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What is Diabesity, and how to reverse it

Important Points:

  • Diabesity
  • Type 2 diabetes
  • Insulin resistance
  • Obesity
  • Sedentary lifestyle

What is Diabesity, and how to reverse it

If you are like most people you are probably thinking that I have confused diabetes for diabesity, or you are probably wondering whether I intended to say obesity. You are not so far away from the truth as diabesity is a modern disease that links obesity with type 2 diabetes. Diabesity should be a concern for people with normal blood sugars who may be accustomed to unhealthy eating and lifestyle patterns. It is unfortunate that much is not mentioned about diabesity which can predispose you to severe obesity, diabetes, and other fatal chronic conditions.

What Is Diabesity?

Diabesity is a sequence of events that starts with optimal blood sugar balance, to progressive insulin resistance, to being overweight, then becoming obese, and finally to full-blown Type-2 Diabetes. It comes in a spectrum that includes elevated blood sugar, elevated blood pressure, high cholesterol, and other health complications. These problems stem from diet, lifestyle, and environmental toxins interacting with our unique genetic susceptibilities. A study published in NCBI in 2013 concluded that “(diabesity) makes a strong call for utilizing indigenous, low-cost means of enhancing healthy dietary and physical activity habits.” Diabesity can also be described as the coexistence of obesity and type 2 diabetes.

What Are The Triggers For Diabesity?

Diabesity occurs following the development of insulin resistance and obesity. When your diet is full of empty calories: quickly absorbed sugars, liquid calories (soda, juice, sports drinks), and refined carbohydrates, you are likely to develop a resistance to insulin. Insulin (produced by beta cells in the pancreas) is the hormone that is responsible for grabbing glucose out of the bloodstream and storing it in cells. This ensures that blood sugar levels remain stable in the blood. When the body starts ignoring the signal sent out by insulin we call this insulin resistance. Beta cells will keep releasing more and more insulin to try to remedy the situation, so a high insulin level is one of the first signs. Unfortunately, the higher your insulin levels are, the worse your insulin resistance becomes. High insulin levels will also cause a spike in appetite which leads to overeating. Very soon you develop weight gain around the belly, more inflammation, oxidative stress, and other effects such as high blood pressure, high cholesterol, low HDL, atherosclerosis, and increased risk of cancer, Alzheimer’s, and depression.

It is important to note here that the root cause of the problem is insulin resistance and not elevated blood sugar. Fortunately, insulin resistance can be reversed since it is strongly linked to poor diet and an unhealthy lifestyle.

Most people can save themselves from diabesity by eliminating the factors that are upending the balance of their biology and replacing them with what’s needed to help the body re-balance itself.

Diabesity and Genetics

Many people believe that insulin resistance and diabesity are genetic conditions that cannot be extraneously controlled. True enough, our genetic predisposition plays a role in the way we choose what to eat and how to live. It also plays a role in the development of insulin resistance. However, insulin resistance and diabesity are greatly influenced by diet and lifestyle, so controlling these factors can greatly minimize your chances of developing the conditions.

How To Reverse Diabesity

Before reversing diabesity, there are a few things you can do to keep safe. They include:

1.   Know the signs of insulin resistance.

One of the first tell-tale signs of insulin resistance is uncontrollable weight gain. You might also experience increased blood pressure and skin discoloration (acanthosis nigricans) on rare occasions. Unfortunately, insulin resistance may go unnoticed for years. Hence, you may be better off having some tests done.

2.  Get the right tests done

You should get tested if you have a positive family history of type 2 diabetes and are affected by a poor diet as well as a sedentary lifestyle. An insulin response test is the best test to tease out the condition.

If you have already been diagnosed with diabesity, here are three things you can do to start your reversal journey.

Make healthy diet choices

This may involve the input of your physician, nutritionist/ dietician, and yourself to come up with the right meal plan. A healthy diet will start with the elimination of sugary and processed foods. Opt for wholesome grains, fresh vegetables and fruits, nuts, white meat, and unsaturated fats instead. You can read more about this type of diet here. (hyperlink to foods that improve insulin sensitivity).

Get adequate rest

Stress is a major contributor to insulin resistance and blood sugar imbalance. Stress also contributes to making unhealthy food choices and overeating. You need to make a conscious effort to de-stress frequently by:

  • Sleeping for at least 7 hours daily
  • Practicing relaxation techniques such as yoga
  • Taking breaks in between work like every two hours
  • Taking sabbaticals and vacationing periodically

Quit a sedentary lifestyle

Modern jobs involve sitting at an office desk and hitting the keypad hours on end. In a world where work is compensated by the hour, it can be difficult to make time for exercise. However, when you consider the negative long-term effects of a sedentary lifestyle you will be forced to reconsider the value of the extra money. What is the point if it’s going to cost your health in the long run? Quitting a sedentary lifestyle involves making deliberate choices about exercise and fitness. This may mean walking at least 30 minutes every day or engaging in more vigorous aerobic exercise 4-6 times a week.

