Worried about Corona? The real threat is staring you in the face and kills 1.6 MILLION annually!

[Leongsam]

https://www.healthhub.sg/a-z/diseases-and-conditions/626/diabetes

 

[eatshitndie]

i'm more worried about this old toyota corona mowing down cyclists, pedestrians, other motorists, and most critical of all, pmd riders.

 

[Leongsam]

Singapore is No. 2 nation with most diabetics: 5 things about diabetes

A diabetic patient undergoing dialysis treatment at Kim Keat Dialysis Centre. ST PHOTO: DESMOND WEE
PUBLISHED

APR 8, 2016, 12:09 PM SGT

The number of adults estimated to be living with diabetes has nearly quadrupled over 35 years, the World Health Organisation (WHO) has said, warning that it has increased drastically because of "the way people eat, move and live".

Singapore has the second-highest proportion of diabetics among developed nations, a report in 2015, by the International Diabetes Federation (IDF) revealed.

In honour of World Health Day on April 7, we take a look at diabetes and its treatment options.

1. KEY FACTS

Students perform a flash mob at the Ministry of Health in Hanoi, Vietnam, on April 7, 2016. PHOTO: EPA

Diabetes is caused by having too much sugar in the blood. Insulin is a hormone that controls blood glucose levels.

There are two types of diabetes.

Type 1 is genetic and unpreventable. It occurs because the pancreas naturally does not produce enough insulin.

Type 2, related to weight management, is caused by lifestyle factors such as alcohol intake and a lack of exercise.

Obese people are at risk of developing Type 2 diabetes, which is a result of blocked or reduced insulin receptors. Over 90 per cent of diabetics suffer from Type 2 diabetes.

A diabetic registers at least 11.1 mmol/l for blood sugar levels taken after two hours in an oral glucose tolerance test (OGTT).

Poor control of diabetes can cause blood circulation problems and the formation of foot ulcers that may require amputation.
Complications of diabetes include heart disease, blindness and kidney failure.

2. PREVENTION

A man has his blood glucose screening at the Ministry of Health in Hanoi, Vietnam, on April 7, 2016. PHOTO: EPA

Diabetes can be prevented, at the pre-diabetes stage. Pre-diabetics have a reading between 7.8 and 11 mmol/l for blood sugar levels, two hours after an OGTT test.

In Singapore, 12 per cent of the population suffer from pre-diabetes. One-third of which will become diabetic, another one-third will remain pre-diabetic. With exercise and weight-loss, the remaining one-third can revert to normal glucose levels.

"If a pre-diabetic could lose 5-7% of body weight and increase exercise, the rate of progression from pre-diabetes to diabetes could be halved," Professor George Dailey, a senior consultant in the division of Diabetics & Endocrinology at Scripps Clinic, California, said.

Exercise and lifestyle changes help both diabetics and pre-diabetics.

3.EXERCISE

Regular exercise leads to increased metabolism. PHOTO: ST FILE

Regular exercise leads to increased metabolism. Muscles adapt to take up more blood sugar, in response to increased activity. This lowers the sugar levels in the blood.

"Some studies have shown an increase in glucose sensitivity for at least 16 hours from just a single session of exercise," said Mr Ray Loh, an exercise physiologist at the Sports Medicine and Surgery Clinic at Tan Tock Seng Hospital.

However, diabetics require different amounts of exercise, depending on how fit they are.

Dr Joan Khoo, consultant endocrinologist and director of Changi General Hospital's Diabetes Centre, recommends 150 minutes a week of moderate aerobic exercise, like brisk walking, cycling and swimming, for most patients.

To prevent over-exertion, the number of hours should be distributed across at least three days a week.

Diabetics should consult their doctors before deciding on a suitable exercise programme.

All diabetics should wear comfortable shoes to exercise.

Over time, some diabetics develop peripheral neuropathy, which is nerve damage in the arms and legs. They are less sensitive to injury or pressure. Hence, they may develop blisters and sores after exercising, without proper footwear.

Test your blood sugar with a glucose meter before, during and after exercise. The body draws on sugar from the blood, after the body uses up reserve sugar in the muscles and liver.

If your blood sugar before exercise exceeds 13.9 mmol/l, take a urine test before exercising. Refrain from exercising if the urine test registers the presence of ketones.

Ketones are a sign that the body's insulin levels are too low to break down sugar for energy.

Instead, the body breaks down fat, producing ketones. Ketones will cause the urine test strip to turn from beige to purple.

The darker the shade of purple, the higher the level of ketones in the urine.

Diabetics with high levels of ketones can develop diabetic ketoacidosis, a life-threatening condition.

They should consult their doctors and reduce blood sugar levels, so they can exercise safely.

4. EATING HABITS

People with Type 2 diabetes can reduce their blood sugar levels by eating in moderation and losing weight. PHOTO: ST FILE
.
Carbohydrates are the nutrients that break down to form blood sugar. They are the body's main source of energy.

