Questions about the possible complications if diabetes is not managed appropriately
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Can overweight cells return to normal size if someone makes lifestyle changes and loses weight? Would this reduce insulin resistance?
Yes, fat cells can return to normal size when body fat is reduced; and this can help to reverse insulin resistance.
Does diabetes increase the risk of heart disease?
Yes. Cardiovascular disease is around four times more common in people with diabetes, as people with diabetes often have metabolic syndrome clinical indicators (i.e. raised blood glucose, triglycerides, waist circumference and blood pressure, and reduced HDL cholesterol). Hyperinsulinaemia and insulin resistance has an important role in this. However, the good news is that CVD is preventable and making lifestyle changes can dramatically reduce risk.
Is there any evidence/research to suggest that type 2 diabetes, or the risk of developing type 2 diabetes, also impacts on the likelihood of developing pancreatic cancer?
Diabetes has previously been linked with pancreatic cancer, though it is unclear what the reason for this association is (e.g. https://www.ncbi.nlm.nih…/pmc/articles/PMC149418/ ). It could be that diabetes increases the risk of pancreatic cancer or that developing pancreatic cancer leads to an increased risk of diabetes, but fortunately this type of cancer is quite rare and so there is only a tiny proportion of people with diabetes who have it.
Storing extra fat in the body can increase the risk of some cancers, possibly because high levels of insulin and raised blood glucose levels may promote the growth of tumours. This is because insulin is a hormone that promotes cell growth, and many cancer cells can only use glucose (not fat or ketones) for energy. Therefore, reducing insulin levels and achieving optimal blood glucose control may reduce the risk of developing certain cancers.
Can fatty plaque formation be reversed?
Although there is some suggestion that it is possible to reverse the build up of fatty plaques, for the most part evidence suggests that this can’t be reversed to any great extent; either through lifestyle change or through medication. What lifestyle change can do however is reduce other risk factors; such as blood pressure, blood glucose and the amount of fat (triglycerides) in the blood. This reduces the overall chances of any cardiovascular events (e.g. heart attacks or strokes) from happening and can prevent further fatty plaque build-up. Lifestyle change might also be able to help stabilise the fatty plaques that have built up, which reduces the chance of them breaking off and causing problems.
Practically this means that lifestyle change is very important in helping to reduce the risk of things like heart attacks or strokes, even if it can’t necessarily fully reverse all of any damage that has already been done.
The debate around whether it is possible to significantly reverse plaque formation is ongoing, but the stability of the plaque, and whether it is prone to rupture, appears to be more important anyway. The following blog provides an interesting discussion on the topic: https://drmalcolmkendric…es-heart-disease-part-x/
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