I'm trying to understand my husband's heart problems

[JudyS]

My husband, Tom, went to the ER last night with chest pains. He was admitted and is scheduled for an angiogram tomorrow.

Currently his diagnosis is "unstable angina" -- i.e., a shortage of oxygen to the heart muscles, which occurs even when the heart is at rest. (He had gone to bed for the night, and was sleeping when the chest pain woke him up.) Depending on what his blood work shows later today, his diagnosis might be changed to myocardial infarction (heart attack.)

I am trying to understand what caused this. My husband is 61 years old and has had severe Type 2 diabetes for many years, so heart problems are no surprise. (He had a previous "cardiac episode," a mild heart attack, 22 years ago. He was just 39 years old at the time.) What makes this surprising is that he had an angioplasty with stents about six months ago and was given the "all clear". I don't understand why he would get a clogged artery so soon after the problem seemed fixed. The cardiologist who put in his stents thought that my husband's arteries would stay clear for a long time, as long as Tom took his blood thinners each day. (Tom tells me he hasn't missed a single day of his blood thinners.)

So far, my husband is still stuck in the ER -- there are 40 or so patients ahead of him, waiting for beds. Various physicians have stopped by briefly, but I don't think he has an "attending physician" (that is, a physician in charge of his overall hospital stay) yet. So, I'm not sure when he'll have someone who can explain what may have happened.

To sum up, I'm trying to understand why he might have gotten another clog - just six months after an intervention that seemed successful. What could be the physiology here?. A blood clot forming on a stent is the only theory I can think of. Anyone have any other theories?

 

[Passepartout]

No suggestions, but sending best wishes for a full and speedy recovery. He will be given all the usual tests and people a LOT smarter than me will have access to data that will point to the cause. Perhaps the chest pain waking him up is preferable to him NOT waking up to a heart attack?

I had full heart block (an electrical failure) 1 1/2 years ago in Germany and got a pacemaker installed. Angiography was done to check for clogged arteries. None were found. Last Summer they suggested upgrading my pacemaker to one with an extra lead and the capability to kick-start my heart should I have a heart attack and correct atrial fibrilation. So far so good. Saw the cardio doc a few days ago. He said the device had corrected one A-Fib event, but I wasn't aware of it happening. The device transmits data to a communication link beside the bed and thence to the doc.

Judy, stick close to your husband and ask them your questions. I'm sure they have every intention of keeping you informed.

Jim

 

[Panina]

Did you call your husbands heart doctor? He might be or know someone affiliated with the hospital that can help or he might assist you to transfer your husband to a hospital he is affiliated with where he can get sooner care.

 

[rapmarks]

My thoughts are with you Judy, sorry you are going through this

 

[silentg]

Hope you get answers soon Judy, Best wishes for your husband too.

 

[b2bailey]

Whoa. The idea of being stuck in ER with 40 ahead of me is mind-blowing.

 

[MULTIZ321]

Hi Judy,

Make sure he is admitted to the hospital and not sent to a room under "Observation Status"
See this previous Tug Thread for more details.

Some things I've learned about medical insurance this year

This is sorta long. Just a warning! Background: I live in Ohio and have the Cleveland Clinic healthcare for 2019 (called Oscar). The fine print says you can only go to a provider in their network in order for insurance to be used (an in-network provider) EXCEPT in an emergency (I read this...

tugbbs.com

Richard

 

[WinniWoman]

Sorry about your husband, Judy. Definitely what Richard said above. 40 people ahead of him- again- our great healthcare system! OMG....

Also- what Jim said. Ask questions and demand answers. Don't worry about what anyone thinks of you. Be aggressive!

Best of luck. Prayers for you both.

 

[VacationForever]

2 things struck me.

You said he had severe Type 2 diabetes for many years. Does it mean that it was not under control? Organs are damaged when it is not under control.

The other thing is scar tissue could have formed from the stent that was put in 6 months ago. A friend has had 10 stents put in to fix the same problem over the years because the stent that was put in each time closed due to scar tissue. She had a quadruple bypass which also closed from scar tissue. Scary.

