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The Carnivore Diet: 8 Reasons Why It Works

Important Points:

  • Carnivore Diet
  • Weight Loss
  • Insulin resistance
  • Blood glucose
  • Leaky Gut

 The Carnivore Diet: 8 Reasons Why It Works

The carnivore diet is considered a controversial diet by some, yet its followers expound the immense benefits it brings to their health and wellbeing. What about it makes it work? This article looks at its key components in an attempt to find out why it is effective where some other diets have failed.

What is the Carnivore Diet?

The Carnivore Diet is a restrictive diet that only includes meat, fish, and other animal foods like eggs and certain dairy products. In its strictest forms, it excludes all other foods, including fruits, vegetables, legumes, grains, nuts, and seeds.

Its proponents also recommend eliminating or limiting dairy intake to foods that are low in lactose — a sugar found in milk and dairy products — such as butter and hard cheeses.

The Carnivore Diet stems from the belief that human ancestral populations ate mostly meat and fish and that high-carb diets are to blame for today’s high rates of chronic disease.  Other popular low-carb diets, like the keto and paleo diets, limit but don’t exclude carb intake, but the Carnivore Diet aims for near zero carbs.

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The Carnivore Diet has been touted to cure the incurable. Health sites like Meatheals.com, World Carnivore Tribe and ZeroCarb are overflowing with tens of thousands of people who have reversed serious health conditions.

It seems almost too good to be true, right?  We will delve into the reasons why the carnivore diet works so well. 

Why does the carnivore diet work?

1. The Carnivore Diet cuts out all added sugar

Sugar is one of the most controversial topics. To sum it up, sugar is bad for you. Here’s why:

  • It can stick to cholesterol particles in a process called glycation which can lead to atherosclerosis and type 2 diabetes.
  • It’s highly glycemic. Sugar spikes insulin and can lead to insulin resistance over time.
  • When metabolized, it produces AGEs which lead to aging, chronic disease and diabetes.
  • Glucose is oxidatively stressful, causes inflammation, and can produce reactive oxygen species. Oxidative stress plays a role in almost every disease.

In a study conducted, it was found that from consuming just 40 grams of added sugar, people had an increase in inflammation, insulin resistance and weight gain.

Glucose is also speculated to feed tumor growth. The Warburg Effect explains that cancer cells depend on glucose to grow. Very unlike normal cells, cancer cells cannot use Ketones.

While glucose is considered to be bad, fructose is considered to be even worse as it goes directly to the liver where it’s converted to fat. It is twenty times more likely to cause fatty liver than glucose alone.A fatty liver can lead directly to insulin resistance.

2. The Carnivore Diet can cure leaky gut

Leaky gut is a condition when the tight junctions of the small intestine open and allow proteins and toxins into the bloodstream.So far, the carnivore diet has been one of the few clinically shown ways to reverse intestinal permeability and the attendant consequences.

How does the carnivore diet cure leaky gut? Three main ways:

  • It reduces inflammation, which reverses gut microbiome imbalances
  • It is the most nutrient rich diet on earth, which heals the gut.
  • It removes foods that pry the tight junctions in the small intestine open like Lectins and Gluten

3. The Carnivore Diet eliminates refined carbohydrates

Carbohydrates are converted to glucose in your body (sugar). Here are some of the negative effects of consuming refined carbs:

  • Because all the fiber has been removed, refined carbs are digested very rapidly and cause major blood sugar spikes. This can lead to insulin resistance over time especially when consumed with fat.
  • Refined carbohydrates also damage the gut. Sugar and carbohydrates are fermented by the gut and colon which can exacerbate GI issues and lead to leaky gut. This is why a well-established treatment for IBS, recommends low carbohydrates to starve your bacteria.
  • Over time, refined carbohydrate consumption has been linked to inflammation and obesity.
  • Refined carbohydrates also increase blood triglyceride levels, which is a risk factor for Type 2 Diabetes and Heart Disease . Fat hanging out in your bloodstream is a sign that something is seriously off.

Eating refined carbs such as pasta are no different than eating straight sugar. Seven ounces of cooked spaghetti has the same amount of sugar as 4 12 oz cans of Pepsi.

4. The Carnivore Diet cuts out most carbohydrates

Carbohydrates range from simple sugars to complex carbohydrates. But even unrefined carbohydrates can be bad for you. Many forms of starch, for example, raise blood sugar as much as eating glucose.

Below are some reasons why cutting out all carbohydrates may be beneficial (yes, even the “healthy ones”):

  • High carbohydrate diets can lead to insulin resistance especially if combined with fat
  • Many whole grains are loaded with anti-nutrients, like lectins
  • Carbohydrates halt fat burning because of the insulin response; the more carbohydrates you eat the less body fat you burn.
  • Getting to < 50g a day allows you to burn fat and enter ketosis. Ketosis has a number of health benefits.
  • All carbohydrates break down into glucose, which can produce some of the negative effects mentioned above: AGEs, glycated LDL particles, insulin resistance, etc.
  • Carbohydrates and fiber are fermented by the gut, which can exacerbate gut issues like IBS

5. The Carnivore Diet is the very effective in reducing insulin resistance

Insulin resistance is related to almost every chronic disease. Though it might not cause all the conditions, its presence exacerbates them. Some of these conditions are: Heart disease, 62% higher cancer mortality, 160% higher gastrointestinal cancer mortality, prostate cancer, Alzheimer’s disease, aging, inflammation from elevated CRP and IL-6, and acne.

The good news is that you can reverse insulin resistance. The carnivore diet is the most effective way to reverse insulin resistance with these actions:

  • Cutting out the highly glycemic carbohydrates powers your body off of ketones and increases insulin sensitivity
  • Cutting out fructose increases insulin sensitivity
  • Certain plant antinutrients like lectins can bind to insulin receptors and make you more insulin resistant
  • Vegetable oils cause insulin resistance
  • Protein is satiating and high protein diets burn body fat, which reduces insulin resistance
  • People generally intermittent fast on the carnivore diet, which increases insulin sensitivity

If you want to live longer, you need to lower fasting insulin levels.

6. Carnivore Diet Increases Natural Saturated Fat Consumption

Despite the prevailing dogma, saturated fats are associated with longevity.

Saturated fats are highly beneficial to health. Your body cannot function without them. Diets high in natural saturated fats are associated with longevity. Hong Kong, for example, consumes more meat per capita than any other nation in the world, but they actually have the world’s longest life expectancy at 84.5 years.

Studies continue to debunk the myth that saturated fat causes heart disease. A review from 2014 looking at 76 studies, found no link at all between saturated fat and heart disease

7. Intermittent Fasting

Intermittent fasting isn’t a pivotal part of the carnivore diet. Nor is it prescribed. But people naturally tend to find themselves eating in a shorter window, which brings tremendous health benefits.

