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How do we become resistant to insulin and what causes our beta cells to fail?Insulin resistance can develop as a result of fat cells releasing more pro-inflammatory chemicals such as IL-6, and fewer anti-inflammatory chemicals such as adiponectin.
That is not what some of my textbooks say, which claim that type 2 diabetes has a stronger genetic component than type 1 diabetes. Unfortunately their authors have been lazy and taken the fact that type 2 diabetes runs in families as evidence of a genetic link.
It is all to do with the fact that people in the same family follow a similar dietary pattern, and often a similar exercise pattern as well.
In fact type 1 diabetes has a much stronger genetic component with a few genes on chromosome 6 being responsible for much of the susceptability. In type 2 diabetes a large number of genes are associated with risk and none particularly strongly.What happens in the diabeticThere are some tissues in our body that let glucose in without insulin. Fat and muscle cells contain GLUT-4 transporters, which don't allow much glucose in without insulin being present. The brain on the other hand has a lot of GLUT-3 transporters, which allow appreciable amounts of glucose in without insulin being present.Tissues which let in glucose without insulin are found in the eye, kidneys, peripheral nervous system as well as the liver, ovaries and seminal vesicles.
The unfortunate result for these cells is that they can accumulate too much glucose over time.
However, those cells in the eyes, kidneys and in our peripheral circulation accumulate sorbitol, which causes swelling of the cells due to osmotic pressure. Most of these complications result from raised levels of glucose in cells which do not rely on insulin to obtain it.
In particular some cells lining capillaries and nerves in the kidneys, eyes and limbs are vulnerable. As a result they leak proteins which ultimately result in constriction of the blood vessels supplying the kidney. Since the brain uses sugar as its main energy source it goes to plan B which is creating ketones, which can provide energy also. Too many ketones acidify our blood and cause excess urination, thirst, vomiting and tummy pain.


Ultimately severe dehydration, swelling of the brain and coma can occur, which is why hospitalisation is often needed. This is a serious complication of type 1 diabetes.
However, it is uncommon with type 2 as some insulin is normally available.Curing diabetes naturallyExercising more and consuming foods that do not raise blood sugar levels is the key to reversing diabetes.
While it becomes harder to regain full health the longer you have had diabetes, when first diagnosed, the vast majority of people have the potential to completely cure themselves of the condition.The correct dietThe modern western diet is the main cause of diabetes. For instance on one of my GI lists I have a baked potato with a GI of 111, greater than pure glucose while peanuts are listed with a GI of just 7, which implies that foods containing the East Asian sauce, satay would be very low GI. So in other words the GI is not an absolute value, but just a guideline. Sometimes it is more realistic to consider the glycaemic load or GL of a food, which takes account of the amount of a food you eat. Obviously one Cornflake (GI=93) is not going to raise blood sugar as much as a whole can of baked beans (GI=40), but a small bowl of them probably will.Foods that are normally low GI can be eaten as the main part of a diet for someone with diabetes. These include meat, fish, eggs, dairy as well as nuts, seeds, most vegetables and some fruits.
The one vegetable that has a high GI is the potato (this includes the sweet potato), and the fruits with a high GI include ripe bananas, dates and raisins.
Generally speaking fruits from warm climates have a higher GI than those from more temperate climates.
For instance if you exercise soon after consuming the food then some of the blood sugar it creates will be taken up by your muscle cells. If you combine it with other foods of much lower GI or eat a small portion of it you will also find your blood sugar does not rise as far.Timing foodsIn general if you exercise then you will reduce your blood sugar level. A 30 minute exercise stint before food will allow you to get away with a higher overall glycaemic load. Equally if you do some light exercise soon after a large meal you can lower the peak which your blood sugar will reach.In general it is best to leave some time between any meal and completely sedentary activity such as bed or watching the TV. Kids get it about right when they automatically rush about after a meal, often to the frustration of their bloated parents.
A bit of housework, gardening or short walk are often quite effective at making a real dent in your blood sugar readings.Treating diabetes with drugsIt really is best to avoid the need for drugs.
I would always advise making concerted efforts to control blood sugar levels with increases in exercise and changes to the diet.
Many people find they can come off drugs completely when they do this properly.For those who cannot control their blood sugar levels without drugs then it is sensible to take them.


The cumulative effect over time of high blood sugar levels is extremely damaging, and this is why so many diabetics suffer from amputations, blindness, heart attacks and strokes.Blood sugar lowering agentsThe main one is perhaps Metformin which lowers the amount of sugar your liver produces. Thiazilienediones such as Rosiglitazone increase insulin sensitivity of the tissues and glucosidase inhibitors such as Acarbose reduce absorption of glucose from the gut.
All these drugs will be more or less effective in different people depending on how their diabetes is affecting them. Measuring blood sugar levelsDiabetes is diagnosed using criteria that are arbitrary.
There are several ways that are used to measure blood sugar problems:Fasted blood sugar level - FBGThis measures blood sugar levels after not eating anything for at least 8 hours.
However, this value will vary depending on factors such as stress, recent exercise and illness. Secondly their muscles get used to using fat as a fuel place of glucose and so more glucose is left in the blood.
If you come into this category the measure below could be more useful to you.Long term blood sugar controlTo assess this we measure the amount of glycosylated haemoglobin - HbA1c, in your red blood cells. Haemoglobin - Hb, is the protein found in red blood cells that is responsible for carrying oxygen to your tissues. In good health somewhere between 3-5% of our haemoglobin is in the HbA1c form.Red blood cells live for an average of 120 days. There are a number of factors that can skew the measurement:People with healthy low blood sugar have longer lived red blood cells that may survive for an average of 150 days. In this case a high end reading for HbA1c does not imply bad blood sugar control.Diabetics with high blood sugar levels have red blood cells that live shorter lives than average, typically around 90days. It may be a better measure than HbA1c, and gives an indication of blood sugar levels over the previous 2-3 weeks(5).Glucose challenge or OGTTThe oral glucose tolerance test - OGTT is a measure of our response to consuming 75g of glucose in one hit. It is unrealistic as most people never consume such a large and purified amount of glucose.
For most people achieving the low GI meal involves limiting the amount of starchy carbohydrates they eat.



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Comments

  1. Tonny_Brillianto

    Connoisseur butter and chesse, and yes grass fed meats) However intake from your.

    28.11.2013

  2. Leon

    Diets, as I believe carbohydrate levels should be set.

    28.11.2013