sugar consumption increase 8200%

Would you like to know why our chronic disease problem is so bad? Look no further than this!

The USDA recently published “U.S. Trends in Food Availability and a Dietary Assessment of Loss-Adjusted Food Availability, 1970-2014.”

This long-worded and cumbersome title means the report was trying to answer this question: “What kind of changes in food consumption can we see over the specified period of time?” In this case, that specified period of time would be 1970 to 2014.

For a little history: The late 60’s and early 70’s was when the low-fat message started hitting Americans. The USDA published the first dietary guidelines about this time, asking Americans to eat less fat, saturated fat and red meat.

Guess what? Americans, for the most part, followed suit.

There was essentially no change in protein consumption overall – a 1% change in 40 years. Not significant. However, chicken consumption increased significantly – more than doubling during the time period. Since chicken doubled and the overall amount was essentially unchanged, this means red meat consumption went down. As instructed.

Similarly, there were decreases in saturated fat consumption and increases in poly-unsaturated fat consumption (think soybean oil).

But at what cost?

High Fructose Corn Syrup

Between 1970 and 2014, the amount of HFCS consumption increased by 8,212%, going from 0.5 pounds per person per year to 45.5 pounds. This means the average American is consuming nearly 1 pound of HFCS per week!

Grain-Based Products

Wheat and corn-based products also increased in consumption, with wheat based products increasing by 31% and corn-based products increasing by 23%.

While wheat and corn-based products look and taste different than sweets, they act the same once they reach the digestive system. In other words, bread and sugar act the same.

Look Mom, It’s a Chronic Disease Carnival!

Replacing some meat products and lowering fat consumption led to an increase in sugar and processed food consumption.

Processed foods are devoid and any nutritional value. This leaves the body hungry, craving nutrition. But people continue eating processed foods. This starts a viscous cycle.

It starts with slightly, but chronically, elevated blood sugar because insulin starts losing its ability to function efficiently. It manifests itself as pre-diabetes, high blood pressure or problems with cholesterol. Then, usually, type 2 diabetes.

Over time, a person’s health continues to deteriorate because we give them medication to change a number and do nothing to fix the problem. Chronically elevated levels of insulin and fluctuating levels of blood sugar is toxic to all tissue in the body.

This leads to increased risk for kidney problems, vision problems, liver problems, neurological problems, etc…

The shift to this dietary approach means we have chronic diseases popping up all over the place, as if we were in a field of PEZ Dispensers.

How do we fix this problem?

It’s a two-pronged approach.

First, we need a shift from quantity of calories to quality of calories.

Earlier I mentioned that people continue eating processed food when hungry. Why do they do this? Part of it is convenience. But another important part is the thought that we can eat whatever we want, as long as we eat less. This justifies eating for convenience because it’s only the amount of calories consumed that is important.

But if forgets a serious issue: If the body is craving nutrition and we never feed it quality food, we will always be hungry. Remember, foods of convenience are devoid of nutritional value. They are just calories.

So we need more focus on quality of calories. This does not imply that calories are unimportant. It only means the quality of calories is more important. Stated another way: 1,000 calories from a grilled steak salad with vegetables and an olive oil, is not the same as 1,000 calories from Twinkies and Pepsi. Our digestive system is not the same as a bomb calorimeter.

Second, we need to focus on treating these individuals once they become diagnosed. Currently, we only managing their condition by prescribing medication to change a number. This does nothing to fix the problem. If it did, the possibility of getting off medication at some point would exist. It doesn’t (unless they take it upon themselves to do something).

Dietary policy led us here and it can lead us out

If we simply make a change in dietary policy as mentioned above, we would eliminate many of the chronic conditions anticipated in the future. We need to do this sooner rather than later. Current incidence and prevalence data for obesity and these chronic conditions suggest a tidal wave hitting our heatlhcare system soon.

That’s how we get out of this mess!

Thank you!

About Brian Sekula

Brian Sekula, PhD, is the founder and CEO of the Health Performance Institute, where they work with employers, their employees and individuals to alleviate the burden of chronic conditions by preventing diagnoses or helping individuals get off their medications. They do this by focusing on fixing the problem, rather than trying to reduce a number that is a symptom of the problem.

