Got Diabetes? You Must Know This

Everyone knows having diabetes is harmful to you and you can have undiagnosed diabetes causing you harm years before you have any symptoms of being unwell.  So… logic says that that testing people for diabetes and treating them as early as possible is a good thing and should reduce illness and death from diabetes.

However….

1) A recent trial of thousands of people over many years comparing people that were tested against those not tested showed that not only did the screened group not live longer but in fact might even live less! (Although in terms of statistics we cannot say this was a significantly worse result.)

How is this possible? – We must be doing something wrong!

Part of the answer is simply that most people – including most doctors – do not know that raised insulin itself is bad for you!

If you do not manage diabetes by lowering insulin resistance – as well as lowering blood sugar, then you are failing to deal with most of the harms of diabetes.

READ CAREFULLY:

What is Diabetes?

Diabetes is a disease that leads to high blood glucose (blood sugar) which eventually causes the typical symptoms of thirst, passing lots of urine and tiredness. The main reason for this relates to Insulin – a hormone (chemical) produced by beta-cells in the pancreas which controls the glucose levels in your blood.

In Type 1 Diabetes your pancreas stops producing insulin and this means your blood sugars will rise. This is because your immune system attacks the beta cells in the pancreas (called autoimmune disease).

However 90% of diabetes is Type 2 Diabetes and what is far less widely known is that this is not caused by a lack of insulin but that Type II Diabetes is basically a disease caused by insulin resistance. (This can be alternatively described as lack of insulin sensitivity.)

In fact in most people with Type 2 Diabetes (usually until the very late stages) your insulin levels will actually be significantly raised and higher than a healthy person.

As an aside – Type 1 Diabetes is a lack of insulin BUT in those people with Type 1 diabetes that becomes overweight and inactive they too can lose sensitivity to insulin that they are injecting so the same advice applies to them.

Six things to know about the actions of insulin

  1. Insulin lowers your blood sugar the good news!
    High levels of glucose in the blood lead the pancreas to release more insulin and the action of insulin is to push the glucose into cells from the blood stream. It also stops your liver from producing glucose and releasing it into your blood stream.
  2. Insulin promotes magnesium storage in your cellsmore good news! 
    Magnesium is a mineral required for the entire energy making in your cells. It is also required to allow muscles to relax and stop contracting.
    BUT…..
  3. Insulin makes you fatsome of the bad news!
    Once you have glucose in your cells there are two possibilities – it is eitherBurned as fuel immediately OR it has to be stored.

    So once your cells’ immediate energy needs are met then the excess glucose is converted to fat and stored in the cells –
    IN OTHER WORDs…..insulin makes you manufacture fat by converting glucose (sugar) into fat.
    TO ADD TO THIS – insulin also increases fat storage by
    increasing the uptake of fat into cells from dietary fat in your blood.
    blocking the breakdown of fats in cells.
    stimulating the new production of fat from carbohydrates in the liver.
    More bad news…..other less well known actions of insulin include –
  4. Insulin slows the clearance of toxins from cells
    It switches off your natural garbage disposal system –this is the way that toxins and waste product are removed from your cells.
  5. Insulin powerfully stimulates your sympathetic nervous system
    This is a part of your unconscious nervous system – the sympathetic nervous system is the trigger of adrenaline and stress hormones i.e. the fight or flight response to fear- and long term raised levels of stress hormones lead to many bad health affects including worsening blood sugar control – double whammy!
  6. Insulin DIRECTLY triggers furring (atherosclerosis) of the arteries
    Animal studies show that if you drip insulin into a blood vessel it will become almost totally blocked with plaque (clot) after about three months. The opposite side blood vessel will remain totally clear -simply the contact of insulin in the artery causes it to fill up with plaque.

The Vicious Cycle of Insulin Resistance and Rising Insulin

If your lifestyle (and possibly your genetics) leads to continuously high levels of glucose in the blood then your pancreas is continuously stimulated to produce high levels of insulin. This matters because when your cells are constantly exposed to high levels of insulin the receptors in your cells then stop responding to the insulin –THEY BECOME RESISTANT TO INSULIN

The best way to understand this is to think of the experience when you are in a room when someone is vacuuming – your ears adjust to the noise and screen it out and then you suddenly notice it has gone quiet when the vacuum is switched off having not noticed the noise before.

The consequence of this lack of response leads to a vicious cycle as your blood glucose rises then your insulin levels rise further leading to more stimulation and then more resistance etc, etc.

Note- after many years of this then in fact the pancreas may well become exhausted and your insulin levels will then actually start to fall (blood sugars will then be potentially even more uncontrolled) and treatment with insulin may be required even in Type II Diabetes.

What are the risk factors for rising insulin resistance?

There are several known factors that are linked to rising insulin resistance –some of these obviously cannot be changed but others are in your control to improve.

Aging – insulin resistance will always slightly increase with age which is clearly your of your control!

Genetics -your family history is part of the picture but less important than lifestyle.

Things you can improve:

Glycaemic load of your diet – the glycaemic load is an indication of how much of a food substance is converted in to blood glucose when you eat it.

