Thursday, August 15, 2013

Understanding Type 2 Diabetes, insulin and blood sugar.

These days everyone seems to know at least one person who is fighting some kind of dread disease or chronic illness. It's become so commonplace and yet we still feel so shocked when it hits us close to home because it IS shocking, and horrible, seeing a loved one suffer. Cancer and heart disease are right at the top of the list, but something else that has become just as commonplace is Type 2 Diabetes. Every second person either has it, or has extremely high sugar and needs to monitor it to avoid becoming a full blown diabetic.

There are two types of diabetes, as most people know by now (because it has become so common) so let me first explain the differences between the two.

Type 1:

Type 1 Diabetes is an autoimmune disease that the majority of sufferers will acquire before the age of 40, which is why it's often called Juvenile Diabetes. When your own body destroys the good guys in your body, it is known as an autoimmune disease. In the case of Type 1 Diabetes, the person's own body has destroyed the insulin-producing beta cells in the pancreas. That means that that person is simply not capable of producing their own insulin. About 15% of diabetes patients have Type 1.

Type 1 is not a preventable disease. It is absolutely not the result of a person's lifestyle. It makes no difference what size a person is, or how active they are. In fact, the vast majority of people who develop Type 1 are not overweight and are mostly healthy when it starts. You can't reverse or prevent Type 1 by exercising more or eating carefully but doing both of those things will help a person manage it better. Simply put, the cells that produce insulin cease to function meaning that the person needs to inject insulin for the rest of their lives in order to survive. No-one really knows what causes Type 1 Diabetes. Genetics probably plays a role, exposure to certain viruses may trigger it and sometimes a really bad shock can also trigger it.

Type 2:

A person with Type 2 Diabetes has one of two problems, and sometimes they are affected by both. Firstly, they are not producing enough insulin and secondly, their insulin is not working properly. This is known as insulin resistance. Type 2 is directly the result of bodyweight, fitness and lifestyle. Most sufferers have been overweight, unfit and eating badly for some time and the constant trauma to the body as it tries to adjust, leads to insulin resistance, and Type 2 Diabetes.

It would make sense, looking at the above paragraph that Type 2 Diabetes is both preventable and reversible. But how does being overweight, unfit and unhealthy actually cause Type 2 Diabetes and what does insulin resistance actually mean?

When you eat food, your body digests all the macronutrients, ie. proteins carbs and fats. WE measure those macronutrients in terms of grams and calories, but your body sees them, simply, as fuel. If you eat more fuel than your body needs (which most people do) the body has no choice but to store the excess fuel. This ability to store comes from our ancestors being in a constant "feast or famine" state thousands of years ago. Our bodies are very clever. They evolved to make sure we survived as a species in times of famine. Unfortunately, that process is still very much in action despite the fact that a lot of us in 1st world countries have far too much food available these days!

In case you didn't realise it, every type of carbohydrate that you eat (this includes bread, pasta, cereal, potatoes, rice, fruit, dessert, sweets, fizzy drinks and fruit juices) is eventually converted to a simple form of sugar known as glucose. While glucose is a necessary fuel, it can be quite toxic in excessive amounts, which is why you don't want it to stay in your bloodstream. You want to get it inside your cells to be burned for fuel and our bodies have evolved a clever way of getting it into those cells.

The muscles and the liver are storage places for glucose. They store it in the form of glycogen. Glycogen is a muscle fuel that is used by hard anaerobic exercise (think sprinters like Bolt or power weight lifters) Remember I mentioned how in Type 1 Diabetes, the beta cells in the pancreas have stopped working? Well, in a normally functioning body, those beta cells in the pancreas would sense when there is an overload of glucose in your bloodstream after you've eaten and they would secrete insulin. Simply put, the job of insulin is to allow glucose to gain access to the inside of muscles and liver cells. But there's a catch: Once those cells are all full of glucose, as they are almost all the time with inactive people, the rest of the glucose is then converted to saturated fat.

Here is the great irony, the saturated fat that we eat is NOT what gets stored as fat, it's sugar that gets stored as fat. This is something that is really confusing for a lot of people who think that saturated fat is the root of all evil. 

This is the reality: If we go back 10,000 or more years, we'll find that our ancestors had very little access to sugar or ANY carbohydrates for that matter. They had some fruit here and there, a few berries, roots and shoots but most researchers believe that our ancestors only consumed around 80 grams of carbs A DAY. The rest of their diet consisted of different amounts of fat and protein. (Compare that to today where most people eat around 400-1000 grams of carbs A DAY!) Because the carbs they ate were very fibrous and complex (think roots and shoots) their effect on raising insulin was minimal. In fact, there was so little carbohydrate/glucose in our ancestor’s diet that our bodies evolved FOUR ways of making EXTRA glucose ourselves and only one way of getting rid of the excess we are eating. Go figure.

When we eat too many carbs, the pancreas releases loads of insulin as it's been programmed to do, but if the liver and muscle cells are already filled to overflowing with glycogen, those cells eventually start to become resistant to the call of insulin. The insulin “receptor sites” on those cells start to lose their efficiency and, since the glucose can’t get into the muscle or liver cells, it stays in the bloodstream.

The pancreas senses there’s still too much toxic glucose in the blood, so it panics and pumps out even MORE insulin, which causes the insulin receptors on the surface of those cells to become even more inefficient and resistant. Why? Because, to add insult to injury, excess insulin is also toxic and they don't want anymore of it! Eventually, after bucket loads of insulin have been released, it invariably DOES help the glucose find its way into your cells.... just not the right ones. It ends up in your fat cells, where it is stored as fat. So you see, at the risk of repeating myself, it is not fat that gets stored as fat, it's sugar.