Good luck and all the best.

 

[Hobokie]

I used to be a stent sales rep (coronary and "peripheral" i.e. legs and carotids) some years ago, here's something to consider... coronary artery disease (and all atherosclerosis, for that matter) is a progressive disease. He very well could have it in another artery in his heart (there are 3) or in a different part of the artery that was previously stented. Now mind you, if he had a stent placed six months ago then the angiogram at the time would have revealed if one of the other arteries was stenosed (partially blocked). If this was the case & the doctor didn't also "fix" that other artery it was for a reason... either the blockage was not significant six months ago or perhaps the physician took a more conservative approach & decided to wait and medically manage (there's data published that suggest a doctor should fix the "culprit" lesion while leaving the others alone).

Another thing to consider Is that some patients are resistant to plavyx. Your husband may very well have been super diligent about taking his meds, they simply didn't work for him. This is especially true of Asians who have an alarmingly high resistance to this genetic drug & would perhaps do better on a different anti-platelet drug.

The diagnostic testing (ie EKG) should reveal which part of the heart (and therefore which artery) seems troublesome.

Anyway, just trying to give you some data points to ask questions when you do get to chat with a doc. I suggest you call his cardiologist while you wait! BEST OF LUCK!

 

[Hobokie]

Oh, and I should've mentioned... If your husband smokes, he needs to stop. Seriously, it's the absolute worst thing for his condition!!

 

[JudyS]

Thanks for all the replies! Lots of good ideas here -- I am always impressed by how much Tuggers know!

First, some answers to questions people here have asked: My husband is still stuck in the ER, waiting for a bed to open up. He technically *was* admitted, yesterday afternoon, (as a patient, not just for observation), but no rooms are available. He has been in the ER since about 1 am yesterday. So, this is the second night he will spend in the ER. They did find him a stretcher in a relatively quiet area.

Asking his regular cardiologist for admission to a different hospital is a good suggestion. However, his regular cardiologist is in fact part of the same large university hospital system as this ER. So, his regular cardiologist doesn't have admitting privileges anywhere else.

I would definitely like to ask my husband's hospital cardiologist some questions. However, my husband still has not seen his main hospital cardiologist -- his "attending physician" -- despite being a classified as an in-patient for about 20 hours now. So, there is no one to ask. (My husband doesn't even know his attending physician's name.) Cardiac is in a different building than the ER, and my guess is 'the Big Man" doesn't have time to come to the ER.

Instead, Tom has had a steady stream of trainee physicians -- medical students, residents, and fellows -- coming in to ask him questions again and again because his case is so unusual. He says what a popular patient he is! However, I would rather they let him get some rest. Food is also very limited in the ER, and he will not be allowed to eat again until he has further tests done.

He has definitely never smoked.

About his Type 2 diabetes being controlled, he has tried all sorts of diets, has always been active (even now, in his 60s), and takes enormous amounts of diabetes medicine. However, none of this is enough to bring his blood sugar close to the normal range. The only drug that ever really worked for him was Rezullin, but the manufacturer pulled it from the market due to liability issues. Currently he is given very high amounts of insulin (along with metformin and Jardiance). Insulin lowers blood sugar in the short range but almost certain worsens Type 2 diabetes and heart attack risk in the long range. He generally takes about 500 units of insulin a day -- his MD would give him more, if his insurance would pay for it. He has also tried Actos, Avandia, Symlin, and Byetta, but none of them affected his blood sugar much at all.

Insulin is very potent at causing weight gain, and his weight has gone up and up as he takes more and more insulin. I would like him to consider bariatric surgery -- it's really the only effective treatment for severe Type 2 diabetes and its complications -- but he is horrified at the idea. At any rate, he may not qualify now that he is sicker.

I've thought of another relevant factor -- he has obstructive sleep apnea and hates to use his CPAP (a breathing machine that uses pressurized air to keep the airways open.) He was not using his CPAP when the symptoms occurred. I strongly suspect that was a factor.

