Diabetes Self-Management Blog

For decades now, we have been told that fatness (or “obesity”) is a major cause of diabetes. Health “experts” have warned about this, but they could never say how being overweight could cause insulin resistance (IR). Without IR, you can’t have Type 2 diabetes, so the whole “blame fat” theory has been suspect.

Well, now they have a plausible explanation. Obesity may cause inflammation, causing IR, leading to diabetes. But is this theory true? Does adipose (fat) tissue really create inflammation? Or do both obesity and inflammation come from some other cause? Get ready for some science as I try to explore these questions.

In a new report in the Journal of Leukocyte Biology, two Japanese scientists report that “obesity is associated with a state of chronic, low-grade inflammation.” They explain that as fat cells get larger, they seem to attract immune cells called macrophages. These cells produce inflammatory chemicals called cytokines that help cause insulin resistance. Chief among these chemicals are interleukin-6 and tumor necrosis factor-alpha.

In animal models, insulin resistance doesn’t occur until after macrophages invade the fat cells. So the question remains, which comes first, the inflammation or the fatness? What draws the immune cells into adipose tissue?

Remember that most overweight people never develop diabetes. And some overweight people have much more inflammation than others. (The same is true of thin people, of course.) Why do some develop this fat-related inflammation and some don’t?

Some think that weight itself provokes inflammation. According to French scientists writing in the journal European Cytokine Network, weight loss is associated with reduced “macrophage infiltration” and reduced inflammation. Also, another chemical, adiponectin, protects against insulin resistance and blood vessel damage. Adiponectin levels are often reduced in obese people for some unknown reason.

But researchers at the University of Tennessee found that most of the inflammatory chemicals released by adipose tissue do not come from fat cells, but from other cells (probably the macrophages) that have invaded. The fat cells themselves produce more leptin and adiponectin, chemicals that should reduce insulin resistance.

What Is Going On?
Why should increasing the size of fat cells cause inflammation? Inflammation is the body’s response to a threat (like an infection) or an injury. I can’t see why fatness should cause this reaction.

One possible answer is stress. Microbiologist Paul Black, MD, at Boston University writes that “repeated acute or chronic psychological stress may cause [inflammation seen in diabetes and cardiovascular disease].” He thinks that it may be the combination of stress and increasing fat levels that leads to insulin resistance and diabetes.

In another paper, Dr. Black reported that the liver and fat tissues are two of the biggest sources of cytokines, and that stress often activates cytokine production. So it looks as though fatness creates a potential risk of inflammation (because fat can produce more cytokines), and stress may be the actual cause (by telling the fat cells to actually produce these chemicals.)

Of course, there are many causes of inflammation besides stress. And there are many causes of stress besides psychological stress. Cold, heat, infection, fatigue, pollution, certain chemicals, and many other factors can create stress and/or inflammation. Yet the “experts” are convinced that fat is the only significant cause. I doubt it.

Obviously, as the scientists like to say, more research needs to be done. But since sustained weight loss is so difficult, I think the priority for heavy people should be to reduce inflammation, not to lose weight. Reduce stress, take an anti-inflammatory like salsalate, take care of your gums. (Gum disease is a major source of inflammation.) Relax, get out in nature, things like that.

Note: I loved the outpouring of responses to the blog entry on reasons to live. I think it would be great to do a book on reasons to live. (I have a chapter on it in The Art of Getting Well, but I’d like to expand it into a book.) I could use your help. If you have any stories about reasons to live, the benefits of having them, or the effects of not having them, please send me an e-mail at nurse@davidsperorn.com.

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Comments
  1. Father, Mother, and brother are all type 2 diabetics. I had gestational with 2 of 4 children. I’ve been checking myself occasional and the average morning fasting number is 120. Dr. has given me blood tests twice recently and say they are within normal range and I am not diabetic. This morning I felt horrible (dizzy, blurry eyes), meter test was 123, an hour later it was 122. I ate plain made with water oatmeal and tested again after about 1 1/2 hrs and it was 136.

    Isn’t this considered diabetic levels? Should I be concerned? Feeling so yucky and tired lately.

    Posted by Sandi |
  2. Thank you for the posting. Yes, a lot more research needs to be done on the causes as well as what to do if you are diagnosed with diabetes.

    Treatments for diabetes are one of the research studies we’ve been working on here in DeLand, Florida. Some of our investigational treatments have shown promising results, but there is we need to do additional research studies to test investigational methods that may help us understand the condition.