References

1.   Science Daily (2012): Genetic variant is linked to obesity and insulin resistance. Retrieved from https://www.sciencedaily.com/releases/2012/06/120626151107.htm

2.   NCBI (2011): Is fast food addictive? Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21999689

3.   NCBI (2013): Diabesity. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23905459

 

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What did you have for dinner?

Important Points:

  • Healthy diet
  • Type 2 diabetes
  • Nutrition
  • Carbohydrates
  • Protein

What did you have for dinner?

If type 2 diabetes were an infectious disease, it is said we would be in the midst of an epidemic. This problematic disease is striking an ever-growing number of adults, and with the rising rates of childhood obesity, it has become more common in youth especially among certain ethnic groups. The good news is that prediabetes and Type 2 Diabetes are largely preventable. About 9 in 10 cases in the U.S. can be avoided by making lifestyle changes. These same changes can also lower the chances of developing heart disease and some cancers. In this article, we will look at diet as a means to prevent and regulate type 2 diabetes.

How What You Eat Affects You

According to the Centers for Disease Control and Prevention, one out of every three American adults has prediabetes; that is 86 million people. Without intervention, up to one third of them will go on to develop type 2 diabetes within five years.

Is all lost? Not at all! Lifestyle changes can help. While excess body fat is a recognized risk factor for diabetes (and weight loss is an important way to lower risk), specific diet patterns and foods seem to decrease or increase risk, independent of weight. The latest research suggests that diabetes risk (as well as risk of heart disease and stroke) is largely influenced not by single nutrients but by specific foods and overall diet patterns.

Poor diet quality may influence weight and metabolic risk independent of calories; different types of foods have different effects on satiety, glucose-insulin responses, liver fat synthesis, fat-cell function, craving and reward responses in the brain, and the creation of visceral fat.

Foods that Lower the Risk of Getting Type 2 Diabetes

We will discuss in some detail every day food that might either aid in the prevention of diabetes or accelerate your progression towards it. When you are making the decision of what to eat, choose wisely.

  1. Choose high-fiber, slow-release carbs

Carbohydrates have a big impact on your blood sugar levels—more so than fats and proteins—so you need to be smart about what types of carbs you eat. Limit refined carbohydrates like white bread, pasta, and rice, as well as soda, candy, packaged meals, and snack foods. Focus on high-fiber complex carbohydrates, also known as slow-release carbs because they are digested more slowly, thus preventing your body from producing too much insulin.

2. Eat more plant foods
Minimally processed plant foods such as fruits, non-starchy vegetables, legumes, and nuts/seeds are consistently linked to better cardio-metabolic outcomes, including decreased diabetes risk.

3. Choose protein wisely
While they have been studied to different extents, meat, poultry, eggs, fish, and dairy protein sources appear to impact diabetes risk differently.

In their 2011 meta-analysis, Pan and colleagues determined that red meat consumption, particularly processed red meat, is associated with an increased risk of type 2 diabetes and suggested that substituting one serving of nuts, low-fat dairy, and whole grains per day for one serving of red meat would lower diabetes risk by 16% to 35%.

4. Use quality fats instead of quantity
Most research on fats typically looks at their impact on cardiovascular, not diabetes risk, and fats’ association with diabetes risk is in need of clarification. Recent evidence suggests that the quality of fats consumed in the diet is more important than the total quantity of dietary fat.  In other words, the exact fats consumed are more relevant than just the quantity of consumption, and some fats may be proinflammatory (omega 6 fats from industrial seed oil, vegetable oil) and others may be anti-inflammatory (omega 3 fats from natural products or saturated fats found in real food). Some researchers point out that source of fat is important. In studies looking at total fat intake and health effects, results showed:

  • A Mediterranean dietary pattern which is relatively high in monounsaturated fats may help prevent type 2 diabetes.
    • Intake of high-fat dairy products is associated with a decrease in type 2 diabetes risk.
    • Omega-3 fatty acid ALA (alpha-linolenic acid) may be associated with modestly lower risk.

5. Drink unsweetened beverages and water
What to drink is a choice we make every day, and it is just important to get into healthy drinking habits.