 

[JudyS]

Second, my husband's current treatment plan: He was told, at first, that his next test would be an angiogram. However, he has now been told that first he will be given some unusual kind of cardiac stress test to look at the pattern of heart problems. Depending on where the blockage is, a different approach to angioplasty may be tried. The stress test will be no earlier than 2 pm today (Thursday.) The test must be done no sooner than 24 hours after he last had caffeine -- and they gave him coffee yesterday (Wednesday) at 2 pm.

 

[JudyS]

And third, here is something that would really help me out.

I have a PhD and am retired due to multiple illnesses. I am working on a book that presents two main themes:
1) The growing evidence that weight is not under behavioral control
2) A set of new theories about the causes of Type 2 diabetes and its complications.

There are a lot of smart people on TUG, and I would love to hear your ideas about my book.

What I want more than anything is to present the new research on why these problems have become so common. The actual researchers in this area do *not* say what the media and public health authorities are saying. The actual researchers say this is a physiological problem and diets do not help.

My book will be aimed at "an educated lay audience" (i.e, any who took a few science class in college.) I know there are a lot of people in the world who have tried -- and tried, and, tried -- to get their weight down. I think many of these people would be interested in my book. There are also many people who have Type 2 diabetes, and treatment is often not fully successful in severe cases. I think such people (and maybe their loved ones) would be interested in such a book, too.

My health problems and my husband's health problems have become overwhelmingly stressful. One of the biggest stressors is that everyone seems to think the problems are own own fault. I also have Type 2 diabetes. My husband and I support each other in reminding each other to take our meds, limiting what we eat, etc. Despite following our physician' instructions -- which have radically changed over the decades -- my problems have become both disabling and life-threatening, and Tom's are headed that way.

The evidence says our problems are biological, not behavioral. I want to encourage real research into these illnesses. Instead,we get endless battles in which endocrinologists hector Type 2 diabetics to eat low-carb, high-fat diets while dietitians hector us to eat high-carb, low-fat diets -- and no matter what we do, people say we are wrong.

The main question is how to find people interested in my book. I am hoping some people here would be interested in the ideas in my book and would give me feedback on my ideas. The main thing I'd like to know is whether what I say is clear and convincing. I can present the ideas in various format -- a short, written "elevator speech" that does a 30-section summary,a full book (as I write it) without lots of heavy duty science, a full book with heavy duty science added at the end of each section, audio recordings, etc. Feedback on any of these format would be helpful to me. This will be along-term project, so all I need now is an expression of interest and maybe 5 - 15 minutes to read about my main ideas. Any other input can come later.

Any takers?

 

[easyrider]

And third, here is something that would really help me out.

I have a PhD and am retired due to multiple illnesses. I am working on a book that presents two main themes:
1) The growing evidence that weight is not under behavioral control
2) A set of new theories about the causes of Type 2 diabetes and its complications.

There are a lot of smart people on TUG, and I would love to hear your ideas about my book.

What I want more than anything is to present the new research on why these problems have become so common. The actual researchers in this area do *not* say what the media and public health authorities are saying. The actual researchers say this is a physiological problem and diets do not help.

My book will be aimed at "an educated lay audience" (i.e, any who took a few science class in college.) I know there are a lot of people in the world who have tried -- and tried, and, tried -- to get their weight down. I think many of these people would be interested in my book. There are also many people who have Type 2 diabetes, and treatment is often not fully successful in severe cases. I think such people (and maybe their loved ones) would be interested in such a book, too.

My health problems and my husband's health problems have become overwhelmingly stressful. One of the biggest stressors is that everyone seems to think the problems are own own fault. I also have Type 2 diabetes. My husband and I support each other in reminding each other to take our meds, limiting what we eat, etc. Despite following our physician' instructions -- which have radically changed over the decades -- my problems have become both disabling and life-threatening, and Tom's are headed that way.

