Diabetes prevention

My blood sugar levels are always the lower end of normal. Do i need to still worry about diabetes? I'm underweight and always tired, so i can't exercise much. Am physically active, but in slow motion.    

My hemoglobin is around 9.5, ferritin is almost always at 10.

Iron levels are normal, though i was wrongly made to take iron supplements for several years. I had many endocrine problems at the time, many of which are normal now. I still take medicines for hypothyroid.

I have supplements with my food - to digest it, it contains  pancreatin and dimethicone.

I am on a gluten free diet which manages my IBS.

Have pigmentation which always made us suspect cortisol issues, but haven't been able to catch anything on paper. Seems normal everytime.

All advice will be appreciated. Thanks all!   

I read this article yesterday. Diabetes is a growing problem and especially in Indians and Asians in general. For prevention of Diabetes, the best I think anyone can do is to Exercise and diet. By exercise, you don't have to do weights, just light walking can also help.

From:- http://www.cnn.com/2009/HEALTH/11/09/diabetes.questions/index.html

Can diet or exercise really prevent diabetes?

Yes, exercising and eating a healthy diet helps you keep off excess weight, which can prevent or at least delay diabetes. If you already have diabetes, doing aerobic exercise and resistance training helps by encouraging the muscles to take up more blood sugar.

Over the short term, it may even reduce the amount of blood-sugar-lowering medication you need to take. Long term, exercise helps lower the risk of complications like blindness and nerve and kidney damage by helping you better manage blood-sugar levels. On the diet front, a recent study found that type 2 diabetics who ate a Mediterranean diet, which is rich in fish, fruits, nuts, and olive oil, lost more weight and went longer without blood-sugar-lowering medication than those on a low-fat diet.

Nothing much to add, however, I know diabetes can be prevented if one takes care of their diet. I remember an article few years back that mentioned white bread is one of the worst food with very high sugar contents. Some other high sugar food/drink included POPS, Juices from concentrate, alcohol etc.....

Thanks,

But a lot of these articles say exercise keeps the weight off, and that helps prevent or delay diabetes.

I am already underweight, I also have a very high BMR, and was wondering in those terms. I am also on gluten free - which means no bread/flours etc. I only have rice products and other gluten free grains.

Is there a specific prevention procedure for thalassemics to try to prevent diabetes?

Is there a specific prevention procedure for thalassemics to try to prevent diabetes?

Pretty... pretty... pretty... good question, Preety.

Yes there is and it's the same procedure, as for anybody else (ie. without thalassemia).
I'd say number one factor to avoid  from the statistical point of view is fructose, ie. table sugar (seems like pure glucose and starch is fine). Avoiding this one helps avoid diabetes type 2.

http://www.ajcn.org/cgi/content/full/76/5/911?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1077102153430_1815&stored_search=&FIRSTINDEX=0&sortspec=relevance&volume=76&firstpage=911&journalcode=ajcn

The intake of dietary fructose has increased markedly as a result of the steady increase in added sugars in the American diet (134). In the past, fructose was considered to be beneficial in the dietary management of diabetes mellitus and insulin resistance because fructose ingestion results in smaller postprandial glycemic and insulin excursions than do glucose and complex carbohydrates (28). In light of the information presented here, a cautionary note is warranted. Obesity is a growing epidemic in the United States. In terms of feedback to the CNS regarding energy status in peripheral tissues, fructose consumption results in decreased production and, therefore, decreased signaling to the CNS from 2 hormones (leptin and insulin) involved in the long-term regulation of energy homeostasis and body adiposity (11, 69).

Fructose has been implicated as a contributor to nearly all of the classic manifestations of the insulin resistance syndrome. Insulin resistance, impaired glucose tolerance, hyperinsulinemia, hypertension, and hyperlipidemia are associated with fructose intake in animal models. The data in humans are less clear, perhaps in part because the effects of fructose are often compared with those of sucrose, which is composed of 50% fructose. Other complicating factors obscuring the effect of dietary fructose on metabolic indexes include the duration of the studies, the age and the sex of the subjects tested, and the state in which the measurements are made (ie. fasting or postprandial).

Number 2 factor is to avoid milk, as it causes production of antibodies, that destroy insulin islets.
Avoiding this one helps avoid diabetes type 1.

http://www.thefreelibrary.com/Cows%27+milk,+diabetes+connection+bolstered-a055165308

Babies' immune systems largely ignore cows' milk proteins that have been chopped up. However, contact with one intact protein in cows' milk, bovine insulin, may set off a destructive process, suggest immunologist Outi Vaarala and her colleagues at the University of Helsinki The University of Helsinki is not to be confused with the Helsinki University of Technology.