Intermittent fasting is restricting your feeding to a window less than or equal to 8 hours. This is a direct contradiction to what many American’s do today.

Fasting is extremely beneficial. It has been shown to:

  • Reduce inflammation 
  • Increase insulin sensitivity
  • Promote fat loss
  • Increase cognition, memory and focus
  • Increase autophagy, the natural cellular cleansing process
  • Increase BDNF, which upregulates neuronal creation and maintenance
  • Improve immune system
  • Starve bad gut bacteria
  • Improve autoimmune symptoms like RA and Crohn’s

8. The Carnivore Diet puts you into ketosis

Your body can use two types of fuels: glucose (from carbs) and ketones (from fat).

Everybody on the carnivore diet is in ketosis to some extent. When you stop fueling your brain and body with glucose, fat needs to take its place.

Here are some major benefits of going into ketosis:

  1. Upregulates FOXO genes which regulate oxidative stress and insulin sensitivity and influences longevity. 
  2. Ketones improve mood and have antidepressant like effects
  3. BHB reduces oxidative stress in the brain and may be beneficial in preventing neurodegenerative disease
  4. BHB lowers inflammation and blocks NLPR3 inflammasome
  5. Increases endogenous antioxidant production
  6. Ketones improve insulin sensitivity
  7. Increased fat loss while preserving lean muscle mass and performance
  8. Ketones can slow tumor growth by starving them of their preferred fuel, glucose, and lowering IGF-1

9. The Carnivore Diet is Simple

In the complexity of life, food doesn’t need to be complicated. The carnivore diet involves just eating meat, meat, and more meat. This makes it easier to stick to as there are no meal plans and measurements.

The Carnivore diet works…

If you have tried everything to in an attempt to stay in shape and manage any chronic conditions you might have, maybe it’s time you tried the carnivore diet. Its basic mechanisms make sense and are likely to cause some positive effects in your health. If you do have a chronic disease, like diabetes or heart disease, talk to your doctor before trying an extreme diet like this one. Do not follow the carnivore diet if you have any level of kidney disease.

References

  1. Healthline (2019): All You Need to Know About the Carnivore (All-Meat) Diet. Retrieved from

https://www.healthline.com/nutrition/carnivore-diet

  • Every day Health (2018):On the Carnivore Diet, People Are Eating Only Meat: Here’s What to Know. Retrieved from

https://www.everydayhealth.com/diet-nutrition/diet/carnivore-diet-benefits-risks-food-list-more/

  • Carnivore Aurelius (2019): 16 Reasons why the Carnivore Diet Works. Retrieved from
https://carnivoreaurelius.com/carnivore-diet/
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Reversing Diabetes: What Does and Doesn’t Work

Important Points:

  • Type 2 diabetes
  • Insulin resistance
  • Weight loss
  • Diabetes reversal
  • Diabetes remission

Reversing Diabetes: What Does and Doesn’t Work

About 30 million people in the US have diabetes, and of these, about 8 million don’t know that they have it. Early diagnosis of diabetes can help in the treatment and possible reversal of diabetes. But what is diabetes reversal?

Diabetes reversal is similar to long-term diabetes remission. It is not a definite cure for diabetes but a return to normal blood sugar levels without having to take diabetic medication hopefully for a number of years. This can be achieved through a number of factors which we shall discuss below. Before getting there, let’s shed some light on type 2 diabetes.

Diabetes type 2 Reversal

Type 2 Diabetes used to be a disease of the elderly, but with the adoption of a modern lifestyle, even young children are being plagued by this debilitating disease. Genetics and ethnicity play a role in the acquisition of type 2 diabetes, but diet and lifestyle factors are great contributors as well. By controlling the latter, a person predisposed to the disease is able to avoid it in some cases.

Type 2 Diabetes occurs when there is a gradual build-up of insulin resistance. Insulin is the hormone that removes sugar from the bloodstream and stores it in cells. Over time, a person becomes less sensitive to the effects of insulin leading to a buildup of sugar in the blood, beta cells are further stimulated to produce more and more insulin until eventually they are exhausted and depleted.

Reversal of type 2 diabetes targets the restoration of insulin sensitivity and in some cases the regeneration of beta cells such that a person with diabetes reversal should be able to maintain normal blood sugar levels without the use of diabetes medication. Research has shown that weight loss is one of the most effective approaches to achieving diabetes reversal.

Here are four ways to achieve healthy weight loss and diabetes reversal:

1.    Very Low-Calorie Diet

Several studies have looked at the effects of a very low-calorie diet on diabetes. In one study, two people followed a mostly liquid diet of 625-850 calories a day for 2-5 months, followed by a less restricted diet designed to help them keep off the weight they lost. Results showed that a low-calorie diet helps to reduce weight and improve insulin sensitivity. In another study, seven obese patients with type 2 diabetes were put on a very low-calorie diet of 900kcal and 115g of protein. This led to significant improvement in blood sugar control that was mainly attributed to improvements in insulin sensitivity.

Note that these types of diets are extreme. You have to work with a professional who will assess your fitness for undertaking such a drastic approach. Most people who have had success in reversing diabetes with this approach are those who have not had diabetes or a long time; to achieve this, it’s important to start the weight loss journey as soon as possible after you’re diagnosed.

2.    Exercise

Regular exercise is another way of improving diabetes but must be combined with diet and other measures in order to achieve diabetes reversal. Exercise needs commitment and dedication in order to bear fruit.

Regular exercise is associated with decreased demand for insulin as well as increased sensitivity to insulin. A 2015 study published showed that 67% of participants were able to achieve partial remission by taking part in a 6-month diet and exercise regimen. All the study participants were newly diagnosed with type 2 diabetes.

3.    Bariatric Surgery

Bariatric surgery helps one achieve weight loss by reducing their food intake. This, in the long run, has helped type 2 diabetes patients achieve reversal as evidenced by a 2010 study. A 2013 study reported that 24% of participants with type 2 diabetes achieved remission six years after receiving gastric bypass surgery. The study concluded that:

“Bariatric surgery can induce a significant and sustainable remission and improvement of Type 2 diabetes and other metabolic risk factors in severely obese patients. Surgical intervention within 5 years of diagnosis is associated with a high rate of long-term remission.”

Bariatric surgery is suitable only when your BMI is 35 or higher. It works best for people who’ve had diabetes for less than 5 years and are not on insulin. For newly diagnosed type 2 diabetics who are obese, this can be a suitable option to help them reverse diabetes.

