The Pathogenesis Of Diabetes

pathogenesis of diabetes

 

 

 

 

 

 

 

If you've been following along, this article is sort of a recap of some of the things we've discussed so far, but I know that some people don't follow the articles and posts from beginning to end and may start somewhere along the way, so if that's the case, well this will bring you up to speed on things somewhat as far as what we've talked about with the pathogenesis of this disease, which means the manner in which it has developed and continues to develop.

The main thrust of this particular article though is to speak about how we tend to set aside what's behind diabetes once we got it, like for instance you've had a lot of insulin resistance over the years and here you are now, with diabetes, so we can just forget about that part of it and just focus on treating its effects now.

This is exactly how allopathic, or conventional medicine treats diseases in fact, they don't worry at all about what are behind them if you don't have it, they might think they do but whatever little preventative advice tends to be way off base here, actually we don't even need the tends to, it just is way off base, but for the most part they don't worry about the pathogenesis of any disease really.

So if you don't have it yet, for instance if you do have elevated blood sugar but it isn't high enough to be diabetic, well come back and see me when you get worse and then I'll have something for you then.  This sounds ridiculous but it's pretty typical, sadly.

It actually doesn't matter because all they have for you is drugs anyway, and you just don't qualify for them yet, and therefore you don't qualify for their help yet.  Even though they are essentially drug pushers, they at least have enough sense to not push the drugs on people who aren't bad enough for them yet, so they simply wait until you are, which tends to happen sooner rather than later anyway, out of neglect of the condition.

So when you do get it, well they still aren't concerned about the underlying causes here, the term allopathic medicine was coined actually as an insult to them referencing their preoccupation with just treating symptoms, and even though that's a pretty stupid way to treat disease, that's what they do.

So we do know that type 2 diabetes has several influencers, the ones they talk about are things like obesity and inactivity, gluttony and sloth in other words, they might tell you to lose weight but it's very rare that they might have even an idea of what causes obesity, or why you struggle so much on eating less, or why your energy levels don't permit you to exercise the way you should, or why even if you manage all this it still doesn't work very well and you just end up failing over and over again, and return to your old weight or worse, the so called yo yo effect.

They usually don't know all that much about insulin resistance but it's very widely known that type 2 diabetics suffer from this and this is what drives our disease in fact.  So even the most modest understanding of diabetes contains this as a primary mechanism at least, although all it really gets is lip service, and worse, it's ignored, not just mostly but completely.

So in other words, sorry to hear you had insulin resistance all those years and it led to this, now your blood sugar is high, let's come up with a plan to lower your blood sugar now, but this plan generally involves not starting to pay attention to insulin resistance finally, it not only involves ignoring it, it involves intentionally making it worse.

So then as the disease gets worse and worse they tell you, well that's diabetes, we're doing all we can, when what they are doing is making it worse and worse themselves.

So we know that as type 2 diabetes develops, our insulin levels rise, and that causes our bodies to over time resist these high levels, and eventually the regulatory mechanisms break down, the ones that are supposed to keep us from going too low, but now they no longer realize we are high from this insulin resistance and keep pumping our blood full of glucose when we already have too much.

So the the main pathology here doesn't even have anything to do with peripheral insulin resistance, in other words the insulin resistance in our fat and muscle cells, that does play a role but the minor role compared to the role our glucose regulatory system plays, which involves the pancreas and liver.

So in the pancreas, there are two types of cells, the beta cells which secrete insulin which lowers our blood sugar, and the alpha cells which secrete glucagon which raises our blood sugar.  In a healthy pancreas they are balanced, and when blood sugar goes up, insulin is turned on and that turns off glucagon, it's not good to have these two hormones fight, and when blood sugar goes too low, insulin is turned off and now it's glucagon's turn.

So when the alpha cells become insulin resistant, from being exposed to too much insulin over time, well this isn't good for any cell but it's especially unhealthy for these ones, as they will secrete glucagon when it is not appropriate, when we don't need it, and that causes the beta cells to secrete more insulin, and the two types of cells go to war here.

What ends up happening is that the alpha cells become even more resistant to insulin and secrete even more glucagon as a result, the beta cells look to counter this with even more insulin, and you get a vicious circle going on here, and the pancreas itself takes a big hit here.

Glucagon instructs the liver to secrete glucose, but higher levels of insulin also serve to limit this, so the liver is sensitive to insulin as well which keeps it from secreting too much glucose, but when it becomes insulin resistant as well from high insulin levels over time, being still very sensitive to glucagon which wants to get it secreting more, and less sensitive to insulin which wants it to slow down, then it just ends up secreting more and more as our disease progresses.

So the progression here is insulin resistance, and this does not cease to be an issue once we get type 2 diabetes, it actually becomes more and more of an issue as time progresses after diagnosis, and therefore focusing on improving this has to be our primary focus.

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