The University of Helsinki (Finnish: Helsingin yliopisto, Swedish: Helsingfors universitet . The immune system would attack pancreas islet cells that make human insulin human insulin
n.
A protein that has the normal structure of insulin produced by the human pancreas but that is prepared by recombinant DNA techniques and by semisynthetic processes. , which resembles bovine insulin, and would produce antibodies.

At 2 years of age, 10 of 89 children getting cows' milk formula had formed antibodies associated with type I diabetes. However, only 3 of 84 babies receiving the treated milk showed these antibodies, says Hans K. Akerblom, a pediatrician at the University of Helsinki.

These autoimmune antibodies, or autoantibodies, are made by immune B cells and appear to dispose of To determine the fate of; to exercise the power of control over; to fix the condition, application, employment, etc. of; to direct or assign for a use.

See also: Dispose  damaged pancreatic islet cells, says Hans-Michael Dosch, an immunologist at the Hospital for Sick Children in Toronto. The antibodies indicate that bovine insulin might be spurring an immune system T-cell reaction against the child's own islet cells, he says. Insulin regulates sugar metabolism in the body.

The same applies to meat. Avoiding this one helps avoid diabetes type 2.
http://natamcancer.org/page22.html


So, when you stop or greatly limit these things in your diet, your chances not to get diabetes and stay healthy are pretty... pretty... pretty... much higher than in general population.
Goes without question, that avoiding meat and milk helps IBS, or I should rather say that you probably avoid these things already, right?

Regards,
B.

Thanks Bigg for sharing these informative links, very good ones as usual

manal

To explain even further...
Our bodies do have some mechanisms preventing diabetes and obesity - on a cellular level. The cell for example does not make fat when it is in abundance. Fructose bypasses all these regulatory mechanisms, and that's where the problem arises...

As of milk and diabetes - there is also another protein that induces antibody production against islets - unfortunetely I don't remember the name and I can't find it...
And of course also other diary counts, like cheese, etc.

On a more phisolophical plane...
The problem with today's diet is that we ALL want to live long (like a 100 years) and healthy. So our food has to be nutritious and can't have any side effects. If there are any side effects this means that there will be group of peoople that will have these side effects, so it's not gonna be ALL people living long and healthy.
Take this milk for example. In past (50 years ago or so) it was considered the healthiest possible food. It was because nobody could ever see the risk (like diabetes at later age, lifespan was shorter, etc.) - and the benefits were clearly visible (milk is source of calcium and vitamin D, and thus it's good influence is clearly visible at young age). Now the lifespan is longer and the health problem it causes are also visible.
Have you ever wondered what is going on with these diet recommendations - some people say milk and meat is good and necessary, other say just the opposite. Kind of paradox.
So there is the answer - these recommendations changed in the last 2 decades. And even "changed" is too much to say, because it is difficult to find other food of similar nutritional value like milk - so these recommendations haven't changed yet, and probably never will, until we find something else to eat. It's just a warning for milk drinkers that they should limit their intake considerably. In small quantities the possibility of immune system reaction and antibody production is much much smaller. Difficult to provide exact numbers, but it's like - drink 2 tmes less and the probability of diabetes gets lower 8-fold.
Thankfully, knowing that there is problem with milk, we can do something about (because we avoid meat anyway...), but many others are not aware of this problem, especially these advertisers "Got milk!". These ads are also in my country, and I just wonder if this is done for children,s health or just the opposite... Just a brain teaser...

Preety,

I don't think diabetes is a concern if you test on the low end. Diabetes in thals is primarily related to iron overload in the pancreas, so this should not be a concern in thal minor. Also, when one is underweight, exercise will help you add muscle mass and weight, as long as protein intake is adequate.

The possibility of a cortisol problem, along with some of your symptoms does raise the question about Addison's Disease.

http://www.merck.com/mmhe/sec13/ch164/ch164b.html

   
In Addison's disease, the adrenal glands are underactive, resulting in a deficiency of adrenal hormones.

    *
      Addison's disease may be caused by an autoimmune reaction, cancer, an infection, or some other disease.
    *
      A person with Addison's disease feels weak, tired, and dizzy when standing up after sitting or lying down and may develop dark skin patches.
    *
      Doctors measure sodium and potassium in the blood and measure cortisol and corticotropin levels to make the diagnosis.
    *
      People are given corticosteroids and fluids.

Addison's disease can start at any age and affects males and females about equally. In 70% of people with Addison's disease, the cause is not precisely known, but the adrenal glands are affected by an autoimmune reaction (see Autoimmune Disorders) in which the body's immune system attacks and destroys the adrenal cortex...
Blood tests may show low sodium and high potassium levels and usually indicate that the kidneys are not working well. Doctors who suspects Addison's disease measure cortisol levels, which may be low, and corticotropin levels, which may be high. However, doctors may need to confirm the diagnosis by measuring cortisol levels before and after an injection of corticotropin. If cortisol levels are low, further tests are needed to determine if the problem is Addison's disease or secondary adrenal insufficiency.