4.    Intermittent Fasting

Intermittent means going without any food or drink with calories for a given amount of time. For example, you can restrict your eating to eight hours each day and you starve for the remaining sixteen hours. Caution: you need to consult with your doctor before embarking on a fast, even if it’s partial and for medical reasons.

A small study looked at three men between the ages of 40 and 67 who tried intermittent fasting for approximately 10 months. All were able to stop insulin treatment within a month of the study period. According to the author of the study Jason Fung, this showed that intermittent fasting could be effective in reversing type 2 diabetes. This result should only be used as anecdotal. Larger clinical trials need to be conducted to determine the clear effectiveness of this approach.

What Doesn’t Work?

There is a lot of hype when it comes to diabetes reversal. Shrewd businessmen have tried to exploit vulnerable patients by selling magic pills that they purport to cure diabetes. They come in all forms of preparations such as:

  • Over-the-counter pills
  • Herbs
  • Supplements
  • Alternative medicines
  • Homeopathic products
  • Prescription drugs

If you or a loved one is living with type 2 diabetes, it is important that you consult with your healthcare provider before embarking on any diabetes reversal program. As much as diabetes reversal is achievable, you need to be wary of greedy scammers eager to make a dishonest buck.

References

1.   Healthline: Type 2 Diabetes Statistics and Facts. Retrieved from https://www.healthline.com/health/type-2-diabetes/statistics#1

2.   NCBI (2019): Reversing Type 2 Diabetes: A Narrative Review of the Evidence. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520897/

3.   NCBI (1998): Early and long-term effects of acute caloric deprivation in obese diabetic patients. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/3291612

4.   Diabetes UK: Reversing Type 2 Diabetes. Retrieved from https://www.diabetes.co.uk/reversing-diabetes.html

5.   NCBI (2013): Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24018646

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Metabolic Inflammation: What is it?

Important Points:

  • Insulin resistance
  • Sugar
  • Type 2 Diabetes
  • Glucose

Metabolic Inflammation: What is it?

The modern diet contains a large amount of simple sugars. From bread, to donuts, to carbonated drinks, to chocolate, cookies and candy, everywhere you look, temptation abounds. The potential impact on health of diets rich in free sugars, particularly fructose, is of major concern. Does the sugar we take in have an impact on insulin resistance and obesity?

Sugar and Insulin resistance

Sugar has a bittersweet reputation when it comes to health. It occurs naturally in all foods that contain carbohydrates, such as fruits and vegetables, grains, and dairy. Consuming whole foods that contain natural sugar is safe. Plant foods also have high amounts of fiber, essential minerals, and antioxidants, and dairy foods contain protein and calcium.

Where does the problem with sugar come? – Added sugar, which is usually extracted or synthesized.

There is plenty of evidence to suggest that consuming too much sugar can have a negative effect on our metabolic health. Regular sugar consumption produces a constant release of the hormone insulin. Over a period of time, excess insulin can lead to serious problems, such as the synthesis of triglycerides, insulin resistance, fatty liver disease, type II diabetes, an increase in very low-density lipoprotein (the bad kind of cholesterol), and the accumulation of fat on all tissues.

Added sugar intake may contribute to and certainly does exacerbate insulin resistance. Added sugars cater to particularly energy-hungry but metabolically inefficient cells, including senescent cells, cancerous cells, and even quickly proliferating pathogenic bacteria in the gut.

There are several genetic and lifestyle factors that can contribute to how likely you are to develop insulin resistance. But even if you have a genetic risk, you can help yourself with regular exercise, a balanced diet, avoidance of added dietary sugars, healthy sleep patterns, and stress reduction activities.

 Risk factors for insulin resistance and prediabetes include:

  • Obesity
  • Aging
  • Physical inactivity
  • High cholesterol
  • High blood pressure
  • Sleep disorders or circadian rhythm disruption

It is said that one in three Americans—including half of those age 60 and older— have insulin resistance.

What exactly is Insulin Resistance?

Insulin resistance is when cells in your muscles, body fat, and liver start resisting or ignoring the signal of the hormone insulin when it signals to grab glucose out of the bloodstream and put it into our cells. Glucose, also known as blood sugar, is the body’s main source of fuel. We get glucose from grains, fruit, vegetables, dairy products, and drinks that bring break down into carbohydrates.

How does Insulin Resistance develop?

While genetics, aging, and ethnicity play roles in developing insulin sensitivity, the driving forces behind insulin resistance include excess body weight, too much belly fat, a lack of exercise, smoking, and even not getting enough sleep.

As insulin resistance develops, your body fights back by producing more insulin. Over months and years, the beta cells in your pancreas that are working so hard to make insulin get worn out and can no longer keep pace with the demand for more and more insulin. Then – years after insulin resistance silently began – your blood sugar may begin to rise and you may develop prediabetes or type 2 diabetes. You may also develop non-alcoholic fatty liver disease (NAFLD), a growing problem associated with insulin resistance that boosts your risk for liver damage and heart disease. 

What are the Signs and Symptoms of Insulin Resistance?

Insulin resistance can be triggered by a combination of factors linked to weight, age, and genetics, being sedentary, and smoking.

– Polycystic ovary syndrome (PCOS): Insulin resistance can worsen the symptoms of PCOS, which can include irregular menstrual cycles, infertility, and periods that cause pain.

A large waist. Experts say the best way to tell whether you’re at risk for insulin resistance involves a tape measure and moment of truth in front of the bathroom mirror. A waist that measures 35 inches or more for women, 40 or more for men (31.5 inches for women and 35.5 inches for men if you’re of Southeast Asian, Chinese or Japanese descent)increases the odds of insulin resistance and metabolic syndrome, a condition linked to insulin resistance.

Additional signs of metabolic syndrome. According to the National Institutes of Health, in addition to a large waist, if you have three or more of the following, you likely have metabolic syndrome, which creates insulin resistance.

  • High triglycerides. Levels of 150 or higher, or taking medication to treat high levels of these blood fats. 
  • Low HDLs. Low-density lipoprotein levels below 50 for women and 40 for men – or taking medication to raise low high-density lipoprotein (HDL) levels.   
  • High blood pressure. Readings of 130/85 mmHg or higher, or taking medication to control high blood pressure
  • High blood sugar. Levels of 100-125 mg/dl (the prediabetes range) or over 125 (diabetes).
  • High fasting blood sugar (or you’re on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes.

Acanthosis nigricans: This skin condition can develop in people with insulin resistance. It involves dark patches forming on the groin, armpits, and the back of the neck.

What health conditions are related to Insulin Resistance?