• Both coffee (caffeinated and decaffeinated) and tea are associated with lower risk of diabetes.  The problem arises because many people add sweeteners and artificial creamers to coffee, which may contain significant carbohydrates and defeats the purpose of not consuming refined carbohydrates.

•Fruit juices have historically been considered safe, but the reality is that most fruit juices contain about the same amount of carbohydrate as does soda.  We urge our patient’s to avoid both soda and fruit juices altogether.

• There’s strong evidence that moderate alcohol use is associated with lower diabetes risk across diverse populations, but people who don’t currently drink alcohol shouldn’t be encouraged to do so, and drinkers should limit themselves to up to two drinks per day for men and one to 1.5 for women.

In Summary

Eat more:

  • Healthy fats from nuts, olive oil, fish oils, flax seeds, or avocados
  • Fruits and vegetables—ideally fresh, the more colorful the better; whole fruit rather than juices
  • High-fiber cereals and breads made from whole grains
  • Fish and shellfish, organic chicken or turkey
  • High-quality protein such as eggs, beans, low-fat dairy, and unsweetened yogurt

Eat less:

  • Trans fats from partially hydrogenated or deep-fried foods
  • Packaged and fast foods especially those high in sugar, baked goods, sweets, chips, desserts
  • White bread, sugary cereals, refined pastas or rice
  • Processed meat and red meat
  • Low-fat products that have replaced fat with added sugar, such as fat-free yogurt

A Healthy Lifestyle

It is easier to adapt a healthy eating lifestyle than to go on a diet. Working with dietary patterns instead of focusing on individual nutrients or “superfoods” (or vilifying particular food groups) allows greater flexibility for you and lets you choose foods you like at times that are convenient to you.

Given the health advantages of plant foods like leafy greens and whole grains and their association with reduced diabetes risk, you should ensure your diet pattern includes a healthy serving of them at all times.

References:

  1. Today’s dietician (2017):Diabetes Management & Nutrition Guide: Foods and Eating Patterns for Diabetes Prevention. Retrieved from

https://www.todaysdietitian.com/newarchives/0717p40.shtml

  • Harvard School of Public Health (2019): Simple Steps to Preventing Diabetes. Retrieved from
https://www.hsph.harvard.edu/nutritionsource/disease-prevention/diabetes-prevention/preventing-diabetes-full-story/
  • Health Guide (2018): The Diabetic Diet. Retrieved from
https://www.helpguide.org/articles/diets/the-diabetes-diet.htm
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Unraveling the Metabolic Syndrome

Important Points:

  • Metabolic syndrome
  • Type 2 diabetes
  • Blood sugar
  • Insulin resistance

Unraveling the Metabolic Syndrome

Metabolic syndrome can be defined as a cluster of conditions that increase one’s risk for heart disease and type 2 diabetes. The cardinal signs involved include increased blood pressure, high blood sugar levels (insulin resistance), excess belly fat, high triglyceride levels, and low levels of good cholesterol (HDL). If you have at least three of them – you may already have the condition.

If you have any of the listed symptoms you should not panic as this is not a sure sign that you will develop heart disease or type 2 diabetes; however, it means that you should take caution because you are at a higher risk for developing either or both the diseases. Having more risk factors puts you at a greater risk as well.

Approximately 47 million Americans suffer from metabolic syndrome which translates to a staggering one in six people. There is a genetic link to this syndrome which mostly affects African-Americans, Hispanics, Asians, and Native Americans. The risks of developing metabolic syndrome increases as you age. Fortunately, aggressive lifestyle changes can delay or even prevent serious health problems for those at risk of developing the disease.

What are the Symptoms of Metabolic Syndrome?

Metabolic syndrome is a cluster of conditions that indicate an underlying disease process. Some conditions including elevated triglycerides, high blood sugar, and high blood pressure need to be lab tested which makes it harder to pick up on the symptoms of the syndrome. Generally, a large or increasing waist circumference together with one or two other lab-tested signs may be an indication of the syndrome.

What are the Causes of Metabolic Syndrome?

Metabolic syndrome is closely linked to a sedentary lifestyle defined as sitting or lying down for long hours without expending much energy. When this is combined with an unhealthy diet such as eating processed foods packed with empty calories, chances of developing metabolic syndrome are increased.

Metabolic syndrome is also linked to insulin resistance. When a person has insulin resistance their cells don’t respond normally to the hormone insulin which removes sugar from the blood and stores it in cells. This leads to an increase in blood sugar levels.

Abdominal obesity, having extra fat around the waist, is another risk factor for metabolic syndrome. Lastly, hormonal imbalance and conditions including polycystic ovarian syndrome may also contribute to the development of the metabolic syndrome.