The higher the glycaemic load the more rapidly your blood sugar rises and for a longer time. This is a huge contributor to raising your insulin levels

Lack of Exercise – the less you exercise the less muscle cells you have and so the less blood glucose you burn up as energy leading to surplus levels.

Also – muscle cells are able to store extra glucose as glycogen to be available to be quickly broken down to sugar when your muscles need energy. Once you have filled your glycogen stores as we have seen the excess sugar is stored as fat hence the less muscle you have the more readily you store excess sugar as fat.

Mineral and/or Vitamin Deficiencies –a significant number of vitamin and mineral deficiencies which are common in the population worsen insulin resistance.

Insulin resistance is NOT equal in all cell types – another huge problem for you!

Different cell types become resistant more quickly than other cell types -liver cells become resistant first, then muscle cells and then your fat cells.

Firstly:

When your liver is resistant to insulin it manufactures glucose – your morning sugar levels before you eat is in fact mostly due to glucose produced by your liver overnight. Your liver will carry on producing glucose through the night if it is resistant to insulin aggravating the vicious circle!

At this stage your muscle cells will still be sensitive to the insulin which will be raised and will be switching of the detoxifying system in your muscles so that poisons will build up.

Then:

Muscle cells will then become resistant – this stops sugar being taken up by your muscles so that they have less energy making it harder to exercise and also of course this raises your blood sugar further!

To add to this – muscle cells that are resistant to insulin will also no longer take up magnesium – this will reduce your energy levels further AND stop your muscles relaxing. Your blood vessels are surrounded by layers of muscle cells and when these layers do not relax your blood vessels are “squeezed” raising your blood pressure.

Eventually:

Fat cells become resistant – but not for a while as it take them longer. While your fat cells remain insulin sensitive they will continue to turn your excess sugar into fat so your weight will rise and rise.

To make matters worse:

The cells lining your blood vessels – endothelial cells – do not become resistant to insulin so the all that raised insulin continues to damage the lining of your blood vessels.

So Why is Uncontrolled Diabetes Bad for you? (RECAP)

Uncontrolled diabetes causes a huge number of harmful problems – for example – heart disease, strokes, peripheral vascular disease (blood flow problems in your legs), kidney disease, skin ulcers and nerve damage.

The harm is caused by raised glucose.
Because excess glucose combines with anything else in the body – it is essentially a very “sticky” substance – this process is called glycation. In particular it will stick to cell lining proteins and if the glucose is not removed then it produces advanced glycated end products (AGEs). These damaged proteins lose their ability to function properly.

A good way to think about this is to imagine your fingers after eating candy floss and not washing your hands – sticky, unpleasant and not very practical!

Even more worryingly some proteins cannot be easily repaired or replaced e.g. nerve cell proteins and collagen. Collagen is a very widespread protein that lines all your blood vessels and this is a reason why uncontrolled diabetes causes so many diseases related to blood circulation.

BUT ALSO:
The harm is caused by raised insulin levels.
As you now know your raised insulin is also extremely harmful and in fact may well be worse for you than the raised sugars.

It is also very important to note also that the harmful effects of raised insulin start even before your blood glucose levels are high enough to be called diabetes- **At this stage EVEN if your blood sugars are in a normal range it is possible to have very high insulin levels**

If you have diabetes then this advice on insulin resistance is equally important to your family even if they do not have diabetes as insulin levels can be raised for decades before you develop diabetes.

How should we treat (or better still prevent) Type 2 Diabetes?

From our understanding of insulin resistance and all of the consequences we can see that by far the best way to treat Type 2 Diabetes is to improve insulin sensitivity.

Unfortunately- a number of conventional drug treatments actually work by increasing your insulin production from the pancreas. This may have become a necessary way of controlling your blood sugar but is clearly a second choice option as this raises your insulin levels even higher with all the potentially harmful consequences – they may also speed up the rate at which the pancreas becomes exhausted.

There are a number of lifestyle changes that have a huge impact:

  • Lowering carbohydrate intake- a LOW glycaemic load diet
  • Exercise (even moderate amounts)
  • Stress reduction

However,

  • Firstly you now understand that a number of the effects of insulin resistance can make lifestyle changes harder to implement.  For example, your muscle cells may lack energy so raised insulin stimulates your stress hormones.  Catch 22.
  • Secondly lifestyle changes are often hard to make and even harder to keep up – remember all those New Year Resolutions!! – This is especially true if you are already overweight and tired out!
  • Thirdly common deficiencies in minerals and vitamins will make insulin resistance worse!

Fortunately there are a number of supplements and herbal remedies that have been scientifically proven to improve your insulin sensitivity and so help you turn the vicious cycle of insulin resistance into the virtuous cycle of insulin sensitivity -even to the level of possibly reversing diabetes altogether when combined with lifestyle changes.

So a combination of

  1. EXERCISE
  2. LOW GLYCAEMIC LOAD diet (Low Carb)
  3. STRESS REDUCTION

The above supported by appropriate SUPPLEMENTS and REMEDIES is your key to taking control of diabetes restoring your health safely and optimally.

Take care of you!

Dr David Morris

Family Practitioner and Integrative Medicine Physician

Ref1 http://www.ncbi.nlm.nih.gov/pubmed/23040422

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