The most common health condition related to Insulin Resistance is prediabetes and the resultant Type 2 Diabetes. Insulin resistance also doubles your risk for heart attack and stroke and triples the odds that your heart attack or ‘brain attack’ will be deadly.
Insulin resistance and metabolic syndrome are also linked with higher risk for cancers of the bladder, breast, colon, cervix, pancreas, prostate, and uterus.This is because the high insulin levels early in insulin resistance seem to fuel the growth of tumors and to suppress the body’s ability to protect itself by killing off malignant cells.

Furthermore, research has found a strong association between insulin resistance and memory function decline, increasing the risk for Alzheimer’s disease.

Can you prevent or reverse insulin resistance?

The good news is that yes, insulin resistance can be prevented and also reversed in some cases. Here is what you can do:

  • Get recommended amounts of physical activity and structured exercise
  • Get adequate sleep
  • eat when the sun is up (we are more insulin resistant at night and after a night of poor sleep, due to disrupted circadian rhythms that help regulate our metabolic state)
  • Reduce stress and therefore stress-related inflammation
  • Maintain a healthy weight
  • Increase your plant fiber intake.

All the above can help improve your insulin sensitivity. It has been shown that combining changes to both diet and exercise has the most impact on insulin sensitivity.

In a fascinating University of New Mexico School of Medicine study, published in the International Journal of Obesity, overweight people who lost 10% of their weight through diet plus exercise saw insulin sensitivity improve by an impressive 80%. Those who lost the same amount of weight through diet alone got a 38% increase. And those who simply got more exercise, but didn’t lose much weight, saw almost no shift in their level of insulin resistance.

Intermittent fasting is another way in which you can reverse your insulin resistance. This is because it gives your body a break from insulin and glucose signaling pathways that promote cell proliferation and inflammation, and may help increase your insulin sensitivity.

What therefore is the relationship between sugar and Insulin Resistance?

There is an association between diets high in sugars (predominantly sucrose) and risk of disease, and experimental studies have shown that high intakes of fructose (over 100 g/d) can reduce insulin sensitivity. The mechanisms for such associations or effects have not been convincingly demonstrated.

References:

  1. NCBI (2016): A review of recent evidence relating to sugars, insulin resistance and diabetes. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174139/

  • Endocrineweb (2019): Insulin resistance causes and symptoms. Retrieved from

https://www.endocrineweb.com/conditions/type-2-diabetes/insulin-resistance-causes-symptoms

  • Medical News Today (2019):What to know about insulin resistance. Retrieved from

https://www.medicalnewstoday.com/articles/305567.php

  • The Sugar Movement (2016): Sugar vs Fat. Retrieved from

https://thatsugarmovement.com/sugar-vs-fat/

  • Harvard Health Publishing (2017):The sweet danger of sugar. Retrieved from

https://www.health.harvard.edu/heart-health/the-sweet-danger-of-sugar

  • NCBI (2014): Weight Loss, Exercise, or Both and Cardiometabolic Risk Factors in Obese Older Adults: Results of a Randomized Controlled Trial

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3835728/

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Understanding the role metabolic inflammation plays in obesity and diabesity

Important Points:

  • Inflammation
  • Obesity
  • Diabesity
  • Insulin resistance
  • Adipose tissue

Understanding the role metabolic inflammation plays in obesity and diabesity

Obesity is a disease that has plagued the modern day man in recent time. Access to highly processed foods and decrease in physical activity are key contributors to this ailment. Researchers are hard at work looking into what other underlying factors lead to obesity, especially given its relationship with the onset of Type 2 Diabetes, Cardiovascular diseases, and liver disease. We will take an in-depth look at metabolic inflammation and its role in the onset of obesity. Let’s dive in.

1. What is Obesity?

Obesity is a state in which there is an over-accumulation of subcutaneous and/or abdominal fat (adipose tissue) characterized by a low grade chronic state of inflammation in which the level of pro inflammatory cytokines are increased.  This adipose tissue is no longer considered inert and mainly devoted to storing energy; it is emerging as an active tissue in the regulation of physiological and pathological processes including immunity and inflammation.

  Weight (Pounds) x 703       OR         Weight (Kilograms) 

 
Height (Inches) x Height (Inches)      Height (Meters) x Height (Meters)  

Obesity is diagnosed when your body mass index (BMI) is 30 or higher. To determine your body mass index, use one of these formulas:

BMI =  

BMI Weight status
Below 18.5 Underweight
18.5-24.9 Normal
25.0-29.9 Overweight
30.0 and higher Obesity

For most people, BMI provides a reasonable estimate of body fat. Because BMI doesn’t directly measure body fat, some people such as muscular athletes may have a BMI in the obesity category even though they don’t have excess body fat.

2. What is Diabesity?

‘Diabesity’ is the term for diabetes occurring in the context of obesity. This form of obesity-dependent diabetes has emerged as a major public health problem in recent times. Though it is basically explained by insulin resistance and pancreatic beta cell dysfunction, new patterns have evolved to explain these modifications in the context of the modern rates of obesity and diabetes.

3. Is Obesity an Inflammatory Condition?

The connection between obesity and inflammation has been in debate in the recent past. Unbeknownst to many, the link between these conditions was made decades ago. Over a century ago, high doses of a class of anti-inflammatory compounds including aspirin (salicylates) were used to treat Type 2 diabetes. In some cases, the symptoms of diabetes totally disappeared. Unfortunately, this treatment was discontinued due to the serious side effects caused by the high doses of salicylates.

We will now look at the questions of our topic today in-depth; does obesity cause inflammation, or is inflammation caused by something secondary to obesity such as high blood sugar or triglycerides levels? How about diabesity? Does diabesity cause inflammation, or does inflammation cause diabesity? How and why does the body initiate an inflammatory response to diabesity? Let us tackle each item separately.

4. How Does Inflammation Cause Diabesity?

Listed are some lines of evidence that show inflammation directly causes obesity and diabesity.

  • The development of diabesity has been shown to follow inflammation. Raised levels of inflammatory cytokines predict impending weight gain. In a study, infusion of inflammatory cytokines into healthy, normal weight mice caused insulin resistance. This concept is also illustrated by the fact that people with other chronic inflammatory conditions are at higher risk of developing Type2 Diabetes; for example, about one-third of chronic Hepatitis C patients develop Type 2 diabetes, and those with rheumatoid arthritis are also at higher risk.
  • In obesity, inflammation has been noted to start in the fat cells themselves. As fat mass expands, inflammation increases. One explanation may be that dysfunction of the mitochondria (the “power plant” of our cells) caused by obesity puts increased stress on cellular function. Another mechanism may be oxidative stress. As more glucose is delivered to the fat cells, they produce an excess of reactive oxygen species (ROS) which in turn starts an inflammatory cascade within the cell.
  • Inflammation of the fat tissue causes insulin resistance, which is the primary feature of Type 2 diabetes. TNF-α, a cytokine (small protein) released during the inflammatory response and several other proteins involved with inflammation, such as MCP-1 and C-Reactive protein have been repeatedly shown to cause insulin resistance.
  • Inflammation of the brain (specifically the hypothalamus) causes leptin resistance, which often precedes and accompanies insulin resistance and Type 2 diabetes. Leptin is a hormone that regulates appetite and metabolism this through its effect on the hypothalamus. When the hypothalamus becomes resistant to leptin, glucose and fat metabolisms are impaired and weight gain and insulin resistance result.
  • When there is inflammation of the gut, there arises leptin and insulin resistance. This may occur via an increase in lipopolysaccharide (LPS), an endotoxin produced by Gram-negative bacteria in the gut. LPS has been shown to cause inflammation, insulin resistance in the liver, and weight gain.

