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August 24 2007
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Obesity is Only One Piece of the Diabetes Puzzle

Although the health implications of diabetes are clear, researchers are still struggling to understand many of the aspects of the disease.

One question being asked is why most people with type 2 diabetes are overweight or obese, when most overweight or obese people are not diabetics?

The fat cells themselves may offer a clue. These cells release triglycerides and free fatty acids into the blood, which may decrease cells ability to respond to insulin, thereby increasing the body’s demand for the hormone. Paradoxically, another hormone, adiponectin, is also made by fat cells, and this hormone makes cells more responsive to insulin.

According to Dr. C. Ronald Kahn, a diabetes researcher and professor of medicine at Harvard Medical School, the fatter you are, the less adiponectin your fat cells produce. Therefore, one way obesity might increase your risk of developing diabetes is by an increased release of fatty acids, combined with a decline in adiponectin, which would lead to more insulin resistance. If your body’s demand for insulin cannot be met, diabetes eventually sets in.

Another question being pondered in scientific circles is why high blood sugar specifically leads to the disease’s other complications:

–  Heart disease and stroke
–  Nerve damage
–  Kidney damage
–  Sight-threatening eye damage

Theoretically, if your blood contains high levels of glucose, every cell in your body would be affected, yet only certain cells appear to be damaged, leading to the complications mentioned.

Scientists have discovered that the unscathed cells are those capable of keeping out excess glucose, by reducing the number of molecular glucose pumps they use to transport glucose from the blood to the interior of the cell.

Cells that are damaged lack this ability to compensate. They include cells lining the arterial blood vessels, small blood vessels in the eyes and kidney, nerve cells in the legs and feet, and pancreatic cells – exactly those involved in diabetic complications.

New York Times August 20, 2007

 



Dr. Mercola Dr. Mercola's Comments:

The diabetes statistics are quite staggering. Nearly 20 million people in the United States have it, and another 45 million have pre-diabetes. Type 2 diabetes (insulin resistant) accounts for more than 95 percent of diabetics, but a growing number of those with type 1 diabetes (insulin dependent) are beginning to suffer the effects of type 2 as well.

If you have diabetes and weight issues, statistics show that you double your risk of dying prematurely. Fortunately, type 2 diabetes is completely preventable, and is almost always curable, using simple dietary and lifestyle modifications -- excess weight is the most avoidable risk factor for type 2 diabetes.

Solving the Puzzle by Looking at the Right Puzzle Pieces  

Medications and supplements are not the answer for diabetes. This disease can be controlled by recovering your insulin and leptin sensitivities.  

How is this done? 

By eliminating grains and sugars in your diet, getting enough good fats, exercising, and sleeping well. 

Piece # 1 – Your Diet

It is truly unfortunate that the American Diabetes Association (ADA), and nearly every endocrinologist who treats type 1 diabetes, has no idea whatsoever about the concept of slow carbs and nutritional typing.

Everyone needs a certain amount of carbohydrates, but many are addicted to grains, potatoes, and sweets, and most of you are consuming far too many dangerous carbohydrates, which can lead to serious chronic health problems like obesity and diabetes. 

Any meal or snack high in grain and sugar carbohydrates (as opposed to vegetable carbs) typically generates a rapid rise in blood glucose. To compensate, your pancreas secretes insulin into your bloodstream, which lowers your blood sugar. Insulin is essentially a storage hormone that helps you store the excess calories from carbohydrates in the form of fat in case of famine. 

Over time, your body will become “sensitized” to insulin and require more and more of it to get the job done. Eventually, you can become insulin resistant and then diabetes can set in.

Adding to an already problematic situation, when your insulin levels rise due to an excess of carbohydrates, it sends your body a hormonal message telling it to store fat while holding on to the fat that is already there. So not only do excess carbohydrates make you fat -- they keep you fat.

The medical profession still treats diabetes as a disease of blood sugar (since that is a symptom that can be modified with drugs), when in fact diabetes is not a disease of blood sugar; it is a disease of insulin, and perhaps even more appropriately, leptin signaling.

Leptin is the mechanism by which your fat stores speak to your brain, letting your brain know how much energy is available and, very importantly, what to do with it. Studies have shown that leptin plays significant if not primary roles in heart disease, obesity, diabetes, osteoporosis, autoimmune diseases, reproductive disorders, and perhaps the rate of aging itself. 

The only known way to reestablish proper leptin (and insulin) signaling is via diet.  

While nearly all type 2 diabetics need to swap out grains for other foods, some of you will benefit from using protein for the substitution, while others need to use more vegetable-only carbs. Therefore, along with reducing grains and sugars, determining your nutritional type will give you some insight into what foods you should use to replace the grains and sugars. 

