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Ok, so what DOES cause type 2? I thought it was self inflicted...

Discussion in 'Parents Off Topic' started by bnmom, Jan 20, 2012.

  1. bnmom

    bnmom Approved members

    Oct 26, 2010
    I knew nothing about diabetes, any type, before my son's dx. And to this day I thought the most noticeable difference between type 1 and type 2 was that type 2 was most likely self inflicted through poor eating and exercise habits.

    I'm not saying I'm not wrong, but if I am I just want to understand why I'm wrong. I really don't get it.

    I get the basic physiological mechanics...that type 2 is more a problem with insulin usage versus a problem with insulin production.

    But the only people I've ever known with type 2 were folks that were overweight and sedentary. And when I hear about the rise in Diabetes in our country, it seems it's always tied into a mention about the rise of obesity. So how is Type 2 NOT a byproduct of poor eating habits and lack of exercise?

    I would imagine some people may get type 2 even if they aren't overweight, because of some genetic predisposition. But don't the vast majority get it as a result of poor diet and lack of exercise? I'm also under the impression that type 2 can be avoided by good eating habits and exercise. And that type 2 may even be reversible if those things happen after dx?

    As a sheep, I can only tell you that is the impression I'm under about type 2. So please help me understand. I know I hate the misconceptions people have about my son's type 1. I don't want to be that person on the type 2 side.
  2. MamaLibby

    MamaLibby Approved members

    Oct 30, 2011
    The way I understand it is there are several factors including genetics, weight, diet and environmental that could cause a person to develop type 2. There is also pre-diabetes, where a person has borderline high BG (usually fasting above 100, but below 200) and can treat (reverse?) it by exercising, losing weight, testing BG occasionally and limiting carbs and sugar. A friend of mine had gestational diabetes with her second child and then was pre-diabetic for about 10 years before getting a T2 diagnosis and going on oral meds about a year and a half ago. She's not heavy...maybe 10-15 pounds overweight, but not obese by any means and she's always had an "Everything in moderation" kind of diet. She has highs and lows like a T1 (less lows than most T1s), just treats it with oral meds, diet and exercise. Both of her parents and two of her four sisters are type 2 (and her niece is T1), so there's the genetic cause. This is most of what she told me, but I could have misunderstood something. Someone correct me if I'm wrong!
  3. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

    Sep 23, 2007
    If type 2 was caused by fat and sloth then every fat person would have it - since not ever fat person has it, and quite a few fit people do, I think we can safely say that it's a complex metabolic disorder the cause of which is not fully understood. Diet, environment, exercise, genetics etc all contribute to type 2.
  4. emm142

    emm142 Approved members

    Sep 7, 2008
    In many cases there are lifestyle factors in the development of type 2, and especially it is incredibly unusual for somebody under the age of 40 to develop type 2 if they are of normal weight, exercise etc.

    But it's not JUST about weight. You could have person A who is overweight and person B who is exactly the same size with exactly the same lifestyle, but person A has T2 and person B does not. It doesn't make sense to blame person A more than you would blame person B, since they did exactly the same thing. So it doesn't make sense to blame somebody for having diabetes. If you want to blame someone for the lifestyle habits which cause overweightness and obesity, that's different (not saying I approve! Just saying that this particular argument isn't for that situation), but logically it doesn't make sense to blame a person for the diabetes itself.

    My two cents. ;)
  5. selketine

    selketine Approved members

    Jan 4, 2006
    One of my aunts has type 2 - had it for a long time but I don't know how old she was when she got it. She has always been fit and trim.
  6. buggle

    buggle Approved members

    Mar 24, 2008
    Since most doctors automatically assume any adult who develops diabetes is type 2, a lot of people who are actually type 1 or LADA are mistakingly dx'd as type 2. I've seen estimates that 10-15% of adults dx'd with type 2 are probably LADA. In fact, I've read that if thin adults are dx'd as diabetic, to look into LADA or type 1. Adults typically have a slower onset, so they might get by on oral drugs until they have to have insulin and most docs would just think they were insulin-dependent type 2's.