A common myth is that diabetics should avoid carbohydrates. Everyone needs carbohydrates, but diabetics are recommended to consume them in moderate portions, according to Health Promotion Board.

Meal replacements, like low-calorie drinks and nutrition bars, contain slow-releasing carbohydrates in moderate amounts.

Slow-releasing carbohydrates keep blood sugar levels constant. Meal replacements also contain vitamins and minerals.

Soft drinks often contain high levels of sugar. Consuming two or more soft drinks a week leads to a 30 or 40 per cent higher chance of contracting type 2 diabetes, said Associate Professor Koh Woon Puay of the Yong Loo Lin School of Medicine.

Space out meals. The body's sugar levels increase after every meal and it takes two hours for sugar levels to return to pre-meal levels.

5.TAKING MEDICINE REGULARLY

Medicine for diabetes. PHOTO: THE NEW PAPER

Half of diabetics do not take their medication regularly, according to survey results released by the Diabetic Society of Singapore in August 2012.
Slightly more than one in four, or 27 per cent of respondents, said it was frustrating to take different types of oral tablets, the same study revealed.
Diabetics can opt for combination pills, like Kombiglyze XR.

Approved for use in February 2012, it combines two existing types of medication called saxagliptin and metformin. Most patients need to take it only once a day, with dinner.

Both types of medication reduce blood sugar levels, but metformin works on the liver and saxagliptin affects the pancreas.

Taken on its own, the short-acting version of metformin is consumed twice a day, while the long-acting one is consumed once.
Saxagliptin is taken once a day.

Before consuming medication, diabetics should check with their doctors about any potential side effects of the pills.

Sources: American Diabetes Association, Mayo Clinic, Health Promotion Board, MSD, Kombiglyze XR

 

[Leongsam]

i'm more worried about this old toyota corona mowing down cyclists, pedestrians, other motorists, and most critical of all, pmd riders.
View attachment 71379

Sadly production of the Corona came to an end in 2001.

 

[Leongsam]

Diabetes
30 October 2018

https://www.who.int/news-room/fact-sheets/detail/diabetes

Key facts

• The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.
• The global prevalence of diabetes* among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014 (1).
• Diabetes prevalence has been rising more rapidly in middle- and low-income countries.
• Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.
• In 2016, an estimated 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012**.
• Almost half of all deaths attributable to high blood glucose occur before the age of 70 years. WHO estimates that diabetes was the seventh leading cause of death in 2016.
• Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes.
• Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications.

 

[Leongsam]

After watching her partner die, Patty Wunder wants people to understand the danger of type 2 diabetes

Oliver Lewis05:00, Feb 09 2020


ALDEN WILLIAMS/STUFF

Patty Wunder hopes that by sharing her late partner Earl Ropata's diabetes battle she can help others.

Before her partner Earl Ropata died of health problems caused by diabetes, Patty Wunder asked if he had any regrets.
"I wish I would've taken my health more seriously," he replied.

Ropata died in December 2018, and Wunder has now decided to share his story to highlight the potential consequences of type 2 diabetes.

"It seems that everybody has diabetes or knows somebody with diabetes, but nobody sees diabetes," Wunder said.

READ MORE:

* The pre-diabetes tidal wave - harbinger of doom or symptom of an overdiagnosis epidemic?
* Difference between Type One diabetes and Type 2 diabetes explained
* 21-year-old woman goes blind from type 2 diabetes complications

"People don't see it, they just throw the word around but they don't understand the severity of what happens when you don't take it seriously."

SUPPLIED
Patty Wunder with her late partner Earl Ropata, who died in December, 2018 after a long struggle with type 2 diabetes.

An estimated 230,000 New Zealanders have type 2 diabetes, a disease where the body either doesn't produce enough insulin or resists the effect of insulin resulting in high levels of glucose in the blood.

If it isn't managed well, diabetes can lead to a range of health problems including kidney failure, heart disease, nerve damage and loss of vision.
By the time Ropata flew to the United States to meet Wunder in 2006, he was already injecting insulin to manage his diabetes.

ALDEN WILLIAMS/STUFF
Patty Wunder's partner, Earl, died of complications from type 2 diabetes.

The couple met online when Wunder was living in Chicago. Ropata was charming and funny, she said, a hard worker and a talented musician.
By the end of their third phone conversation, she had written in her diary: "I think I'm moving to New Zealand". She arrived in Christchurch that September.

From the outset, Wunder said it was a struggle to get Ropata to eat more healthy food.

"If I had a million dollars I could put it in the vege drawer and he'd never find it," she said.

As his health problems worsened, Wunder found it more and more frustrating that Ropata wouldn't change his lifestyle to better manage his diabetes.

SUPPLIED
Patty Wunder says her late partner struggled to change his unhealthy habits.