    Posted by Don |
  3. Dear David

    Causality may have little meaning in the medical field in some cases. Straight linear thinking like broken bone caused by car crash is ok. But obesity and IR maybe in some feedback loop. Why it should be a not good “positive” feedback loop beats my comprehension. At least God should have made it the more IR the less hungry you should be (i.e. a stable negative feedback loop) but not so the more IR and the less glucose inside the cells that need it and the hungrier you get. Gaining weight seems to make IR worst in some people.

    Posted by CalgaryDiabetic |
  4. Hi, Does anyone know how to take salsalate or has anyone tried this? How did it work for you. I am insulin resistant and I am having a hard time controlling my sugars.

    Thanks
    JB

    Posted by jbarrag |
  5. Hi, David.

    The CDC has predicted that one of every three people born in the U.S. in 2000 will develop diabetes. Of course, this will be mostly type 2.

    About a third of American adults today are overweight; another third are heavier, in the obese category.

    Already, over 50 million U.S. adults have prediabetes. One of every four prediabetics develops diabetes over the next three to five years. [U.S. population is about 300 million.]

    If the CDC is right, I’m betting those of us who are obese are much more likely to be the ones developing diabetes.

    The good news? I think it’s pretty well established that lifestyle changes (including loss of excess weight and moderate-intensity exercise) can significantly reduce the odds of becoming diabetic.

    Even without knowing an individual’s underlying inflammatory status.

    Now, I’m not saying lifestyle change is easy…

    -Steve

    Posted by Steve Parker, M.D. |
  6. @Sandi - certainly those readings are cause for concern - try this link for help on what to eat; oatmeal doesn’t sound like it’s suiting you
    http://www.alt-support-diabetes.org/new.php

    This may help too
    http://www.phlaunt.com/diabetes/18856280.php

    Nicky.

    Posted by Nicky (Type 2) |
  7. To JB who asked how to take salsalate. Get a prescription — other anti-inflammatories might work too, it’s just that salsalate is the one that has been studied. It’s cheap, too. Take it with food.

    Sandi, those blood glucose levels aren’t that high. Whether they qualify for being diagnosed with diabetes or not is kind of a close call. But it shouldn’t be making you feel that sick. So I think you might want to go back to the doctor and ask to be checked out more for your symptoms.

    Posted by David Spero RN |
  8. I thoroughly enjoyed reading your blog. I think the focus on body weight as the culprit for all our ills has gone overboard. Body weight is an outcome, just like heart disease and diabetes. We need to step back from the scale, especially since we have no “cure” for obesity. However, we are seeing evidence to support the idea that making changes in our lifestyles improves our health, no matter what does or does not happen on the scale.

    Posted by Carol |
  9. To Sandi,

    Your numbers indicate pre-diabetes, the stage of diabetes development that warrants lifestyle changes, but not the diagnosis for diabetes. I am NOT diagnosing, but giving you guidance on what to ask your physician.

    You should ask your physician if he/she is familiar with the criteria for diagnosing DM, and that diabetes CAN be prevented in 75% of the cases of pre-diabetes…. You are worth the time and energy it would take to prevent the awful disease!

    Posted by Joan |
  10. Sandi,

    Sorry, here’s more….

    To diagnose PRE-diabetes, one would have a fasting blood sugar of 100-125, inclusive. To diagnose diabetes, it takes:

    TWO fasting of 126 or higher on two separate days

    An A1C of 6.5 or higher

    An oral glucose tolerance test two-hour test of 200 or hight

    A random blood test of 200 or higher with an accompanying symptom (thirst, frequent urination, etc).

    You can take this to your physician and ask appropriate questions. An endocrinologist would also be a great approach.

    Posted by Joan |
  11. Thank you for the bit of information. It makes me feel a bit better. I was a normal weight person who got gestational diabetes when pregnant. Diet didn’t help so I ended up on insulin injections. 8 years later was diagnosed with type II and a thyroid problem (under active)at age 44. I was never an obese person. I only had problems with weight when I was diagnosed with type II and even then I was only 10 lbs over weight. I was always active with competitive swimming. I swam a mile the day before my Son was born. I thought the life guard was going to faint when he saw me enter the pool. I still continue to swim as well as do other exercise ie. kick boxing and Tae Kwon Do.