It took 2 minutes to piss me off

That’s it – 2 minutes.

After a great weekend and time spent on Sunday prepping for Monday, I was ready.

Around 5:30am, this is sitting at the top of my inbox.

And what did I do?

I read the article.

And that’s what started this whole thing.

It’s like I’m screaming in a vacuum!

The article goes into detail how the state of California has been caught off guard by the soaring rates of amputations in type 2 diabetics.

On an almost daily basis, I repeat myself. “There is a tidal wave coming.” “If you think it’s bad now, wait 10 years.” “Over half the population is at risk.”

All of this happens because we do a terrible job – from a health, medical and wellness perspective – of treating the condition. We do a great job of managing the condition, but that has essentially zero impact. So statistics like this will continue and states will be “surprised.”

Managing blood sugar does nothing to improve the condition or reduce risk!

But I repeat myself.

A few of the reasons given for the rise in amputations: No clear cause (seriously, this was a response it was even in the byline of the article!); new medications; too aggressive surgeons; and the list goes on. No one blamed diabetes or how it is managed. It’s almost like they don’t know. Maybe I am screaming in a vacuum.

For those interested, here is the article.

All emotions in one!

It’s frustrating, maddening, overwhelming and sad all at the same time.

It really doesn’t have to be this way.

Some of you know and some of you don’t. For those that don’t, you know now.

This is my mom.

This pic was taken about 2 months before her last bout of pneumonia, which was listed as her official cause of death.

She had type 2 diabetes. Did her best to control blood sugar with medication, just like every other type 2 diabetic. It didn’t seem to help, as she had kidney problems, neurological problems and more. The neurological problems led to chronic pain in her foot. Her leg had to be amputated below the knee. This pic was a few weeks after that surgery.

I’m telling you this because it doesn’t have to be this way!

She loved me. She was proud of me. But she didn’t listen to me. She thought, like millions of others, that her doctor knew best. As it turns out, not really.

She had Stage 4 or 5 CKD (depending on who answered the question). CKD is chronic kidney disease. Her kidneys weren’t working. So her body filled with fluid and dumped it into the lungs – that’s pneumonia.

Officially, she died from pneumonia.

In reality, it was type 2 diabetes. It’s what caused the kidney problems to begin with. It’s what caused the neurological pain to begin with.

It’s also why amputations in California are skyrocketing and “professionals” don’t seem to know why.

At times, it’s like an uphill battle

I get up daily to help type 2 diabetics. At times it’s like an uphill battle.

Type 2 diabetics are stressed enough as it is and stuff like this scares the hell out of them. They don’t want this. But they have nowhere to turn for helpful advice.

Everything they are told is counterproductive to improving their health. When it comes to food, they are told to eat fewer calories. This doesn’t help because they will try to follow the recommendations but their metabolic condition is so jacked up, they will end up being hungry. Then they will give into temptation. Making matters worse, they will be blamed for not having enough willpower to follow the recommendations.

They are told to burn calories with exercise.

“What should I do?” The patient asks. “Exercise” is the response. What kind of prescription is this? It’s nothing. It’s more important for type 2 diabetics to burn calories in a certain way, rather than just burning calories.

No one, it seems, is telling them the right things to do.

That’s why it feels like an uphill battle at times.

You need a plan

You can’t just wake up one day and decide to make changes. You need a plan. We have a bunch of free stuff on our Facebook page to help you get started in creating your own plan. See this post.

If all of the free stuff helps you, awesome! Your job is to tell us how well it helped you and to direct more people to that free stuff!

If you need more help, check out our type 2 diabetes coaching program – this one starts the week of October 2, 2017. The focus of this coaching program is to help you develop your plan so you can improve your condition. It focuses on food and exercise.

And, finally, if you are an employer, you have a problem with type 2 diabetes whether you know it or not. If you are self-insured (or self-funded) you need to address it. Programs you get from your consultant, broker, TPA or anywhere else, will have no impact. They are extensions of what I discuss above. If you would like to see how The Academy may help, fill out this contact form or send us an email. Happy to see if we can help.

PS. If you are an employer that already knows you have a problem with type 2 diabetes and are serious about addressing it, it’s a good idea to contact us quickly. We have a special going on until Monday, October 2, 2017.