Piece # 2 – Your Physical Fitness 

If you live a sedentary lifestyle, you’re at a higher risk of developing diabetes because you’re missing the beneficial effects of exercise. Exercise works by increasing the sensitivity of insulin receptors so the insulin that is present works much more effectively, and your body doesn't need to produce as much.  

One special note, however, would be that diabetics with blood sugars over 170 mg/dl need to use extra caution and medical supervision for their exercise program, because elevated blood sugars may rise further with exercise.

Most diabetics will benefit from one hour of intense exercise at least five times per week, and more if their blood sugar is currently out of control.

Piece # 3 – Your Sleep Habits and Stress Patterns

Too little sleep may reduce levels of leptin, leading to weight gain and increased risk of diabetes. If you suffer from any kind of sleep disturbance, try one or several of these simple, natural recommendations to get the proper rest your mind and body needs.

The Emotional Freedom Technique (EFT) can be used to treat emotional stresses, including food cravings such as those related to sugar and grains.

No matter how devoted you are to a healthy lifestyle, it is nearly impossible to reach your goals if emotional barriers stand in your way. EFT uses a combination of kinetic energy input and positive affirmations to release you of your emotional "blocks," and can help you deal more effectively with your day-to-day stresses.

How do You Know if You Have Diabetes in the First Place?  

More than 50 percent of pre-diabetics are not even aware that they have this disease, which can be devastating.  

A fasting blood sugar test can reveal if you have diabetes. The formal definition of pre-diabetes is blood sugars over 110, yet below 126. However, realistically it should be below 100. If your blood sugar is over 100, you will most certainly want to use the two most effective "drugs" known for diabetes: Diet and exercise. 

Remember that pre-diabetes is far easier to turn around if you catch it in the earlier stages, and achieving a healthy weight through diet and exercise can put you on the road to reversing the disease.

 


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Community Comments ( 34 )
Comment on this Article
  
  
Lloyd Fielder, D.C.
[ Joined on 06/06 ] [ Posted on August 23, 2007 ]
23 Points        
   
 
Savvy User
On a side note.........

Why is it that most birds found to have maggots on them always appear to be dead but that most dead birds do not have maggots on them?

Gross I know........

Genetics + Lifestyle =  Expression

You may be predisposed for Type II diabetes genetically but unless you eat poorly or inconsistent with what is natural and healthy you cannot get it.  It doesnt just magically appear without help of the inadequate lifestyle choices........


Lloyd
 [ Reply ]
Mercola
  
Dr. David Spitz
[ Joined on 12/06 ]  [ Posted on August 23, 2007]
14 Points        
   
Apprentice User
  Mercola
Dr LLOYD....couldn't have said it better....good job.

Dr. Dave
Mercola
  
Russ Bianchi
[ Joined on 09/06 ]  [ Posted on August 23, 2007]
9 Points        
   
Savvy User
  Mercola
Perfect Lloyd, predisposition being only triggered by oxidative stress, to erode telomerase enzymes, on the DNA, resulting in disease, by poor nutrient intake, incorrect nutrient intake, toxic exposure, etc.

Uncle Russ
Mercola
  
Lloyd Fielder, D.C.
[ Joined on 06/06 ]  [ Posted on August 23, 2007]
13 Points        
   
Savvy User
  Mercola
Russ
I would so not want to tangle with you in scrabble :)
Mercola
  
Patty D
[ Joined on 06/07 ]  [ Posted on August 24, 2007]
11 Points        
   
Savvy User
  Mercola
Hmm, I'm a Scrabble nut...would be a mighty challenge and I'm sure I'd be soundly trounced.
Mercola
  
Russ Bianchi
[ Joined on 09/06 ]  [ Posted on August 24, 2007]
9 Points        
   
Savvy User
  Mercola
I do not play Scrabble and am dyslexic, so I would need the spell check version.

;-)

Uncle Russ
  
  
vociferum
[ Joined on 08/07 ] [ Posted on August 24, 2007 ]
12 Points        
   
 
Apprentice User
This post was deleted because it violated our Terms Of Use :
Abuse, harass, humiliate, deceive, threaten, impersonate, intimidate or engage in any other abusive behaviors with those who comment on Mercola.com.
 [ Reply ]
Mercola
  
Rogway
[ Joined on 06/06 ]  [ Posted on August 25, 2007]
12 Points        
   
Savvy User
  Mercola
Good point Dan. Seems like I read that somewhere. Maybe that's why good whole healthy food helps diabetics so quick because it's loaded with enzymes.
Mercola
  
curious7
[ Joined on 03/07 ]  [ Posted on September 13, 2007]
       
   
Apprentice User
  Mercola

We must consider from whom we learned how and what to eat.