Age and ethnicity are other risk factors as risk increases with age and metabolic syndrome is seen more in certain ethnicities such as Hispanics in the US.

What are the Complications of Metabolic Syndrome?

Having metabolic syndrome can predispose you to the risk of developing:

  • Type 2 diabetes. One of the signs of Metabolic Syndrome is insulin resistance which is a precursor to type 2 diabetes.
  • Heart Disease. High levels of bad cholesterol and high blood pressure due to metabolic syndrome can lead to atherosclerosis. Many times, this eventually leads to heart disease and increased risk for stroke.

How is Metabolic Syndrome Diagnosed?

There are a few signs that may point towards metabolic syndrome. They include:

  • Having a large waist circumference measuring at least 89 centimeters for women and 102 centimeters for men.
  • Having high triglyceride above 150 milligrams per deciliter (mg/dL).
  • Low “good” (HDL) cholesterol levels below 40 mg/dL in men or below 50 mg/dL in women.
  • Having increased blood pressure of 130/85 millimeters of mercury (mm Hg) or higher.
  • Having high blood sugar of 100 mg/dL (5.6 mmol/L) or higher.

How Can You Prevent Metabolic Syndrome

Metabolic syndrome is largely a diet and lifestyle enhanced condition. Making the following lifestyle changes can prevent conditions that cause it:

Regular exercise

Health experts recommend exercising for at least 30 minutes each day. This may include brisk walking, aerobics, or slow jogging. If you are at high risk for heart disease you will need to consult with your physician before you can engage in strenuous physical activity.

Lose Weight

If you have extra weight around the mid-section it may be wise to shed it off. You can achieve this through targeted weight lifting and controlling your calorie intake. Losing 7 to 10 percent of your body weight can reduce insulin resistance and blood pressure and also decrease your risk of diabetes. Avoid embarking on weight loss crush programs as you are bound to rebound and gain more weight than you had previously. Instead, work on a program that allows you to lose weight gradually and sustainably.

Adopt a healthy diet plan

A healthy heart diet should be comprised of:

  • Vegetables
  • Fruits
  • Unsaturated fats
  • Whole grains rich in fiber
  • White meat

You should avoid or limit your intake of the following:

  • Sugar-sweetened beverages
  • Processed foods
  • Red meat
  • Excess alcohol
  • Excess salt
  • Trans fats and saturated fats

Reducing or manage stress

Stress is a big contributor to unhealthy lifestyle patterns. If you are at high risk for developing metabolic syndrome regular distressing may be necessary for you. Exercises such as meditation and yoga can be good ways to help you relax. Listening to classical music, taking up a hobby or traveling for leisure can also be of help. Ultimately, you will need to commit to a healthy lifestyle which will not only lower your risk for metabolic syndrome but also reduce your risk for other chronic conditions such as cancer and osteoporosis.

References

1.   Medscape (2019): Metabolic Syndrome: A Growing Clinical Challenge: Epidemiology. Retrieved from https://www.medscape.org/viewarticle/484166_2

2.   Heart.org: What is Metabolic Syndrome? Retrieved from https://www.heart.org/en/health-topics/metabolic-syndrome

3.   WebMD: What is Metabolic Syndrome? Retrieved from https://www.webmd.com/heart/metabolic-syndrome/metabolic-syndrome-what-is-it#

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Should people with diabetes try the Carnivore diet?

Important Points:

  • Carnivore diet
  • Meat
  • Type 2 diabetes
  • Side effects
  • Weight loss

Should people with diabetes try the Carnivore diet?

The diabetes state of affairs has taken the world by storm. With easy to access processed foods and a sedentary lifestyle, obesity has become all too common, and we would all like a cure. Though many diabetics are often under treatment, it is well understood that conventional medicine only manages the diabetic condition but does not offer any hope for reversal or a cure. Is the carnivore diet the missing piece in this puzzle?  How can adapting the carnivore diet start reversing the effects of this disease? In this article we will look at the possibilities in these questions and shed some light on how the carnivore diet can actually help.

Facets of the Carnivore Diet Making It Ideal for Reversing Type 2 Diabetes

The carnivore diet is very effective in achieving the two common aims of diabetes control: lowering blood glucose levels and reducing weight.

The all meat diet, also known as the carnivore diet, is exactly what its name suggests: a diet that consists 100% of meat. Think of the keto diet without any salads or low carb vegetables.