"The hardest thing is the frustration that somebody doesn't want to fight for their own life."

Ropata had to deal with numerous health problems caused by or associated with his diabetes, including heart failure, kidney failure, nerve damage which resulted in him losing feeling in his feet and fingers and circulation problems which contributed to the loss of his legs.

Wunder said he was devastated when he could no longer use his fingers to play guitar.

Wunder, who lives in Waikuku Beach in North Canterbury, shared graphic photographs on social media of Ropata in hospital showing the rotting, black skin on his feet and legs, both of which were amputated a month before he died.

Ropata, who died aged 47, spent much of his final months in Christchurch Hospital, where he went for dialysis, or in a hospice.

It was a traumatising time for his daughter, Chloe Ropata, 20.

"It was extremely difficult for me, watching dad eat the way he did," Chloe said.

"I could see where it was leading and in the last year of his life I could physically see him disappearing."

SUPPLIED
Her father's death was trauamatising for Chloe Ropata.

"Leading up to his death I suffered with pretty bad mental health. I was pretty much watching my dad die a slow painful death."

Despite the efforts of his friends and family, Chloe Ropata said her father never seemed to take his diabetes seriously.

Sugar was an addiction for him, and he would try and hide the junk food he ate.

She recalled trying to hide unhealthy food from him as a child. By speaking out, she hoped to make people realise how serious diabetes was and to encourage them to change their eating habits.

ALDEN WILLIAMS/STUFF
"The hardest thing is the frustration that somebody doesn't want to fight for their own life."

University of Otago professor in medicine and human nutrition Jim Mann said diet was important for preventing and managing type 2 diabetes.
Obesity was the biggest risk factor for developing the disease, so people should aim to lose "a bit of" weight by following a diet low in saturated fat with lots of vegetables, fruit and whole grains.

The epidemic of diabetes was tied to the obesity epidemic, Mann said. If people diagnosed with prediabetes (where blood sugar levels are higher than normal) reduced their excess body weight by 5 to 10 per cent, Mann said studies showed they would dramatically lower their risk of developing diabetes.

Mann said a reasonable number of people with type 2 diabetes required insulin, but some people were able to manage the disease through diet and exercise.

"If you get someone who has type 2 diabetes and goes for a 10-15 minute walk after a meal you can reduce blood sugars significantly," he said.

"There is no doubt that even people who are down the path of diabetes, they will benefit from changing their lifestyle."

*comments on this article have been closed

 

[eatshitndie]

Sadly production of the Corona came to an end in 2001.

they should have updated it and brought it back. anything to replace the camry name will be a good idea.

 

[Hypocrite-The]

Sadly production of the Corona came to an end in 2001.

Isn't the Corona a Camry?

 

[laksaboy]

Fasting is great for dealing with diabetes. And no, it's not the Ramadan '12 hours between binge eating' type of fasting. At least 48 hours or 72 hours without any food. Most Sinkies lack the discipline to do that.

'Taking (diabetes) medicine regularly' sounds like advice sponsored by the pharmaceutical industry. It's not too different from articles featuring 'experts' who advise you to get flu shots, or 'get help' for your mental illness so they can almost immediately prescribe some SSRI crazy pills for you.

 

[Hypocrite-The]

Boss Sam. Diabetes does not spread like the Wuhan virus. N to me better to Soylent Green than be diabetic. N diabetes can be controlled. Become a proper vegetarian. Eat more healthy veg n eliminate carbs. Cut or eliminate sugar n salt n hydrogenated oils. But eat like tat better to Soylent Green. I rather eat tasty n fatty rich foods and go with a bang. Death is part of life. Deal with it

 

[nayr69sg]

Must be all the food in sinkieland. Diabetogenic.

 

[Hypocrite-The]

Must be all the food in sinkieland. Diabetogenic.

Good food is always unhealthy

 

[Leongsam]

Fasting is great for dealing with diabetes. And no, it's not the Ramadan '12 hours between binge eating' type of fasting. At least 48 hours or 72 hours without any food. Most Sinkies lack the discipline to do that.

'Taking (diabetes) medicine regularly' sounds like advice sponsored by the pharmaceutical industry. It's not too different from articles featuring 'experts' who advise you to get flu shots, or 'get help' for your mental illness so they can almost immediately prescribe some SSRI crazy pills for you.

Back from the brink: How I reversed my type 2 diabetes
John McCrone05:00, Aug 17 2019

Stuff writer John McCrone has beaten diabetes through a low carb diet and exercise.

Being diagnosed with out-of-control type 2 diabetes was a shock for Stuff writer JOHN McCRONE. But is this how we can all fight back?
Whoa. Not just diabetes, but completely red-lining it. Fair to say that as a slimmish, fittish, 60-ish, white male, I wasn't expecting the diagnosis.
Perhaps skin or bowel cancer. Those would seem more my risks. Yet here I was.