    I recently had trouble with A1C going up to 7.9. I gained about 10 lbs even though I ate healthy, swam and took metformin and Levoxyl (for thyroid). I went to the Endo and he told me if I lost 20 lbs I could get off medication. I felt the way he said it was implying it was my fault I have diabetes because now I am 20 lbs over weight. He added Januvia to my med routine and I immediately lost 8 lbs in two weeks. My numbers are much better now, but I think it is because of the medication not because I lost a few lbs from diet changes (I didn’t make any - since I already eat healthy). When I told the dietician my numbers were much better she said she wants me to make diet changes and get some regular exercise. I don’t think she heard a word I said about the regular exercise I already do. Makes me upset. They make it seem like you fat person it is your fault you have diabetes. Never mind that my Grandmother, her Brother, Her Son (my Father), her Daughter (my Aunt) all had TII. Plus my sister and cousin were recently diagnosed with insulin resistance. Doesn’t take a brain surgeon or, I should say an Endocrinologist, to know that it is heredity that is causing the type II and not a few extra lbs. I am not obese.

    It all makes me frustrated because I have to go to the Endo for treatment feeling like he and the dietician think I do not live healthy. And they don’t believe me when I say I do. Makes me MAD.

    Posted by Diane |
  12. I have spent the last 15 years helping people lose weight. Prior to that I saw what obesity’s toll was as an ICU nurse in a cardiac unit. By incorporating more fruits and vegetables, fewer refined flour/sugar products and engaging in physical activity, these folks get off medications for diabetes, cholesterol, and blood pressure. I never learned this was possible in nursing school, and I am sure most people taking these meds are not aware it’s possible. They are able to accomplish this with 25% protein, 55-65% complex carbohydrates, and less than 10% fat. Obesity kills! Its that simple. No matter what the mechanism, eating foods low in nutritional value, and high in calories with little to no physical activity is not the formula intended for a healthy human body-its a formula for obesity, diabetes, high cholesterol, and hypertension. Totaled up, this equals premature death or disability. Lets spend less time analyzing the problem and do something constructive to help people who are overweight engage in health promoting behaviors. Our environment of poor food choices and our pill popping paradigm of medical management has led to the demise of the American health profile. We were in danger back in 1955 when the presidential physical fitness testing program spurred a drive to get Americans in shape. Apparently we did not take it that seriously then, and are suffering the consequences today.

    Posted by Denise |
  13. Ok, let’s get something straight once and for all time - the type II dilema is way more complicated than “you eat too much or wrong foods”. Further, the answer is not the same for all people. Someday, when all of this has been studied even more I believe we’ll end up with a Type III, IV and V or more forms of diabetes.

    Me on Quick study: Oldest of 5 children, all growning up in same house, same food, all really, really active (I personally was a cheerleader, played on the HS Tennis team and rode a 10 speed literally everywhere in metro Chicago - we did not get use of a car). Outcome, 4 really thin siblings and one moderately chubby me at 5′4″ and 135 lbs. I could never get lower ! I tried and tried. 40 years later I have been a type II diabetic for 16 years. I’ve tried every diet imaginable, run 5Ks and a half marathons, been told I must be “cheating” by doctors, and well a lot more that was very hurtful. It has been outright insulting, infuriating and frustrating dealing with this problem.

    I personally am being scheduled for gastric by-pass surgery and my BMI is 32 now, (not 40+) but I’m recommended because of other health problems and documented (well documented) attempts to control my blood sugars as I’ve aged with this metabolic sydrome as it is now called.

    If you want to wonder about how I came to this decision check out the latest research on the results gained with surgery for Type II diabetics, its astounding. People are being “cured” or “in remission” (both terms are used. Oh, and by the way the results happen almost immediately, prior to any significant weight loss post surgery. With my 16 year history I am reaching for a goal of greatly reduced amounts of daily long acting insulin. The “cure” or “remission” rate of 90+ percent seems to be happening on people who were more recently diagnosed.

    Hmmmm, makes me think there is still much more to this problem than is readily understood yet.

    Thanks for giving me a spot to throw my two cents in. My hope is that after surgery I will learn to eat what I need to eat post surgery, and then forget about anything else becauase I will be able to live without all the meds and the equally important live without constant hunger.