The article I read this morning that set all of this in motion bothered me so much, I had to do a live video to get some things off my chest.

Implanting sponges in fat tissue?

Implanting sponges in fat tissue?

Things are getting crazy!

This report suggests that implanting sponges into the fat tissue of type 2 diabetics may be a helpful process, as a previous study showed positive results in rats.

You can read the article in its entirety at the link above, but I do have issues with a few of the statements. These are highlighted below.

Here is the main quote from early on in the article:

“The team found that 3 weeks after receiving polymer sponge implants in their fatty abdomens, obese mice with type 2 diabetes fed on a high-fat diet gained less weight and had lower levels of blood sugar than untreated equivalent mice.”

This outcome is what provides them “promise” of it being helpful to humans in the future.

A couple of nit-picky points on this:

  • A high-fat diet in “research talk” for mice is typically a higher fat rat chow, with most fat calories coming from some processed, poly-unsaturated fat like soybean oil.
  • They gained less weight? They had lower levels of blood sugar? Is this confirmation that elevated blood sugar leads to weight gain?

This can be confusing because the experts tell us that chronically elevated blood sugar is not associated with fat gain. But this statement seems to contradict that.

Type 2 diabetics are lazy or stupid (maybe both)

Here is one statement in the article, which clearly shows medical professionals (practitioners and researchers) have no clue how to treat or think of type 2 diabetics:

As yet there is no cure for diabetes, and current treatments depend heavily on patients’ ability to manage them. Thus, researchers are keen to discover ways to manage diabetes that do not need patients to perform daily tasks.

Come on!

Let’s look at the first part of this statement. “As yet, there is no cure for diabetes.” Of course there isn’t! As I constantly say, the approach to treating type 2 diabetics is a misnomer. It should be more appropriately called condition management. The problem is insulin resistance and the target for treatment is blood sugar. It’s as if we don’t even know what the hell we are doing.

The second part of this statement is also infuriating. “…researchers are keen to discover ways to manage diabetes that do not need patients to perform daily tasks.” It’s as if researchers think diabetics are incapable of performing a simple finger stick.

Don’t get me wrong. I understand there is a huge secondary market for strips on places like eBay. But why would a type 2 diabetic endlessly stick their finger when they are constantly told that their diabetes can’t be cured and all they have to do is take their medicine?

Yay…

Excuse me while I don’t celebrate!

the team found that compared with non-implanted mice, the PLG-implanted mice had 60 percent raised levels of glucose transporter type 4, which is a protein that helps to transport sugar from the blood into muscle cells.

So these sponges, implanted into the fat tissue, increased Glut4 levels? When this happens, your body is better at moving glucose from the blood into the muscle tissue. Do you know what else does that? Exercise! Do you know what else does that? Proper sleep! Exercise and sleep do it by improving insulin resistance. Unfortunately, these sponges have zero impact on insulin resistance.

With a zero impact on insulin resistance, these sponges will have no effect on the incidence or prevalence of type 2 diabetes. In the end, all it means is that the pool of type 2 diabetics gets larger and the costs continue to increase.

Why Bother?

What is the point? Why would anyone or why should anyone expose themselves to an implant like this if the outcome doesn’t change? Their condition will not be eliminated; it won’t even be improved. Why should or would anyone do this?

It’s just more of the same and until the target is changed, little will be done to stem the tidal wave.

Maybe we should all hope that Warren Buffett sees the light and starts putting pressure on the American Medical Association.

In the meantime, we will be here, helping diabetics improve their condition. We do that better than anyone because we understand that insulin resistance is the problem, which allows us to fix the problem.

 


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3 Snacks for Type 2 Diabetics

3 Snacks Type 2 Diabetics need to keep with them at ALL times!

No blood sugar impact snacks

Most type 2 diabetics struggle with controlling their blood sugar. Since almost all foods seem to raise their blood sugar, they also tend to stress out over what kind of snacks they can eat.

But since they also get hungry, this is a problem. So…what to eat?

Listed below are three different snacks you should have on “your person” at all times. Under most circumstances, they have a zero to minimal impact on your blood sugar, which means you should be able to eat them without worry (at least regarding your blood sugar).