My surprise was mixed with guilt and embarrassment. Somehow I had screwed up. But where exactly?

My doctor appeared lost for a ready answer. He was muttering something vague about a "decompensation" – a stressed body finally giving out – as he pushed a diabetes guide across his desk.

READ MORE:
* It's not the calories, it's our modern lifestyle that is killing us
* Feeling high on a low-carb diet? The effect on your brain is similar to an illicit drug
* Ketogenic diet could help us live longer, but could also lead to weight gain
* The pre-diabetes tidal wave - harbinger of doom or symptom of an overdiagnosis epidemic?

Absorb the shock, he advised. Then come back for the pills and likely the insulin pump which could be my lifetime companion now I had succumbed to this nasty disease.

Type 2 diabetes mellitus. A sugary rot produced by an excess of blood glucose adhering to the body's proteins, gumming up its works in every direction.

Kidney failure, blindness, gangrenous sores, limb amputations. Possibly also the strokes, coronary artery disease, Alzheimer's, maybe Parkinson's, which are now all being linked to the condition.

I would be falling apart by stages for about the next 20 years – if a diabetes-prompted heart attack didn't carry me off rather sooner.

How could it have happened? In the mirror, I had to admit to about 5kg of middle-age spread. And in particular, there was a bulge, a distension, just under the rib-line.

Better informed, I can now read that as a fatty liver. However, nothing seemed that out of control. I could still stand up straight and mostly suck my gut out of sight.

And while I had always indulged freely with cake and chocolate, I believed I was compensating with healthy food too.
Lean cuts of meat, tons of vegetables, and enough of the good carbs – the recommended "food pyramid" foundation of potatoes, bread, rice and pasta – on my plate.

I had also exercised hard all my life. Given the calories in/calories out principle, my feeling was I would have been burning off the worst of any excess dietary sugar along the way.

ALDEN WILLIAMS/STUFF
Real food: Feature writer John McCrone showing what his LCHF diet is built around.

So an unlikely candidate for diabetes. However confession time. My annual blood test had shown an HbA1c reading – the measure of your average blood glucose – that had crept up into the official pre-diabetic zone.

My last result had hit 46 millimoles per mole (mmol/mol). On the coloured "speedometer" chart doctors use, this was still in the green, but paling towards a cautionary yellow.

The warning had been easy enough to shrug off. I reasoned the change looked a gradual thing. There would be plenty of time to do something about it. Check back in another year.

Yet now, barely six months later, my HbA1c had rocketed to 99 mmol – straight into the screaming red zone.

I was broken. And the clue to how bad was that the diabetes speed dial actually topped out at 100. So off the road, down the ravine, tumbling into oblivion, I had to guess.

I was looking for a better explanation than just a decompensation – something snapping. But my 10-minute appointment was over. The doctor had his "time's up" face on. The essential news had been delivered.

Being a journalist and science writer – used to getting answers – I went straight home and got stuck into researching my diagnosis. Thank goodness for Google, YouTube and internet discussion forums.

Three months later I was back at the surgery for a follow-up HbA1c result. My blood glucose had dropped to 56. Down from panic stations to merely serious alarm.

Another three months and it was right down to 35. Not even pre-diabetic anymore. Normal range. To all intents and purposes, fixed.

I was disappointed that my doctor didn't fall off his chair in amazement, only furrowed his brow in mild curiosity.

Conventional wisdom says there is no cure for diabetes. You just use drugs to mask the worst of its symptoms.

However, I had been lucky with my timing. With diabetes reaching epidemic proportions across the world, it looks like our medical understanding of it is also being turned on its head.

ISTOCK
John McCrone's focus on a low carbohydrate diet has helped to turn around his blood glucose levels.

As basically a lifestyle disease, a drastic lifestyle change can – if not fully cure it – put it into remission. Or at least that is what my own story appeared to prove.

THE LOW CARB SWITCHEROO

What did I do? The short answer.
After poring over the many contrasting opinions offered up by the internet, I arrived at the low carbohydrate/high fat (LCHF) diet. Or as some prefer to call it, the low carb and healthy fat diet.

Simply put, take away the fuel of diabetes. Get rid of all dietary sugar. Even your fruit intake needs to be limited.

And then restrict anything starchy as well. Potatoes, bread, flour, oats, rice, noodles, pasta – all the stuff which is one step away from being converted to sugar.

Even if standard dietary wisdom is that these are necessary staples, the message is starve the disease.

Yes, I found it a daunting thought too. As humans, we are our habits. I couldn't even imagine mealtimes with these basics missing.

However I got started. Out went marmalade and toast for breakfast, my morning routine for any number of years. In came a couple of eggs scrambled with a large knob of butter. Just that. It looked rather naked and alone on the plate.

Lunch became more eggs – usually fried with bacon or some other protein – laid on a crunchy bed of green veg and salad. At least on an LCHF diet, you can still eat all the broccoli and cabbage – low density carb – you could possibly want.