    Although it's true that not every overweight, sedentary person develops type 2, more and more people are and aren't the projections that 1/3 will eventually have it if we continue on this road of obesity? So, although people may be predisposed to it, most would never get it if they were active and normal weight. It used to be rare and now it's really common. And it used to be pretty much nonexistent in kids, but so many kids are now fat and inactive, that it's not uncommon at all anymore for kids to get type 2. So, lifestyle is a major component of type 2. And even type 1 children and adults can develop type 2-like diabetes if they become obese and inactive.
  7. Lee

    Lee Approved members

    Oct 5, 2006
    Yes - weight and lack of exercise CAN lead to developing Type 2 - but only if you are genetically geared to that anyway - much like Type 1. The body has to work harder to process the glucose, and eventually, they get worn out - therefore becoming insulin resistant.

    It is a stereotype to think every fat person is Type 2, it is even a stereotype to think that every fat person is lazy and eats unhealthy. Add on the burden of "if they only ate better and exercised" they would loose weight and not have Type 2, well - that works for many but not all fat people.

    It is the myth that Type 2 is self inflicted that is damaging and heartbreaking for those that a) are Type 2 without weight issues (there are MANY) and b) those that continuously struggle to manage or gain control of their weight and still have Type 2.
  8. obtainedmist

    obtainedmist Approved members

    Aug 3, 2010
    Type 2 is a lot more linked to family history than Type 1.
  9. bnmom

    bnmom Approved members

    Oct 26, 2010
    The genetic predisposition makes a lot of sense. I've been googling type 2 since I posted (I am such a google geek!) and so far most of what I've read says no sure cause...genetic predisposition makes it more likely, bad diet and sedentary really ups the ante.

    My own grandma (a physician no less!) started the day with bacon, eggs and sticky buns, kept a box of Anthony Thomas at her bedside, always had a Pepperidge farm cake of some sort for dessert, smoked a pack a day and considered shopping a strenuous exercise. She lived to 90 with no major health issues. I'm crossing my fingers hard that she passed those genes on to me - cause in my reading I'm checking off way more risk factors than I'd like.

    I appreciate the responses, I really didn't know that many fit or trim people had type 2. According to the almighy google, they do seem to be the exception rather than the rule. But I guess all anyone can do is the best they can do, and keep fingers crossed it pays off.
  10. miss_behave

    miss_behave Approved members

    Aug 28, 2006
    That was exactly what I was going to say! Whenever I hear of "fit, slim, marathon runner" or whatever Type 2's, I immediately wonder if they actually have LADA/ Type 1, particularly when they don't have much success with oral meds and need insulin for good control fairly early on. Unfortunately, many GPs who diagnose T2 in adults refuse to do further testing to confirm the diagnosis and stubbornly refuse to believe an adult could even get Type 1. Its sad, because it seems many adults don't get the treatment they need due to this ignorance.
    There is definitely a strong genetic component to Type 2, no one refutes this, but the reality is that the explosion in cases is due to sedentary lifestyle and obesity. As the population grows in size, so does the number of people with T2. It was virtually unheard of 50 or so years ago when obese people were the minority.
    Last edited: Jan 21, 2012
  11. CassiesMama

    CassiesMama Approved members

    Jan 17, 2010
    My dad's wife is type 2 and slim and trim. Never a day over weight in her life, but has a heavy genetic link and ended up with it. One of my friends, her mothers side, once again heavy type 2, plus she was over weight for a long time and ended up getting surgery to avoid getting type 2. She lost over 150 lbs and still ended up with type 2. It seams that there is just a really large genetic factor that alot of people like to dismiss cause its easier to then blame the pwd. There is so much more research that needs to go into all of it, to really find what the triggers are for type 2.
  12. MommaKat

    MommaKat Approved members

    Sep 2, 2011
    In addition to genetics, there is a racial heredity factor. African American and Hispanic descendants are more likely to become type 2 diabetics.

    The confusion around it being self inflicted is fairly understandable. Type 2 is caused by the body's inability to utilize insulin. The cell markers that should bind with insulin and allow glucose into the cell don't recognize insulin, or fail to stick to insulin, and in turn allow that channel to open. In a non diabetic, the number of cell markers (think of them as doors) increases when blood sugar levels remain high in order to move the glucose out of the blood stream. It causes damage to vessels when too much accumulates, and the body needs it for the energy of metabolism. In someone dealing with insulin resistance, the increased concentration doesn't trigger that increase in 'doors'.

