No one knows what causes Type 1 or Type 2 diabetes. It's a pretty good bet that there is a genetic component to Type 2 because if one family member has it then others are more likely to have it -- including adult siblings, adult cousins, nieces, nephews, aunts, uncles etc. who do not live with or eat with the diagnosed family member.

It's also a pretty good bet that diet is a factor in Type 2, as changing diets to include more refined carbs seems to correlate with the incidence. However, at the same time that diets have changed so have environmental factors including specific pollutants at increased levels, depletion of some minerals from soils in which foods and silage are grown. Lifestyles have also changed -- in general people exercise less, employees in most countries are working much longer hours often without real vacations for extended periods, more stressful lifestyles with less opportunity for relief from stress, more geographical moves placing people in new locations increasing stress, etc.

To take a specific group, Pima Indians, we know that when they began eating a western diet that obesity rates skyrocketed and Type 2 became an epidemic. We do not know if the Pima had diabetes before they began eating a western diet, nor do we know if they returned to the traditional diet if the next generation of Pima will be diabetes free. We do know they eat among the worst sort of western diet -- lots of processed flours, sugars and oils -- but we also know that their traditional diet is pretty high carb, too. We do not know if stress associated with changing lifestyle, unemployment and poverty had an impact.

A pretty good argument cam be made that it is not the carbs that trigger any gene expression but one or more nutritional deficiencies. Mineral deficient foods are made even more mineral deficient by many types of processing. Processing that is designed to return minerals to foods -- by adding nutrients to foods such as hulled and polished rice -- are of questionable value as there is no guarantee that the nutrients added are in a bioavailable form.

We can argue till the cows come home about the cause, but it still comes down to "no one knows."

For a number of reasons having nothing to do with diabetes, it seems intelligent to advise people to eat whole foods. It does not seem to me to be intelligent to advise a specific dietary approach so as to minimize the number of people who have diabetes. After all, the way we got where we are today is advising people on how to eat to avoid heart disease. That advice was so good that we now have lots of people with heart disease because the advised diet promotes heart disease.

Public policy should not be based on unproven supposition, which was at least as big a take home message from GCBC as any message about carbs and fats.

If a disease is the inabilty or limited ability to metabolise sugar, then people who do not eat sugar will have never heard of it, since they are never attempting to metabolise sugar, they are not going to have realised that some people cannot do it.

It is a like how you cannot get sunburn, unless you sit in the sun...if a person were to never go outside of a building ever, and had no contact with anybody else that had...those people would have never heard of sunburn.

LessLiz, I don't know what you mean by "know what causes" in the case of Type 1...we do know that in the blood of Type 1's there are anti-bodies to pancreatic beta cells, indicating that their own immune systems have attacked those cells.
There is confusion out there regarding the defintion of the Types...but I think you probably meant that we don't know why their immune systems have attacked their pancreatic beta cells.

Even the cause of Type 1 is debated. There is good evidence that autoimmune disorders or viruses cause Type 1. Even that, though, is not certain. Alternate theories are still being proposed.

But again, Type 2 diabetes isn't something you're born with, you develop it after years of abusing carbohydrates, or at least it used to be that way until people started incubating their children in an environment already on metabolic overload.

Sure, many (perhaps even most) people are born with the predisposition to get some form of a metabolic disease, whether it is insulin resistance or diabetes. But like some people tolerate cyanide a lot better than others, does it mean that someone who reacts worse to a poison has a genetic abnormality? Someone will surely have a grandmother who ate cyanide for breakfast everyday for 95 years therefore proving that cyanide is perfectly healthy for "normal" humans.

It could have something to do with the fact that a couple of decades ago the doctors in most countries that have formally organised healthcare, along with the big diabetes organizations, decided to try and find all the people in their countries that had T2 Diabetes. They were deliberately trying to diagnose more people, and specifically people with Type 2. There might be nothing more dreadful happening now than those people (the doctors and the charities) have succeeded.



Who is saying that it is purely a matter of genetics?

I am sure that you have pointed out during your previous posts on this issue, that Type 2 generally only appears in people who are beyond child bearing age, and as far as I know you are right. That being the case, surely we would not be looking at a scenario where disease created infertility diminished the disease?

Actually, there is a lot of evidence that I was born Type 2. I had all the symptoms from a very early age, as in a few weeks old. By the age of 4 I had a severe case of acanthosis nigricans, and I did not eat a high carb diet.

No one is going to have a grandmother who ate cyanide for breakfast everyday for 95 years, and if most people did, they would die. Most people have not become diabetic, even though we have been eating carbs for thousands of years.

I used to know someone who was born Type 1.

Nancy, people actually do develop it without years of abusing carbohydrates. Carbohydrates are not drugs, and to consume them is therefore not to abuse them. To eat food is not abuse.





My eye colour was dictated by my genes. That is not an abnormality, but it is genetic. It is possible for something to be genetic, but not be an abnormality.

I remember reading many studies when peoples with the genetic predisposition/high incidence of diabetes went back to or stuck with their traditional/non westernized diets they had much lower incidence of T2 or T2 appeared at a much lower rate that those eating a Westernized diet.

Lets see, there were the Pima's, Apache, Australian Aborigine, Hawaiians, Inuit, Aleutian Islanders, etc.

Effects of traditional and western environments on prevalence of type 2 diabetes in Pima Indians in Mexico and the U.S.
http://www.ncbi.nlm.nih.gov/pubmed/...Pubmed_RVDocSum

The effect of Indian or Anglo dietary preference on the incidence of diabetes in Pima Indians.
http://www.ncbi.nlm.nih.gov/pubmed/...Pubmed_RVDocSum

The prevalence of diabetes mellitus in a traditional-living Polynesian population: the Wallis Island survey.Taylor RJ, Bennett PH, LeGonidec G, Lacoste J, Combe D, Joffres M, Uili R, Charpin M, Zimmet PZ.
http://www.ncbi.nlm.nih.gov/sites/entrez

Dietary fat and disease patterns in Chukotka Native adults.Mamleeva FR, Efendieva JB, Nikitin YP.
Institute of Internal Medicine, Novosibirsk, Russia.
PMID: 10093300 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/...Pubmed_RVDocSum

Yes, that would be the situation, because if a disease is the inabilty to metabolise sugar, you cannot become aware that you have it until you attempt to metabolise sugar...by eating some.

If a diet can control a condition, then eating the diet will control the condition.

I think that maybe what Nancy is trying to say is that, in a human's natural wild environment, there is not an abundance of sugar and never was an abundance of sugar; therefore, the inability to metabolize sugar, as you put it, is not a "disease" as much as it is a malfunction due to trying to use the body in a way it was never meant to be used. It would be like trying to pour grain alcohol into a car's gasoline tank...the car would malfunction, but it's not because there's a problem with the car, it's because you're trying to feed it something it isn't meant to be fed.

If that's not what Nancy is trying to say, I'll just go back under my rock now.

Nope, you hit the nail on the head, Kallyn. Good analogy!