    Posted by Lily |
  14. Food cannot be just left floating around. If you keep eating then something has to be done. This theory states that your body tries to save your life by 1) storing the surplus calories in fat tissue, 2) send a 911 call to stop the over consumption; which we interpret as “inflamation” because the emergency is handeled by the same “troops” and 3) tell your muscles to ignore the insuline signal because they are totally filled up already with glycogen and fat; which we interpret as insulin resistance. Things go wrong if there is no more fat tissue to store your overconsumption. Then the fat is stored in places where it causes havoc : ectopic fat in your liver, leading to Non Alcoholic Fatty Liver Dessease. (etc) The article was in the trends series. It is free. If they don’t allow the direct link to the *.pdf use the second to their home page and look from there.

    Trends Endocrinol Metab. 2010 Feb 23.
    Gluttony, sloth and the metabolic syndrome: a roadmap to lipotoxicity.

    Abstract
    Once considered divine retribution for sins, comorbidities of obesity (metabolic syndrome) are today attributed to obesity-induced metabolic defects. Here, we propose that obesity and hyperleptinemia protect lipid-intolerant nonadipose organs against lipotoxic lipid spillover during sustained caloric surplus. Metabolic syndrome is ascribed to lipotoxicity caused by age-related resistance to antilipotoxic protection by leptin. Published by Elsevier Ltd.

    PMID: 20223680

    Gys

    Posted by gys de Jongh |
  15. Hi Lily,

    Please be careful about the gastric bypass. It seems to be more remission than cure. Look at how long the remissions are likely to last, and decide if surgery is worth the risk.

    Gys, thanks for posting the abstract. I don’t buy any of it, actually. The title “Gluttony, Sloth and the Metabolic Syndrome” should tell you the authors have very prejudiced attitudes. I’m going to read the paper, but it sounds an unlikely theory.

    Posted by David Spero RN |
  16. For Sandi,

    You may be having high insulin resistance that results in your pancreas overreacting and putting out too much insulin to compensate. The result can be that your blood sugar levels drop too much too rapidly and then the body will start to put out a lot of epinephrine to bring the blood sugar back up to more normal levels, which will make you feel really terrible. At the same time, your blood sugar is not working right so that the nerves do not get enough sugar and you may feel dizzy. I find that my stomach may feel upset because of this, but that varies.

    This condition is what is called reactive hypoglycemia and is a state that some people apparently go through on their way to becoming diabetic. You probably should see an endocrinologist and ask for a glucose tolerance test. When you go for that test, take someone with you who can drive you home afterwards and also take some orange juice with you as you will almost certainly go into a glucose deficiency on the way home. You do NOT want to be driving when that happens. The test takes 3 hours or sometimes 4 to do. They will take repeated blood samples during the test. From the blood samples they will measure your blood glucose and insulin levels. It is very likely you will have very high insulin levels during the test.

    I know all of this from personal experience with reactive hypoglycomia. So far I have never turned diabetic and hope I do not. My wife is type 2 diabetic and I definitely don’t want it. In my case the reactive hypoglycemia is partially caused by the steroid like medications I have to take for my asthma and allergies. I also have irritable bowel syndrome from the asthma. I probably had relatively higher blood sugar before this all started from the medications, but when my doctor complained that my vitamin D levels were too low, I raised my intake until it brought the blood levels up to normal. Then I develaped the reactive hypoglycemia. It took me 5 years of scientific literature research before I really understood what was going on. It is the interaction between the vitamin D and the steroid like medications that caused the reactive hypoglycemia and continues to even today. I have to carefully regulate the vitamin D levels.

    I reduced the steroid like medications as much as I could, but doing that caused a lot of trouble for me with the asthma at first, but have found that the reactive hypoglycemia does help control the asthma, which is useful to me. A dangerous side effect, however, is that I tend to dump out a lot of salt in the urine, so have to take in quite a bit to maintain normal blood pressure. I think that sometimes contributes towards dizziness, but more often causes anxiety attacks.

    I have had to take different things to improve the insulin sensitivity. I do take Avandia, which is an insulin sensitizer, but I also take alpha lipoic acid, which helps some. Vitamin B12 helps a little. My doctor also found that I was deficient in testosterone, so supplemented that, which did help. I also found that reducing sources of fructose helps as it causes insulin resistance. Even with fresh fruit, I had to reduce the intake of it, depending on what it has in it. There is a product that is designed for diabetics that you can use which will probably help you. It did help me. It is a form of aloe vera juice called Aloe Life. It seems to help sensitize the insulin receptors and reduces inflammation. However, it can cause diarrhea, so you have to be a bit careful not to take too much or it can cause you problems. I found that when I first got onto it and found the right dosage, I did start to feel better.