    Someone with a strong genetic predisposition, racial heritage, a body type with more central fat / adipose tissue (think apple or pear shape as the health industry likes to refer to it), etc. can develop type 2 without poor lifestyle choices. That said, the poor lifestyle choices that we typically think of with type 2 (and use to blame them for making themselves sick) such as being over weight, obese, sedentary, consuming diets high in fat, etc all create a level of insulin resistance, which can - over time become chronic, and for some, a permanent condition. We know that high fat foods like pizza delays carb absorption and bg spikes, right? Imagine eating a high fat diet all the time as having the same exact effect, all the time. If someone has a genetic predispostion towards the insulin resistance seen in type 2, their body doesn't respond to this high fat diet and subsequent increased blood glucose by creating more cell markers that insulin can bind to, and the longer the bg level remains high, the less responsive to insulin their bodies become.

    Sedentary lifestyle and it's relationship to type 2 is easier to understand if you think about the lows we worry about when our kids are super active. We know that exercise drops our kids' bg, which is great and can help them manage D when done properly. Now imagine a person who's system is primed to become insulin resistant. If they exercise routinely, it can help delay or reduce that insulin resistance, but if they are sedentary much of the time, the condition will certainly come on more quickly.

    So, while it isn't true that type 2 is self inflicted, the extent and severity of one's type 2 diabetes is strongly influenced by life style choices, choices that can make the difference between quality of life and lack thereof. It's really tough to hear if you don't know better until you're diagnosed, and I think that's where the ire with the Paula Dean situation comes in.
  13. Lisa P.

    Lisa P. Approved members

    May 19, 2008
    To the OP, I'm a little heated on this subject, please don't think it's targeted at you, you ask a good question in a good way.

    No, Type 2 is not self inflicted.

    My endo explained it very well. He said current thinking is that you are born with Type 2 genes. You are likely to develop it over the course of a lifetime. How you eat and how active you are can -- can -- contribute to how quickly or slowly it develops. Like a rubber band being stretched.

    Now, personally, I believe this from my reading and from what I see with Selah's own blood sugar. Fat (both dietary fat and carried fat) affects the way insulin is used (fatter people have more insulin resistance) because the body is a complicated feedback machine and it does this on purpose because in the past getting fat was about storing up for the winter. We, as I read in one book, store up for a winter that never comes. Also, activity drastically changes insulin resistance. So if you become fatter and less active, you are going to have a problem with insulin usage, and if you are Type 2 diabetic your insulin already isn't working properly.

    But -- but -- here's what I've noticed since Selah has had diabetes. When she is low, or when she's high because she doesn't have enough insulin, she is ravenous. And for carbs.

    So, if a person has Type 2 diabetes, and their body doesn't use insulin properly, doesn't it make sense that that person's body thinks it is starving all the time? So someone without Type 2 can talk all they want about will power, but they never have a physiological famine response to will power their way past. You're asking someone whose body feels like it is starving to death to push away the food. I think people with Type 2 are naturally predisposed to eat what you would if you thought you were starving -- a whole bunch of very high calorie food. Making yourself not do that is very hard.

    As for exercise, once you are feeling poor and have gained weight it become geometrically harder. Weight gain often means knees go out, or your back.

    It's a pretty cruel circle.

    Then you get blamed -- blamed for it all. Blamed when you eat. Blamed when you sit. Blamed when you take medicine. Blamed when you get complications. The whole world feels like it has the right to tell you when to eat a hamburger. Because we're in a society where gluttony is fine, gluttony is encouraged, as long as you don't look bad from it.

