled for, say, BRCA testing).
Right now, we can sequence a human genome, to a clinical standard (which means 4 sequences, overlaid to get a consensus. Genome sequencing involves making copies, which results in errors, for reasons much related to why we get cancer), really cheaply. We can thank David Cameron for that; he pushed through the 100k project, to get the cost of a full sequence down to a couple of hundred pounds. A decade ago, that would have cost £250,000. What we can do with that sequence in 2024 is limited. But we can do a lot more with it in 2044, in 2064, in 2084. You wouldn’t tell a 6 year old me that by aged 56, I will have diabetes. There would be no point. But it might have made a 46 year old me take pause.
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I thinks that we should think of type 1 and type 2 as different diseases with similar effects.
For sure but, if you don’t take the chance offered when skipping to a Type 2 diagnosis then you end up with Type 1.
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Type 1 has a different cause (almost certainly auto immune) and is currently irreversible and needs insulin injections (multi per day). Type 2 is mainly weight and diet related and can often be treated without insulin (with diet and tablets). If left untreated it will worsen and insulin will be required. Indications are that type 2 is often reversible.
It can be “reversible” (though some question that term, preferring remission). The trials data can be viewed from many different angles. The problem was patient retention rates weren’t great (people couldn’t stick to the diet), so quite a high dropout. Type 2 that was diagnosed more than 6 years previously is much less able to be reversed. Type 2 can be reversed, or put into remission, but the approach might not be terribly realistic for “at scale”.
I’ve been attempting a diary. I haven’t yet really addressed diet.
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I stand corrected re genotype/phenotype
As you have demonstrated it’s way more complex than my simplistic explanation
But hey…did about an hours lecture on the matter way back in 1987-1990 and so not qualified to say much more…and figured if posters were interested in this subject they could do their own research…as with other ‘stuff’ mentioned in my post
I would address diet first.
In my opinion, it is the biggest factor in diabetes control.
Hi everyone,
In 2014, read Professor Roy Taylor’s research and followed 5:2 principles with real food not shakes. 90 kilograms down to 63 kilograms in under 8 months. My HbA1c was high and at a pre-diabetic level. Cholesterol was a one off high too. After the 8 months, my blood chemistry was perfect! Waist was 44 inches and is 32 inches now.
The 8 week blood sugar diet is also worth studying.
Ofiaich,
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Hi,
I helped a good friend following the 8 Week Blood Sugar diet strictly. He lost 28 lbs in the 8 weeks, and is now 10 stone 2 pounds!
Ofiaich
Surely joint the Diabetes UK forum may be a better idea ? Just saying.
My personal journey with T2D probably started back in 2018/19 when my blood tests (I was having regular tests for prostate issues) showed HbA1c readings of around 50mmol/mol and I was warned that I was prediabetic. I had been drinking a lot of cold coffee sachets due to the hot weather and when I checked the sugar content of one sachet was probably my whole daily ‘allowance’ and I was drinking two or three sachets almost every day!! Add to this my sugar intake from other items and this could have been the cause of my elevated HbA1c levels.
I undertook a ‘purge’ of all the things I’d been consuming and my levels dropped back to 40mmol/mol around 5 months later.
Since Sept 2020 (and over the COVID outbreak which probably didn’t help!) the level slowly crept up to 61mmol/mol this June and the doc bluntly announced I was no longer prediabetic but I was now in Type 2 group (great bedside manner!!)
Not wanting to take any more drugs than necessary (I currently am only on Ramipril for high BP) I set out to reduce my carb intake and my last test in October showed a drop in HbA1c to 52mmol/mol.
Hopefully the careful diet will continue to show a reduction in the HbA1c levels for a ‘normal’ 68yr old…
My dad’s sisters both had diabetes and I recall them disappearing through the day to inject whenever we visited so there could be a unavoidable DNA cause of diabetes? One of my nieces is investigating the possible links of diabetes and genetics.
On the prostate issue - I’d been on medication for BPH (Benign Prostate Hyperplasia) for some years with regular 6 monthly PSA tests and by November 2022 I was getting up maybe 6 times a night to urinate. Then mid December I went into urinary retention ending up in A&E for almost 7 hours waiting to be seen. I ended up getting a catheter installed and when I saw the urologist a week later I was told the NHS waiting time for prostate surgery was 72 weeks. I emptied my piggy bank and went private in the end (I had “Greenlight Laser” surgery on 6th March 2022 - around 7 weeks later).
Recovery was complicated due to various factors including 4 bouts of UTI from the indwelling catheter and I have never experienced such levels of pain but by June/July I was almost back to a normal nights sleep getting up once a night (if at all).
I urge any man who is having any symptoms of urinating frequently to get it checked. I’ve helped several friends with advice on the options available and hopefully it has guided their decision making.
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You should get free eye checks on the NHS if you are flagged as pre/diabetic? I was having a yearly NHS checks until the last one and they decided I could have one every two years. I also have the OCT check (for £10) when I have my free Specsavers eye sight check.
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Correct.
You’re entitled to a free NHS sight test if you: are aged 60 or over. are registered blind or partially sighted. have been diagnosed with diabetes or glaucoma .
Always wise to go for regular screening.
OCT is an additional safeguard…… worth the cost in my opinion.
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