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Comment by DoreenMichele | Hacker News Reader

I've seen a fair number of diabetes related articles over the years that posit, for example, connections between diabetes and inflammation plus connections between insulin resistance and low protein.

I wish we would focus more on developing a better mental model for the processes involved in developing diabetes and find some way to effectively address those and prevent or reverse diabetes, at least in some cases.

But we aren't likely to because there isn't enough cool factor or profit motive. It makes me crazy.

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One of the issues that causes confusion is there are two types of diabetes, type 2 which is developed because you don't generally take care of yourself (diet, exercise, etc.) and type 1, which is an autoimmune disease which does not 'develop' due to poor lifestyle choices.

Most people confuse the two. If only they'd chosen better names to differentiate them.

One of the issues that causes confusion is there are two types of diabetes

I'm aware of a third type of diabetes that you almost never hear anything about: Cystic Fibrosis Related Diabetes (CFRD). My risk of developing it is the reason I read diabetes articles.

I have been told it is neither Type 1 nor Type 2.

My blood sugar levels are more stable than they used to be. My first-hand experience makes me skeptical of a lot of the sweeping assertions I get told we know with certainty.

Diabetes is actually more of a continuum than a pair of diseases. I was diagnosed with a Type 2 variant (low insulin output and high insulin resistance) when I was in my twenties, and I was very skinny at the time. I can't tell you how offensive it is when people (including many Type 1s) blithely blame Type 2 exclusively on lifestyle choices. That said, diet and exercise do work very well to control Type 2 diabetes.

I'd say diet is a failure on societal scale but at the same time individuals are the only ones who can fight against it. No one is going to help you because it is more profitable for corporations to ruin your health.

I have never heard of Cystic Fibrosis Related Diabetes (CFRD), but I have heard of Latent Autoimmune Diabetes in Adults (LADA, sometimes called Type 1.5). It's an autoimmune type of diabetes (like type 1), but it doesn't start showing symptoms until adulthood (typically middle age or later, but I know of one case that manifested in early 20s). It is often mis-diagnosed as type 2, because of the later onset, but patients often become insulin dependent.

Thank you. This is new information for me.

There are actually a number of "diabetes" beyond Type 1 and Type 2. Some women become diabetic during pregnancy. There is also "water diabetes" which is more neurological, essentially your bladder, brain, and whatever tells your hydration level don't tall and you end up always drinking or needing to drink and not being able to tell when you need to urinate.

Not actually sure if the water diabetes effects humans. Its not too uncommon in dogs though.

Thanks.

I need to keep gestational diabetes more in mind. I already knew of it's existence. It just never crosses my mind.

But I bet there's interesting information out there on it.

> and prevent or reverse diabetes

Those of us with Type 1 diabetes (which this article is about) don't love hearing that we should change our lifestyles to reverse the condition. Type 1 diabetes is an autoimmune condition that is not preventable or reversible.

Eating too much and the "wrong" things proved valuable over our long trek of survival. The compulsion to eat calorie heavy foods and to over-eat, because we can, is fundamental to the animal part of us. People have a lot of conditioning as well on top of that. The solution isn't as simple as making a better mental model. You basically need people to allow themselves to be hungry and be okay with it. Like having a chain smoker stop cold turkey. It doesn't really work for any meaningful percentage of people. https://www.reddit.com/r/WatchPeopleDieInside/comments/biche...

This research contradicts the idea that overeating is the issue:

https://news.ycombinator.com/item?id=8748147

The existence of Cystic Fibrosis Related Diabetes (CFRD) in a population where about 90% of patients are quite underweight also contradicts the "fat" hypothesis.

I don't know why but people seem to have an obsession with "taste" even to their own detriment. Every time I see submissions on HN about artificial meat in the top 10 comments you can find multiple people talk how this is great and how companies can use this to increase the flavor of the meat.

For companies that need to make a profit increasing flavor generally means adding additional ingredients or processing the food in a way that is as cheap as possible. Often this means adding high fructose corn syrup, sugar, carbohydrates or fat far beyond what is naturally available in the food.

Instant Ramen is an extreme example of this. Instead of just drying the noodles they deep fry them because it is cheaper and fatty foods "taste" better. Suddenly noodles made out of flour and water which should have zero fat now have 25% of their weight as fat in addition to the existing carbohydrates. I'm sure you can find less extreme examples but across the board this could result in x% more calories being consumed even if people eat the same things they did 30 years ago.

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