Diabetes Mellitus is a group of conditions that affects about 26 million Americans– just over 8% of the population. Most of those cases (90% or so) are Type 2 Diabetes (T2DM), a condition in which the cells of the body become less responsive or unresponsive to the affects of the hormone insulin. This is preceded by a process called insulin resistance (IR). Once the IR is progressed enough that the body can no longer keep fasting blood glucose (sugar) below 126 the diagnosis of T2DM is made, but make no mistake- the two are really one in the same. As the body’s cells become more and more resistant to insulin two things happen. First, the pancreas needs to produce more and more insulin to have any affect. Secondly, if the cells are not able to respond to insulin and take glucose in from the bloodstream, glucose levels will rise.
Insulin has numerous roles in the human body, but some of the most notable occur in the fat cell (adipocyte). Insulin brings sugar (glucose) and triglycerides into the cell and stimulates the cell to store fat. Insulin also turns off the enzymatic pathway needed to get fat out of the fat cell. Since insulin is only really released upon ingestion of sugar and carbohydrates* this means that high-sugar, high-carbohydrate diets such as the Standard American Diet (SAD) are really high-insulin, weight-gain diets. This has had obvious and devastating consequences on our health and waistlines.
*(a very minor rise is seen with ingestion of protein)
The good news is that there is a lot that can be done to make the body more responsive to insulin.
1. Exercise, exercise, exercise! This is a real no-brainer, but exercise really is one of the absolute best ways to make your insulin receptors more sensitive to insulin (among many other amazing things it does for the body). Additionally, exercise counteracts the actions of insulin on the fat cell. Epinephrine, one of the hormones produced during strenuous exercise, stimulates the hormone (HSL) that releases fat from the fat cell.
2. Stop secreting so much insulin by drastically reducing sugar and carbohydrates in the diet. Atkins wasn’t a quack- he knew his physiology. Low carb diets work magnificently for a multitude of different conditions because of one hormone: Insulin. Stop bombarding your cells with high amounts of glucose and insulin and not only will the insulin receptors become more sensitive and work better (reversing that nasty IR wind-up), but you’ll likely be able to lose weight, too.
The diet I generally recommend people to start with is a low-carb, NO-sugar Paleo diet. Paleo accomplishes both of these points anyway, but for those who wish to manage or reverse their diabetes I recommend that they stay away from all deserts (even healthy paleo deserts) and make sure they don’t go too wild with fruit and starchy root vegetables. Once you learn to manage your blood sugar and accomplish your weight loss goals, you may wish to play around with your carbohydrate tolerance, but this should come later. If you would like to read about people who have overcome numerous diseases using the Paleo diet, check out the Paleo Miracle Book.
3. Some supplements may help make your insulin receptors more sensitive, which can be helpful in the beginning stages of change. It is important to note that the main mechanism of action of Metformin (the most prescribed diabetes drug) is NOT the reversal of Insulin Resistance. Metformin works mostly by decreasing glucose synthesis in the liver. No drug can fully undo the damage done by lifestyle and dietary choices.
In my office I generally start patients off by doing a thorough history and exam and ordering blood work. At minimum I usually run blood work that includes things like glucose, HbA1C, lipids and cholesterol, CBC, electrolytes, liver markers, and Vitamin D. In diabetic patients I may run other tests that are more specific to their needs such as fasting insulin and GAD Antibodies. If you know anybody who was diagnosed with T2DM but is skinny or normal weight, PLEASE have them read this article about type 1.5 diabetes.
If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham “triangle” area.