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Back in 2008, I began writing about the effect of dietary fat on insulin sensitivity, and blood levels of glucose and insulin. Over the years I learned that saturated fat decreased insulin sensitivity more than other fats, e.g. One mechanism by which dietary fat decreases insulin sensitivity, raising blood glucose and insulin levels is through reduced action of the glucose transporter GLUT4. Rats fed a high (50% of calories) fat diet for 8 weeks showed 50% decreases in insulin-stimulated glucose transport. Subjects were deprived of dietary fat (via gastric surgery that decreases predominantly fat absorption).
Mice that were fed a high-fat diet and that became obese were protected against insulin resistance and the high glucose and insulin levels of their counterparts when they were bred to have more GLUT4. That reduction in endothelial NO (NO is nitric oxide) production contributes to high blood pressure. This entry was posted in Diabetes, Fat and Oil, Insulin Resistance, Saturated Fat on June 5, 2014 by Bix. Bix Saturated fat is one of our best sources for environmental pollutants, a confounder not adjusted for here. Fanatic Cook by Bix is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Generally, fasting blood sugar (the value you get when you’re tested upon waking without any food intake) is also the baseline blood sugar level. Irrespective of what you eat, tiny amounts of insulin are squirted into the blood stream in small pulses every few minutes.
The counter-regulatory (anti-insulin) hormones that are secreted in our bodies shortly before dawn, raise the blood sugar slightly.
Change the timing of your basal insulin – insulin taken later in the day often controls fasting sugar better.
We all know that eating too much can be bad for our health, especially if we become overweight or obese.
Obesity is the medical term for the accumulation of excess fat, leading to adverse effects on health and reduced life expectancy.
Obesity can lead to increased risk of heart disease, type II diabetes, osteoarthritis and some types of cancer. In the medieval period, obesity was a sign of status – only the wealthy were able to eat too much (and would have lower activity levels). It is very difficult to estimate the weight, and therefore the BMI of a skeletonised person, and because of that any estimates have wide error margins.
There is eburnation (polishing) and flattening of the head of this femur (thigh bone), which is indicative of osteoarthritis of the hip. The largest factor influencing the likelihood of having osteoarthritis is age – put simply, the older you are, the more wear and tear on your joints.
Diffuse Idiopathic Skeletal Hyperostosis (DISH; also known as Forestier’s disease) is a non-inflammatory joint disease which causes ossification (turning to bone) of the spinal ligaments and the regions where tendons and ligaments attach to bone (entheses). DISH is more commonly seen in males over the age of 50 and is associated with a rich diet, and with Type II diabetes, although the exact causes of the disease are unknown. This first metatarsal (foot bone) has a large hole at the distal end, caused by the build up of urate crystals in gout.
For diabetics keeping an acceptable blood sugar level is a daily chore and quite a hassle, so what is a acceptable blood sugar level? There seems to be both a reduced expression of the GLUT4 gene, and a reduced translocation or movement of GLUT4 to the cell membrane in the presence of a high-fat, especially high-saturated fat diet.  (GLUT4 is one of the glucose transport proteins that move glucose from the bloodstream into muscle and fat cells. When normal amounts of insulin fail to clear blood of glucose, the pancreas responds by releasing more.
Also, the fat we eat can change the composition of lipid in cell membranes.  A diet high in saturated fat has been shown to make membranes less fluid and may impair GLUT4 insertion. There really is abundant research on the role of dietary fat in the development of insulin resistance, a condition which manifests as elevated glucose, elevated insulin, and the development of type 2 diabetes. But people with type 2 diabetes may have much higher morning blood sugars than the level they achieve after meals, for the rest of the day.