    There are a million versions of gluttony out there, almost all of us practice it in one form or another. I'm good with a great old fashioned rant against using things improperly. Let's start with all the cr@p we buy from China that we don't need, and end with the candy our kids get fed in school every day. But I think media targets people with Type 2 diabetes not to discourage gluttony, but to excuse it. We get to point our fingers at those people, and figure that if we're not fat and Type 2 then our gluttonies are all right. Then the commercials can sell us junk food and junk diet food and all sorts of other diabetes prevention or diabetes products.
  14. ChristineJ

    ChristineJ Approved members

    Dec 25, 2010
    Great post, Lisa! I wholeheartedly agree with you on all of this. :)

    I've been watching this thread as well as the one on Paula Deen, debating if I should post because I also get heated on this topic. I don't have a diagnosis of T2, but I am definitely at high risk for it because I do have a diagnosis of PCOS. One of the key issues with PCOS is a genetic insulin resistance. I have struggled with weight all my life because of it, despite trying to eat healthy and exercise. Genetic insulin resistance creates a vicious cycle that is so hard to manage, and often feels like a losing battle.:(

    For someone to be in that position and then go on to be diagnosed with T2, only to then be blamed for a physiological process that is incredibly complex and NOT entirely under your control must be incredibly disheartening. When the finger-pointers are other members of the DOC, (some of whom get very frustrated about getting "blamed" for their, or their T1 children's, disease), it must feel that much more oppressive. Yes, a person CAN do things to help manage it and possibly delay the onset of an official T2 diagnosis, just like those with T1 can use diet and exercise to help better manage their disease. NO member in the DOC should be blamed or unsupported by others. Whether T1, T2, or monogenic diabetes, we all need to support each other in this diabetes journey.:)

  15. MamaBear

    MamaBear Approved members

    Jul 20, 2010
    Thank you! I have 5 (or 6 if you count my tax guy)friends with Type 2, one friend who is pre type 2 but also has Hashimotos. ONE, of those people, only one is overweight and eats poorly. The rest are very fit and eat pretty well. ETA one of them tries to convince me,every time I see her, to go with her to kickboxing class. Hardly sloth.
    Last edited: Jan 21, 2012
  16. 3kidlets

    3kidlets Approved members

    Aug 3, 2010
    I haven't read thru all the responses, so I don't know if this was mentioned, but does anyone know why if you've delivered large babies, you are at a risk for Type 2 later on? I was told this when I was pregnant with all three babies, who were 9 lbs. 16 oz, 9 lbs. 3 oz, and 10 lbs 2 oz. My dr. mentioned that I should be screened at my physicals.
  17. bnmom

    bnmom Approved members

    Oct 26, 2010
    I'd never thought of it that way, but that makes all kinds of sense. And I totally agree with that last sentence. It's sad, but undeniably true.

    I'm glad you did post, Christine. I appreciate everyone that has taken time to post - more views and opinions to consider. And a different way of looking at things can lead to a better understanding.
  18. mmgirls

    mmgirls Approved members

    Nov 28, 2008
    Yes it does, but not always.

    The idea behind it is that you where probably having elevted bgs, not D numbers but consistantly elevated while you where prego. and allthough blood is not shared with baby, glucose is small enough to pass to baby.

    Also being a large baby increases there chances of become T2 later in life, also being a very small baby also increases chances of t2 later, go figure!
  19. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

    Sep 10, 2006
    I haven't read all of the posts above.
    Type 2 diabetes is about insulin resistance, which can be caused by a gazillion things. About a year ago I made a list of things I could think of right then that are known to cause insulin resistance, or that are risk factors for type 2 diabetes. Here it is:

    -many medications and drugs, including many antidepressants and antipsychotics, corticosteroids (should not be a surprise given what folks on here have talked about happening to their kids' insulin doses when they needed steroids- and some people need to take steroids permanantly), antiretrovirals, heroin, methadone, marijuana and more!

    - some mineral deficiences, such as zinc

    - genetics

    - longterm inactivity, past or present

    - smoking

    - Polycystic Ovarian Syndrome in women, hypogonadism in men

    - alcoholism (although alcoholic diabetes tends to more like type 1 diabetes, with destruction of much of the pancreas)

    - bisphenol A consumption

    - some diseases, such as chronic hepatitis

    Looking at my list now, I think I should add autoimmunity, since diabetes antibodies are positive in more type 2 diabetics than in the general population.
  20. thebestnest5

    thebestnest5 Approved members

    Aug 16, 2006

    Anyone look at a Glucerna package?

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