The carnivore diet has been claimed to have a variety of benefits including:

  • lower blood pressure
  • improved insulin sensitivity
  • reduced dependency on medication
  • reduction in weight
  • improvements in high-density lipoprotein (HDL), or “good” cholesterol, without adding to low-density lipoprotein (LDL), or “bad” cholesterol
  • a drop in insulin

Proponents of the diet tout its ability to aid in weight loss, cure autoimmune diseases, decrease digestive issues, and improve heart health. The total elimination of carbohydrates as part of this diet results in more consistent insulin levels.

The carnivore diet should consist of the following types of food:

  • Meats: Fatty meats are acceptable, but should be eaten in moderation to be mindful of heart health. Also, be mindful of consuming too much protein. Combining a high level of protein with low levels of carbohydrates may cause the liver to convert the protein into glucose. This would raise blood sugar levels.
  • Eggs: Eggs are low in carbohydrates, as well as being an excellent source of protein.
  • Fish: This is a good source of protein.
  • Poultry: Also a good source of protein
  • Organ parts: A good source for nutrients besides protein
  • Cheese: Not everyone on a carnivore diet takes cheese but it can be included.

There has been anecdotal evidence that people with diabetes have been able to stabilize their blood sugar using this diet. From a biochemistry standpoint, if you’re eating only meat, you’re largely not taking in glucose, so your blood glucose levels are likely to be stable.

Effects of Carbohydrates on a Diabetic

Foods containing carbohydrates, such as bread, rice, pasta, milk, and fruit, are the main fuel source for many bodily processes. The body uses insulin to help bring glucose from the blood into the cells for energy. As Type 2 Diabetes is a disease of insulin resistance, people suffering from this condition produce too much insulin because their receptors don’t work. This disrupts the body’s ability to use carbohydrates effectively and, in turn, causes high blood sugar levels. When a person with Type 2 Diabetes eats a high-carb meal, this can lead to a spike in blood glucose.

Because the carnivore diet totally eliminates carbohydrates, glucose spikes are avoided. In fact, the body starts using the stored up fat for energy. This leads to weight loss and stable sugars.

In a nutshell the carnivore diet might:

  • reduce the risk of diabetes in people who do not yet have it
  • improve glycemic control in people with diabetes
  • help people to lose excess weight

Impact of the Carnivore Diet on Diabetics’ Medication

The carnivore diet may help reduce blood sugar levels. As such, some people with type 2 diabetes who start this diet may be able to reduce their need for medication. One should have their blood glucose levels constantly monitored so as to adjust medication accordingly.

Impact of a Carnivore Diet on Weight Loss?

People on a carnivore diet tend to lose weight because:

  • They totally eliminate carbohydrates and sugar, which are readily converted to fat.
  • Their bodies start burning fat for energy. Naturally, this leads to reduced weight.

Diabetes has been linked to obesity and one of the factors that help in the prevention and management of this disease is keeping one’s weight within the recommended guidelines. As such, this aspect of the carnivore diet can go a long way in managing, and even reversing Type 2 Diabetes.

Side Effects of the Carnivore Diet

The Carnivore diet may be a viable glucose management option for some people with type 2 diabetes, however, as the it involves switching to a different source of energy, it’s not right for everyone.

Short-term side effects

The dietary change might cause symptoms that resemble withdrawal from a substance, such as caffeine.

These symptoms may include:

  • keto-flu, a short-term group of symptoms that resemble those of flu
  • noticeable changes in bowel habits, such as a running stomach
  • uncomfortable leg cramps
  • a noticeable loss of energy
  • mental fogginess
  • frequent urination
  • headaches
  • loss of salts

In most instances, the side effects are temporary. People often experience no long-term health problems.

Long term side effects

Measuring blood sugar looks at the short-term, immediate effect of food. But over time, eating a diet of mostly or only meat can have long-term health consequences.

Long-term effects might include the development of kidney stones and an increased risk of bone fractures due to acidosis. Other complications include the risk of dyslipidemia (buildup of fats in the blood) and a possible increase in hypoglycemic (below normal blood sugar level) episodes.

Some animal studies have suggested that, since a low-carb diet often involves additional fat, there might be a higher risk of cardiovascular disease (CVD), due to a buildup of fats in the arteries. People with diabetes already have an increased risk of CVD.

There is a lack of evidence about the long-term safety and effectiveness of the carnivore diet, and researchers have called for more primary studies and more evidence before recommending this diet.

Alternatives to the Carnivore Diet

A doctor may recommend a specific meal plan rather than suggesting a diet. The carnivore diet is one of many eating plans that might help people manage their weight. A majority of health professionals do not recommend the carnivore diet for managing diabetes because there are many other nutrient-dense diets available that aim to balance carbohydrate, protein, and fat intake, control body weight, and keep blood sugar within a healthful range.

