Re: Can dieting cause diabetes

On Mar 2, 8:29 pm, Susan <neverm...@xxxxxxxxxx> wrote:
x-no-archive: yes

I've seen papers which show GTT normal curves going well above 105
with HOMA B calculations still showing high beta cell function. Your
statement is valid only if you define "normal" as someone who's
between 80-105 irrespective of how many carbs/sugar they eat, i.e. its
only true by definition.

I didn't use the term "normal." I used the term "intact pancreatic
function."

Normal is an arbitrary line.

Firstly, the OP asked if the response was abnormal and you responded
yes. So you did use the term "normal" implicitly. In any case, let me
change my comment to keep you happy:

"Your statement is valid only if you define "intact pancreatic
function" as someone who's between 80-105 irrespective of how many
carbs/sugar they eat, i.e. its only true by definition.

Are you ready to give any more references ? You quoted Dr. Bernstein
earlier. But Bernstein doesn't have any references either and he
actually didn't say what you claimed, he says that BG levels can spike
briefly after a high carb meal even for "normals". He even says that
BGs can go as high as 160 for non-diabetics(although such swings are
rare). In short, your supposed reference contradicts you.

You can well have intact pancreatic function as defined by HOMA B, and
still peak higher than 120 in a GTT. There are GTT curves that have
shown this. [ Your HOMA IR might be high, but that measures Insulin
Resistance, not pancreatic function]



If you do research on the HbA1c level at which
mortality and CVD risks rise, it's A1c above 4.8-5%, corresponding to
that range.

Well, no.

Well, yes.

I've yet to see anything that correlates a1c levels with a

BG level at a random time after eating. Even among people with normal
glucose tolerance, blood glucose peaks and insulin peaks vary
significantly depending on type of response, rate of gastric emptying
and the like. That is why most research focuses on the 2 hour
postprandial number.

It's not my fault if you haven't sought out the information. The fact
is that cardiac mortality risk rises all along the normal spectrum,
beginning in the lowest deciles.


Its not my fault if you can't read properly. Please note what I said

"I've yet to see anything that correlates a1c levels with a BG level
at a random time after eating. Even among people with normal glucose
tolerance, blood glucose peaks and insulin peaks vary
significantly depending on type of response, rate of gastric emptying
and the like. That is why most research focuses on the 2 hour
postprandial number."


Ann Intern Med 1998 Apr 1;128(7):524-33

Metabolic risk factors worsen continuously across the spectrum of
nondiabetic glucose tolerance. The Framingham Offspring Study.


And ta-da, the study you cite uses ... 2 hour postprandial number in
response to a standard glucose challenge. Please give me one study
that correlates a1c levels or CVD risks with BG level at a random time
shortly after a meal.

So to sum up

1) The OP mentions a number of 120 some short time after around 80
grams of fasting carbs.

2) You claim that people with intact pancreatic function remain
between 80-105 at all times.

3) When asked for a reference, you cite bernstein. Not only does he
not say what you did, he explicitly says otherwise

4) You also mention how an a1c in a certain range has the lowest risk
of CVDs. You do not however, mention how one can go from one reading
shortly aftre a high carb meal to an a1c.

5) And when asked about that, you come back with a survey that
shows .. 2hour readings. Not an arbitary reading at an arbitrary
time.







Meigs JB, Nathan DM, Wilson PW, Cupples LA, Singer DE
Massachusetts General Hospital, Harvard Medical School, Boston
University School of Public Health, 02114, USA. jme...@xxxxxxxxxxxxxxxxxxx

BACKGROUND: Categorical definitions for glucose intolerance imply that
risk thresholds exist, but metabolic risk for type 2 diabetes mellitus
or cardiovascular disease may increase continuously as glucose
intolerance increases. OBJECTIVE: To examine the distributions of the
following metabolic risk factors across the spectrum of glucose
tolerance: overall and central obesity, hypertension, low levels of
high-density lipoprotein cholesterol, and increased triglyceride and
insulin levels. DESIGN: Cross-sectional analysis. SETTING: The
community-based Framingham Offspring Study. PARTICIPANTS: 2583 adults
without previously diagnosed diabetes. MEASUREMENTS: Clinical data;
fasting glucose, insulin, and lipid levels; and glucose and insulin
levels taken 2 hours after oral challenge were collected from 1991 to
1993. Glucose tolerance was determined by 1980 World Health Organization
criteria. Patients with normal glucose tolerance were categorized into
quintiles of fasting glucose. The distributions of each metabolic risk
factor and the metabolic sum of the six risk factors were assessed
across seven categories from the lowest quintile of normal fasting
glucose level through impaired glucose tolerance and previously
undiagnosed diabetes. RESULTS: The mean age of patients was 54 years
(range, 26 to 82 years); 52.7% of patients were women. Glucose tolerance
testing found that 12.7% of patients had impaired glucose tolerance and
4.8% had previously undiagnosed diabetes. Multivariable-adjusted mean
measures of risk factors and odds ratios for obesity, elevated
waist-to-hip ratio, hypertension, low levels of high-density lipoprotein
cholesterol, elevated triglyceride levels, and hyperinsulinemia showed
continuous increases across the spectrum of nondiabetic glucose
tolerance. Although a threshold effect near the upper range of
nondiabetic glucose tolerance could not be ruled out for triglyceride
levels in men and for insulin levels 2 hours after oral challenge in men
and women, no other metabolic risk factors showed clear evidence of
thresholds for increased risk. CONCLUSIONS: Metabolic risk factors for
type 2 diabetes mellitus and for cardiovascular disease worsen
continuously across the spectrum of glucose tolerance categories,
beginning in the lowest quintiles of normal fasting glucose level.

PMID: 9518396, UI: 98175274

--------------------------------------------------------------------------------

Susan



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