More Ways Than One (Photo by: Josh Mahoney)
Can we really prevent diabetes? My cousin is one we rightly call the “Sweeper” because he is the last man out of the table after meals. He can finish just about everything that is left on the table as long as it is edible.
Regularly, we check his blood sugar and (surprise, surprise) he is way below the threshold for diabetes.
Even those in the medical profession have diabetes. I am most likely to get it with my strong family history, sedentary lifestyle and propensity to de-stress with bingeing. My cousin though, even if he keeps not just his own plate clean, is an avid walker. He walks daily to and from work and just about anywhere he can.
Can we really prevent diabetes? The latest study from the Diabetes Prevention Program Outcomes Study (DPPOS) may hold the answer. The study is a randomized controlled trial that compares long-term diabetes risk of those who achieve normal glucose control (defined as having fasting blood plasma glucose level of less than 100mg/dL and a 2-hour plasma glucose level of less than 140mg/dL) during the Diabetes Prevention Program with those who actually diabetes already that remains uncontrolled.
The study observed the incidence of diabetes and grouped the participants according to their medications and treatment. Insulin secretion of the subjects and their sensitivity to insulin during the study was also observed.
Remarkable findings of this on-going observational study was numerous and interesting. If a participant achieved normal glucose regulation at least once during the Program, risk for progression to diabetes was reduced to 56%. When a participant achieves normal glucose regulation twice the risk reduction increases to 61% and further increased to 67% if the number of glucose regulation occurs thrice.
These findings point to tweak in our understanding of primary and secondary prevention of diabetes. This research clearly points out that diabetes is preventable and can be further delayed even with attainment of just once instance of normal glucose regulation.
The authors point to one plausible explanation for this significant reduction in diabetes risk which is related to the concept of “beta-cell rest”. Beta cells in the pancreas produce insulin needed to transport blood sugar (glucose) across all cells in need of energy to survive. With the volume of blood sugar in persons with diabetes, the beta cells may have long been exhausted or even depleted. Reaching normal levels, even for brief periods, provide them with the opportunity to “rest” their exhausted beta cells.
In contrast, some point to insulin insensitivity of the receiving cells as a reason why glucose remains in the blood stream instead of going in the cells. This research weighs in on the benefit of rest rather than on insensitivity of cells.
Therefore, it is best that once people who are diagnosed with diabetes should be treated aggressively just so they achieve this window of opportunity for reversing the progression of diabetes just by having “beta-cell rests” once, twice or continually.
Let us all have a wonderful and healthy life ahead! Let us rest our beta-cells and not just sit around moribund.
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