    Some foods have natural insulin stimulants in them and can cause a lot of trouble for you through the insulin stimulants. I had quite a bit of trouble with oatmeal because it contains quite a bit of soluble fiber in it, which is digested by bacteria in the colon. When it is broken down by the bacteria, it forms chemicals that are insulin stimulants but also can sensitize the insulin receptors a little. The oats themselves contain quite a bit of carbohydrate, so when you combine taking in a high dose of carbs and you stimulate insulin and you already tend to put out too much insulin anyway, the result is you will feel extremely lousy for hours afterwards, yet the blood sugar will not go very high. For the last five years my blood sugar rarely ever goes above 100, and when it does, it is in respense to extra epinephrine. I feel really lousy when that happens. My blood sugar usually tends to vary not much more than about 10 to 15 mg/dl.

    I am on thyroid also, but have found that I dare not eat salt with iodine in it as it will make me feel very ill. I don’t fully understand it, but that is the way it is. I just have to cooperate!

    I also can have muscle cramping along with it, which I found that carefully regulating my calcium intake helps with that. However, that has a flip side to it. If I don’t take enough, then because of the effects the steriod like medications I take for my asthma have on the calcium channels of the muscles, then if I don’t get enough calcium, I get very weak and go into tetany. I have to take calciuum daily, and do so 3 times daily to even out the dose. Too much calcium causes cramping for me.

    If you are on any medications, you should, if you can, do some experiments with your doctor’s approval and direction, to see if any of them may be causing increased insulin resistance. I have found that some medications that are not known to cause insulin resistance can in fact do so, at least, they do on me. Change them if you can and you might get a reduction in the problem.

    If you do have reactive hypoglycemia, I suppose it is remotely possible that the doctor might be willing to give you beta blockers to reduce the effects of the epinephrine, but that can be a bit dangerous because it may leave you with too little blood sugar and you might pass out. So, your doctor may not give you anything for that, depending on what he finds and thinks might help you.

    I think many doctors are unaware of this condition or don’t think of it when they get complaints from a patient that they feel so lousy after eating certain things, and yet the blood sugar seems very normal. They will tell you that everything is fine. If you persist, they might investigate further, or they’ll decide that it is in your head and you should just go home and get over it. Grow up! Unfortunately, that does not work. But likely they will investigate and will work with you and you can get improvement in your condition.

    One other remote possibility is that you have irritable bowel syndrome as it can also make you feel very lousy, but that does not usually cause dizziness. Also, oatmeal is something that usually improves that condition because of the soluble fiber in it (it blocks prostaglandin E2 production, which is one of the chemicals involved). You would also likely have diarrhea or constipation or a back and forth pattern.

    But when I read your symptoms, it reminded me of my own experience with the reactive hypoglycemia much more than the irritable bowel syndrome. I would check that out first.

    For the type 2 diabetics,

    I ran across recent research in which scientists experimented with giving mast cell stabilizers such as zaditor or cromolyn sodium to diabetic animals, and it caused virtually all the symptoms of the diabetes to go away as long as they continued to give them the medication. No human experiments with these drugs has yet been done to my knowledge, but I think that if they do them and the results are positive, it should be helpful. I am trying to find some natural product that can do this effectively and not cause other problems so that my wife can benefit from this research. So far, no luck, but I’ll keep looking.

    Posted by Wendell |
  17. Denise: Amen! If we are going to STOP Diabetes (pre, and Type 2) we have to encourage anyone who is overweight to eat healthy and exercise! I’m Type 1 (for over 30 years), I eat healthy and exercise every morning. I’m proud to say that I’m a very healthy diabetic. Changing a lifestyle doesn’t happen overnight, but it you do it little by little the payoff is excellent! My mother died at age 43 and my sister at age 18 (many years ago) both from diabetic comas (Thye were Type 1). Now that is reason enough for me to keep up my lifestyle changes.

    My motto: I can’t live to be 120 years old if I don’t take care of me NOW! Please people get up and do something, go for a walk, ride a bike, stretch, lift weights, run, but do something. And if you are lucky enough to have someone like I do, do it with them. It is worth it!

    Posted by Bev |
  18. To Diane:
    If you doctor(s) won’t listen to you, then GET A NEW DOCTOR! Period. Don’t waste your precious time (life) on any more idiots.

    OK. I’m done.

