The Heart Of Diabetes Part 1

diabetes science

 

 

 

 

 

 

I want to talk more about the huge role that high glucagon levels play in diabetes, in both type 2 and type 1 diabetes actually, and for this article I want to point you toward a brilliant lecture presented by Dr. Roger Unger recently, during his acceptance of the Rolf Luft Award for his recognizing the role of glucagon in diabetes and blood sugar control.

This is not a new discovery by any means, Dr. Unger discovered this decades ago, and while he's certainly not a household name, it's not an exaggeration to say that Dr. Unger is the Einstein of diabetes research.  His impact on mainstream thinking has been pretty minimal thus far though and the biggest reason is that his research doesn't readily lead to profit, as they haven't figured out a good pharmacological solution to the problem of diabetes as he presents it, and in fact paying more attention to glucagon involves their admitting that their approach is broken, so there is naturally a reluctance to do that.

Dr. Unger first discovered the role of glucagon in diabetes all the way back in the 1950's in his early days as a professor of medicine at UT Southwestern.  He first stared testing people for glucagon back in 1959, and all these years later, the test is very rarely done, and very rarely is actually an exaggeration.

In addition to his work with glucagon, Dr. Unger also elucidated the role of leptin in diabetes, as well as the role that lipotoxity, poisoning by excess fat, plays in diabetes, and in particular, how leptin helps protect us from lipotoxity.

Dr. Unger's career in medicine has now spanned 60 years, and he continues to make significant contributions to the understanding of diabetes.  This recent lecture is called "A New Biology for Diabetes," and is well worth watching if you have any interest in diabetes at all.

Dr. Unger starts out talking about what he calls "Dogma Displacement Inertia," where he states that new scientific information is not assimilated into mainstream scientific thinking because science can't really keep up with it.  I think this is a very generous way to characterize it, and especially where it comes to the medical field, I would explain this inertia as being a characterization of the reality that medical research is almost always driven not by the pursuit of knowledge or the pursuit of better treatments, but instead by the pursuit of profit.

An example of this, he references the geocentric view of the universe, which held that the Earth was at the center, being maintained by scientific consensus for 450 years after it was convincingly disproven.  This is actually a great example as it elucidates the role of arrogance in science, we were too arrogant to accept that our planet isn't at the center of the universe, just like we tend to be too arrogant to abandon our scientific beliefs generally.

Diabetic dogma is no less difficult to displace, and focuses generally around insulin being the way to treat it, going back to 1922 when it was first used on type 1 diabetic children.  So since then all you hear is how insulin is a miracle treatment, and this has spilled over into being the way we treat type 2 diabetics as well, under the guise of our presumably having a "relative insulin deficiency," and this methodology is practiced with no regard to its absurdity or failure rate in type 2 diabetics.

Dr. Unger starts out talking about type 1 diabetes though, and few people even realize that there is some pretty big dogma going on with the way we treat type 1's, and the dogma is of course centered around insulin being essential for life.  So it's held that without enough insulin, we die, this is what is killing these people, so this is an easy fix, just give them insulin for life, and this is called insulin dependency.

We also have what we call type 2 insulin dependency as well, so this pertains to us as well, although it is very interesting and refreshing to have Dr. Unger start with type 1, and the dogma surrounding the need for insulin with this type is much more firmly entrenched to be sure.

Dr. Unger points out that we have proven this to be false though, and we can not only live but thrive without any insulin at all, and shows a video slide from one of Dr. Unger's experiments with two rats, both completely insulin deficient, and one of them is very healthy indeed.

So the difference in these two rats is that the healthy one was given a glucagon suppressor, to keep high levels of glucagon in check, and we know from other data that the problem with high blood sugar in type 1 diabetics isn't lack of insulin at all, it's too much glucagon.

Not surprisingly, the sick animal had very high levels of glucagon, where the healthy one had normal levels.  The sick animal by the way suffered from extremely high blood sugar and resulting polyuria, and from the slide you can see the huge amount of urine in the cage of the sick animal compared to the healthy one, which is very striking.

By the way, in this lecture, Dr. Unger wants us to know that he has now moved from his bihormonal approach to treating diabetes to a unihormonal one, glucagon, and he sees glucagon as being the true problem here.

So the conclusion of this experiment was that insulin is not essential for life, provided that glucagon levels are managed.  Now to be fair, insulin does play a major role in suppressing glucagon, but the dogma here is that insulin is the only way to do this, and what happens is that if we just focus on insulin to manage glucagon, we end up creating hyperinsulinemic states, and this is the case with type 1 diabetics as well, as the majority of them are overweight and suffer from other metabolic disturbances due to hyperinsulinemia being created to try to treat hyperglucagonemia.

I'll pick this up in Part 2.

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