Dinner continued to be roasts and stir fries. Just reinvented to be without potatoes, rice or pasta.

Dessert was reduced to a single square of 90 per cent dark chocolate. Snacks were a handful of nuts or a cracker piled as high as I liked in peanut butter.

A blessing of the LCHF diet is that fat is back on the menu. It is how you fill up. And as the LCHF pundits promise, the diet is naturally satiating. So you shouldn't end up overeating.

Sugar only turns your appetite on. After one biscuit you are always ready for another. It is an evolutionary thing.

Our hunter/gatherer ancestors were hard-wired to gorge on fruits and berries when they became available during a brief few summer weeks – a once-a-year passing treat.

But protein turns our appetite off. We know when we have had enough. So once the habit of having sugar and starch at every meal is broken – that built-in expectation – there is no particular nagging craving.

SUPPLIED
In the dread zone: The blood glucose "speedometer" telling what HbA1c reading is out of control.

I didn't believe it would be the case either. Yet I discovered it was true after I tried.

As well as seeing my blood sugar plummet back to safe levels, I found my waist band shrinking by whole sizes. I was having to punch new holes in my belts, cinch in my trousers, then eventually just go out and buy a new wardrobe.

Another unexpected bonus of joining the LCHF club was it appeared to put me in the middle of everything trendy.

Keto monitors, barbell training, intermittent fasting, bio-hacking, sleep tracking, even turmeric, coconut oil and apple cider vinegar. I was part of the cool crowd for a change.

Of course I was only what low-carbers call an n=1 experiment – a single patient clinical trial. Fair warning. My experience might not be your experience.

But how could I doubt the evidence it was working? And the more I looked into the theory behind low carb, the more it seemed to make perfect sense.

FALLING OUT OF BALANCE

YouTube was a great resource. You get to look over the shoulders of scientists as they present their latest research findings in lectures and conference sessions.

And YouTube certainly seems flooded with low carb advocates. The likes of Professor Ben Bikman, Professor Tim Noakes, Dr Jason Fung, Dr Michael Eades, Dr Ted Naiman, and the "fat emperor", Ivor Cummins, stood out for me.

New Zealand has its own community, led by Professor Grant Schofield at Auckland University of Technology (AUT), along with others at his Human Potential Centre, like Dr Catherine Crofts and Dr Caryn Zinn.

Schofield helped host a Low Carb Down Under meeting in Auckland back in 2014. And the pace has picked up so much that Australia ran six Low Carb Down Under events last year.

It has also been moving from the medical fringes – a subject largely for physiologists, nutritionists, sports scientists and family doctors – to the mainstream.

In 2018, the reinsurance giant Swiss Re teamed up with the British Medical Journal to put on "Food for Thought" in Zurich. LCHF as an answer to diabetes is on the map.

I listened. And what I picked up about my own plight was that after years of silent abuse, I must have finally burnt out my pancreas.

That decompensation was an abrupt failure of the pancreatic beta cells which produce the body's insulin. And it could have been a collapse 20 years in the making.

My diagnosis actually came in August 2017. I was 60 and had just returned from a trip around Europe – a holiday dedicated to scone teas and cake stops at every museum cafe.

The only symptom coming home was a thirst. I couldn't wait to gulp down glasses of Christchurch's pure tap water. But also I was suddenly shedding weight. A kilo a week without trying.

A first hopeful thought was that it was the delayed effect of tramping hours a day around European capitals. The truth was my pancreas was shot and the insulin regulation of my blood glucose had just given out.

ALDEN WILLIAMS/STUFF
Exercise helps: John McCrone mixes hard gym sessions and long easy walks for metabolic health.

I was peeing out excess glucose by the bucket-load. The kilos were simply calories overflowing the kidneys and splashing their way down the toilet.
Getting back from the doctor's, one of the other things I immediately did was invest $30 in a blood glucose monitor and test strips. I needed to know exactly what was going on.

The idea of pricking your finger for beads of blood was another psychological hurdle. But easy to brush aside. Realising why you see so many one-legged people in wheelchairs these days – it's the diabetes not the car crashes – served as encouragement enough.

HbA1c readings give you a three-month rolling average. With a glucose monitor, you can check what your levels are doing right at the moment, before and after each meal.

A healthy baseline number on this type of reading is between 4 and 6 mmol/l. My scores soon confirmed my red-lining status. I was tracking along all day at between 16 and 20.

Fellow diabetics I chatted with were almost impressed I had managed to achieve such catastrophic levels. The only good news was that I found out so soon after my insulin-producing collapse.

As I said, glucose does its damage by sticking to cellular tissues. That is how the HbA1c measurement itself works. It is a calculation of the percentage of your red blood cells that have haemoglobin molecules which have become glycated.