The evidence says our problems are biological, not behavioral. I want to encourage real research into these illnesses. Instead,we get endless battles in which endocrinologists hector Type 2 diabetics to eat low-carb, high-fat diets while dietitians hector us to eat high-carb, low-fat diets -- and no matter what we do, people say we are wrong.

The main question is how to find people interested in my book. I am hoping some people here would be interested in the ideas in my book and would give me feedback on my ideas. The main thing I'd like to know is whether what I say is clear and convincing. I can present the ideas in various format -- a short, written "elevator speech" that does a 30-section summary,a full book (as I write it) without lots of heavy duty science, a full book with heavy duty science added at the end of each section, audio recordings, etc. Feedback on any of these format would be helpful to me. This will be along-term project, so all I need now is an expression of interest and maybe 5 - 15 minutes to read about my main ideas. Any other input can come later.

Any takers?

I would be interested. Years before I had the heart attack a blood chemist told me that my diet was why my lipid panel was bad. She was right. I found out the hard way. I drastically changed my diet and routine and now the plaque has slowly been going away.

Bill

 

[easyrider]

My husband, Tom, went to the ER last night with chest pains. He was admitted and is scheduled for an angiogram tomorrow.

Currently his diagnosis is "unstable angina" -- i.e., a shortage of oxygen to the heart muscles, which occurs even when the heart is at rest. (He had gone to bed for the night, and was sleeping when the chest pain woke him up.) Depending on what his blood work shows later today, his diagnosis might be changed to myocardial infarction (heart attack.)

I am trying to understand what caused this. My husband is 61 years old and has had severe Type 2 diabetes for many years, so heart problems are no surprise. (He had a previous "cardiac episode," a mild heart attack, 22 years ago. He was just 39 years old at the time.) What makes this surprising is that he had an angioplasty with stents about six months ago and was given the "all clear". I don't understand why he would get a clogged artery so soon after the problem seemed fixed. The cardiologist who put in his stents thought that my husband's arteries would stay clear for a long time, as long as Tom took his blood thinners each day. (Tom tells me he hasn't missed a single day of his blood thinners.)

So far, my husband is still stuck in the ER -- there are 40 or so patients ahead of him, waiting for beds. Various physicians have stopped by briefly, but I don't think he has an "attending physician" (that is, a physician in charge of his overall hospital stay) yet. So, I'm not sure when he'll have someone who can explain what may have happened.

To sum up, I'm trying to understand why he might have gotten another clog - just six months after an intervention that seemed successful. What could be the physiology here?. A blood clot forming on a stent is the only theory I can think of. Anyone have any other theories?

I don't have the answer but I have met others that had problems like you describe at the support network at heart.org. This website is free to join and for me anyway, was a huge relief to find and communicate with others in my same circumstance. I still show up to help at the support network occasionally. If you click on the link and click health topics you will see where to click for the support network. I hope thing go well.

Bill

American Heart Association | To be a relentless force for a world of longer, healthier lives

Learn more about the American Heart Association's efforts to reduce death caused by heart disease and stroke. Also learn about cardiovascular conditions, ECC and CPR, donating, heart disease information for healthcare professionals, caregivers, and educators and healthy living.

www.heart.org

 

[Patri]

For your book, I would be curious for you to explain the obesity rate today vs. 50 years ago (when we were all kids) vs. 100 years ago. Biology shouldn't have changed much, but our lifestyles have.

 

[AnnaS]

I hope you get some answers soon and your husband Tom gets a room too!!

My sister and mom had Type II diabetes and were both on insulin. It was a struggle and so much work trying to check it constantly and keeping it under control. They did not really follow/stick to a healthy diet. They tried........

 

[Panina]

And third, here is something that would really help me out.

I have a PhD and am retired due to multiple illnesses. I am working on a book that presents two main themes:
1) The growing evidence that weight is not under behavioral control
2) A set of new theories about the causes of Type 2 diabetes and its complications.