But, if the factors that control this basal secretion go haywire, your body may only secrete insulin in response to meal-time rises in glucose and result in a high fasting blood glucose level. But in diabetics, this rise can be exaggerated, leading to high blood glucose levels in the morning.
You might wake up in the middle of the night with a jolt, thudding heart, soaked in sweat – a low blood sugar or hypoglycemic reaction, which drives you to eat sweets resulting in a sugar spike in the morning. A Metformin Sustained Release pill taken at bedtime will have a stronger impact on fasting blood sugar than the same pill taken in the morning.
Obesity itself does not cause pathological lesions in bone, however recent research has suggested that obesity can cause an increase in the size of bones, especially the width of the femur (thigh bone). Strenuous activity, especially from an early age, will also increase the likelihood of developing osteoarthritis.
Clinically, the patient initially suffers from pain in the mid back, and over time experiences increasing stiffness as the bones of the spine fuse together. The vertabrae are fused together due to the ossification of a ligament running along the front of the spine.
DISH has been observed to be particularly common in medieval skeletons from monastic cemeteries, suggesting that either these were monks who enjoyed a particularly rich diet or possibly that these were rich patrons who chose to be buried at the monastery. Lead was used as a sweetener and preservative in wine, and liquid containers often had lead glazes.
The result is impaired glucose tolerance, hyperinsulinemia, and eventual development of type 2 diabetes.
However, it is ideal that you get tested for both FPG and PP to understand how well you are managing your blood sugar. More dangerous is the unrecognized drop in blood sugar at night during sleep which triggers a burst of counter-regulatory hormones. Carrying too much weight can lead to type II diabetes and osteoarthritis of weight bearing joints, and certain diseases such as DISH (Diffuse Idiopathic Skeletal Hyperostosis) are also seen more often in obese individuals.
It is well known that activity increases bone size and bone mass – and carrying around excess weight has a similar effect on bone. Therefore very few researchers have investigated the prevalence of obesity in medieval populations.
Once all of the cartilage has worn away, bone on bone contact occurs – which leads to polishing (eburnation) and porosity of the bone surface.
Obesity puts extra strain on the main weight bearing joints – especially the knees – and therefore also leads to an increased risk of developing osteoarthritis. Documentary evidence suggests that although monks ate a frugal diet at the start of the Middle Ages, they became adept at bending fasting rules and there are many accounts describing the rich and varied diet they enjoyed.
Diabetes is where the body’s organ called the pancreas fails to produce the amount of insulin that is needed to keep the body healthy.
Over time, compensatory insulin output from beta cells in the pancreas diminishes and a person with type 2 diabetes may find themselves injecting insulin instead of just taking oral meds. These hormones push the blood sugar back up – to higher than normal levels by the morning (Somogyi phenomenon). Although patterns of obesity, dietary intake and skeletal pathology are far from simple and therefore difficult to interpret, there is plenty of evidence that being overweight can even affect our bones!
According to the World Health Organisation, a BMI of over 30 is obese and a BMI under 18.5 is considered underweight.
Osteoarthritis of the knee, hip and possibly also the lower back and feet have all been associated with obesity in modern populations. Fat friars became famous through stories, including Friar Tuck, the rotund friend of Robin Hood, and Chaucer’s monk, described as a ‘fat and personable priest’. High lead levels in the body cause kidney damage and this inhibits uric acid excretion, leading to hyperuricemia.
Type 1 diabetes is where the body stops making insulin and the blood glucose level goes very high. Insulin is used for the changing of the body’s blood sugar into fuel that the cells can use. In order to manage your blood sugar you should talk to your doctor about getting a glucose meter to help keep an acceptable blood sugar level.


In the medieval period, obesity was an indication of wealth, and was also seen in monastic communities where a high-calorie diet and low levels of physical exertion led to problems we often associate with our modern, sedentary lifestyles. Waist circumference is strongly linked to obesity and these increased health risks – and it is understood that carrying excess weight around the waist is particularly harmful to health. In archaeological populations we can see the changes on the bone joint surfaces of people who had osteoarthritis – but these are more advanced changes than those required to make a clinical diagnosis of osteoarthritis, which rely on identifying narrow joint spaces (the size of the gap between the bone ends in a joint) on x-rays. Osteoarthritis of the spine is very common in medieval populations, and is directly related to age.
Some people who have type 2 diabetes may also need to have insulin injections to help control blood sugar levels. Without suffient amounts of insulin the blood sugar levels skyrocket which damages the body.
Osteoarthritis of the major joints is less common, but is still seen quite often – especially in the knees, hips, elbows and shoulders.
The damage that is most often done is eye damage, heart damage, an increase in the chance of heart disease, nerve damage, kidney damage, and even kidney failure. Again, this is directly associated with age; however, one study has suggested that osteoarthritis was more common in older individuals (estimated to be over 45 years of age) predicted to be obese compared with older individuals with a normal BMI.
There are different types of insulin available which are classified according to how quickly and for how long they work.
Your doctor or diabetes nurse will discuss the various preparations and devices available and help you choose a regimen that is right for you. Making this one of the most common and most mobile glucose machines, and a wonder at helping you maintain an acceptable blood sugar level.
Treatment with insulin is usually lifelong.  What is insulin and how does it work? So, when your blood glucose level begins to rise (after you eat), the level of insulin should also rise. Insulin works on the cells of your body and makes them take in glucose from the bloodstream.
Some of the glucose is used by the cells for energy, and some is converted into glycogen or fat (which are stores of energy). Some glycogen or fat is then converted back into glucose which is released from the cells into the bloodstream. If the blood glucose level remains high despite these measures then tablets to reduce the blood glucose level are usually advised.
Insulin cannot be taken by mouth, as it is destroyed by the digestive juices in your digestive system. Insulin may come in a vial to be injected with a separate syringe, in a cartridge to be used with an injection device (pen), in a pre-filled injection device, or it can be given continuously by a pump. They are available as vials to be injected with a separate syringe, as a cartridge to be used with an injection device (pen), or in pre-filled injection devices. Before you start treatment your doctor or diabetes nurse will give a lot of advice and instruction on how and when to take the insulin. An insulin pump may be suitable for people who have lots of 'hypos' (blood sugar becomes very low) or very high blood sugar in the morning, even when on a suitable insulin regimen.
This part can be measured and gives a good indication of your blood glucose control over the previous 1-3 months. But if you have a lot of hypos or you are unable to tell when you are going to have a hypo then you are not allowed to drive. You will need to inform the Driver and Vehicle Licensing Agency (DVLA) that your have diabetes and are taking insulin.



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