Of course, as time progresses, we continue to eat too much sugar and insulin resistance continues to build up until, eventually, only medication can regulate the situation but medication can only do so much.

Here is what happens when a person develops Type 2 Diabetes: 
  1. There is more glucose in the blood for much longer because the glucose can’t get into the muscle cells. This excess glucose is like toxic sludge which clogs arteries, binds with proteins to form harmful AGEs (advanced glycated end-products) and causes inflammation throughout your system, increasing your risk of heart disease.
  2. More sugar gets stored as fat over time. The muscle cells will be getting less glycogen because they have become resistant, and, to make it worse, insulin inhibits the fat-burning enzyme lipase, so now you can’t even burn the stored fat as easily. So you get fatter and eventually those fat cells become resistant to insulin as well!
  3. Then it gets worse. Your insulin STAYS higher for longer because the pancreas thinks "this isn't working so we need more!" The problem is that insulin is very toxic at high levels. It causes plaque build-up in the arteries (which is why diabetics have so much heart disease) and increases your risk of cancer.
  4. As I said, insulin resistance prevents glucose from entering your muscle cells but it also prevents amino acids from entering and these are essential for building and maintaining your muscles. Along with that, other parts of your body think there’s not enough stored sugar in the cells (because of the insulin resistance), so they send signals to start basically cannibalising your muscle tissue to make MORE sugar! You get fatter and you lose precious muscle tissue.
  5. You start to feel tired all the time and when your energy levels drop, you get hungry... for MORE carbs. You also have zero energy to exercise. Ironically, you actually crave more of the poison that is slowly killing you.
  6. When your liver becomes insulin resistant, it can’t convert the thyroid hormone T4 into the T3, so you end up with an underactive thyroid, something else that plagues most women these days. Doctors will say they don't know why it happens. 9 times out of ten, THAT is why it happens.
  7. You start to develop nerve damage and pain in your extremities because the damage from all the excess sugar destroys nerve tissue, and you begin to lose your eyesight as well.
  8. Eventually, the pancreas is just so exhausted, it can’t produce any more insulin and you wind up having to inject LOTS of insulin just to stay alive and that is when a person has full-blown, insulin dependent, Type 2 Diabetes.
Sounds bad, right? It IS bad. But there is good news! It's entirely avoidable and, to an extent, reversible. I say "to an extent" because, if you are insulin dependent and already have nerve damage and eyesight damage, that will be pretty hard to reverse. You can, however, make it MUCH better.

Of course, first prize is to simply avoid the risk of getting it altogether. Medical experts will tell you that some people are just genetically predisposed to Type 2 Diabetes and it's got nothing to do with lifestyle. I will say this: I believe that we are ALL genetically predisposed to Type 2 Diabetes because our bodies were never designed to consume so much sugar. If we all ate the same, we'd ALL get Type 2 Diabetes. Thankfully we don't all eat the same, but there is a large portion of the population that does and they are ALL getting Type 2 Diabetes. It's become as common as flu, only it lingers forever.

I think it's a no-brainer that we need to stay away from refined grains and sugars. It kills me when I see dieticians STILL telling people that they need to eat 60% carbs a day!!! Are they insane? That is what started the madness in the first place and now it's become like a runaway train, almost impossible to stop. Every food place is based around carbs, more specifically, refined carbs. How do you re-train entire nations?

It starts one person at a time which is why I write this blog and why, I hope, you share this blog. The solution to preventing, and curing, Type 2 Diabetes is in your diet and how active you are. It's so simple and yet, it's not, because our brains have been trained to think a certain way. You need to go back to grass roots and start questioning everything you've ever been told about the world and our bodies, and how it all works.

You don't "need" grains, you don't "need" sugar, you don't even "need" starches. The foundation of every good diet is organic vegetables. That is ALL the carbs your body actually needs. I wouldn't even go with 5 helpings of fruit a day, unless you split them up into several meals. Fruit is sugar. But I would still recommend eating them in moderation because they DO contain loads of goodness as well.

When I was doing my first year of exercise science and I had to shadow personal trainers for a while, I was quite shocked at the total lack of knowledge that one of them had. He was on a strict diet and he had cut out carbs altogether, he told me. He said he was struggling because he was hungry all the time. So I said, "So you're just eating protein and fat then?" He said, "NO! No fat at all. Just meat and vegetables, strictly no carbs." His idea of carbs was rice, bread, potatoes and pasta. What he'd actually done was cut out grains and starches but, as he didn't consider vegetables to be carbs, he had convinced himself that he was literally starving himself to death by cutting those grains and starches out so he was only doing it for a month because he was too hungry all the time.

This kind of diet is actually a waste of time and not a longterm option because, for one, your body NEEDS fat to function, and secondly, when he introduces grains and starches again, as he will, he'll just  gain back all the weight he lost. If he was so hungry when he cut out grains and starches, he should have simply increased the amount of vegetables he was eating, and added fat to his diet, and he'd have felt satisfied. You can eat as many vegetables as you like. They are so low in calories they won't be anything but good for you and they are high in fibre so they fill you up. He was actually going through withdrawal from the grains and starches because your body does get addicted to them. Had he increased his vegetable and fat intake and pushed through, he'd have found it easier to cut grains and starches out altogether and felt fine AND maintained his body weight.

So, it's simple. Make your diet predominantly fat and protein-based, with vegetables and a bit of fruit as your carbs and you will prevent the onset of Type 2 Diabetes, as well as things like heart disease and high blood pressure etc. You have nothing to lose and everything to gain by doing it, especially if you have already been told your sugar is high and you are at risk of developing Type 2 Diabetes.

Stop diabetes before it stops you!

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