There are a lot of smart people on TUG, and I would love to hear your ideas about my book.

What I want more than anything is to present the new research on why these problems have become so common. The actual researchers in this area do *not* say what the media and public health authorities are saying. The actual researchers say this is a physiological problem and diets do not help.

My book will be aimed at "an educated lay audience" (i.e, any who took a few science class in college.) I know there are a lot of people in the world who have tried -- and tried, and, tried -- to get their weight down. I think many of these people would be interested in my book. There are also many people who have Type 2 diabetes, and treatment is often not fully successful in severe cases. I think such people (and maybe their loved ones) would be interested in such a book, too.

My health problems and my husband's health problems have become overwhelmingly stressful. One of the biggest stressors is that everyone seems to think the problems are own own fault. I also have Type 2 diabetes. My husband and I support each other in reminding each other to take our meds, limiting what we eat, etc. Despite following our physician' instructions -- which have radically changed over the decades -- my problems have become both disabling and life-threatening, and Tom's are headed that way.

The evidence says our problems are biological, not behavioral. I want to encourage real research into these illnesses. Instead,we get endless battles in which endocrinologists hector Type 2 diabetics to eat low-carb, high-fat diets while dietitians hector us to eat high-carb, low-fat diets -- and no matter what we do, people say we are wrong.

The main question is how to find people interested in my book. I am hoping some people here would be interested in the ideas in my book and would give me feedback on my ideas. The main thing I'd like to know is whether what I say is clear and convincing. I can present the ideas in various format -- a short, written "elevator speech" that does a 30-section summary,a full book (as I write it) without lots of heavy duty science, a full book with heavy duty science added at the end of each section, audio recordings, etc. Feedback on any of these format would be helpful to me. This will be along-term project, so all I need now is an expression of interest and maybe 5 - 15 minutes to read about my main ideas. Any other input can come later.

Any takers?

I definitely think there would be interest. Unfortunately many in the medical profession just look at the norm, what they believe happens to most people thus missing the rest of us. I have experienced it myself.

 

[Passepartout]

I've thought of another relevant factor -- he has obstructive sleep apnea and hates to use his CPAP (a breathing machine that uses pressurized air to keep the airways open.) He was not using his CPAP when the symptoms occurred. I strongly suspect that was a factor.

I agree with this. I simply didn't know I wasn't getting proper rest until the second sleep lab test. I thought it was 'normal' to be up every couple of hours and thought I just had a weak bladder, It showed not obstructive sleep apnea, but 'central apnea' where my brain didn't signal my diaphragm to breathe. Yes the CPAP (mine's a VPAP that's part ventilator) takes some getting used to, but has improved my overall health dramatically. I sleep 7-8 hours- usually without moving at all. I had been diagnosed with pulmonary fibrosis and prescribed night time oxygen. Now, no O2 and the lung doc is likely to turn me loose when I see him in a couple of months. All due to using the 'sleep machine'.

I truly hope you and Tom can start getting the answers to the questions you have and find some solutions that work.

Jim

P.S. Judy, I think your book would be well written and offer insight from the perspective of one that lives with the illness. I probably don't have the persistence or attention span to deal with more than the 'elevator' version before my eyes would glaze over. Good Luck

 

[Bailey#1]

Judy, I have nothing to add but good luck to the both of you.

 

[VacationForever]

And third, here is something that would really help me out.

I have a PhD and am retired due to multiple illnesses. I am working on a book that presents two main themes:
1) The growing evidence that weight is not under behavioral control
2) A set of new theories about the causes of Type 2 diabetes and its complications.

There are a lot of smart people on TUG, and I would love to hear your ideas about my book.

What I want more than anything is to present the new research on why these problems have become so common. The actual researchers in this area do *not* say what the media and public health authorities are saying. The actual researchers say this is a physiological problem and diets do not help.

