How diabetes type 2 can be predicted much earlier

September 23 2015 by in Diabetes studies

Early sign of T2DM: elevated insulin

Looking for early signs of type 2 diabetes usually involves measuring blood glucose – either fasting or after drinking a glucose load. However, this misses a much earlier sign – elevated insulin, signalling insulin resistance (i.e. the main abnormality in type 2 diabetes).

Here’s a long and fascinating post on a true pioneer of this topic, Dr. Joseph Kraft:

Dr. Jeffry Gerber: Diabetes is a Vascular Disease – More on Joseph R. Kraft, MD

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12 Comments

1
Bill
September 23 2015
Kraft's theory that diabetes is the real cause of CVD is fascinating. But haven't rates of CVD dropped dramatically just as rates of diabetes have exploded? Wasn't CVD at its peak long before the diabetes epidemic really took off? How can the theory that diabetes ---> CVD be squared with the epidemiology?

Replies: #2, #10
2
Reply to comment #1 by Bill
Dr. Andreas Eenfeldt
September 23 2015
Add smoking as (another) truly massive factor behind CVD and the epidemiology should make sense.
3
greensleeves21
September 23 2015
But isn't this exactly the problem with Kraft's old data, Andreas? It will be confounded with the widespread smoking habit back then, at a minimum.
4
Bill
September 23 2015 1
The decline of smoking certainly helps to explain the CVD decrease. But I don't think the epidemiologists believe that can explain all of it, nor can other "risk factors." Maybe they do, who knows?

But in the spirit of Gary Taubes science means doing everything you possibly can to falsify an attractive hypothesis before you allow yourself to believe it. The explosion of diabetes (and hyperinsulinemia) over the very same time period that CVD incidence and mortality nosedived is sobering for the Kraft hypothesis I think. I'll stick with low carb . . . but I suspect there's an awful lot about CVD we still don't understand.
5
Jeffry Gerber
September 24 2015
Pre-diabetes, diabetes and CVD incidence don't seem to track over the past decades but it is hard to say why they don't.

I just have to think that the under-reporting of pre-diabetes and diabetes which we still see today was also the case historically and needs to be considered. Today I see cardiac patients who are overtly type 2 and they nor their previous docs knew it. It creeps me out every time! The epidemiologist would have reported them as non-diabetic.
6
Mikael
September 25 2015
Those dreams from kraft is wrong. You can't get a confirmation that you are a type 2 diabetic that way - period. Our body can generate high insulin levels even when you are not insulin resistance. And humanity have eaten high amount of glucose for thousands of years without getting type 2 diabetes. We got type 1 from it but not type 2.

Reply: #7
7
Reply to comment #6 by Mikael
bill
September 25 2015
Mikael:

...and what is your evidence?
8
Paul TR
September 25 2015 1
Mikael,

"...Our body can generate high insulin levels even when you are not insulin resistance. .."

I am honestly interested in your observation, could you link me to any supportive data please?; is this your own clinical observation?
9
Ian
September 26 2015
The statement, “Kraft noted that those with vascular disease, all of them, had hyperinsulinemia”, is a big claim. A massive association, if not a causal link. If so, the method surely deserves research? For the rest, the claims in the article seem to me to be perfectly consistent with Jason Fung’s model?
10
Reply to comment #1 by Bill
Ivor Cummins
September 26 2015 1
Hey Bill

This might help a little: http://jaha.ahajournals.org/content/4/4/e001524.full.pdf+html

As might this :-) http://www.thefatemperor.com/blog/2015/9/22/kraft-konfirmed-the-bizar...

Association Shmassociation - the mechanistic evidence screeches also, and the experimental when you rack up carb....

best

Ivor
11
Dr. Jeffry Gerber
September 30 2015
Mikael, insulin does rise when eating a high carb meal. In normal people Kraft called that pattern 1. The mechanisms are undeniable as Ivor says above.
12
Dr. Jeffry Gerber
September 30 2015
I agree Ian. The association between hyperinsulinemia and vascular disease is STRONG and also supported by solid mechanisms.

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