Click to listen to the audio…
Could a “missing” enzyme be the cause of type 2 diabetes ?
For years, we’ve been told type 2 diabetes “starts” with obesity……………
As the science has expanded, it has become clear, obesity and type 2 diabetes, is associated with low grade inflammation.
So what causes the inflammation ?
One theory……………. UNHAPPY fat cells.
Now, unhappy fat cells can be cry babies. But, there are people who are morbidly obese, with contented fat cells and normal weight individuals, who are ON FIRE.
So, fat cells aren’t responsible for ALL the inflammation.
A leaky gut
Which leaves UNHAPPY gut cells, specifically the cells that line the gut, as another potential source of this INFLAMMATION.
Okay, okay – unhappy might not be the right word. The problem is when the gut becomes leaky.
Being an enterocyte is a tough job
The gut is an interesting place – if you think of your body as donut, the gut IS THE HOLE in the middle. It’s outside and inside at the same time.
The cells lining the hole, the enterocytes – have their work cut out for them.
These little guys have to keep the bad things out and let the good things in. Unfortunately for them – GOOD and BAD is not black and white. And, getting things in, is not just simply a case of opening up the gate, things have to be PROCESSED.
And PROCESSING depends on exactly what has arrived.
And in every bite, there is good, bad and ugly.
Now to be fair, it is a team effort. The gut cells get a lot of help and support from the immune system and some of the bacterial residents.
Some……………… NOT ALL.
Remember, there are a trillion or so bacteria, jostling for a bite to eat and a place to sleep.
The majority are good neighbours – doing there bit to help process the food. But, there are always rough characters.
And, anytime you have a crowd – wastes accumulates.
Waste NEEDS to be picked up
One particularly troublesome bacterial waste product, is lipopolysaccharide, better known as LPS. It not something the bacteria produce, deliberately – but when bacteria that belong to the gram negative clan, roll out their sleeves and get busy. They leave LPS behind.
When this LPS is not picked up timeously……………..inflammation can happen.
The reason, the LPS doesn’t sit tight, it can slip past the layers of cells lining the gut and get INSIDE. Once in the blood vessels, the immune system goes “crazy” – they’re thinking INVASION etc, thus this LPS causes inflammation !
Now, this is one, of many of the metabolic problems of people with metabolic troubles.
Could it be THE PROBLEM ?
The clean up crew
Intestinal alkaline phosphatase or IAP, should sweet through the gut and clean up .
IAP is a pretty tough enzyme, it persists all the way down the GIT tract.
All the way down i.e. it appears in the POOP.
Looking for intestinal alkaline phosphatase – IAP
A researcher from MH Samorita Medical College in Dhakar, set out to quantify how “on the ball”, the IAP clean up crew was, in type 2 diabetics.
POOP samples were collected, from Bangladeshi residents, with the help of a team of local doctors. The patients were all between the ages of 30 and 70 years.
- 202 people (63 male and 139 female) were diabetic. These people either had fasting blood glucose levels higher than 7 mM or were taking diabetes meds.
- 445 people (114 male and 331 female) were healthy.
The IAP poop data, was then correlated with metabolic health.
Note : The people in the study all belonged to the same ethnic group and were eating what they liked i.e. they were not following a restricted diet of any kind.
Type 2 diabetes a picking up problem
In people with type 2 diabetes, the clean up crew was short staffed.
On average, people with type 2 diabetes had 50 % less, IAP in their poop.
So what………… isn’t this just another thing that’s gone awry in type 2 diabetes ?
High IAP was protective
This patient population, was not the typical patient population studied in the West – there was little to no obesity. The average weight of the healthy people was 59.3 ± 0.5 kg, while the diabetes weighed in at 59.6 ± 0.7 kg.
In fact, only their total cholesterol levels, LDL and fasting glucose levels were significantly different.
With the big difference coming in fasting sugar levels. 4.4 mM versus 8.0 mM.
To all intents and purposes, the diabetics were “normal” except for the fact that the clean up crew, was short staffed. When the numbers were crunched, it was found for every 25 U/g decrease in stool IAP, there is was a 35% increased risk of diabetes.
Is IAP the straw that breaks the camels back ?
Give me more IAP please
The science is pointing to something in the gut, being the trigger.
At this stage, “we” don’t know why the IAP level is lower, but having more seems push the odds in your favour – and who doesn’t what the odds tipped in their favour.
Especially when you realize, IAP levels are responsive to what you eat.
A quick list of some of the nutrients known to stimulate IAP release… calcium, Vitamin K1 and K2, saturated fat, several spices and omega-3.
Endotoxemia (LPS) is contributes to the low grade inflammation associated with obesity – but it shouldn’t be circulating, house keeping should sweep it away
The story of diabetes is always written like this…. you put on weight, become insulin resistant, then eventually diabetic. But, this diabetes timeline is WRONG.
In insulin resistant peeps, the resident bacteria have ganged up and decided, insulin is NOT COOL. Since body cells, don’t want to break social protocol………….