My book will be aimed at "an educated lay audience" (i.e, any who took a few science class in college.) I know there are a lot of people in the world who have tried -- and tried, and, tried -- to get their weight down. I think many of these people would be interested in my book. There are also many people who have Type 2 diabetes, and treatment is often not fully successful in severe cases. I think such people (and maybe their loved ones) would be interested in such a book, too.

My health problems and my husband's health problems have become overwhelmingly stressful. One of the biggest stressors is that everyone seems to think the problems are own own fault. I also have Type 2 diabetes. My husband and I support each other in reminding each other to take our meds, limiting what we eat, etc. Despite following our physician' instructions -- which have radically changed over the decades -- my problems have become both disabling and life-threatening, and Tom's are headed that way.

The evidence says our problems are biological, not behavioral. I want to encourage real research into these illnesses. Instead,we get endless battles in which endocrinologists hector Type 2 diabetics to eat low-carb, high-fat diets while dietitians hector us to eat high-carb, low-fat diets -- and no matter what we do, people say we are wrong.

The main question is how to find people interested in my book. I am hoping some people here would be interested in the ideas in my book and would give me feedback on my ideas. The main thing I'd like to know is whether what I say is clear and convincing. I can present the ideas in various format -- a short, written "elevator speech" that does a 30-section summary,a full book (as I write it) without lots of heavy duty science, a full book with heavy duty science added at the end of each section, audio recordings, etc. Feedback on any of these format would be helpful to me. This will be along-term project, so all I need now is an expression of interest and maybe 5 - 15 minutes to read about my main ideas. Any other input can come later.

Any takers?

Judy, what I have to write is not personal but I have to say it. I don't buy what you are saying here and it is irresponsible to write a health and medical book based on opinion instead of data. There will be buyers for your book with your line of reasoning because most people want someone else to tell them that it is not their fault that their diabetes is out of control or for their weight gain.

Controlling Type 2 diabetes is about taking the right medications, limiting carb, limiting calories and exercising to improve the quality of their body tissue and burning excess blood sugar in the system after a higher carb meal. Several times a day of blood sugar testing at home is the best way to understand the effects of food and exercise on blood sugar until the person has a good understanding of how much carbs is allowed in their diet, before dropping testing to morning and evening.

My husband has been a Type 2 diabetic for more than 20 years. He has kept it under control all these years with diet, exercise and medications. His has always been overweight but no more now than before as he is also very disciplined in limiting carb and calories. Carb control is a little different for every person as it depends on the severity of diabetes and how each body processes carbs. The biggest failure perhaps is that dieticians and doctors give cookie cutter dietary recommendations. We attended a diabetic class together and the dietician recommended no more than 40 grams of carbs per meal, 3 meals a day. My husband can eat no more than 15 grams of carbs per meal, 3 meals a day or his blood sugar will be much higher than where he should be. He understands his limits by reading of his blood sugar after a meal. If he eats a bit more carbs for a meal, he is on the exercise bike for an hour immediately after his meal. He golfs 4 times a week and is on the elliptical for an hour each day on the other 3 days. Sometimes he even gets on the exercise bike after a round of golf. My husband cannot eat fruits other than an occasional half a cup of blueberries otherwise his blood sugar will be high. On the other hand, we have diabetic friends whose body can handle some fruits without sugar spikes.

My mother was a Type 2 diabetic and her greatest downfall was a plate of rice. She never liked meat and would pile vegetables on her rice. Until the day she died, her diabetes was never under control. I was pre-diabetic but now I am not. When I realized that my fasting blood sugar was in the pre-diabetic range, I started to limit my carb intake every meal and every day. If I start to eat too much carbs for a few days, I make sure I get it back under control. I take my blood sugar regularly to ensure that my fasting blood sugar tests are not above 100 in the morning and also no more than 135 after I have a high carb meal. If my blood sugar is above those numbers, I go back on a 80g to 120g carbs daily for several days. I strive to eat no more than 120g carbs daily. I am no longer pre-diabetic.

Is there a genetic element in diabetes? I agree that there is and that some people are more predispositioned to get Type 2 diabetes than others. But it is how we avoid becoming a diabetic by taking early intervention or if we are already diabetic, controlling our diet is the most important factor in the outcome of our health.