5. How  does Diabesity Cause Inflammation?

In the past, fat was considered an inactive tissue with no biological action. It wasn’t considered for much other than storing energy. It has now emerged that fat tissue is a metabolically active endocrine organ that secretes hormones and inflammatory cytokines such as IL-6 and TNF-α. This metabolic activity of fat is the key to understanding its role in diabesity.

6. Why would obesity cause inflammation?

The first theory is that obesity-induced inflammation is a protective mechanism that prevents the body from losing mobility or fitness. Fat storage is an anabolic process, which means it builds up the organs and tissues. Inflammation, on the other hand, is a catabolic process which breaks down organs and tissues. It’s possible that the activation of catabolism via inflammation is the body’s attempt to keep weight within acceptable bounds. Evidence that experimentally induced local inflammation in fat tissue improves insulin resistance and causes weight loss supports this theory.

The second theory is that, obesity-induced inflammation is simply a malfunction that was never selected against in human evolution. Obesity and its related disorders have been extremely rare throughout human history, and have only become common in the past 40 years. The surplus of modern, processed foods that accompanies diabesity is also a relatively new phenomenon. It’s possible that the stresses of obesity are similar enough to the stresses of an infection that the body reacts to obesity in the same way it would to an infection: via inflammation. Supporting this theory is evidence that the same intracellular, inflammatory stress pathways are activated in both obesity and infection.

7. Tackling Inflammation in the control of diabesity

We can therefore conclude that inflammation is both the cause and the result of diabesity. Once obesity and/or insulin resistance have been established, each can further stimulate the production of inflammatory cytokines, forming a vicious cycle of inflammation and diabesity.  

Reduction of inflammation is a major key in preventing and treating diabesity. Focusing exclusively on regulating blood sugar and fat hormones without addressing other potential causes of inflammation is bound to produce inferior results.

 

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Metabolic inflammation as a cause of insulin resistance

Important Points:

Metabolic inflammation as a cause of insulin resistance

In previous articles, I have discussed the role of metabolic Inflammation in obesity and diabetes. Today, we will narrow down to the specifics of what insulin resistance is, its effects, and how metabolic inflammation increases the chances of one developing it.  

1. What is Insulin resistance?

Approximately 30% of Americans, and up to 50% in the 60 years and over bracket, have a silent blood sugar problem known as insulin resistance. It begins when cells in your muscles, body fat, and liver repel or ignore the signal sent out by the hormone insulin to take glucose from bloodstream into our cells for breakdown or storage. Glucose, commonly called blood sugar and is the body’s main source of fuel.

Insulin resistance increases the risk for prediabetes, Type 2 diabetes, and a host of other serious health problems, including heart attacks, strokes and cancer.

2. How does Insulin Resistance Develop?

Some factors that determine insulin resistance are aging and ethnicity, but the driving forces seems to be excess body weight, too much belly fat, a lack of exercise, smoking, and even sleep depravity.

As the insulin resistance develops, more insulin is produced by your body as it tries to fight back. After an accumulated period of time, several years even, the beta cells in your pancreas get worn out because of all the extra work and can no longer keep pace with the increased demand for insulin. Then – years after insulin resistance stealthily began – your blood sugar may spike and you may manifest prediabetes or type 2 diabetes. You are also at risk of developing non-alcoholic fatty liver disease (NAFLD), a condition that increases your risk for liver damage and heart disease.

3. What are the Signs and Symptoms of Insulin Resistance?

Insulin resistance does not always manifest to the naked eye but here are other possible signs that are visible:

  • A large waist. Experts say the best way to tell whether you’re at risk for insulin resistance involves a tape measure and moment of truth in front of the bathroom mirror. A waist that measures 35 inches or more for women, 40 or more for men (31.5 inches for women and 35.5 inches for men if you’re of Southeast Asian, Chinese or Japanese descent) increases the odds of insulin resistance and metabolic syndrome, which is also linked to insulin resistance.
  • Additional signs of metabolic syndrome. According to the National Institutes of Health, in addition to a large waist, if you have three or more of the following, you likely have metabolic syndrome, which creates insulin resistance.
  • High triglycerides. Levels of 150 or higher or taking medication to treat high levels of these blood fats.
  • Low HDLs. Low-density lipoprotein levels below 50 for women and 40 for men or taking medication to raise low high-density lipoprotein (HDL) levels.  
  • High blood pressure. Readings of 130/85 mmHg or higher or taking medication to control high blood pressure
  • High blood sugar. Levels of 100-125 mg/dl (the prediabetes range) or over 125 (diabetes).
  • High fasting blood sugar or you’re on medicine to treat high blood sugar. Mildly high blood sugar may be an early sign of diabetes.
  • Dark skin patches. If insulin resistance is severe, you may have visible skin changes including patches of darkened skin on the back of your neck or on your elbows, knees, knuckles or armpits. This discoloration is called acanthosis nigricans.

4. Chronic low-grade inflammation and the development of insulin resistance

As early as 1950’s, a connection between inflammation and insulin resistance seemed to present especially in the obese, but the mechanics of the link were unknown. Recently, this has become clearer. Research has shown an association between the body activating signal pathways for inflammation over and over and a decrease in insulin sensitivity which is a rise in insulin resistance. Elevated levels of many inflammation signaling molecules (cytokines) and the inflammatory marker C-reactive protein (CRP) were found in those with insulin resistance and its symptoms, especially those that were obese.

5. What Health Conditions are Related to Insulin Resistance?

An estimated 87 million American adults have prediabetes; 30-50% will go on to develop full-blown type 2 diabetes., and up to 80% of people with type 2 diabetes have NAFLD. But those aren’t the only threats posed by insulin resistance.

Thanks to years of high insulin levels followed by an onslaught of cell-damaging high blood sugar, people with insulin resistance, prediabetes, and type 2 diabetes are at high risk for cardiovascular disease. Insulin resistance doubles your risk for heart attack and stroke and triples the odds that your heart attack or ‘brain attack’ will be deadly, according to the International Diabetes Federation.

