In parts 1 and 2 of this series, we’ve started to have a look at David Hite’s article on the internet entitled Diabetes Basics, which is a fairly lengthy FAQ that goes over a lot of the things that he teaches in his diabetic education classes. So we’re in the process of looking at this article, and given that his material is designed for type 2 diabetics that aren’t that familiar with the disease, since he is referring to the term basics in his title, we’ll make this about the basics as well, but from a different perspective.
So you will read a lot here that you won’t find in basic discussions of type 2 diabetes, but I’m looking to present this at a level which requires no prior understanding of diabetes, as Dr. Hite does, but at the same time I’m looking to frame my side of the story in terms of what we really know about this disease.
So I’ve started talking about the importance of monitoring our level of insulin resistance as that’s the disease we suffer from, but it’s more correct to describe diabetes as a condition of glucose dysregulation caused by various hormonal imbalances, particularly insulin and glucagon imbalances, and excessive levels of both is what is mostly behind our disease, although there are other hormones that play a lesser yet still significant role.
So we could simplify this and say that type 2 diabetes is caused by excessive secretion of several hormones, and I do want to mention the main ones again. Insulin is the main player here, which is the daddy of insulin resistance in excess, and insulin is being resisted because we secrete too much of it, it really is as simple as that.
This excessive insulin secretion is bad enough in itself and this makes us fat among other things, and this is actually the prime driver by far of obesity, it can significantly increase the risk of cancer, because insulin is after all a growth hormone, it can give us various inflammatory conditions, because excess insulin is very inflammatory, and it can also kill us by damaging our cardiovascular system, from giving us heart attacks and strokes and such.
There are two basic types of insulin resistance, the one we normally think of, when our cells resist it to prevent them from getting excessive macronutrients, glucose and fat basically, that’s called peripheral insulin resistance. The other form we’ll just call organ insulin resistance to keep this simple, it’s our organs resisting insulin, involving mostly the pancreas and liver but other organs as well. This is where the major battle is fought, particularly in the alpha cells of the pancreas, which secrete glugacon, the hormone that works to raise our blood sugar.
Our bodies are designed to function even when we don’t eat, and we can thank glucagon for the fact we don’t die from not eating for a few hours, as this serves to keep our blood sugar up. If not, the brain, which needs a steady supply of glucose around the clock, would just die, and being brain dead is not a desirable state if you don’t want to die that is.
Healthy alpha cells are sensitive to insulin and this keeps glucagon levels normal. Excessively high levels of insulin over time causes our alpha cells to be poisoned by excess fat, and this is what insulin does generally to the body, but the alpha cells can’t handle this stuff, and they start secreting more and more glucagon.
Glucagon goes directly to the liver, and the liver will normally regulate our blood sugar by adding some when it’s low, but all this extra glucagon makes it go haywire and it just secretes way too much all the time, around the clock. This is what we call type 2 diabetes.
The peripheral insulin resistance is hardly even worth consideration compared to the effects of organ insulin resistance, and in fact if our glucagon levels are normal, our blood sugar levels will be normal even after a high carb meal, and even without insulin at all, surprisingly enough. It’s actually high glucagon, not low insulin, that has the blood sugar of type 1 diabetics racing out of control to deadly levels, and they will maintain normal blood sugar even on no insulin if we suppress glucagon, because it’s the glucagon that runs it up to these levels.
We’ve also normalized glucagon in type 2’s, and then fed them high carb diets and their glucose response to them was normal, that’s how important excess glucagon is, and we can say with a fair bit of confidence that high glucagon is the reason why our blood sugar goes too high, period, so this is pretty important stuff indeed.
In order to fix this, there’s only one way out, and that’s to seek to normalize insulin levels so that the pancreas can heal, not the beta cells but the alpha cells actually, the beta cells do get damaged by this but in spite of that can secrete excess insulin right up until the late stages of the disease, where we start seeing them secrete more normal amounts but by then a huge amount of damage is done, a huge amount of damage to the alpha cells specifically.
So there you have it in a nutshell, when it comes right down to it, type 2 diabetes is primarily a disease of high glucagon levels, although you very rarely see this hormone mentioned, but it needs to be even in the most basic discussions of diabetes, if you’re interested in informing them in any meaningful way about what is actually wrong with them.
In the entire article, Dr. Hite only mentions glucagon once, when he’s talking about a class of medication called GLP-1 and he mentions that one of the things this does is inhibit glucagon, which he does understand is generally a good thing for type 2 diabetics. How about looking to keep glucagon from being too high in the first place? Well that’s not part of the curriculum, neither ours or his for that matter, as in spite of being a diabetes educator, this really isn’t part of their education.
I don’t want to be too unfair to Dr. Hite and his lot, but it’s pretty amazing to me just how little these people know about the role hormones play in type 2 diabetes, even the hormone insulin for that matter. This is the case with just about all medical doctors as well though. A lot of people think MDs are experts on diabetes but in actuality their understanding about the disease is sorely lacking and is limited to what the drug companies want them to know so they can best sell their wares for them.
So Dr. Hite mentions up front that he strongly advises us to get regular care from a “doctor,” and from reading the entirety of the article he’s talking about an MD, as people generally do when they say see your doctor regularly. We’re out to question all of this and this is actually a better question than most realize, should we even have a medical doctor primarily manage our diabetes, and if so, why?
Now I don’t want to be too hard on the profession in their approach to diabetes, or perhaps I do but I don’t want to throw them all in the same boat, and Roger Unger was an MD after all, and Dr. Unger is the most brilliant diabetes researcher of all time, and a lot of what we know about the disease is thanks to his decades of work, although most doctors aren’t aware of it because they don’t study diabetes, they just get the handouts from big pharma basically.
There are many medical practitioners who have the MD degree but practice holistic or functional medicine, treating diseases not symptoms, treating the whole person not just one small part of them. Most doctors, maybe almost all of them, are genuinely interested in treating us and trying to make us better, but they just don’t have the proper knowledge to do it right, they just have not studied this or have been taught the right things, even things as simple as what I’m going over with you in this introductory series, including the most basic discussions about what is actually wrong with us as diabetics.
So that’s where we’ll pick this up in part 4.