Disclaimer - I am not a physician. I have an MS in Environmental Biology and oddly, that degree may be the perfect one to really understand Type II diabetes. Some might argue that if your only tool is a hammer, then every problem looks like a nail and therefore, my environmental approach to solving the riddle of diabetes starts using the wrong tool. I would suggest the data supports me and to some extent, puts physicians in the role or using the wrong tools (weight loss and drugs) to deal with diabetes. The best these tools can do is stave off the inevitable progression of the "disease." Changing the environment can at least halt the progress of the disease, and a growing body of evidence suggests it can reverse the disease. How far the reversal can go has not been quantified.
Type II diabetes is a group of "conditions" (diseases?) where the body develops resistance to insulin and blood sugar levels rise. The pancreas is still producing insulin; perhaps even more than a person without Type II diabetes. When insulin production increases, it appears there's a risk of "burning out" the beta cells in the pancreas that produce insulin. This is currently understood to be irreversible but this may soon be reversible thanks to modern medicine. So control of blood sugar is important to a Type II diabetic. When enough of the insulin producing cells die off, insulin injections become necessary. Interestingly the ADA (American Diabetes Association) has different and more lax standards than the AACE (American Association of Clinical Endocrinologists). More on this in another post.
In the book The China Study T. Colin Campbell shows a rather convincing graph comparing diets in six or seven different countries. The data are about 50 years old but aligned perfectly with his findings. Where a low fat-high carbohydrate diet is consumed diabetes is almost non-existant. Yes I said high carbohydrate. He then goes on to show a near perfect linear relationship showing the incidence of diabetes increases as the ratio of fat to carbohydrates increases. If the advice you've been getting is like what I've been hearing, you probably thought carbs were bad for diabetics. Some are for sure, like refined sugars and white flour, but they are not the cause of diabetes. They simply raise your blood sugar and stress your pancreas. Complex carbs, like those found in plants, are actually good for diabetics.
The causative factor of diabetes seems to be fat. Moreover, the body's environmental response to fat is to conserve the energy. Prior to meat becoming a common and primary element of the diet, the response made perfect sense and aided the survival of the animal. Fat was stored both in the cells and on the body (frequently around the waist or the buttocks). The body's response to fat also included reducing the number of mitochondria within the cells of the body. The mitochondria are found in essentially every living cell of the body and are where energy is produced. The process is known as the Krebs-citric acid cycle and reduces ATP to ADP releasing energy, and uses glucose to "recharge" the ADP to ATP.
The Krebs-Citric acid cycle is complicated but well known. What is important to know is intracellular fat is long-term stored energy for the body to use later - perhaps months or years later. ADP is what the body uses to produce energy and it is quickly recharged using glucose. Glucose is taken from the easiest source - foods that have recently been ingested. When this is exhausted the body uses glycogen, and finally fat, but not directly. This is why you can significantly drop your blood sugar by exercising after eating. You are using the glucose that your body absorbed from your meal. It is also why exercise "burns" fat.
The problem comes when a person eats too much fat. The body automatically wants to conserve the fat (this is not the "starvation mode" dieters experience) and predictably, it responds to excessive amounts of fat with an excessive response. Two different things happen, both of which contribute to Type II diabetes. First, in order to conserve energy the body reduces the number of mitochondria within the cells. With all the fat energy there you don't need all the mitochondria producing energy. Fewer mitochondria allow a person to function without burning off the fat needlessly. Fewer mitochondria also reduces the bodies ability to burn glucose quickly. The result is a small, perhaps insignificant rise in blood sugar. The other thing that happens is the intracellular fat interferes with the ability of insulin to communicate with the cell and allow it to bring glucose into the cell. I'd speculate that the cell is saying, "I'm full" take your glucose to a cell that's still "hungry." The body is placing a limit on how much intracellular fat it will allow.
If this explanation is accurate, and I can cite quite a body of hard science (as opposed to whack-a-do-docs selling a diet plan), then diabetes is an environmental disease. There is a small but growing body of supporting research to suggest that the environmental changes are the result of epigenetic changes. DNA markers change in response to environmental conditions causing the changes that have been described. The good news then is changing the environment, may be able to utterly reverse the disease. This would be the cure for diabetes. Interestingly, it isn't a pill or a shot but a change in the environment - mainly a change in one's diet that results in a cure. Isn't it ironic that the most modern medicine can do is prolong the progression of the disease while the individual has the power to cure themselves?
Next time - Working on a Cure.
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