Meanwhile, insulin resistance and metabolic syndrome are also linked with higher risk for cancers of the bladder, breast, colon, cervix, pancreas, prostate and uterus. The connection: High insulin levels early in insulin resistance seem to fuel the growth of tumors and to suppress the body’s ability to protect itself by killing off malignant cells.

Research has also found a strong association between insulin resistance and memory function decline, increasing the risk for Alzheimer’s disease

Research has also found a strong association between insulin resistance and memory function decline, increasing the risk for Alzheimer’s disease.

6. Can understanding the causes of Insulin Resistance aid in future preventive approaches?

As obesity-associated chronic low-grade inflammation is responsible for the decrease of insulin sensitivity, so obesity is a major risk factor for insulin resistance and related diseases such as type 2 diabetes mellitus and metabolic syndromes. The state of low-grade inflammation is caused by over-nutrition which leads to lipid accumulation in adipocytes and interferes with insulin signaling and action. This interference only adds to the cascade of errors (pathogenesis) that leads to insulin resistance. It has been suggested that specific factors and signaling pathways are often correlated with each other; therefore, both the accumulation and the interference mentioned should be studied further to fully understand the connection between inflammation and insulin resistance.

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Insulin Resistance and Chronic Pain

Important Points:

  • Fibromyalgia
  • Chronic pain
  • hemoglobin A1c
  • insulin resistance

Insulin Resistance and Chronic Pain

An estimated 10 million adults in the United States live with fibromyalgia — a condition that causes pain throughout the body often to the point where it’s difficult to function. Could the key to understanding and treating fibromyalgia and other chronic pain involve insulin resistance? We will shed some light on current research on this topic.

So, what is Fibromyalgia?

Characterized by chronic and widespread pain, increased sensitivity to pain, and heightened feelings of fatigue, brain fog, etc., fibromyalgia remains poorly understood. The condition is also hard to diagnose, difficult to manage, and diminishes the quality of life for those struggling with it.  It is reported that there’s an estimated global prevalence of 2.7%, with females outnumbering males nearly three to one. In addition, a couple of studies have noted that fibromyalgia seems to be more prevalent among individuals with Type 2 diabetes (T2d) suggesting a link between the two conditions that is worthy of further study. While experts agree that genetics and environmental factors are at play with fibromyalgia, little is known regarding how and why the syndrome develops.

Diagnostic criteria for fibromyalgia comes from the American College of Rheumatology (ACR) guidelines. The Widespread Pain Index measures pain or tenderness felt in the week prior to the appointment in 19 different body regions. The Severity Scale is deduced by the patient’s reporting the severity of symptoms like fatigue and brain fog on a scale from 0 to 3. ACR guidelines combine these two measurements using a rating scale from 0 to 31, and according to them, a score of 13 or higher corresponds to a diagnosis of fibromyalgia.

The global economic impact of FM is enormous. In the United States alone, the healthcare cost is around $100 billion/year and is comparable to reports in European countries. Due to lower pain thresholds, patients with FM also have a higher incidence of symptomatic musculoskeletal and spinal disorders which in themselves contribute to the financial burden of managing this disorder.

Many hypotheses have been advanced to explain the extensive array of symptoms including inherited abnormalities, dysfunction of neurotransmitter pathways such as substance P, immune dysregulation, and several others. Unfortunately, none of these propositions has led to practical advances beyond symptomatic treatment. In fact, recent reviews of FM published in 2016 and 2017 have concluded that there have been no substantive advances in our understanding of this disease.

2.  What are the Similarities Between Fibromyalgia and Insulin Resistance?

Although more recent reviews of fibromyalgia research do not make mention of the purported link between the syndrome and insulin resistance or diabetes, the two conditions affect brain vasculature in strikingly similar ways.

According to Miguel Pappolla, MD, PhD, a professor of neurology at the University of Texas Medical Branch and medical director of St. Michael’s Pain and Spine Clinics in Houston, insulin resistance is known to impair brain microcirculation leading to slowed blood flow and oxygenation (hypo-perfusion) in certain brain regions. “What is very interesting,” he said, “is that patients with fibromyalgia also have hypo-perfusion in several brain areas.” The question remains, however, whether insulin resistance may be behind these similar decreases in blood flow experienced by those with fibromyalgia.

  • Research into these Similarities

To investigate this question, Dr. Pappolla led a retrospective, cross-sectional study, reviewing medical records from 23 patients (21 females, 2 males; 11 White, 8 Hispanic, 4 African American; ages 35 to 60) at St. Michael’s Pain and Spine Clinics.7 All 23 patients met the ACR criteria for diagnosis with fibromyalgia.

As a measure of insulin resistance, the team selected the hemoglobin A1c, in which values between 5.7 and 6.4 define prediabetes and values of 6.5 or more constitute diabetes. They compared the A1cs on record for the 23 patients with fibromyalgia to those of two separate control groups: the non-diabetic subset (1,350 people) from the Framingham Offspring Study characterized by normal glucose tolerance (FOS NGT) and the non-diabetic subset (1,592 people) from the National Health and Nutrition Examination Survey (NHANES).

When the investigators compared the A1c test results of the people with fibromyalgia with those of age-matched controls, they found that the former group had significantly higher levels of hemoglobin A1c than the latter indicating a measure of insulin resistance.

“[People with prediabetes] with slightly elevated A1c values carry a higher risk of developing central (brain) pain, a hallmark of fibromyalgia and other chronic pain disorders,” notes Dr. Pappolla, pointing out that this link between insulin resistance and fibromyalgia has been around for a long time. Surprisingly, this link went unnoticed. “Considering the extensive research on fibromyalgia, we were puzzled that prior studies had overlooked this simple connection,” the first author says.

“The main reason for this oversight is that about half of fibromyalgia patients have A1c values currently considered within the normal range. However, this is the first study to analyze these levels normalized for the person’s age, as optimal A1c levels do vary throughout life,” the researcher continues.

“Adjustment for the patients’ age was critical in highlighting the differences between patients and control subjects,” he explains.

As part of the study, the researchers administered metformin — a drug that people typically take to treat insulin resistance — to the participants with fibromyalgia and muscular or connective tissue pain.

Metformin successfully reduced pain in this cohort, prompting the researchers to suggest that this common drug could be a viable and less expensive treatment option for some people with this chronic pain condition.

“In the [U.S.] alone, the healthcare cost is around $100 billion [per] year; comparable to reports in European countries,” the researchers write in the study paper.

“Earlier studies discovered that insulin resistance causes dysfunction within the brain’s small blood vessels. Since this issue is also present in fibromyalgia, we investigated whether insulin resistance is the missing link in this disorder.”