Nuts

Nuts are high in fat, good fiber, vitamins and minerals. While they vary slightly – from one variety to another – in nutrient content, they are all high in fat, which means they will have minimal impact on your blood sugar. Additionally, the fat, vitamin and mineral content will help keep you full (or sated) until your next meal.

They are pretty hardy and travel well, making them an excellent snack choice for just about anyone, but type 2 diabetics in particular.

Eat them raw (our preference) or roasted. Just don’t eat them loaded with sugar or syrup or covered in chocolate (but you already knew that).

And if you happen to be allergic to nuts, seeds are good too. Pumpkin and sunflower seeds do essentially the same things!

Beef Jerky

Another snack high in protein and fat – the combination you need to keep your blood sugar from spiking.

Our preference: Buy it from a meat market or butcher shop (or make it yourself) so you know that it has been minimally processed. Another tip: If you buy from the store, check the label and look at the sugar content. Many types of beef jerky sold at the store have a lot of added sugar. Try to keep it below 5 grams of sugar per serving.

Best bet: Sugar free beef jerky.

A Boiled Egg

This is the least hardy of our recommendations but unless you have to leave these snacks in your car and it’s hot outside, you don’t really have to worry about the boiled egg.

Eggs are a great source of healthy fats, vitamins and minerals and an excellent source of protein.

Our recommendation: Always keep a dozen boiled eggs in the refrigerator. They are great snacks at any time!

Stay away from those…

Those little packets of 100 calorie snacks should be avoided by most people, especially type 2 diabetics. They are little more than sugar-spiking food products. It does not matter that they contain only 100 calories. It matters that they consist of some type of flour and sugar, both of which spike your blood sugar. Who thinks it’s better to eat a 100 calorie pack of cookies over one triple-double-stuffed Oreo cookie, which is also 100 calories?

That is insane

These snacks help you better control your blood sugar

While the 100 calorie snack packs are insane, these three snacks are not. Eat them when hungry. Your blood sugar will thank you!

If you liked these tips and would like more, sign up for our email newsletter below.

As a bonus, there are 3 gifts from the HPI Diabetes Academy included!

Insulin Sensitivity Webinar

Thank you for viewing our webinar!

Listed below are links where you can download the files discussed during the webinar – the exercise tip sheet and the Module 1 Guide.

A link to enroll in the HPI Diabetes Academy, as discussed during the webinar, is also below.

Click here to download the slides used during the webinar.

Purpose of the Webinar: Stress the importance of improving insulin sensitivity, which is not done by conventional treatment methods.



Exercise Tip Sheet

Module 1 Guide

As mentioned during the webinar, we have an offer to enroll for an exclusive discount of $150 off.

If you’d like to enroll, get access to all 10 Modules of the HPI Diabetes Academy, all of our webinars and more, click the image below to be taken to our shopping cart where you can enroll right now and get immediate access to our website!

Here is how the process will work:

When you click the link below, you will be taken to our shopping cart. Once your transaction is complete, you will be automatically taken to the “Account Creation” page for the HPI Diabetes Academy website. From that point, all you have to do is create your account and you are registered and enrolled!



See you there!

Glycemic Control for Patients With Type 2 Diabetes Mellitus



Controlling blood sugar is not enough!

A recently published article confirms what many other articles have shown:

For type 2 diabetics, controlling blood sugar does not reduce the risk of complications.

Link to Abstract

A pull-quote from the conclusion in the abstract:

“Discordance exists between the research evidence and academic and clinical policy statements about the value of tight glycemic control to reduce micro- and macrovascular complications.”

In other words, what type 2 diabetic patients are being told about controlling their blood sugar and it reducing their risk for kidney disorders, vision problems or pain-related issues, is not consistent with the research.

In fact…

“This evidence reported no significant impact of tight glycemic control on the risk of dialysis/transplantation/renal death, blindness or neuropathy. …however, most published statements and guidelines unequivocally endorsed” the benefits.

So we have a conundrum…

Not really. There are at least three issues here

One off blood tests indicate nothing

When we visit the doctor and have a fasting blood sugar test done, it indicates almost nothing regarding blood sugar control. A step in the right direction would be to monitor blood sugar control with regular A1c tests.