Criticisms of the Carnivore Diet

Critics of the carnivore diet focus on the adverse effects, including the possibility of kidney damage, CVD, and hypoglycemic episodes while noting that there is no evidence to support the long-term benefits of the carnivore diet.

Maintaining this type of diet can also be difficult on a long-term basis, as it is highly restrictive. This may lead to weight gain later on, particularly if an individual starts to eat unbalanced levels of carbohydrates once they switch back to a regular diet.

So, is it advisable for a diabetic to go on a carnivore diet?

Unlike the other diets, the carnivore diet is easy to track and maintain because it involves eating all kinds of meat in any quantities. It is thus easier to follow and much harder to fall off the wagon than being on diets such as the keto diet and others that need careful monitoring and measuring in some.

Much remains to be discovered about how this way of eating impacts our health, but it’s certainly worth a try if you’re struggling with autoimmune diseases, obesity, diabetes or psychiatric issues. Going on a carnivore diet as a short-term experiment is reasonable and safe, albeit socially challenging.

Therefore, at this point in time, without scientific studies to back the safety of this diet, and without substantial anecdotal evidence about long-term success, there isn’t really any way to say for certain if the all meat diet is good for people with diabetes. One thing it won’t do, however, is raise blood sugar levels. And that’s a good thing!

References:

  1. A sweet life (2018): Is the All Meat Diet Good for People With Diabetes? Retrieved from
https://asweetlife.org/is-the-all-meat-diet-good-for-people-with-diabetes/
  • Nutrita (2019): The ultimate guide to the carnivore diet. Retrieved from

https://nutrita.app/guide-to-the-carnivore-diet/

  • Healthline (2019):All Meat, All the Time: Should People with Diabetes Try the Carnivore Diet? Retrieved from

https://www.healthline.com/health/diabetes/carnivore-diet-for-diabetes#1

  • NCBI (2017):Effects of Ketogenic Diets on Cardiovascular Risk Factors: Evidence from Animal and Human Studies. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452247/

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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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The role of Reactive oxygen species (ROS) in the progression of Type 2 diabetes

Important Points:

  • Oxidative stress
  • Reactive oxygen species
  • Type 2 diabetes
  • Cardiovascular

The role of Reactive oxygen species (ROS) in the progression of Type 2 diabetes

Type 2 diabetes is the most prevalent metabolic disease currently known to man. Its hallmarks are pancreatic beta-cell dysfunction and insulin resistance. The Reactive Oxygen Species (ROS) is a little understood factor as far as the progression of Type 2 diabetes is concerned, and therefore, in this article, I will shed some light on what it is and the effect it has on this chronic disease.

1. What is ROS?

ROS is a type of unstable molecule that contains oxygen and that easily reacts with other molecules in a cell. A buildup of reactive oxygen species in cells may cause damage to DNA, RNA, and proteins, and may cause cell death. Reactive oxygen species are free radicals, also called oxygen radicals.

2. How does ROS interact with cellular function?

Traditionally, ROS have been thought to be generally harmful to biological systems producing useless by-products of respiratory metabolism in mitochondria. Growing evidence shows that, in many instances, ROS is not harmful or useless, but rather an essential element for certain biological responses. It’s been demonstrated that ROS are critical factors in how cells normally send signals and regulate some insulin secretions. Excessive or sustained ROS production can disturb the way cellular parts function, such as DNA, protein, or lipids.

3. So, when is ROS action harmful?

As discussed above, ROS action is generally beneficial. Under diabetic conditions, chronic hyperglycemia and consequent augmentation of reactive oxygen species (ROS) deteriorate beta-cell function and escalate insulin resistance leading to an aggravation of the type 2 diabetes. Additionally, chronic hyperglycemia and ROS are also involved in the development of atherosclerosis which is often observed under diabetic conditions.

Such disturbances contribute to the formation and progression of various diseases, including diabetes. To counteract these insults, most cells, including β-cells, have intricate mechanisms of defense against ROS toxicity often resulting in oxidative stress.

In response to oxidative stress, activation of certain proteins (Nrf2) dramatically increase the activation of antioxidant enzymes thus increasing the ability to remove the extra oxygen from the cells. This removal of abundant oxygen from the cells is critically important for returning to homeostasis or state of rest and protects cells from irreversible oxidative damage.