    Posted by Tom P |
  19. Bev and Denise. Again you all are dumping everyone with Type II as fat obese couch potatoes. SHAME ON YOU. There are people who have it because of heredity that are not obese couch potatoes.

    There are those of us who eat right (veggies and small amounts of fruit), have lived a healthy active lifestyle all along and still have Type II. Is swimming 1 mile 2x/week, Tae Kwon Do 1 hour 2x/week, Kick boxing 1 hour 1x per week, plus 3 miles of 2/1 walking 1/2 jogging 2x/week mixed in when the pool is not available, sound like a couch potato to you????

    FOR SHAME……

    Posted by Diane |
  20. I haven’t read all of the entries, and sorry if anyone has asked, but what about insulin resistance in Type I? Is there anything to improve IR for us?

    Posted by Mo |
  21. Have I missed the research study that shows that Type II diabetes is not the cause of obesity?

    I believe there is a relationship between Type II and obesity, but which is the chicken and which is the egg! I was 25 years old in 1973 when I was given a glucose Test and told I was a diabetic. I have had weight problems ever since.

    JohnVC.

    Posted by John VC |
  22. Simply AMAZING how many comments here refer to some need to get fat people to eat better and exercise more. Has nobody ever stopped to consider what stereotypes they are promoting in such statements? Do you REALLY think you can know about somebody’s behaviors by their weight (fat or thin)? I shouldn’t be surprised. While earning my MPH, this was always the assumption — If somebody is fat, they must be doing something “wrong” (because of course, being fat is bad, and being thin is good). And of course, if somebody is sick at any weight, they must be doing something “wrong/bad/judgeable.” Health educators and others would do well to study Confirmation Bias, the Just World Hypothesis, Attribution Theory, Victim Blaming, Sizism, Healthism, and Health at Every Size. But that won’t happen, because most of us (yes, I said “us”) who go into health promotion have a fondness for the idea that we are gods who can judge others.

    Posted by FSGinger |
  23. May I point out that not all people who fall into the “obese” category are couch potatoes who overeat?

    I’m 40 years old and I’ve fallen into that category since I was a teenager: 5′-5″ and between 180 and 220 pounds. There are people in my parents’ generation (on the side of the family I wasn’t raised by, incidentally) who have weighed 400 pounds+. For 15 out of the past 20 years, I’ve walked to work and back every weekday and only occasionally driven my car. That’s at least 2 miles of walking a day. For many of those years, I also went to exercise classes several times a week. My mom, who raised me, has always been a health nut. I grew up eating tofu stirfry and pasta with vegetables, and I still eat a balanced (though not puritanical) diet. I’m not diabetic or pre-diabetic, although I do have a tendency to get low blood sugar easily - and type II runs on the heavier side of the family.

    I’ve often wondered if type II is caused by insulin overproduction. That would explain the link between diabetes and higher weights. You overproduce insulin and need to eat in order to get your energy and focus back,the insulin makes sure that most of what you eat is stored as fat, and that makes you heavier. Eventually, the overproduction makes your insulin receptors wear out.

    Posted by Dee |
  24. How come since most people cut down on their fat there are more diabetics in the world today?I think it’s because we are eating more carbohydrates to replace the fats.Also maybe we are eating too much fruit because we are told it’s good for us.Also regular sugar has been replaced with High Fructose Corn Syrup.I don’t thing humans were meant to eat corn.Corn is for birds.I don’t think fat is what causes weight gain.We all need fats and as long as all the fats are combined properly it won’t kill us.It is the fat that slows down the glucose to go
    into our body and causes our body to produce more insulin than we need.Maybe that is what causes insulin resistance.Your liver doesn’t assimilate fructose the same way as it does glucose that your body makes out of everything you eat.The HFCS is bad for your liver.It sort of turns it into a chemical and sort of make get to the brain and prevents you brain from sending the message to your body that you’ve had enough.Why do you think so many people have beer bellies.Even people who don’t drink alcohol.

    Cattle farmers give insulin to cattle to make them eat more.

    Posted by Eva Walker |
  25. We may not all be diabetic for the same reasons. No one in my family was diabetic. I was underweight at 135 when I married. Then I started to gain and I also got less active as the years passed. I gained a bit each year (35 yrs +55 pounds =190 pounds). I blame this on excessive candy, soda, ice cream and cookies and less exercise. Shortly thereafter I was diagnosed with type 2 and a diabetic diet slowly got my weight down to my normal 165. Unfortunately the TV and the computer are often more interesting than exercise. And I must avoid the ice cream aisle too.