First author Dr. Miguel Pappolla

“We showed that most — if not all — patients with fibromyalgia can be identified by their A1c levels, which reflects average blood sugar levels over the past 2 to 3 months,” Dr. Pappolla adds.

The A1c test is a blood test that allows doctors to measure a person’s blood sugar levels by looking at “hemoglobin A1c,” a blood cell protein that binds to the simple sugar glucose. Doctors use this test to diagnose prediabetes and type 2 diabetes

In order to supplement this finding, the evolution of the pain scores of patients with FM who had had their Insulin Resistance treated pharmacologically was also reviewed. This subgroup of patients reported dramatic improvements of their myofascial pain after treatment with metformin.

  • Do these findings offer hope for the future for Chronic Pain Treatment?

This evidence, although preliminary, suggests a pathogenetic relationship between Fibromyalgia and Insulin Resistance, which may lead to better treatment plans.  Along with this, Metformin, a drug commonly used to treat diabetes patients by targeting insulin resistance, has shown promise with treating pain from fibromyalgia; it may translate not only into a radical paradigm shift for the management of [fibromyalgia] but may also save billions of dollars to healthcare systems around the world.

That said more research is needed to better understand the link between insulin resistance and fibromyalgia and other types of chronic pain.

References:

  1. NCBI (2016): A Correlative Relationship Between Chronic Pain and Insulin Resistance in Zucker Fatty Rats: Role of Downregulation of Insulin Receptors. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmed/26705975

  • Science Daily (2019): Does insulin resistance cause fibromyalgia? Retrieved from

https://www.sciencedaily.com/releases/2019/05/190507145523.htm

  • MedicalNewsToday (2019):  Fibromyalgia: Is insulin resistance ‘the missing link?’ Retrieved from

https://www.medicalnewstoday.com/articles/325155.php#1

  • Plos One (2019): Is insulin resistance the cause of fibromyalgia? A preliminary report. Retrieved from

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216079

  • Practical Pain Management (2019): Fibromyalgia and Insulin Resistance: Correlational or Causal Relationship? Retrieved from

https://www.practicalpainmanagement.com/pain/myofascial/fibromyalgia-insulin-resistance-correlational-causal-relationship

  • Healthline (2019): Drug Used to Treat Diabetes May Be Effective Against Fibromyalgia. Retrieved from

https://www.healthline.com/health-news/does-insulin-resistance-cause-fibromyalgia

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Foods That Improve Insulin Sensitivity

Important Points:

  • Insulin sensitivity
  • Insulin resistance
  • Fiber
  • Processed foods

Foods That Improve Insulin Sensitivity

Insulin is an essential hormone responsible for regulating levels of blood sugar, and the bodies response to the release of insulin is called insulin sensitivity. When the sensitivity is high, the body will require a small amount of insulin to reduce blood sugar levels. When sensitivity is low, the body may fail to respond to even high levels of insulin, and this labeled as insulin resistance.

Insulin is made by beta cells in the pancreas. When the body’s cells are insulin resistant, they can’t use insulin effectively and the blood sugar level rises as it builds up in the blood. When your pancreas senses high blood sugar, it makes more insulin to overcome the resistance, but this may not improve the situation. Chronic insulin resistance, common in type 2 diabetes, may deplete beta cells in the pancreas. Prolonged high blood sugar can damage nerves and organs, so improving insulin sensitivity to reduce insulin resistance in imperative.

Here are 8 ways to improve insulin sensitivity.

1.   Eat More Soluble Fiber

Eating soluble fiber has many health benefits and has been linked to increased insulin sensitivity

There are two kinds of fiber: soluble and insoluble. Insoluble fiber helps in forming stool that can easily move through the bowels, while soluble fiber plays a huge role in promoting insulin sensitivity, as shown in a study published in NCBI. Another study showed that women who ate more soluble fiber had significantly lower levels of insulin resistance. Soluble fiber promotes the growth of friendly bacteria in your gut which has been linked to decreased insulin resistance.

Foods that are rich in soluble fiber include legumes, oatmeal, flaxseeds, Brussels sprouts, and fruits like oranges.

2.   Eat More Colorful Fruit and Vegetables

Colorful fruits and vegetables are rich in antioxidants which rid the body of free radicals causing harmful inflammation and insulin resistance.

3.   Use Herbs and Spices

A number of spices play a role in promoting insulin sensitivity. They include:

  • Fenugreek seeds have high soluble fiber content. A 2001 study concluded that “fenugreek seeds improves glycemic control and decreases insulin resistance in mild type-2 diabetic patients.”
  • Turmeric containsan active component called curcumin which has strong antioxidant and anti-inflammatory properties, both of which help to reduce insulin resistance.
  • Ginger contains acomponent called gingerol which increases sugar uptake and improves insulin sensitivity.
  • Cinnamon is known for its ability to reduce blood sugar and increase insulin sensitivity.

4.   Drink More Green Tea

Green tea is a choice drink for people with diabetes type 2. Green tea has been linked to increased insulin sensitivity and reduced blood sugar levels. Green tea also has antioxidants that help to fight off free radicals and many other health benefits.

5.   Try Apple Cider Vinegar

Vinegar, a key ingredient in apple cider vinegar, could help increase insulin sensitivity by reducing blood sugar and improving the effectiveness of insulin. Vinegar helps to slow gastric emptying hence allowing time for the body more time to absorb sugar. This gives insulin more time to act. Apple cider vinegar can be added to cold salads or drinks.

6.  Cut Down on Carbs

Carbs are the main stimulus behind high sugar levels and the production of insulin. Carbs release sugar into the bloodstream when they are broken down, and this sugar is an essential source of energy for the body. When the body breaks down carbs into glucose and releases it into the blood, the pancreas releases insulin to move the glucose from the blood into the cells. Consuming excessive carbs could cause insulin resistance because of the excess glucose from those carbs sparks an overproduction of insulin. Reducing your carbohydrate intake could increase insulin sensitivity. There is no need to eliminate carbs as that will cause other problems. Processed carbs that are likely to trigger insulin resistance include white rice, pasta, and white bread.

7.  Avoid Artificial Trans Fats

Trans fats are partially hydrogenated oils that are usually added to processed foods to help them keep for longer and to give them a better taste. Foods that typically contain artificial trans fats include cakes, cookies, pies, doughnuts, and fried fast foods. Artificial trans fats are typically found in more processed foods.  

Trans fats have been shown to cause inflammation and increase the risk of type 2 diabetes. The US Food and Drug Administration (FDA) declared trans fats unsafe to eat in 2018, however, this directive is yet to be implemented by manufacturers. It is up to you the consumer to scrutinize the ingredient list before buying any processed foods.

