Alan wrote:
> On Sun, 11 Feb 2007 13:14:22 -0500, Frank Roy
> > wrote:
>
>>Hi Chris:
>>
>>>>>In this context, it seems likely that early, effective
>>>>>management by diet and drugs of hyperglycemia in type 2
>>>>>diabetes is an important aspect of preserving residual
>>>>>b-cell function. The same argument for meticulous
glycemic
>>>>>control can be made after pancreas or islet
>>>>>transplantation."
>>>
>>>
>>> If this is like many other cases of mild recoverable
damage which if
>>> too prolonged can become permanent, then it's not just
the length of
>>> exposure to high BGs which will matter, but the time
interval
>>> between episodes. What often seems to harden mild
temporary
>>> recoverable damage into permanent damage is if the
interval between
>>> the damaging episodes is not long enough for full
recovery to take
>>> place. That's what would make the episodes have a
cumulatively
>>> damaging effect, even though they may be brief and only
very mildly
>>> damaging.
>>
>>I tend to view type 2 diabetes as a pathological
phenotype. It is
>>possible to restore physiological phenotype to some degree
by changing
>>gene expression (mRNA), but it depends upon how far gone
the diabetic
>>pathological phenotype is established, i.e., what tissues,
what
>>organs, etc. This is in accord with what you have said
above, but a
>>little less generally. A case in point relates to the
responses type
>>2s have versus type 1s and normal glycemics to
intravenious ascorbic
>>acid and endolthelial dysfunction as measured by dilation
in the
>>forearm and blood flow. The following article is not the
one I was
>>looking for but it partially illustrates the point:
High-dose oral
>>vitamin C partially replenishes vitamin C levels in
patients with
>>Type 2 diabetes and low vitamin C levels but does not
improve
>>endothelial dysfunction or insulin resistance -
>>http://ajpheart.physiology.org/cgi/c...ull/290/1/H137
>>>
>>> I have no idea how long it takes to recover from soft
recoverable
>>> glycation damage, but it wouldn't be too surprising if
it was longer
>>> than a day. In fact on first principles I would suspect
that it
>>> would follow the common half life logarithmic
progression of
>>> recovering by 50% each fixed half-life interval of time
(because
>>> that's the law of chemical mass action in solution). If
that were
>>> the case, then a big long high spike once a week might
be ok, but a
>>> brief little one every day might lead to progressive
permanent
>>> damage.
>>
>>I am looking at the impact that the drugs that improve
incretin effect
>>have on type 2 diabetics. Hopefully there may be some
long term
>>positive effects.
>>
>>>
>>> The A1C test is based on blood cell glycation damage. If
there are
>>> some important kinds of glycation damage which have
different
>>> recovery rates than blood cell glycation (which would
hardly be
>>> surprising), then all a low A1C will tell you is that
you're
>>> protected from those kinds of damage which recover at
the same rate
>>> or more slowly than blood cell glycation damage.
>>
>>A1c does not tell us much about damaged proteins, tissue,
etc.
>>>
>>> I note that at diagnosis I was already suffering from
some typical
>>> diabetic complications, such as some neuropathy in hands
and feet,
>>> despite having an A1C of 5.6%. My problem was that a few
times a
>>> day I was having brief (probably 30-45mins) BG spikes in
excess of
>>> 200. When I reduced the size and frequency of those
spikes my
>>> neuropathy started to improve.
>>>
>>> My condition now seems to be close to the threshold of
neuropathic
>>> damage, because if I keep my BG spikes down my
neuropathy continues
>>> very slowly to improve, but one single brief BG spike
over 150 will
>>> produce mild tingling in the edges of my hands.
>>>
>>> Other T2s posting here have reported the same kind of
thing, even
>>> though they too are in the 5% A1C club.
>>
>>It seems to be true that better blood glucose control can
reverse some
>>neuropathy and possibly some kidney damage.
>>
>>I will have to come back later. The twins have a birthday
party.
>>
>>Frank
>
> It would be nice if you could bring yourself to speak less
> pompous scientific words, so that the rest of us can
> understand what you're saying.
>
> That might help a great many more people. . . .!

Huh?