    Posted by Jay Potts |
  26. All these comments are somewhat contradictory which suggests that we have no idea what is causing the present problem. Some people blame obesity. Well I lost 85 lb lower than my high school football weight and exercised 2 hours per day. Did it fix my diabetes no! the BG was still much too high. The doctors refused to give me a very small amount of insulin in the begining because that was not the treatment protocol. Now I have to take massive amounts to stay alive and yes it is a make fat drug.

    Denise suggestion of a super high carb diet is probably part of the problem. If you are insulin resistant and eat so many carbs you will end up at 500 lb. Most diabetic that have good control both of the blood sugar and of their weight do so on a very low carb diet.

    The food supply in America is really bad. High fructose corn syrup is most likely toxic. Fluffy breads. Enormous amount of salt in all the prepared foods. Veggies and fruits that are imitations of what they should be an designed for long term transport. Very poor govt labeling. Health canada caters to Big Food instead of the health of the citizens. Peanut butters have hydrogenated veggy oil in them when everybody knows trans-fats are not natural and the body cannot cope with them.

    Posted by Calgarydiabetic |
  27. As a Type2 who limits carbs to less than 30grams/day along with salt and fats, even after losing 65pounds, my sugars still run in the mid 200 range and my A1C is 11+. I’m currently on 60u of Appedria and 70u of Lantus a day with little to no change. Most oral meds attack your pancreas, and having had 3 hospitalizations with pancreatitis (non-drinker here), I’m not risking that. They didn’t help anyway.
    I honestly think that some of us are meant to have higher numbers. 95% of the time I feel great. Maybe they (medical society) need to realize that one set of ‘norms’ is not the answer!

    Posted by Patrick |
  28. David, thank you for sharing these important questions and scientific insights.

    Posted by Miriam |
  29. To dovetail to FSGinger and to the article itself: “repeated acute or chronic psychological stress may cause [inflammation seen in diabetes and cardiovascular disease].” I’ve been hearing of studies indicating that chronic fear elevates risk of many of the same maladies which are at elevated risk in fat individuals. To me it raises very starkly the question of the degree to which “obesity-related” health issues can be traced to the long known true epidemic of hazing and bullying leveled at the adipose from childhood on. How much of their blood is on the hands of those who delight in their torment, at times to the systematic point of healthwashing, greenwashing, economywashing and otherwise claiming pragmatic cover for manufacturing misery?

    Posted by Avery Ray Colter |
  30. Does diabeties caurse eye sight problem? if it does pleas give me some advise.

    Posted by Julius |
  31. In Jan 2003 I stopped eating all flour and sugar (sugar, honey etc but do eat fruits, rice etc.) and ALSO weigh and measure my food - 1 oz oatmeal or no sugar cereal, 6 oz fruit, and 2 eggs or 8 oz plain yogurt at breakfast: 4 oz protein, 6 oz cooked veges and 6 oz salad and 6 oz fruit at my lunch and dinner. I don’t eat at all between meals - started meditating 30 min a day, exercise regularly and I no longer have diabetes (in remission) - I lost 110 pounds and have kept it off, no longer take diabetes meds (was taking gloucophage for 5 years), no more high blood pressure meds or cholesterol meds.

    I did not do this on my own - ALong with checking in regularly with my doctor, I joined a 12 step program called Food Addicts Anonymous (foodaddicts.org) because I need ongoing support to live this way. It is a free 12 step program based on AA. Many of us have been able to get off these types of medications and get back to a healthy way of living. Pretty amazing.

    Posted by Linda |
  32. It makes my blood boil when people assume someone who is overweight is only that way because of overeating and not exercising. This is simply not true for many people struggling to lose weight.

    I have been thin my entire life, until menopause. In my mind, there is a connection to other hormones in the body; something has gone awry. I ate healthy and small portions. I excercised 6 days a week, still no weight loss. I am not prediabetic either although diabetes runs in my family. What is ironic is that I probably ate better and exercised more than my own MDs, who sat at a desk all day seeing patients. It’s like a switch flipped around a certain age and weight loss became impossible but weight gain was the norm. It’s horrid to live with this way with no answers. I don’t believe blood work tells the whole story.

