Before we get back to Amy Berger’s very long article on this subject, I want to start this segment off by having a peek at another article entitled It’s the Insulin, Stupid, by Dr. Andreas Eenfeldt, a Swedish medical doctor who runs a popular site called the Diet Doctor.
It truly warms my heart whenever I see an MD that gets this and while I don’t hold back the criticism of his profession in general I am also quick to praise them when it is due. In this brief article, the Diet Doctor references a study where they genetically modified rats to secrete less insulin, and they stayed slim on the same diet that made normal rats fat.
This is exactly what we would expect to see though given our understanding of how insulin works. Dr. Eenfeldt doesn’t mention this, but it’s worth mentioning that these lower insulin secreting rats did not exhibit an insulin deficiency, they maintained normal weight and health because they weren’t insulin deficient, rather they didn’t oversecrete it, and the normal rats did.
So our friend cites this as more evidence that the people who deny insulin plays a role in obesity, or that high insulin is even a problem at all, should find embarrassing. There’s actually lots of things they should find embarrassing, and most notably, the fact that we can just make rats or people or whatever obese and give all these creatures diabetes as well, at will, just by increasing their insulin levels. This is clearly demonstrated causation we’re talking about here, not speculation or a theory.
Dr, Eenfeldt then suggests we change our model of how type 2 diabetes evolves, and he presents an old model and a new model. In the old model, we have bad food, leading to obesity, leading to insulin resistance, leading to hyperinsulinemia, leading to beta cell exhaustion, leading to type 2 diabetes.
In the new model he proposes, it starts with bad food, leading to hyperinsulinemia as the second step, and this part is correct. I do think that it’s overly simplistic by the way just to call the first step bad food, as there’s more that goes into this than just bad food, and by the way it’s not just the so called bad food that is to blame.
A lot of food that people consider to be good food is involved here, he blames so called junk carbohydrates, but too many carbohydrates of any quality will do us in as well, and too much eating period is a problem as well.
If the model is going to be comprehensive, this would need to include quite a bit of other stuff, for instance stress levels are a big thing, as well as environmental stressors, but the point here is to show that hyperinsulinemia is certainly right at the top of the list as far as the ranking of the timelines of conditions. So we can just call this first step improper diet actually to keep this simple.
So hyperinsulinemia does come next, not insulin resistance, although the two do go hand in hand and one does cause the other. It’s quite clear though that high insulin is the real cause of all this stuff though, this cascade of disorders.
Whether obesity or insulin resistance come next is a matter of some debate, but I would put insulin resistance before obesity, as we tend to get that even before we become obese, and the moment insulin rises at least some insulin resistance is created, because our cells will always resist too much insulin. So the point where insulin resistance starts is actually only moments after insulin excess is created, and both of these hammer at us from the start of the metabolic disorder really.
Some people think that which comes first, hyperinsulinemia or insulin resistance, is like which came first, the chicken or the egg, but in this case, since insulin resistance is a response to too much insulin, and high insulin is actually required to resist it in the first place, we know that the high insulin must come first, even though it may only come a bit earlier.
High insulin causes the obesity here as well but that takes longer to manifest, so that would be fourth on my ordering of things.
In both models he has beta cell exhaustion in there, so he’s bought into that myth, and apparently does not realize that the beta cells of type 2 diabetics are far from exhausted, in fact they continue to pump out levels of insulin several times normal.
If beta cell exhaustion does occur, meaning the beta cells can no longer secrete normal amounts of insulin, that only happens in the very late stages, after decades of secreting too much insulin, and having the beta cells exposed to both glucose and fat toxicity over all these decades, all these decades of not controlling the diabetes in other words.
Although our friend is way more hip and knowledgeable about all of this than most medical doctors, he putting beta cell exhaustion in there at all does exhibit a lack of understanding about how type 2 diabetes actually occurs, and if he had really done his homework he would out hyperglucagonemia in there instead.
Excessively high levels of glucagon caused by high insulin over a long enough period is the proximate cause of diabetes actually. The story you hear a lot is that at some point the beta cells can’t keep up to control blood sugar and diabetes results. This is false though, the beta cells can indeed keep up, and as long as glucagon levels are normal, that actually doesn’t matter anyway, blood sugar will stay normal even if you reduced the excessive insulin we see created here all the way down to normal.
So in other words we can maintain good blood sugar even on what he calls a junk diet, a very high carb one even, as long as glucagon is kept normal. It’s even been shown that we don’t even need insulin at all to do this provided glucagon is kept in check, and the experiments of Roger Unger proved this, where he reduced insulin to zero and controlled glucagon and blood sugar was normal. It’s a myth actually that we need insulin for our cells to take in glucose, the extra insulin just allows it to take in more, when more is present.
That’s what the high glucagon does though, it puts more and quite a bit more glucose into our system, and we can take in a certain amount of this extra glucose but it does overwhelm us, and our blood sugar then becomes high. So hyperglucagonemia isn’t something we see talked about but it’s the real problem where type 2 diabetes is concerned.
So what causes hyperglucagonemia? It’s the insulin, stupid. He got that part right.