Mercola
  
C Ed Wright
[ Joined on 06/07 ]  [ Posted on September 14, 2007]
1 Points        
   
Savvy User
  Mercola

still.learning, I'll take a shot at that question.

Remember, each digestive enzyme is exactly specific to a certain protein, like a key is to a lock.  If it doesn't 'fit', AND 'depress the pins' exactly correctly, nothing happens; try another.  That's how digestion works, and why it takes a lot of time.  "Protease" is not THE protein-digestive enzyme, it means ANY particular digestive enzyme that catabolizes any particular part of any particular protein molecule; each of which has its own name.  (In contrast to, for example, Lactase that only snips Lactose into its two component simple sugars.)

To answer your question, this is not authoritative, meaning I'm not absolutely sure, but what I'm pretty sure about is this:  We have specific digestive enzymes to break down most proteins into amino acids, but probably do not have enzymes to break down beneficial dietary enzymes.  Therefore the nutritive enzymes don't get broken down to amino acids, after which, as you surmised, they would be useless as enzymes because they wouldn't be enzymes anymore.  Make sense?

  
  
Rogway
[ Joined on 06/06 ] [ Posted on August 23, 2007 ]
12 Points        
   
 
Savvy User
Interesting article. Come to think of it, most people I know with type 2 diabetes is not overweight at all. Most of them has told me that their blood sugar was up a little when they were tested, and the doc told them uh-oh, you have diabetes, you need to begin meducation. Others has told me their blood sugar was good, but their doc wanted them to continue their medication.

I have read that your pancreas just gets tired from being overworked due to sugar and the likes, it has to pass the extra load on to the cells, then the cells say, whew, I too am tired from working overtime trying to burn off the sweet stuff and have to take a break. Next thing you know, type 2 diabetes.

But also, I have read that some has gotten off of their medication in as fast as ten days just by changing their diet to the healthiest food in the world. Seems like it is always the ones that are willing to change, that are the ones who get better! In my case, this proves true beyond everything else.
 [ Reply ]
  
  
mmc88121
[ Joined on 11/06 ] [ Posted on August 23, 2007 ]
9 Points        
   
 
Moderator User
Type 2 diabetes is not from a lack of insulin, it is from the inability of the insulin to allow the glucose molecule into the cell.   Many people with type 2 diabetes have normal or above normal insulin levels.  It is in type 1 diabetes that the body does not produce insulin.

Mary
 [ Reply ]
  
  
proatc
[ Joined on 12/06 ] [ Posted on August 23, 2007 ]
7 Points        
   
 
Savvy User
"Why, for example, are most people with Type 2 diabetes overweight or obese, yet most overweight or obese people do not have diabetes?"

Maybe the obese that supposedly don't have diabetes just don't know that they have a problem.  Many obese people stay away from MD's to avoid the "you need to lose weight" lecture.

Testing blood sugar levels can be misleading if the patient lies (House) and doesn't fast before testing.  And most tests are for blood sugar not insulin production. "It is likely that high glucose levels aren’t causing all the complications of diabetes,” Dr. Kahn said. And that is one reason, researchers say, why diabetes care has to include more than just glucose control."
 [ Reply ]
Mercola
  
Bridestein
[ Joined on 12/06 ]  [ Posted on August 23, 2007]
4 Points        
   
Savvy User
  Mercola
Proatc - If I don't eat sugar, fruit or grains and my blood sugar is 84, should I still be tested for diabetes? Wouldn't I have other symptoms besides obesity?
Thanks in advance.
Mercola
  
proatc
[ Joined on 12/06 ]  [ Posted on August 24, 2007]
5 Points        
   
Savvy User
  Mercola
Bridestein,
Testing your fasting blood sugar, 84 you stated, is clinically a test for diabetes.  Since 84 is in the normal range (~20-100) then you don't have diabetes.  Not enough for medical intervention including an A1c test.

As far as obesity being a symptom of diabetes, I would have to say that diabetes would be a symptom of obesity, just like high blood pressure, which is what ultimately needs to be controlled or you will die.  You don't have to have symptoms to have diabetes either, and the majority of people that get diagnosed never knew their blood sugar was higher than what is considered normal.

I was trying to point out that according to www.diabetes.org , there are over 6 million people that are undiagnosed with diabetes.  I read this thinking the number is a bit low, and they need to correlate this number with obesity. I find it interesting that there are no statistics on their website that shows the status of diabetics and their weight, just age, sexual and racial profiles.  I'll bet money there is a very, very high number of diabetics that are obese.

The title of the article is "Obesity May Be Only One Piece of Diabetes Puzzle", I find it is one of 2 major pieces to the puzzle, the other is exercise.
Mercola
  
stoicathos
[ Joined on 08/07 ]  [ Posted on September 13, 2007]
4 Points