Wholly invested in controlling blood sugar

Everything we do regarding treatment of type 2 diabetes and/or prediabetes (a terrible term) is geared to control blood sugar – we’ve built the entire industry around it. Whether it be the medication, a fasting blood sugar test, or “official statements” from AHA, CDC, NIH or the ADA, it’s all about controlling blood sugar and reducing risk.

This leads to zero positive impact on the cause of type 2 diabetes – insulin resistance.

Maybe type 2 diabetes really is an insidious condition

It is quite possible that insulin resistance and blood sugar dysregulation are more complicated than we currently think and/or know.

It is amusing, telling and disturbing when a complicated concept is taken to a point where it is too simple – simple beyond reason.

But…if the risk for these complications in type 2 diabetics is higher, it means those without type 2 diabetes have a lower risk. So it plays some role – maybe we don’t really understand if the risk is causative or associative. But the risk is there.

So what should you do?

First, understand and come to grips with the fact that artificially controlling your blood sugar (in other words, through medication) is not enough. In spite of what your healthcare professional(s) tell you, the evidence simply does not support it.

Second, take steps to improve insulin sensitivity, which will decrease insulin resistance. Some of these steps include the right diet, proper exercise and ensuring enough sleep (I recently hosted a live webinar on these very topics. If you’d like to view it, enter your name and email address below).

If you can improve insulin sensitivity, you make progress on naturally controlling blood sugar – as opposed to artificially. The more consistent you are, the more your insulin sensitivity improves. The more it improves, the more your body starts acting like someone who doesn’t have type 2 diabetes.

In the long run, and as noted above, this reduces your risk.

View the Webinar

Enter your name and email address below to view the webinar on improving insulin sensitivity mentioned above.

3 Keys to improving insulin sensitivity

What they aren’t telling you!

As a type 2 diabetic, you are keenly aware of the importance in controlling your blood sugar. Whether it is with your diet, the frequency or dosage of your medication, this point is hammered home!

But there is something they aren’t telling you.

Everything you are instructed to do is to control blood sugar:

  • Medication? Find the right dose so the numbers are where they like them?
  • Diet? These are the exchanges. Use them, but eat fewer calories.
  • Exercise? Go burn some of those calories you just ate!

This is nonsense.

It’s nonsense because…

Controlling blood sugar will not fix anything. Sure, you want to keep your blood sugar in check and taking your medication will help you do that. But…type 2 diabetes (and prediabetes) is a problem of insulin resistance. You’ve been told that before, right?

Insulin resistance is what causes your blood sugar to rise. Taking medication to control your blood sugar does nothing to improve insulin resistance!

So you take your medication and check your “numbers.” But what happens when your medication runs out? You need a refill or your blood sugar goes back up. Right?

This is the problem!

In order to improve your health and control your condition, you need to improve insulin sensitivity. This will allow your body to deal with the elevated blood sugar naturally, as opposed to doing it artificially with medication.

So how do you do that?

The Metabolic Problem

Outside of the obvious, type 2 diabetics are fundamentally different than non-diabetics when it comes to their metabolism. For example, at rest they burn a significantly higher amount of carbohydrates to produce calories than their non-diabetic counterparts. This is a major problem because we should all be burning fat while at rest. This holds true as they exercise – they burn a significantly lower percentage of calories from fat at all levels of exercise intensity. Beyond the metabolic and exercise differences, they have a hard time dealing with hunger and feeling satisfied because of this metabolic problem.

This is why the standard approach doesn’t work.

When you combine this with the above information – medication that controls blood sugar doesn’t improve insulin sensitivity – it is no wonder that average type 2 diabetic is told they will never be able to get off of their medication. Nothing is done to properly help them.

Improving Insulin Sensitivity is Key

There are three ways a type 2 diabetic can improve insulin sensitivity:

  • Proper diet
  • Proper exercise
  • The right amount of sleep

I know. Very groundbreaking, right?

But something in this list is key: The word proper! Because if the right kind of food is not eaten, the right kind of exercise is not done and if the right amount of sleep is not part of the equation, insulin sensitivity will not improve.