4. ROS and Cardiovascular Complications in Diabetic Patients

Diabetes mellitus (DM) is an independent risk factor of heart failure. The Framingham Heart Study reported that the frequency of heart failure is 2-fold higher in male diabetics and 5-fold higher in female diabetics than in age-matched control subjects. An increase in reactive oxygen species (ROS) has been regarded as a dominant mechanism of cardiac dysfunction in patients with DM. ROS are important intracellular signaling molecules and mediate various cellular functions, including activation of transcriptional factors, protein kinases, and ion channels; however, high levels of ROS are detrimental to cardiomyocytes.

It can therefore be said that Reactive oxygen species (ROS) are the main facilitators of cardiovascular complications in diabetes mellitus (DM). Emerging evidence shows that mitochondria and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase are dominant mechanisms of ROS production in the diabetic heart.

In physiological conditions, ROS levels are appropriately controlled by antioxidant enzymes to minimize cellular damage from oxidation. Oxidative stress occurs when ROS production overwhelms antioxidant capacity in pathological conditions. It is apparent that ROS production and oxidative stress are increased in the diabetic heart, and oxidative stress induces various cardiovascular complications including cardiac dysfunction which is facilitated by inflammation, apoptosis, and fibrosis.  The rise in the ROS level in the diabetic heart is brought about by multiple mechanisms making it a complex problem.

5. What should we expect to see in the future?

ROS are induced under diabetic conditions, which are possibly involved in the progression of pancreatic cell dysfunction and insulin resistance found in type 2 diabetes. Suppression of ROS in obese type 2 diabetic mice restores cell function and insulin sensitivity, leading to amelioration of glucose intolerance. In addition, ROS are involved in the progression of atherosclerosis which is often observed as the way blood clots and fat build up in the arteries under diabetic conditions.

Taken together, it is likely that ROS are closely associated with the development of type 2 diabetes and atherosclerosis, but at present, several clinical trials with antioxidants show only a little effect, if any, on the progression of type 2 diabetes. Future therapy might look into the suppression of ROS and infusion of stronger and more appropriate antioxidants as a way of exerting some beneficial effects against the development of type 2 diabetes and atherosclerosis.

References

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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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Is Diabetes linked to bacteria invading your colon?

Important Points:

  • Gut bacteria
  • Microbiota
  • Type 2 Diabetes

Is Diabetes linked to bacteria invading your colon?

The gut has been called by many scientists as the second brain. Our brain regulates the intricate functions of our body autonomously while we go about our business. The same goes for our gastrointestinal system. Our GI is not just an organ system dedicated to digestion and excretion; it is a highly specialized network of neurons lining our guts and a complicated collection of microscopic organisms that play a vital role in our mental state, emotions, and metabolism.

In a recent study conducted by the Georgia State University, the role of the gut was shown to have major significance in predisposing a person to type 2 diabetes. In the study, researchers from the Institute of Biomedical Sciences have discovered that when gut microbiota stays within the outer regions of the mucus lining, it has no significant negative effect on the person but when the gut microbiota encroaches upon the cells well beyond its designated area, it has been found to cause inflammation which can interfere with the normal functioning of the hormone insulin and thus leading to type 2 diabetes.

As of the moment, researchers are still conducting follow-up studies to isolate the specific bacteria that invade the lining and cause the inflammation that triggers the metabolic cascade into diabetes. Researchers are optimistic that when the bacteria are identified, it would pave the way in developing new treatments for type 2 diabetes.

Think Twice: How the Gut’s “Second Brain” Influences Mood and Well-Being

https://www.scientificamerican.com/article/gut-second-brain/

Diabetes Linked To Bacteria Invading The Colon, Institute For Biomedical Sciences Study Finds

http://news.gsu.edu/2017/05/30/diabetes-bacteria-invading-colon/
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Achieving Success with Diabetes Remission

Important Points:

  • Diabetes remission
  • Diabetes reversal
  • Sugar levels
  • Weight loss
  • Type 2 diabetes

Achieving Success with Diabetes Remission

Many people living with diabetes often wonder if diabetes remission is a possibility for them.  For most people this is an achievable goal. If you are willing enough to put in the hard work, you can go for years without taking any diabetes medication while still maintaining normal sugar levels. This article will show you how.

Type 2 diabetes is a serious chronic condition that can cause debilitating effects. It can be a lifelong condition worsening over time, or it can present no problems when going into long-term remission.

Most people embrace a triad approach to treating Type 2 diabetes: medication, diet, and exercise. Some lucky few are able to drop off their medication and still maintain normal blood sugar.  Research shows that many people can achieve a similar level of success in the management of diabetes.

Is diabetes reversal the same as diabetes remission?