This glycation of proteins erodes delicate structures like capillaries, nerve endings, the filtering glomeruli in your kidneys.

It also turns cholesterol particles – the body's fat transporters – shrivelled and toxic. The body can no longer recognise the particles to recycle them, so they get lodged in the walls of your arteries, creating inflammation.

That is how diabetes becomes a cause of strokes and heart attacks too.

It does take a good few years of this syrupy marination for bits of you – your eyes, heart, feet, kidneys – to start to fall off.

But that was a disturbing thought too. Apart from a continual dry mouth, I had no particular symptoms telling me my blood sugar had got so high. I felt pretty fine overall. I had no fatigue, high blood pressure, itchy skin, or other of the signs that can be tell-tales of diabetes.

THE BODY'S HYBRID MOTOR

So what had happened inside of me to bring me to my sorry pass? And why did a drastic diet change make such a rapid difference?

Following the science, I learnt the key thing is that the human body is evolved to have a twin fuel system. It is like a hybrid car – energy-efficient and fuel-flexible – designed to alternate between glucose-burning and fat-burning.

The pancreas in fact secretes two different hormones – insulin and glucagon. While insulin is produced by groups of beta cells, glucagon is released by neighbouring islets of alpha cells.

When the level of one is high, the level of the other is low. That way there is binary control over which mode of metabolism is dominating at any time.
Insulin rules when the body is in energy surplus – when food is coming in and we are busy digesting. The pancreas senses this and pumps out an insulin signal telling the body to start using the freely available glucose.

GRAHAME COX/STUFF
Low carbing: Prof Grant Schofield, here with dietitian Dr Caryn Zinn, leads LCHF in New Zealand.

Insulin molecules actually act like a key in a cell's door, binding to receptors on its membrane and letting blood-borne sugars flow in.

But most meals deliver more energy than we immediately require. The whole body only needs a teaspoon of circulating glucose at any moment. So insulin also acts to direct the excess into longer-term storage forms.

First, the muscles and liver are prompted to convert glucose into glycogen – the animal equivalent of plant starch. The body can hold enough of this as a local reserve to fuel itself for a few hours.

After that, the rest of the excess glucose has to be turned into fat for proper long-term storage. The liver processes it into triglyceride molecules which are taken up by our adipose tissue, our body's fat layers.

So insulin runs the body in a glucogenic state. We are concentrated on burning or storing glucose. But then we have to flip into our other fuel mode to begin burning the fat stores we have accumulated.

In nature – back when our ancestors were living by hunting and gathering – it would have been normal to be short of food for a day or two, and often even weeks. Switching into a ketogenic state was the way we survived.

Glucagon takes over as blood glucose drops. This is a signal to the liver to start breaking down fatty acids into ketone bodies – smaller acetone-like molecules like beta-hydroxybutyrate.

Our mitochondria, the powerhouses of our cells, can accept either these ketones or glucose molecules as their fuel. So it makes for an exquisitely balanced system.

Either we are generally building up our fat stores, or else we are generally breaking them down. And as long as we spend enough time in each distinct metabolic zone, everything should be fine.

The trouble with type 2 diabetes is that we don't. Instead, the modern diet leaves us stuck on the glucose half of the cycle and eventually this causes a collapse in our insulin regulation.

Type 2 diabetes used to be almost unknown. Now it is an epidemic. The Ministry of Health says 250,000 Kiwis suffer full-blown diabetes – double the number of 20 years ago.

A further quarter of the population is then pre-diabetic. So on their way to getting diabetes soon enough if they don't do something about it.

CARB-LOADING

Diet is the issue. Anyone of my generation will have been witness to how much the way we eat has changed.

In the 1970s, junk food and sugary snacks went from being occasional treats to standard fare. The food industry had discovered it could make addictive products from dirt cheap ingredients.

Fructose – a variant of sugar – could be factory-produced for next to nothing by running a truckload of corn through a bath of acid and enzymes.
Likewise cheap fat – hydrogenated vegetable oil – could be churned out by the barrel by heat-cracking and solvent-treating a low-cost crop like soybean.

Two industrialised ingredients to then jazz up anything, including your "healthy" morning bowl of muesli, or the sweet and greasy Caesar dressing swamping a takeaway salad.

ANDY JACKSON/STUFF
Medical devices: For too many, insulin pumps become their alternative.

But also, official dietary advice changed too. Due to medical fears about saturated fat and heart disease, the public health emphasis went on cutting back on meat and dairy. People were urged to fill up their plates with "good carbs" instead.

Through the 1980s and 1990s, I was hearing this message like everyone else. So my wedges of butter became guilty smears. It became automatic to reach for the leanest cut at the supermarket, while just also reducing the amount of protein altogether.

The compensation was being liberal with the carbohydrates. When it came to starch like potatoes, rice and spaghetti, or sweetness in the form of apples, bananas, melons and other fruit, any amount seemed allowed. They were nature's bounty, packed with energy and nutrition.