Proper Diet

The diet for a type 2 diabetic should do at least two things: 1) reduce the overall glucose load on the body. This will help reduce fat storage and help the liver better regulate circulating blood glucose (one of its many important functions). 2) It should promote a fat-burning state so that while at rest, a type 2 diabetic can decrease the amount of carbohydrates their body is burning. Did you even realize you could do this with the proper food choices?

Proper Exercise

Any kind of exercise is better than no exercise, but when it comes to a type 2 diabetic, some exercise is superior. Exercise that promotes fat-burning should serve as the bulk of physical activity. It is like a sledgehammer, battering your metabolism into submission and forcing it to get better at burning fat. Note: This will also help with the resting metabolism problem. So it has a nice side benefit. Another thing to mention: This type of activity should be continuous and last more than 30 minutes – with an hour being optimal. Why? Because it takes a while for your body to get into a good fat burning zone. You need to get in that zone and then stay there.

The right amount of sleep

A lack of quality sleep is associated with every chronic condition known to man. Type 2 diabetes is no different. Further, most people don’t necessarily need to go to bed earlier to improve the quality of their sleep. They just need to change a few things in the last hour or so before they go to bed. After a good dinner the night before and a good night’s sleep, your metabolism is just about perfect.

Start doing these things

If you start doing these things, your insulin sensitivity will improve. Your body will start controlling blood sugar naturally, like it is supposed to do.

The longer you do this, the more your insulin sensitivity will improve, which means in the long run, you won’t have to panic if/when your medication runs out.

If you’d like to learn more…

I recently hosted a webinar on these very topics.

If you’d like to view a recorded version of the webinar, enter your name and email address below and we will send it to you right away.

Why knowing what happens to digestible carbohydrate is important

What happens to the carbohydrates we eat?

Type 2 diabetics (and many others) know they turn into blood sugar. Monitoring blood sugar is something a type 2 diabetic does daily.

But did you know that understanding what happens to blood sugar is also important? I’m not talking about whether it goes up or down after you eat a meal or snack. I’m talking about after the meal and after it has reached its peak – when it starts to go down. The blood sugar goes somewhere. Do you know where it goes?

If you don’t, you should. Because knowing this will help you understand the fate of blood sugar, how you can eat to change this and what impact it will have.

Setting the Stage

It is necessary to define a key term before explaining this process and the image above.

That key term is: digestible carbohydrate. Digestible carbohydrate is the amount of carbohydrate digested by your body after eating a food. For example, one cup of zucchini contains about 12 calories (3 grams) of digestible carbohydrate. By comparison, 1 cup of diced potato contains 28 grams of carbohydrate or 112 calories from carbohydrate. However, it contains only 96 calories of digestible carbohydrate. For most foods, the difference between total carbohydrates and digestible carbohydrate is the difference in fiber content.

In both instances (and all instances of eating food) our body must deal with the digestible carbohydrate calories from the food we eat. In the explanation below, it does not matter where those carbohydrate calories come from (zucchini, potato, cake or ice cream) – the principle is still the same.

The Fate of Blood Sugar

When we eat the zucchini or potato or drink a sugary beverage, there are two outcomes for blood sugar (at least as they relate to this article): 1) some of the blood sugar will be consumed by the body to produce energy; and, 2) the rest will be stored.

The first one is easy to understand. When we eat (or drink) something, our body has to digest it. The act of digesting food is work for the body. Work for the body is done by “burning” or “producing” calories. Glucose can be used to “burn” or “produce” energy needed to do this work. So some of the blood glucose from the foods you eat will be consumed for energy production. But, depending on your circumstance and the amount of digestible carbohydrate you consumed, it is a relatively small amount. This means the rest of the blood glucose needs to be dealt with.

So what happens to the rest?

It gets stored and this is important for you to understand! There isn’t much we can do – one way or the other – to impact the amount of blood sugar that is consumed for energy production. Changing foods we eat, various combinations, whatever the case may be, there isn’t a significant change in the amount of glucose consumed during the digestive process. So this amount (whatever it may be) is pretty stable.

But we can have an impact on storage.