Remission is often confused with diabetes reversal, but they mean totally different things. Whereas reversal implies that one is completely cured of diabetes, remission means that a person is living symptom-free for a long duration of time without being on medication. With remission, there is always the awareness that the disease might recur. Our article, seen here, on the difference between diabetes reversal and remission goes into more detail.

 What is diabetes remission?

Diabetes remission occurs in people, suffering from Type 2 diabetes, when they are able to maintain normal blood sugar levels without needing to take any diabetes medication. Diabetes remission is not a cure for diabetes; it simply indicates that Type 2 diabetes may or may not come back. If one resumes normal diet and an unhealthy lifestyle, then their blood sugar is likely to spike making the return of diabetes symptoms more likely.

In 2009, the American Diabetes Association divided Diabetes remission into three categories:

  • Partial remission: blood sugar which does not meet the classification for Type 2 Diabetes; fasting blood glucose 5.5 – 6.9 mmol/l for at least 1 year.
  • Complete remission: normal glucose values i.e. fasting blood glucose < 5.6 mmol/L for at least 1 year.
  • Prolonged remission: normal glucose values i.e.
    fasting blood glucose < 5.6 mmol/L for at least 5 years.

For all the three categories listed above, the patient must have been off all diabetic medication for the given duration of time. According to the American Diabetes Association, when a person combines diet and exercise with blood sugar lowering medication, such as Metformin, they do not qualify as being in remission.

How to Achieve Diabetes Remission

1.    Weight Loss

Losing weight around the waist can significantly increase your chances of remission.

Before embarking on a weight loss journey, it is important to first consult with your healthcare provider in order to make sure it’s safe for you especially if you have other health conditions. You might also need help in determining which weight loss approach would work best for you.

To understand how losing weight can cause remission, we need to draw the link between being overweight and Type 2 diabetes. The fat that builds up around the midsection is dangerous because it surrounds important organs like the liver and pancreas making it more difficult for those organs to work properly. This progression leads to Type 2 diabetes.

Research has shown that almost 50-80% of individuals with type 2 diabetes can achieve remission to a non-diabetic state through weight loss. This has been associated with early and sustained improvement in the functioning of pancreatic beta cells. The easiest way to determine if a person’s type 2 diabetes is reversible is to measure their C-Peptide levels because if they still produce C-Peptide, it’s more likely their diabetes is still reversible.

However, not everyone who develops Type 2 diabetes is overweight. Other factors such as age, ethnicity and family history come into play as well. These factors influence how well the liver and pancreas work, and also where we store our fat. As much as we cannot change these factors, we can influence diabetes type 2 by altering the factors within our control.

Losing extra weight is not a guarantee that one will go into remission, but weight loss on its own has significant health merits for a diabetic person, such as taking fewer meds and having less risk for complications.

2.    Making Diet and lifestyle changes

Research has shown that a low-calorie diet could help people lose weight and go into remission. Not only does switching to a non-inflammatory diet promote weight loss, but it can also reduce insulin resistance. Metabolic inflammation is a key driver for insulin resistance and type 2 diabetes, so improving insulin sensitivity can trigger remission.

Lifestyle changes, such as taking up regular exercise, will also help to achieve weight loss.

3.    Weight loss surgery for diabetes remission

Bariatric surgery can also help one to achieve remission by helping one eat less and achieve healthy and sustainable weight loss. Bariatric surgery is not a quick fix for obesity and diabetes, however, your doctor may recommend this approach in certain circumstances. Before considering this option, you should show dedication and discipline that you will be able to stick through the weight loss program.

What To Do When You Are In Remission

Diabetes remission may mean different things for different people. For many, it may last for a year before it recurs again, while for others it may disappear for extended periods of time. For most if not all, remission comes with reduced blood sugar, better cholesterol levels and reduced blood pressure. These signs are an indication of better health outcomes in the long run.

Once you are in remission, you should strive to maintain the positive health habits that triggered the remission in the first place. Keep going to your regular check-ups and speak to your healthcare team if you’re worried about anything or have any questions. Maintain a positive and hopeful spirit as you work towards achieving prolonged remission.

References

1.   Diabetes UK: What is diabetes? Retrieved from https://www.diabetes.org.uk/diabetes-the-basics/what-is-type-2-diabetes

2.   Diabetes UK: Diabetes Remission. Retrieved from https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/treating-your-diabetes/type2-diabetes-remission#remission%20research

3.  Science Daily (2018): Why weight loss produces remission of type 2 diabetes in some patients. Retrieved from https://www.sciencedaily.com/releases/2018/08/180802141722.html

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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