3) THE BASIC CAUSES OF TYPE 2 DIABETES
d) Insulin Resistance
Type 2 diabetes is typically (but not always!) caused initially by the cell walls in the body developing a resistance to the effect of insulin. Insulin is the basic hormone involved in diabetes. Insulin is the hormone which allows the sugar in the blood to enter the muscle cells, it is the "key" which unlocks the door in the wall of the cell and allows the sugar molecules to enter the cell. Typically in type 2 diabetes the beta cells in the pancreas can initially make enough insulin. But the cell walls are "insulin resistant", they don't allow the insulin to do its job and the sugar can't get into the cells. As the cell walls develop a resistance to insulin, the cells do not get enough sugar. Because the cells don't get enough sugar, the body tells the "beta cells" of the pancreas to pump out even more insulin and the liver to pump out sugar into the blood. So the situation which develops initially in type 2 diabetes is that both sugar and insulin levels get too high in the blood. Insulin resistance per se is difficult to measure and determine. It assumed to be the cause of pre-diabetes, where the fasting sugar levels are over 100 mg/dl.
Note that the exact underlying causes of insulin resistance and diabetes are extremely complex. There appears to be a lot of contribution to the development of insulin resistance and diabetes from obesity and lack of exercise and a lot of contribution from genetics. Doctors have actually isolated the genes and the chromosomes responsible for some of the genetic susceptibility to diabetes. It appears that the genetic components are extremely common. It appears that as much as 40% of the population has some degree of genetic ability to become a person with type 2 diabetes, the "trigger point" of age, obesity and lack of exercise just varies. For some unfortunate populations, such as the Pima Indians, this trigger point is very low for both obesity and lack of exercise. 60 to 70% of the Pima Indians will become diabetic if they don't maintain a low weight and/or if they don't exercise regularly.
Obesity around the waist is a major contributor to insulin resistance. It appears that there are three different types of fat cells in the body: Dark fat around the collar bone which tends to improve insulin sensitivity: yellow fat around the hips and butt which has no effect on insulin sensitivity: and yellow fat around the abdomen which decreases insulin sensitivity. These three different types of fat cells appear to put out differing sets of leptins, hormones which control insulin sensitivity. There are many men who are otherwise thin who have so-called "pot bellies". These men are oftentimes only slightly overweight but they are at high risk for insulin resistant type 2 diabetes. By the same token there are obese women where their weight is concentrated in the hips and in the butt and they are thin at the waist. These women are at a much lower risk of having type 2 diabetes. Research has clearly and unequivocally shown that reducing the amount of fat on the body will greatly improve the prognosis for anyone with type 2 diabetes. Unfortunately there is no way to selectively reduce only the fat around the belly, contrary to the claims of many diet pills.
Current Chapter: THE BASIC CAUSES OF TYPE 2 DIABETES
a) Underlying Mechanism of Type 2 Diabetes
b) Symptoms of Type 2 Diabetes
c) Tests for Diabetes
d) Insulin Resistance
e) The Complexity of Diabetes
f) Poisoning of Body Protein
g) Diabetes, Protein Poisoning and Cognitive Thinking
h) Protein Poisoning and A1c
i) Well Cooked Meat and Protein Poisoning
j) Beta Cell Death in Type 2 Diabetes
k) The Hypoglycemic Spike Effect
l) The "Dawn Phenomenon"
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