Indeed if, like me, you were out running every evening, playing tennis all weekend long, then carb-loading was the thing to do. The way to train.

So apart from the cakes and biscuits, I thought my own diet was pretty much a model of the going Heart Foundation guidelines. And what a laugh that turned out to be.

DISCOVERING TOFI SYNDROME

It is at this point of the story that things get properly controversial. The old colliding with the new.

Current mainstream dietary advice – even for diabetics – remains "heart-healthy". A sensible diet is meant to have a balance of macronutrients where about 50 per cent of our daily calories come from carbohydrates, then some 30 per cent from fat and 20 per cent from protein.

The diabetes management booklet handed me by my doctor toed this line.

It said cut out the processed food, the sugary snacks and fatty treats, of course. Perhaps go easy on the starch and ramp up the greens. But breakfast could still be porridge, Weetbix, or baked beans on toast. Standard carbs.

An LCHF diet tilts the ratios the opposite way. Carbs become 20 per cent of the calories, protein 20 per cent, and fat 60 per cent.

The even more aggressive ketogenic diet – Keto to its advocates – reduces carbohydrate to 10 per cent and takes the fat level to 70 per cent.

With LCHF, you can still get in your healthy five fruit and veg a day. Starchy tubers and grains are carb dense. However, it takes an awful lot of kale, cauliflower, courgette and capsicum – the green and fibrous stuff – to reach the diet's 20 per cent goal.

VIEW MORE - THE EXPERTS SPEAK

* Dr. Jason Fung - 'A New Paradigm of Insulin Resistance'
* Prof. Grant Schofield - 'Low Carb - Where Is The Science At?'
* Catherine Crofts PhD on Hyperinsulinemia and Kraft
* A deep dive in to insulin resistance and personal fat threshold part 2

And the low carb argument is the modern diet is just wrong once viewed in an evolutionary light. We now eat sugar the whole year around. And starch of some kind with every meal. On top of this, we also graze continuously, snacking our way through the day.

It is a pleasant enough way of existing. But the result is we are always on the glucose side of the equation, never much on the ketone-based, fat-burning side.

This sets up an invisible war in our bodies. The beta cells of our pancreas have to be in constant overdrive to flush the excess glucose out of our bloodstream and into our glycogen and fat stores.

Yet that starts to provoke its own response of insulin resistance. Our muscles say they have already got enough. And our fat cells – even though they are designed so they can swell 8000 times in volume – eventually become completely full up too.

These tissues react by becoming deaf to the urgings of the pancreas. They reduce the number of insulin receptors on their membranes, making them insensitive.

This causes the pancreas only to shout even louder. Insulin levels soar as the beta cells redouble their efforts to clear the bloodstream of glucose. It becomes a vicious circle – a state called hyperinsulinemia.

But at this stage, the pancreas is still managing to force the glucose away. So your HbA1c readings might seem fairly normal. Or just a touch pre-diabetic.

The next stage comes when we hit our personal fat threshold. This is the bit that probably caught me out.

Diabetes is thought of as a disease of obesity. And while that is true, about 10 per cent of even severely obese people can remain metabolically healthy – at least in the insulin-resistance sense.

The reason is they can manufacture more fat cells. There is always more room for whatever their diets throw at them.

But other people have a strict fat limit. Once their available fat cells are filled, there are no more. And for slim body types like me – with a relatively thin layer of subcutaneous fat on the hips, trunk and back – it means maximum capacity may be reached that much more abruptly.

That does not mean the pancreas stops trying. Even when our subcutaneous fat cells are full – and now starting to burst and die, releasing their inflammatory contents – the insulin signal will continue, trying to drive fat into every other nook and cranny.

First we develop visceral fat – bloated deposits wrapped around our internal organs. Then the fat begins to invade our muscles and internal organs themselves.
We get the syndrome know as TOFI. Thin on the outside and fat on the inside. The state I was in.

It is like hitting a hard wall as the organ fat builds. The liver clogs. And even the pancreas clogs. Then it is end game.

The beta cells cease to function. Insulin regulation of blood glucose collapses. Nothing is left to hold the sugar back.

You wind up at the doctor's in a daze and find he is muttering something vague about a sudden metabolic decompensation.

LOSING A GRAM IN THE RIGHT PLACE

So goes the simplified version of my diabetic disaster. The full story of the body's metabolic complexity could fill a book. I've read a few of those.
But the bodily mechanics explains how a dietary change can work – what you need to do. And there are in fact a number of fixes you can try.
Bariatric surgery – a gastric bypass – is one. For the seriously obese, a physical restriction on eating will cause fat levels to subside and ease the body back below its personal fat threshold.

Strict low calorie diets can be effective as well. Losing the fat clogging the pancreas can get the beta cells going again, so long as they aren't completely broken down.

