Diabetes: Did someone change the lock?

By Tom Everts PA-C, IFMCP

Diabetes is a condition where your body doesn’t regulate blood sugar appropriately. Type 2 diabetes has become increasingly common, especially in developed countries. A few years ago over 10 percent of Americans had diabetes and 1 in 5 did not know they had it. Diabetes is the seventh leading cause of death in the United States and the leading cause of kidney failure, adult blindness and lower-limb amputation.

Why is diabetes so common? What is the pathology behind this disease? And most importantly, how do I prevent or treat it so that I don’t become a statistic?

Let’s review the normal mechanism of how glucose (sugar) is shuttled into our cells (liver, muscle, fat cells, etc.). First, upon digestion of food containing sugar or carbohydrates our pancreas senses a rise in glucose and releases the hormone insulin. Insulin acts as a key to let glucose into our cells. These cells get the energy they need (glucose!) and our blood sugar remains stable. All is well.

Diabetes is driven by a mechanism known as insulin resistance. It occurs when the cells of your body no longer listen to insulin as it’s trying to unlock the door and put glucose inside the cells. This results in elevated insulin at first: “We need more keys! Try this one! No, this one!” Eventually, as the insulin is unable to keep up we see a rise in the blood glucose. If this process continues what began as insulin resistance, results in pre-diabetes and eventually type 2 diabetes.

This process doesn’t happen over night. In fact, it typically takes years for things to progress into overt diabetes. Most people don’t realize they are heading in that direction. That’s why it’s important to monitor your glucose metabolism and check things like fasting insulin along with your routine labs. This will give you insight into whether your insulin is starting to rise, meaning your cells are starting to change the locks (insulin resistance!).

There is a lot of nuance not discussed here, as glucose is not the only source of fuel for your cells and some cells actually prefer fat, or ketones. The difficulty is that when you become reliant on sugar, you may lose the ability to burn fat. Insulin inhibits the cells from releasing fat for fuel. This is why there is a huge correlation between type 2 diabetes and obesity – even though the fat is there as a potential source of fuel, you can’t access it due to high levels of insulin. This inflexibility can present as hypoglycemia if you don’t keep up with regular sugar intake.

It’s important to have metabolic flexibility. This allows you to use both energy sources as needed depending on what’s available (i.e. what you eat) and prevent insulin resistance and diabetes. Here are some ways to shift your metabolism in the right direction:

Eating Strategy:
Include a variety of vegetables, especially colorful vegetables, which are loaded with antioxidants and phytonutrients. This helps reduce inflammation and nurtures the gut microbiome.

Limiting or avoiding high glycemic index foods is important to reduce glucose, as well as insulin levels. Insulin can be inflammatory when chronically elevated, and perpetuates the process of developing insulin resistance and overt diabetes.

Movement:
Resistance training is a great way to increase glucose uptake in our muscles. Compound movements like squats and deadlifts are encouraged and high-Intensity interval training is an efficient way to promote muscle growth and work our cardiovascular system.

Stress Management:
The stress hormone cortisol increases our blood glucose level, so managing stress is essential. This can take many different forms, the most recognizable being meditation. Here are some other things that help with stress: listening to music, walks in nature, art, deep breathing and exercise.
can take many different forms, the most recognizable being meditation. Here are some other things that help with stress: listening to music, walks in nature, art, deep breathing and exercise.

Sleep:
7-8 hours of sleep is critically important to regulating key hormones, including cortisol and insulin. These hormones, along with others, help regulate appetite, weight and immunity. Reduced sleep has been linked to insulin resistance. Sleep is non-negotiable in the discussion around chronic disease prevention, including diabetes.

Preventing and treating diabetes is challenging, and the current food environment does not make it any easier. A healthy eating strategy and lifestyle is essential. This looks different for everyone based on genetics and environment. If you are concerned about diabetes and are looking for a different approach, reach out to a functional medicine practitioner. We are here to help guide you towards optimal health, whatever that means to you.

Linell King MD, renowned internist and author of “Mastering Vitality” received his medical degree from the University Of Wisconsin School Of Medicine, and completed his residency at The Johns Hopkins University Sinai Hospital Program of Internal Medicine.  He has been practicing for twenty years; currently at his “Naples Vitality” office in Naples, FL.

Our practice size is limited to ensure the best possible care for our clientele; we qualify and accept patients committed to working collaboratively to create improved health and continued success.

Naples Vitality

239-465-0098
www.Naplesvitality.com

3411 Tamiami Trail N. Suite 200
Naples, FL 34103