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[IP] Re: Type 2 NOT caused by obesity...

I disagee on the claim that there is no proof that weight reduction can
prevent Type 2 diabetes.  There have been several well-documented studies in
the U.S., Europe and Japan that have shown that the incidence of Type 2
diabetes can be reduced by up to 50% with moderate weight loss and increased

Three of these studies include:  Eriksson KF, Lindgarde F. Prevention of type
2 (non-insulin-dependent) diabetes mellitus by diet and physical exercise: the
6-year Malmo feasibility study. Diabetologica 1991;34:891b8., Tuomilehto J,
Lindstrom J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by
changes in lifestyle among subjects with impaired glucose tolerance. N Engl J
Med 2001;344:1343b50., and finally, Pan XR, Li GW, Hu YH, et al. Effects of
diet and exercise in preventing NIDDM in people with impaired glucose
tolerance. Diabetes Care 1997;20:537b44.

Using the argument that there is no proof that obesity causes Type 2 diabetes,
only statistical correlation is much like saying that the DCCT did not "prove"
that complications could be avoided with tight BG control.  Technically
speaking, the DCCT did not "prove" that tight BG control eliminates
complications, it only reduced the incidence by a statistically significant
percentage.  Nevertheless, even with tight BG control, some patients still
developed complications, suggesting that there was more than just BG control
at behind the complications.  However, that "correlation" was enough to
convince the medical profession that treatment should focus on attempting to
normalize BG levels, even if that goal is not entirely realistic given the
severe limitations of current treatment modalities.


Dx'd Type 1 9/1976 at age 7; pumping with Animas R1000 since 6/2002 at age 33

Date: Tue, 09 Sep 2003 17:20:16 +0000
From: email @ redacted
Subject: [IP] Re: Type 2 NOT caused by obesity... 

The point is that it may change the way treatment of Type 2, as well as 
prevention measures...will be handled in the future.  Right now the "trend" is
that to avoid developing Type 2, you lose weight.  That is, at this time, only
a theory (there is, as of yet, no proof this is actually true, just statistics
showing that most Type 2's are obese).  Right now, the push is for people to
lose weight to prevent Type 2.  What they might find, however, is that losing
weight has little to do with the development of Type 2 in terms of cause. 
Rather, obesity might be a symptom they look for to catch Type 2 before it
causes problems so that a more preventative measure can be found, such as
adopting lifestyle changes early.

It also means that people who are obese who have struggled with dieting and
trying to eat right for years MIGHT just be prone to obesity by genetics and
NOT due to overeating.  This can help relieve any possible guilt or blame that
occurs.  (There is, aside from the Type 2 issue, growing evidence that people
are genetically predisposed to certain weights PROVIDED they are eating a
healthy diet and have healthy activity.)  

I know that when my wife heard this explanation of Type 2, despite it still
being controversial, it helped her immensely not take on the guilt of being
overweight...and, in fact, has helped her to understand why losing weight has
been nothing but an uphill battle for her.  (She also recognizes her part in
her weight, as well...but now understands that getting to 120 lbs is not a
reasonable goal for her!!!)

You seem to keep fighting this idea based on the "facts".  The "facts" are,
there is no proof that obesity causes Type 2 at all.  There is only stastical
correlation, which is no proof at all.  This recent news from the CDC actually
flies it the face of the theory that obesity CAUSES Type 2.  :-)

It still may be found that for those who have the genetic predisposition to
being overweight and developing Type 2 that being overweight only brings about
the resulting insulin resistance and eventual burn out faster.  But, it isn't
beneficial to see that as the cause.

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