In the previous two parts in our look at a video presentation of Dr. Roger Unger's award winning lecture on diabetes, we started looking at excess glucagon being the primary defect in high blood sugar and diabetes, and unchecked glucagon is the reason behind this, and lack of insulin only is significant insofar as insulin fails to accomplish its primary goal of restricting excess glucagon production.
So this rightly takes our attention away from all the nonsense that hyperglycemia or high blood sugar is a matter of not having enough insulin to get glucose into the cells, and we know from the work of Dr. Unger and others that insulin isn't even required for this, let alone be at a certain level, let alone be at levels less than alarmingly high and toxic.
It is true that high levels of insulin will promote more uptake of glucose, and in fact an abnormally higher intake, since we know that insulin does have this effect. So that's actually a problem, especially when we look at the fact that the ravages of diabetes are caused by both too much glucose and too much fat being put into our cells, and it's too much insulin that does this, and its when this extra glucose goes into our cells that this extra glucose really becomes a problem.
Now it's been shown that with high blood sugar alone, we will take in more glucose than normal, and that's bad, but with higher levels of insulin we accelerate this process even more, making ourselves sicker, and increasing the risk for complications, what we're supposed to be out to avoid, but we often times can look at our blood sugar and see it is more normal and pat ourselves on the back, where we have duped ourselves into thinking that we're making things better when we've made them worse.
While this is going on, our alpha cells which produce glucagon and which are behind the high blood sugar itself get more and more toxic and more and more insulin resistant and make our diabetes worse and worse. Of course we're not only not paying attention to this, not paying attention to hormone levels at all, either glucagon or insulin, we actually use medication to accelerate the progression of our disease, based upon some very faulty thinking that Dr. Unger has made it his life's work to expose and elucidate.
Now back to the lecture. So we left off taking about how Dr. Unger has shown that type 1 diabetes, the hyperglycemia that results from it, isn't caused by lack of insulin, it's caused by lack of glucagon action as he puts it. In fact, if we had something we could administer to type 1 diabetics to keep glucagon levels normal, that would fix the problem, not treat it a roundabout way by using what amounts to excessive amounts of insulin to control glucagon.
The major problem with this approach is that injected insulin isn't very efficient at all, meaning that in order to raise insulin levels in the pancreas where we need them to be raised in order to control glucagon, we need to elevate serum insulin levels to several times higher than normal.
So this will indeed save your life if you are a type 1 diabetic but it's a long way from ideal, and having to raise insulin to such high levels comes with a price, although this isn't something that the medical community looks at at all, they don't notice the metabolic disease this causes in their patients in other words, and even if they did, they don't really know very much about the physiology here, and this includes endocrinologists as well by the way.
Their curriculum is just too slanted toward the administration of current medications and considerations about these medications are simply outside the scope of their knowledge, practice, and concern. It's even very difficult to get your hormones tested at all with conventional doctors, they will look at you with a very confused look even if you want to know where your insulin levels are at on insulin, and if you asked for a glucagon test, they would really think you are crazy.
If you look into the extent that conventional medicine is concerned about high glucagon levels, you will see this described as a rare condition caused by tumors in the pancreas, even though diabetics of all types test with high glucagon levels, and in fact if you have high blood sugar you know your glucagon levels are high, because this is what is behind high blood sugar.
A few people have asked me about glucagon testing, the first thing I tell them is good luck getting one ordered, and this is not going to be seen by doctors as having any practical value, in other words it doesn't lead to their prescribing anything differently, and that's what they do, all they do, so all of the decisions we expect them to make need to be in the context of this.
In fact some of the things they do prescribe do look to reduce glucagon, Metformin for instance, as well as TZD's, however that's not how they prescribe anti diabetic medications, it's more like pin the tail on the donkey. So your blood sugar is still high? Try this. No one needs to know any of the mechanisms behind the tails, they just get pinned on you blindly and the hope is that one or more of them will end up on your butt.
We don't really have any prescription medications that can safely reduce glucagon to desirable levels by the way, they have looked to do things like block receptors and it seems that Dr. Unger, at the end of the day, is wishing we had such a medication, but that's the wrong approach to this problem really, as the high glucagon is just a symptom and we need to not look to block it but to look to treat the things that are behind it.
The good news is that one of the big things behind it where type 2 diabetes is concerned is insulin resistance, and that's a huge area with a lot of potential although we generally don't spend much time thinking about this much.
With type 1 diabetics the problem is going to be more challenging, the worries about blocking glucagon still apply, and we need to keep in mind that glucagon plays a vital role in not just our health but our ability to remain alive, it's not some extra baggage that is there that we can just get rid of, and in fact when we look to artificially block it we need to take great care not to overdo this as we can die just from doing that.
I don't feel that we'll ever come up with suitable pharmaceutical approaches to type 2 since they are focused on the wrong things, and will remain focused on the wrong things, what we need to be doing is correcting the imbalances we have, not worsening these imbalances, and conventional medicine isn't interested in balance of any sort, nor is the industry behind them.
As far as type 1 goes, well we are going to need to address the causes of what is behind that which is ultimately beta cell destruction, and for the time being anyway, if we are injecting them with insulin, we can't diminish their glucagon response too much or we'll be killing them off that way for sure.
This discussion will continue in Part 4.