    Posted by emilie |
  33. Before anyone jumps glibly on the bandwagon of blaming fat people for causing their own diabetes, let’s remember that well over 80% of diabetics are thin and many, many fat people are NOT diabetic. (as stated above)

    However, if you eat a poor diet (and most of the processed foods in our supermarket are cheap rubbish and low in nutrition) and take little or no exercise, you will be unhealthy, whatever your size. Best advice for diabetics of ANY size is eat good, fresh foods and take regular exercise.

    Posted by Lynda Finn |
  34. Ahmen to Linda Finn. Well Stated.
    My experience is control carbs, hearty exercise, control liver with metformin and small amounts of Humalog Lispro (4 units) after meals to make up gland shortfall.

    Although not an expert advise that hearty exercise drops insulin resistance. My experience
    prior to getting massive liver dumps stopped is that in morning body was pushing back and refusing to use insulin or absorb more glucose.

    Walk 1.5 to 2 miles and burn out excessive glucose and BG would drop down to 100 and insulin became active again.

    In AM after liver dump of glucose to 238+ BG, 23 units of 75/25 did nothing till excess glucose booted out by strong walking 2 miles.

    Today after two doses of 500 mg standard metformin - one at 10:00pm and one at 12:00 am midnight - liver glucose dawn effect dumps shutdown and wakeup BG is similar to midnight BG around 135 BG. Then in am - do not need to walk 2 miles to wipe out excess glucose and a small shot of Humalog Lispro 4 units works fine for am and Breakfast. No insulin resistance seen.

    But; one needs to keep up hearty walks total of 1 to 2 miles to keep Glucose marching out or it starts backing up again raising BG and demonstrating Insulin resistance.

    My take as a nobody but 4 years tracking this crap is that when too much glucose gets backed up from no or light exercise, Body’s defense is to stall glucose transfer when too much builds up in cells and Insulin resistance is seen.

    Just a thought.

    Since liver corraled today with metformin

    Posted by jim snell |
  35. According to the book Blood Sugar 101, What Your Doctor Doesn’t Tell You About Diabetes, it’s insulin resistance that likely causes weight gain, not the other way around.

    If you have high blood sugar and are also insulin resistant, you may find it almost impossible to lose weight, even if you cut out your carbs and exercise constantly.

    Any blood sugar levels outside of what is considered completely normal put you at risk for the complications that come with diabetes, even if they only seem slightly higher than normal to your doctor or the ADA, and what most doctors and the ADA consider pre-diabetic or diabetic numbers are far above what the safe numbers really are, so by the time most people are diagnosed with either, you need to take the results quite seriously.

    She thinks that insulin resistance may come about by a combination of having a genetic predisposition for it, as well as environmental factors that contribute to cellular breakdown.

    The author sites evidence that keeping your blood sugar below 140 at all times puts you in a “safe zone” and is enough to keep complications at bay. She also sites evidence that there is a direct link with heart disease and abnormal blood sugar, and that a low carb diet that is higher in fat than what your doctor/ADA would recommend is actually safe as long as your blood sugar remains below 140 at all times and you add a reasonable amount of exercise to your life. She points out that merely losing weight didn’t help her blood sugar levels, and recommends finding a medication that works for you, eating a low carb diet, and being as active as possible.

    Also, an Ayurvedic diet would say to include as much fiber as possible from green vegetables in your low carb diet, rather than relying more heavily on fat or protein.

    It is possible to have diabetes and still have a healthy body.

    Posted by Daria |
  36. Insulin added to cattle, hfcs, etc etc, I think all the stuff added to our food and processed stuff has a lot to do with these problems. have not heard anyone mention gluten products either. Has anyone had success staying off gluten? Just trying to add food for thought.

    Posted by B DeMass |
  37. All confusion will be cleared right now. Insulin resistance occurs only when a diet that consumes animal products on a daily basis overtime.Carbs fuel all cells of the body. Fat has to be turned into sugar before it can be used as fuel. This fat over time builds up in the cells where the insulin stores sugar for energy. once the cells are completely filled with this fat it no longer allows sugar in. this is called insulin resistance and then you get high blood sugar because it gets back up in your blood stream because of this fat blockage. Stop consuming the fat and you fix the problem where it begins. was that simple enough. that’s the truth. the only truth. Get back to the human species specific diet of plant based foods and all problems go away naturally. Cats, Dogs, Lions, Aligators and all types of animal like these are the meat eaters of this plant. humans were designed for consuming a plant based diet like our counter parts the great apes who we share 99% of our NA with. Look at nature for your answere its staring at you in the face.

    Posted by Gary |

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