 

[Cornell]

For your book, I would be curious for you to explain the obesity rate today vs. 50 years ago (when we were all kids) vs. 100 years ago. Biology shouldn't have changed much, but our lifestyles have.

And why obesity is so high in America yet when I was visiting Japan I saw virtually no one that was obese.

 

[Cornell]

Judy, what I have to write is not personal but I have to say it. I don't buy what you are saying here and it is irresponsible to write a health and medical book based on opinion instead of data. There will be buyers for your book with your line of reasoning because most people want someone else to tell them that it is not their fault that diabetes is out of control or for their weight gain.

Controlling Type 2 diabetes is about taking the right medications, limiting carb, limiting calories and exercising to improve the quality of their body tissue and burning excess blood sugar in the system after a higher carb meal. Several times a day of blood sugar testing at home is the best way to understand the effects of food and exercise on blood sugar until the person has a good understanding of how much carbs is allowed in their diet, before dropping testing to morning and evening.

My husband has been a Type 2 diabetic for more than 20 years. He has keep it under control all these years with diet, exercise and medications. His has always been overweight but no more now than before as he is also very disciplined in limiting carb in addition to calories. Carb control is a little different for every person as it depends on the severity of diabetes and how each body processes carbs. The biggest failure perhaps is that dieticians and doctors give cookie cutter dietary recommendations. We attended a diabetic class together and the dietician recommended no more than 40 grams of carbs per meal, 3 meals a day. My husband can eat no more than 15 grams of carbs per meal, 3 meals a day or his blood sugar will be much higher than where he should be. He understands his limits by reading of his blood sugar after a meal. If he eats a bit more carbs for a meal, he is on the exercise bike for an hour immediately after his meal. He golfs 4 times a week and is on the eliptical for an hour each day on the other 3 days. Sometimes he even gets on the exercise bike after a round of golf. My husband cannot eat fruits other than an occasional half a cup of blueberries otherwise his blood sugar will be high. On the other hand, we have diabetic friends whose body can handle some fruits without sugar spikes.

My mother was a Type 2 diabetic and her greatest downfall was a plate of rice. She never liked meat and would pile vegetables on her rice. Until the day she died, her diabetes was never under control. I was pre-diabetic but now I am not. When I realized that my fasting blood sugar was in the pre-diabetic range, I started to limit my carb intake every meal and every day. If I start to eat too much carbs for a few days, I make sure I get it back under control. I take my blood sugar regularly to ensure that my fasting blood sugar tests are not above 100 in the morning and also no more than 135 after I have a high carb meal. If my blood sugar is above those numbers, I go back on a 80g to 120g carbs daily for several days. I strive to go no more than 120g carbs daily. I am no longer pre-diabetic.

Is there a genetic element in diabetes? I agree that there is and that some people who are more predispositioned to get Type 2 diabetes than others. But it is how we avoid becoming a diabetic by taking early intervention or if we are already diabetic, controlling our diet is the most important factor in the outcome of our health.

AMEN

 

[isisdave]

And yet, from American Journal of Clinical Nutrition, "Rice intake and type 2 diabetes in Japanese men and women: the Japan Public Health Center–based Prospective Study"

Although the prevalence of obesity [body mass index (BMI; in kg/m2 ) .30] in the Japanese is lower than in Westerners (Japan: 3% in both men and women; United States: 31% in men and 33% in women) (3), the prevalence of type 2 diabetes in Japanese populations is not dramatically lower than that in Western populations (Japan: 7.3%; United Kingdom: 4.9%; United States: 12.3%)​

​

This metastudy is a few years old, and it's difficult to compare populations because the definition of "having diabetes" varies by time and location. It's a very compelling subject though. I doubt we'll find a complete answer in the next 20 years, but I know that whatever else, it's going to be part genetic, part behavioral, and I think less dependent on food intake and exercise than we want to believe.