If you want to understand type 2 diabetes, it is important to understand the roles that the condition of insulin resistance and hyperinsulinemia, or the diseased condition of high insulin levels in the blood. People throw around the term insulin resistance without really thinking much about it, and this also includes a lot of scientists as well, and that can lead to a distorted perception of our disease and even a distorted view of what diabetes is.
What may be most remarkable about the disease of type 2 diabetes is that very few people realize what the disease even is. They often think it’s high blood sugar, which is pretty foolish actually, as high blood sugar is just one of the manifestations of a broken glucose regulatory system, so just from knowing this we can say it’s the glucose regulatory system that is broken and the high blood sugar results from that.
So we get here just by asking the question, why is our blood sugar high? This is not just a random event, there are reasons for it, and you can say well that’s because I’m a type 2 diabetic, but that admits that it’s being diabetic that is behind our fate, and if we can answer the question as to why our blood sugar is high, why we are diabetic, then we’re at least on the right track.
So there are of course reasons for this and it isn’t that we’re fat or didn’t exercise or even that it is in our genes, these are risk factors of course but this isn’t the disease either, it just means we may be more likely to get it. What’s the disease itself though?
When we ask what makes our blood sugar high, well we could look at the science here which does tell us quite a bit, in fact we can map this all out to give us a working definition of the pathogenesis here, the conditions which cause it in other words, but that’s not what we tend to do.
Instead, we just assume that if there is too much glucose in our blood, then our cells aren’t taking in enough, like for instance what we assume about a type 1 diabetic.
Even the assumptions about type 1’s aren’t correct though, as it’s not that their cells don’t take in glucose, because while insulin speeds this up it’s not required, and you can have normal blood sugar and get plenty in your cells without any insulin at all, and many type 1’s do make a little.
They think that about us though, our cells are glucose resistant and that’s why our blood sugar is high, and they are glucose resistant because they are insulin resistant. They fail to even study this on the simplest of levels though, being aware that all high blood sugar is caused by too much glucose being put in our blood, both type 2’s and type 1’s as well.
With uncontrolled type 1 diabetes, their almost entire lack of glucagon suppression has their liver spewing out massive amounts of glucose because it thinks that we have severe and life threatening hypoglycemia, to the extent that we end up dying.
With type 2, we have the same problem to various degrees, not to the extent that we die, at least die quickly, although this does cause us to die slowly, reducing our life expectancy. We do suffer from a lack of glucagon suppression as well though and that is always the reason blood sugar rises regardless of the type of diabetes, the body can handle any diet you can throw at it provided that hormones like glucagon and cortisol, which drive blood sugar up by producing excessive internal glucose secretion, aren’t too out of whack, but in diabetes they are.
So they are thinking that our cells aren’t taking in enough glucose, but the opposite is actually true, at least in terms of the capacity they have. They end up exceeding their healthy capacity though, due to both more glucose and more insulin in the blood, and the cells become damaged from this over time.
There’s a healthy amount of glucose that cells can metabolize, but when you expose them to more, then this ends up damaging them, although most of the damage with diabetes comes from being exposed to too much fat at the cellular level, which is an even bigger problem. Too much glucose, glucotoxicity, and too much fat, lipotoxicity, are the culprits behind diabetes.
So the next question to ask is, what causes these toxicities, is it insulin resistance for instance? Actually, insulin resistance protects us from both of these, because insulin is to blame for these excesses, and when the cells get damaged they fight back more and more to try to limit further damage.
The other thing to realize is that we will always resist hormones that are at excessive levels, and hormones are designed to be in a tight range, and if we go over that there will be trouble, and this will always be accompanied by cells resisting excess hormones.
Type 2 diabetics both have insulin resistance and excessive insulin, although they don’t want you to know that, because you might question their madness in looking to increase insulin toxicity on purpose, which both increases the damage from insulin as well as increasing insulin resistance over time.
So if we think that insulin resistance is what is wrong with us, that’s a harmful mistake, and will lead us to think that if we only overpower the cells and get them to increase the amount of excessive nutrients we take in, we’ll be treating the disease.
This makes things worse though as you might imagine, and this is the reason why insulin therapy fails, because it looks to reduce our level of protection. There’s a class of meds that reduce insulin resistance more directly, TZDs, like Actos and Avantia, these are even worse though and the reason why they are is because they reduce insulin resistance even more effectively than just bashing our cells with even higher amounts of insulin.
There is so much stupidity surrounding the way we treat diabetes it’s not even funny, and it all comes from a childish view of the disease itself, your blood sugar is high, let’s try to bring it down for a while, you get worse and worse, we’ll just keep bashing away at it though and when things turn bad, well we did what we could.
One of my favorite stories about the medical profession was how they killed off George Washington, he had a cold, they kept taking more and more blood from him, and each time they did he got worse and they got more aggressive with the blood letting, until they took so much that they killed him.
That’s exactly how we treat diabetes, only the scenario plays out more slowly, but I’m sure George’s doctor told his family that he did what he could, no one bothers to think or question any of this though, so they probably believed him.
So with type 2 diabetes, we know that both the disease itself and the complications come primarily from an excess of nutrients, although the higher levels of insulin we are exposed to does quite a bit of damage itself. This hyperinsulinemia is also behind the excess nutrients, the lipotoxicity and ultimately the glucotoxicity, and we know the path, high insulin over time leading to excess lipotoxicity of the alpha cells of the pancreas, leading to higher levels of glucagon, which puts blood sugar up too much, there’s your type 2 diabetes right there.
As this progresses, the higher blood sugar causes insulin levels to remain high all the time, which causes more lipotoxity as well as glucotoxicity, and we get a vicious circle going on here, glucagon goes up even more, blood sugar goes up even more, insulin levels go up even more, and then we get the idea that we’re not deteriorating fast enough and we speed things up by increasing insulin even more, and call that treating the disease.
So insulin resistance isn’t the problem, no more than looking to turn your head to soften the blow of a punch in the face is the problem with being punched in the face, it’s the punch of course that’s the problem.
The fact that we are resisting something that is in our blood in excess, which is the case with our levels of insulin as type 2 diabetics, it should be way clearer than it is that it’s insulin that’s punching us.
Unless we can get clear that it is not the insulin resistance that’s the problem, we’ll remain completely lost as to what is going on, and unless we know what’s wrong with us, we’ll never be able to even start to fix it, and may even do the opposite, throw gasoline instead of water on the fire, and that describes the conventional approach to treating type 2 diabetes pretty well actually.