There also seems to be a connection between Addison's and Celiac disease. The pituitary role in all this does raise some questions in terms of thalassemia, as it has been found that in thal major, the pituitary is undersized and shrinks even in the absence of iron overload. There may be some possibility that your pituitary was damaged by iron supplements or it may have a problem that is independent of iron load.

When all your symptoms are put together, it does raise some questions and an investigation of adrenal insufficiency as seen with Addison's disease, may be warranted.

take great care of ur iron levels................

Yes Andy,

(and everyone else here :-)    )


While i was on iron for the most part, I had a pituitary microadenoma, which seems to have 'gone' after i stopped the iron and switched to gluten free. At that time I also had some imbalance in my lipase/amylase levels. But with time, even that became normal, as did all my other hormonal labs.

That is why i was concerned about diabetes - or rather any imbalance in my pancreas too. (I'm not sure what insulin resistance is.)

The last thing I need is to avoid sugar completely and then pass out from low blood sugar? :-)


The other thing is that - when my tests indicated iron deficieny, taking iron never helped increase either my ferritin or my hemoglobin. Instead I felt eternally unwell.

When we check my iron studies done on fasting - My saturation is low or normal. When we check it non-fasting, its normal or above the upper limit.

Here it is the norm to assume one is iron deficient if ferritin is so low. I was told that iron studies - that is %Tsat can be misleading, if you are taking iron supplements or iron rich foods, But ferritin always gives a clear picture.


What we are now doing is trying without iron. I know my ferritin is always around 10-20, but if hb drops below 9, then I will get back on the iron research. :-)


I haven't had any new pigmentation, and even my low BP is often a coincidence. (Last time i feared an addison crisis, my labs were normal, I just had an infection. I missed it as i didnt have a fever or any lab indications, my ESR is also always normal.)


We definitely have Addisons in mind, should the need arise in future.


Thank you all for your kind words. I am usually very talkative, but I turn blank as to how to show my appreciation here.
 
Love and Hugs to you all,

 

I would like to raise a question here:
what about the sweeteners? canderel and hermesetas and sweet'n'low and every other similar sweetener? Are they being suspected of cancer or not? There is a lot of doubt concerning these sweeteners....


Lena.

I would like to raise a question here:
what about the sweeteners? canderel and hermesetas and sweet'n'low and every other similar sweetener? Are they being suspected of cancer or not?

I can't answer your question, because nobody can.
The studies in this area show that many of these sweeteners are probably safe, but I would avoid many of these anyway (look here for example:
http://en.wikipedia.org/wiki/Aspartame_controversy
).

The list of sweeteners, where you can find decription of side effects too:
http://en.wikipedia.org/wiki/Sweeteners

But the problem with these studies is that they can't take into account everytthing, and especially they can't take into account that people will eat larger doses than was assumed, combine sweeteners with other chemicals like dyes, etc.

I read alarming research paper quite long time ago that one family of dyes was proved safe during studies, but when it came to food processing it was used and then eaten in much higher, possibly toxic doses.
Nobody can stop children from drinking 2 bottles of dyed soda a day - and in this respect the safe limit for the dye was exceeded.
Add to this artificial sweeteners, conservants, and (maaany maaany) other additives, and you have a big problem.

One remark though - you can't assume that every dye is harmful. Many people assume that everything signed E...something is harmful by definition. This is not so.  For example E300 is vitamin C, and it is not harmful although it has "E" designation.

And nobody does research comparing people eating food with additives and without additives, or people eating food with more harmful and a little safer additives. It is simply impossible to do such a comparison - it is not possible to get food without any additives.
The funny thing is that food without any aditives would not be good and safe - it would spoil quickly.

But as far as sweeteners go I can only tell you that the safest possible sweetener is glucose. And it is not because it has been tested and confirmed that it is completely safe, but because people eat glucose for thousands of years and metabolism adjusted to handle glucose safely. So it does not cause cancer as we understand it, but it still does not mean that it is completely good for us. Glucose is good food for cancers - it is used as contrast in PET for example, because cancers really thrive on it and absorb it quickly.

So the rule of thumb is that we should limit glucose, rather avoid sweeteners if it is possible and avoid other food additives, especially if we find that they are suspicious. This will allow to avoid possible long-term problems with these additives if they cause any.

Thank you Bigg, for your detailed reply. I put some sweeteners in my coffee - only that - but I think I'll drop the subject and stay with sugar instead. A little, of course.

Thank you.

Lena.

Hello, you might research and talk with your doctor about correct times of day and factors that influence cortisol levels throughout the day...our cortisol levels fluctuate in a 24 hour period; also, testing at certain times of month for females on hormone panels influences results....