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Diabetes is so much more than a sugar problem
Type 2 diabetes is viewed as a disease of sugar.
So treatments focus on “fixing” the sugar problem.
Managing the sugar issues
There are a multitude of ways to do this………..
Most of them work.
Some better than others.
So the average type 2 diabetic walks around with OK sugar levels, initially at least. But……….. this is NOT enough to STOP the disease progression.
Eye problems. Kidney problems. Feet problems etc. Sugar levels slowly rise, higher and higher and CARDIOVASCULAR events, happen !
More than a sugar problem
But type 2 diabetes is SO MUCH MORE, than sugar problems.
Pretty much every chemical in the body is NOT QUITE RIGHT.
Some are up. Some are down.
Few are actually at physiologically NORMAL levels.
So why don’t we pay these anomalies MORE ATTENTION ?
Cause versus consequence
Well the quick answer is……………..
The reason they’re wrong is BECAUSE of the sugar/insulin problem i.e. it is a consequence, not a cause.
This may very well be true.
But………. this doesn’t mean they are irrelevant.
You see, the body is a system, everything is connected to everything else………
A systems approach to type 2 diabetes
What if insulin/glucose are NOT the central players ? What if they are just two links in a complex network of signals ?
This is a question a group of researchers from India, recently asked.
Now instead of heading for the lab, to look for answers, they took a mathematical approach, they constructed a multi-organ, multi-signal interactive network model.
Basically, they gathered all the metabolic disturbances that have been reported to date in the scientific literature and analysed the relationships, creating a network.
The network they created had 72 nodes.
When the relationships were plotted it looked like a plate of spaghetti ….
Now you know why a systems approach to disease is NOT the norm………..
It’s a work in progress
The researchers admit, their model is NOT perfect.
But it does reinforce the point……………..
There is more to the story than sugar and insulin.
A lot more.
Fixing sugar is NOT enough
When the team fiddled with factors in their network, the effect of the manipulation, radiated throughout the network.
But the outcome was not completely random.
No matter what was tweaked, the system bounced around, until it stabilized into one of two outcomes.
- Outcome 1 : the system was insulin sensitive and glucose levels were controlled i.e. healthy
- Outcome 2 : the system was insulin resistant and glucose levels were elevated i.e. a state of type 2 diabetes.
This was quite unexpected………
A non-biological system, with so many interconnections would behave quite differently.
Most of the time, it would become chaotic.
Suggesting that …..
Insulin resistance IS a system
This means, you don’t wake up one morning and find yourself insulin resistant…………….. lots of little tweaks have happened, over a period of time to get you to this state.
The path to insulin resistance………….. IS PERSONAL, i.e. everyone get’s there by a slightly different pathway, thanks to their genes and lifestyle.
And when you’re there.
I won’t say you’re stuck there, but, moving to being insulin sensitive, is not a one or two step process. It’s going to take a LOT of tweaks to make the shift to insulin sensitive.
A lot of tweaks………….
Shifting states hard work
This is exactly what our team observed using their model.
Moving the needle back, from insulin resistant to insulin sensitive, was do-able, but to do it, required a combination of the “right” interventions.
The more “right” interventions applied to the situation, the better the response.
So what are the “right” interventions ?
Got to go wider
The different approaches currently targeted for treatment of type 2 diabetes include
- reduction in obesity,
- normalizing plasma glucose,
- insulin supplementation
None of these “interventions” was able to make the move to insulin sensitivity.
So what was ?
The team identified several nodes, which when they were turned up or down, seemed to be able to move the needle towards insulin sensitivity, on a permanent basis.
These included :
- growth hormone
- serotonin (this is the only one that needs to be lowered)
Now this is a hodge podge of things……
Some you may be familiar with, like testosterone and oestrogen, others, like osteocalcin, you might never have heard of.
Most of them are drug-able in one way or another.
But, the point of this post, is NOT to add more meds, to the list………… rather it is about a change of thinking.
A big picture perspective
Type 2 diabetes is a very complex disease, it takes years to develop and you need to adopt a whole body perspective, to management.
Getting and keeping that sugar down is A PRIORITY.
But, you also need to take aim at the insulin resistance.
Too much insulin, underlies this insulin resistance, contrary thinking, insulin is NOT a knight in shining armour. Reining in insulin, is a good place to start, this can be done with a variety of dietary and lifestyle modifications.
For example, physical activity, can increase testosterone, growth hormone, muscle mass and osteocalcin. Better sleep / sleep hygiene can boost melatonin levels, testosterone and ghrelin.
You get the picture………
If you’re batting prediabetes or type 2 diabetes, you need to do more than normalize your sugar levels, you need to work at optimizing your body chemistry at as many points as you can……… this is what it will take to shift your biology to a state of insulin sensitivity.
NOTE : You don’t have to get ng “right”, just get enough “right” to shift the balance !
In the insulin resistant, fat production should cease, but it doesn’t – the reason, SREBP1c the little guy charged with following insulin’s orders, obeys someone else
SUGAR is the enemy and INSULIN is the saviour. The “success” of bariatric surgery, as a treatment for type 2 diabetes, is forcing a re-think of the story.
Addressing the trigger is going to be the key to fighting the ravages of type 2 diabetes.