8.   Reduce Your Intake of Artificial Sugars

Artificial sugars are mostly found in processed foods, and they contain two main types of sugar: high-fructose corn syrup and table sugar known as sucrose. Fructose has been linked to insulin resistance even in people with no diabetes.

Can Supplements Help to Improve Insulin Sensitivity?

The idea of taking natural supplements is a controversial one and may require consultation with your physician. If you have been diagnosed with insulin resistance, you may benefit from taking supplements that increase insulin sensitivity. These include chromium, berberine, and magnesium supplements which are linked to increased insulin sensitivity. Another compound, Resveratrol, found in the skin of red grapes and other berries also appears to increase insulin sensitivity in people with type 2 diabetes.

Since supplements can interact with other medication, it is important to consult your doctor before you start taking them.

References

1.   NCBI (2011): Trans Fatty Acids Induce Vascular Inflammation and Reduce Vascular Nitric Oxide Production in Endothelial Cells. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247279/

2.   NCBI (2013): Adverse metabolic effects of dietary fructose: results from the recent epidemiological, clinical, and mechanistic studies. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23594708

3.   NCBI (2014): The impact of soluble dietary fiber on gastric emptying, postprandial blood glucose and insulin in patients with type 2 diabetes. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24901089

4.   NCBI (2013): The Role of Gut Microbiota on Insulin Resistance. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705322/

5.   NCBI (2001): Effect of Trigonella foenum-graecum (fenugreek) seeds on glycaemic control and insulin resistance in type 2 diabetes mellitus: a double blind placebo controlled study. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11868855

6.   NCBI (2014): Effect and mechanisms of action of vinegar on glucose metabolism, lipid profile, and body weight. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25168916

 

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Beta Cells

Table of Contents:

  • Diabetes
  • Insulin resistance
  • Type 1 Diabetes
  • Type 2 Diabetes

Basics of Beta Cells

The pancreas is an exocrine gland that produces two key hormones involved in the regulation of blood sugar: Insulin and Glucagon. Beta cells are distinctive cells within the pancreas that are responsible for the production of insulin. They’re one of a minimum of 5 different types of islet cells, located within the section of the pancreas called the islets of Langerhans, that secrete hormones directly into the blood.

The Role of Beta Cells
The main role of beta cells is to provide and secrete insulin into the bloodstream when needed. When blood sugar levels begin to rise, such as when you are eating, beta cells quickly respond by secreting insulin into the bloodstream to take up the glucose being produced and store it in fat cells. Insulin should be considered primarily a fat storage hormone clearing the blood stream of excessive glucose and converting it to fat. Diabetes is a disease of insulin resistance in which these beta cells are either attacked or destroyed by the immune system (type 1 diabetes), or become resistant to the effects of insulin (type 2 diabetes).

The Role of Amylin and C-peptide
As a byproduct of insulin production, beta cells also produce two other products: Amylin and C-peptide.

  • Amylin slows the speed of glucose coming into the blood in acting as a short-term regulator of blood sugar levels.
  • C-peptide is secreted into the blood in equal quantities to insulin, but its role remains uncertain. It may prevent damage of arteries and diminished blood flow to the extremities as many people suffering from severe diabetes will have these symptoms. It is possible that when beta cells are destroyed, C-peptide is lost, but often patients experience early small vessel disease and neuropathy symptoms prior to Beta cell depletion. 

The Role of Beta Cells in Diabetes

Type 1 Diabetes
In Type 1 diabetes, beta cells die from an immune attack. Immune cells which normally fight harmful bacteria and viruses mistakenly destroy beta cells in the pancreas. The cause and avenue of destruction isn’t clear; however, the results of a study published in early 2011 show that these beta cells become stressed at the earliest stages of the illness.

In studies using mice, cells respond to this stress by triggering a death pathway leading to the loss of beta-cell function and ultimately loss of cell mass. As a result, stress on beta cells resulting from an immune attack may be responsible for type 1 diabetes. Type 1 diabetes has strong genetic links and mostly occurs in children.

Type 2 Diabetes
In Type 2 diabetes, the body loses sensitivity to insulin over time until it becomes immune to the effects of insulin. Consequently, it tries to compensate by producing more insulin. Research has shown that elevated blood sugar levels (chronic hyperglycemia) over a protracted amount of time will result in beta cell burn out or cell turnover. Although the exact cause is unclear, certain factors could contribute significantly such as chronic low-grade inflammation, the accumulation of high levels of glucose (glucotoxicity), or simply the effects of lipoproteins, leptin, and cytokines which play a role in glucose regulation.

Insulin Resistance in Type 2 Diabetes
The beta cells of the pancreas work as extremely connected clusters called islets, and their response to rising blood sugar levels are coordinated by little groups of “leader cells”, which initiate their coordination once blood sugar levels peak in the blood. It is possible that the leader cells are more metabolically active and more glucose-sensitive than the rest making them the primary target for insulin resistance.

Insulin resistance in type 2 diabetes starts out, as described above, with decreasing peripheral sensitivity to insulin leading to an overproduction of insulin by the beta cells.  This peripheral insulin resistance is primarily triggered by chronic over storage of fat as a result of excessive carbohydrate consumption and inadequate glycogen depletion.

Due to the increasing levels of insulin resistance, patients continue to suffer from elevated blood glucose levels with sweeping consequences. After a period of time, internal insulin production decreases, likely from excessive fat accumulation in the pancreas and localized changes in blood flow, resulting in the patient needing an external source of insulin.

New Drug To Stimulate Growth of Beta Cells
Researchers from Mount Sinai Hospital have discovered a unique combination of medication that induces the growth of beta cells. The lead author of the study Andrew Stewart, MD had this to say:

“We have discovered a drug combination that makes beta cells regenerate at rates that are suitable for treatment. The next big hurdle is figuring out how to deliver them directly to the pancreas.”

If beta cells can be stimulated to regenerate, then insulin resistance will no longer be an insurmountable obstacle for diabetics, and it will provide the much-needed breakthrough in the treatment of diabetes.

Keywords

  • Beta cells
  • Insulin resistance
  • Type1 diabetes
  • Type 2 diabetes

References

1.   Mayo Clinic: Type 2 diabetes. Retrieved from https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193

2.   Mayo Clinic: Type 1 diabetes. Retrieved from https://www.mayoclinic.org/diseases-conditions/type-1-diabetes-in-children/symptoms-causes/syc-20355306

3.   NCBI (2008): Insulin signaling in the pancreatic beta-cell. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18481923

4.   Science Daily (2018): Diabetes: New drug cocktail increases human beta cell proliferation at rapid rates. Retrieved from https://www.sciencedaily.com/releases/2018/12/181220111759.htm