Calorie restriction diets appeal to the medical establishment because carbs can still remain half of the daily diet. You just eat less of everything.
But the low carb claim is that it takes direct action. Carbs are the actual villain of the piece. Just cut them instead and get yourself into the ketogenic fat-burning zone.
It is about working with nature, working with your metabolism. Low carbers are big on other lifestyle changes like barbell exercises and high intensity training. Kicking your body up a gear.

I already was active. But I got busy at the gym. I broke out the weights, the rowing machine, the chin-ups. I also went for long glucose-burning walks directly after meals.

Intermittent fasting is another fashionable move. And one I liked more than I expected.

The goal is to give your insulin system as much rest as possible. And stretching out meals is as good as cutting way back on the carbs.

Now I often sleep my eight hours, skip breakfast and then have lunch around mid-afternoon, dinner thereafter. A fast of 14 hours or so. Sufficient time to shift into ketosis.

Again, it sounded like something I never could do, being apparently so addicted to food. And it was actually surprisingly easy when I tried.

BUT NO FAIRYTALE END

If you get right into low carb it can start to become cult-like. The internet is full of buff Instagrammers promoting their highly restrictive keto lifestyle.
Even with the LCHF, I only limited my diet to the degree it made sense. I would tighten my regime and check the result on my glucose monitor. Did blood sugars head in the right direction? Test and repeat until I got where I had to be.

I did start taking metformin tablets, the standard drug for type 2 diabetes. They certainly shaved a few points off my HbA1c early on.

I got down to 35 mmol/mol with the help of those. Stopping saw a bounce back to 39. But that was good enough, I felt.

And as to the final outcome, it isn't fairytale perfect. For some, their pancreas does recover after it has been unclogged. As far as I can tell, my beta cells were burnt out by being red-lined. Even shrinking every last gram of visceral fat hasn't brought them back yet.

So I'm not actually cured. But being in remission for as long as I stick to an LCHF diet is a happy alternative. And I generally feel better in every way for doing so much about my metabolic health.

Once more, I am just only another n=1 experiment. Results may vary from individual case to individual case.

However, it is worth knowing about the insidious damage too many of us are doing to ourselves through our existing eating patterns. And that when we decide to make a radical change, it is perfectly possible to haul ourselves back from the brink.

Stuff

 

[nayr69sg]

Good food is always unhealthy

That's what sinkies say lah. Lol!

 

[Hypocrite-The]

That's what sinkies say lah. Lol!

Because it's true. Char kway teow is healthy?

 

[nayr69sg]

Because it's true. Char kway teow is healthy?

Hello there is good healthy food out there. Just not the rubbish crap that sinkies adore in hawker centers and coffee shops.

Low class unhealthy food that is tasty that you call "good food" is rubbish nutrition.

 

[Hypocrite-The]

Hello there is good healthy food out there. Just not the rubbish crap that sinkies adore in hawker centers and coffee shops.

Low class unhealthy food that is tasty that you call "good food" is rubbish nutrition.

Wat good healthy food? Vegetable n fruits? Steak n salad? Texas BBQ?

 

[Leongsam]

Boss Sam. Diabetes does not spread like the Wuhan virus. N to me better to Soylent Green than be diabetic. N diabetes can be controlled. Become a proper vegetarian. Eat more healthy veg n eliminate carbs. Cut or eliminate sugar n salt n hydrogenated oils. But eat like tat better to Soylent Green. I rather eat tasty n fatty rich foods and go with a bang. Death is part of life. Deal with it

Because of the Wuhan virus every kiasu Sinkie is rushing to stock up on masks, toilet paper and what have you just because there is a slim chance they will catch the virus but even if they do their chances of dying a minimal.

However they have a far greater chance of ending up diabetic and living an extremely miserable life eg blindness, amputation, kidney failure etc before they die from the complications. But do you see the same frantic scramble to get some exercise? Do you see people giving up their sedentary lifestyles and quitting sugar and other highly processed carbs?

Therein lies the folly of human behavior. Common sense is the least common of all senses.

My HbA1C is 36.

 

[nayr69sg]

Wat good healthy food? Vegetable n fruits? Steak n salad? Texas BBQ?

https://www.google.com/amp/s/www.pinterest.com.au/amp/2dogsam/thermomix-all-things-asian/

 

[Hypocrite-The]

Because of the Wuhan virus every kiasu Sinkie is rushing to stock up on masks, toilet paper and what have you just because there is a slim chance they will catch the virus but even if they do their chances of dying a minimal.

However they have a far greater chance of ending up diabetic and living an extremely miserable life eg blindness, amputation, kidney failure etc before they die from the complications. But do you see the same frantic scramble to get some exercise? Do you see people giving up their sedentary lifestyles and quitting sugar and other highly processed carbs?

Therein lies the folly of human behavior. Common sense is the least common of all senses.

Tat is why the solution to human kinds misery is Soylent Green.