Is Type II Diabetes Curable?

Factual Questions
21

Laparoscopic banding (where they put a collar on your stomach, the method you are talking about) is highly effective for type II diabetes. That is the method they used in the study I posted earlier which found a 73% remission rate. I believe other studies (which I can’t find right now) have found even higher remission rates, 80%+ for laparoscopic banding.

If bypassing the duodeum and jejunum is necessary to avoid type II diabetes, a new obesity device is being tested which is basically a 10cm sleeve that is inserted inside the intestines to block absorption of food when it passes through these areas. It is safer, cheaper and more reversible than bypass surgery. However it will cause dumping syndrome like bypass surgery does.

http://www.medicinenet.com/script/main/art.asp?articlekey=94707

Researchers secured a 10-centimeter-long “endoluminal sleeve” at the outlet of the rats’ stomach so it blocked the duodenum and upper jejunum, areas of the small intestine where nutrients are sensed and absorbed. Obese and diabetic rats raised on a high-fat diet given the sleeve consumed 30% less of that diet and lost 20% more weight than their counterparts who did not receive the sleeve. After 16 weeks, the fasting blood glucose levels, insulin levels and oral glucose tolerance of all rats with the sleeve returned to normal levels.

22

Not professional advice.

I think that Diabetes may be one of those diseases that the medical profession doesn’t believe is “curable”, but can only be sent into remission. I think some mental illnesses are like this too. If you had a schizophrenia diagnosis at age 15 and you are 80 now with no mental health symptoms since age 20, you are deemed a mental defect for life who is temporarily able to function despite your condition.

Think about Alcoholics Anonymous- they teach as a matter of doctrine that alcoholism is incurable and that one cannot “go back” to the way one was before one contracted alcoholism, and thus can never socially drink again.

Now, whether or not you still have the disease is kinda dependent on what the medical profession’s practices are, as modern medicine is a model of human functioning rather than human functioning being a model of medical best practices (it’s engineering, not physics). Imagine if you had successfully treated the diabetes yourself without ever receving a diagnosis - you’d probably be undiagnosable today, so its kinda the way things seem to work.

23

It looks to me like the people proposing that it’s “a problem in the upper intestine” or “curable by bariatric surgery” are conflating diabetes and hyperglucemia - they are not the same thing.

Diabetes is a malfunction either of the pancreas, leading to defective insuline or to lowered production of insuline, or of the insuline receptors. It’s a basic change in the body’s biochemistry. It doesn’t just go away.

Hyperglucemia is a high glucose count. This can be due to a problem in the insuline (either to not enough, or to defective insuline, or to the receptors not working) or to “a sugar overdose” along the lines of this breakfast:
a slice of watermelon,
two slices of melon,
half a cantaloupe,
two croissants (one with peach jam, one with margarine and so much sugar it keeps dripping off),
a small red apple,
two slices of ham,
three slices of chopped turkey,
four finger-sized pork sausages,
two slices of almond cake,
a slice of bread about the size of a man’s shoe, with olive oil and salt,
one slice of apple pie,
one slice of peach pie,
two cups of coffee-with-milk,
half a dozen tea biscuits.

What would be surprising is someone whose sugar didn’t break 100 after such a meal.

24

No it’s not. What he is really asking is what is the nature of the disease itself. IOW, is type II diabetes considered a symptomatic disease, or are there observable physiological underpinnings that indicate type II diabetes even in total absence of sickness symptoms? If the former is the case then there is no reason to continue with a diagnosis of illness when the patient has gone without any symptoms for years. If it is the latter then even in the absence of symptoms the disease is present, observable, and measurable, and a diagnosis is warranted.

I don’t know the answer though.

25

See my post re. hyperglucemia vs. diabetes.

There are ways to detect damage to the pancreas or the presence of defective insuline but they’re nowhere near as cheap, fast and easy as those for detecting hyperglucemia.

26

Thanks, that answers the question I think.

So, let’s say Czarcasm went to a new doctor, with no knowlege of his medical history. He obviously wouldn’t be diagnosed with type II, since he shows no symptoms of the disease nor any signs that would show up in a normal checkup, even with basic bloodwork. Are you saying there are other tests the doctor could run that would detect Czarcasm’s faulty pancreatic system then?

27

There are ways to look for a “broken” pancreas or “broken” insuline, but AFAIK (I’m not a doctor, just a chemical engineer who took graduate-school level biochemistry, the primary caretaker of three people over 70 and closely related to a handful of pharmacists and doctors) they can be very invasive (we’re talking “pancreas biopsy” kind of thing for some of them) and, because they’re not standard fare, a lot more expensive and not as trusted as the hyperglucemia analysis.

Basically, when a doctor says “you’ve got diabetes” based on one(1) single blood test, as some will do, they’re overdiagnosing. Now, what is the first phase of the treatment? Changes in diet and lifestyle which are good for anybody.

If you don’t respond to those changes (i.e., you still have hyperglucemia), then they investigate further; often, this investigation doesn’t involve further analysis (in the “let’s take a sample and measure some stuff” sense), but trying different medications. Why? Because it works well and it’s less nasty both for the patient’s physical comfort and for his wallet than doing a biopsy. The “works well” is key.

Of course, if the reason you’re not responding to the changes is that you’re lying through your teeth about your exercise and diet (see my mother’s “light breakfast” above), the pills won’t do much good.

Now. If those tests are avoided in people whose blood glucose is stuck to the roof, there’s zero reason to perform them in someone who’s got it at normal levels. In the case of a biopsy-style test, we’re talking minor surgery and anesthesia. It could be done, but the risks outweigh the possible benefits. Specially given that, once more, what would the doctor tell to someone who turns out to have a minor pancreatic deficiency, but no ill health otherwise, not even elevated blood sugar?

Exercise, remember to eat small but frequent meals, watch your sugar…

28

I am diabetic type II. I have been for almost 40 years. I started with diet only, then moved to 500mg metformin. Later, I moved to 850mg once each day, then finally 850mg twice a day. Still under control, but with more meds. Also important is keeping my weight down to 155 and watching what I eat and eating 6 small meals a day. Remember that diabetes is progressive and will get worse with time. Always listen to your doctor (Endocrinologist.) Incidentally, I am 80 years old.