If you return to the image above, there is a cupcake and eggplant on the left hand side. The digestible portion of carbohydrate, that which doesn’t get consumed during the digestive process, gets stored as either glycogen or fat tissue. That’s what the arrows represent.

But how do we know what amounts goes into each and what can do to impact this?

Great questions!

First, our body would prefer to convert glucose to glycogen – the storage form of glucose. The remaining glucose, whatever doesn’t get consumed by producing energy, goes through step 1. This involves converting the glucose to glycogen and storing it – in either muscle tissue or the liver (the only real places our body can store glycogen). Step 1 continues until a condition is met: 1) Our body runs out of glucose that needs to be stored. If this happens, the process stops. Blood sugar is at “normal” levels and nothing else needs to be done. Or, 2) Glycogen levels in both the liver and muscle tissue are full and unable to accept more glycogen. When our body reaches this point, we go to step 2. Step 2 is converting glucose to fat and storing it in the fat tissue. We go through this step until blood sugar is “normal” and nothing else needs to be done.

Limiting Fat Storage

If you go back and look at the image, we can see the middle section (glycogen) dictates how much glucose gets converted to fat and stored in the fat tissue.

With that in mind, there are two things we can do to effectively minimize the amount of glucose that is converted to fat and stored in the fat tissue.

First, we can increase the storage capacity of glycogen. We can do this in one of two ways. By depleting our glycogen stores through dietary changes or exercise; or, by increasing the amount of muscle tissue on our body. Both of these strategies will work to increase the amount of digestible carbohydrate that gets stored as glycogen and decrease the amount of glucose that gets converted to fat and stored as fat tissue.

The second thing we can do is limit the amount of digestible carbohydrate we eat. Overall, the less digestible carbohydrate we consume, the less there is to convert to fat and store in fat tissue.

Both of these strategies will work to decrease fat storage. As an added benefit, it will also improve the body’s ability to access the fat stores, which helps improve insulin sensitivity. A positive outcome for type 2 diabetics.

Digestible Carbohydrate is an important concept to understand

Overall, as a type 2 diabetic, knowing how certain foods spike your blood sugar is important. However, knowing what happens to the digestible carbohydrate may be even more important to know.

Since we can eat foods that decrease (or limit) fat storage, we can impact our overall blood sugar. This will work to improve insulin sensitivity, so that we can control our blood sugar more naturally – instead of using medication to do it. Beyond all that, none of us like storing body fat – we don’t like the way too much of it makes us feel or look, but the negative impact it has on insulin sensitivity makes it worse.

Understanding this and acting accordingly will have a positive impact on your condition.

Type 2 Diabetics and the Disposition Index

When most of us think about type 2 diabetes, we think about several things: problems with blood sugar control, insulin sensitivity, difficulty in losing weight, struggling with exercise, etc… Most of us, however, rarely, if ever, think about an obscure term known as the disposition index.

It is so obscure, it doesn’t even have its own Wikipedia page!

While most of the things we think about regarding type 2 diabetes are part of the condition, the reality is they are just individual pieces of the same puzzle.

That one thing that encapsulates all of this is the disposition index.

Why Type 2 Diabetes Occurs

The typical progression from normal blood glucose control to type 2 diabetic goes something like this:

Over time, our insulin begins to lose sensitivity. This can be due to a number of factors but is typically the result of chronically elevated blood sugar (glucose) as a result of our diet. As our insulin loses sensitivity, our pancreas starts to secrete more insulin to deal with the elevated blood sugar. Somewhere during this progression, most people start gaining weight, typically when insulin first starts losing sensitivity.

Eventually, insulin struggles to reduce blood sugar so the pancreas secretes more insulin. At some point, our pancreas is unable to continue secreting more insulin. This is when people get diagnosed as type 2 diabetic. They go to the doctor, get a blood test and find their blood glucose is too high. They then go through an OGTT (Oral Glucose Tolerance Test) and get diagnosed as a type 2 diabetic because blood sugars are not reduced appropriately.

In the two paragraphs above, insulin and blood glucose were mentioned frequently. So it it understandable when these things are mentioned as part of the Type 2 Diabetes condition. Notice that we haven’t even mentioned disposition index.

There is a good reason for that because the disposition index encompasses something else we haven’t mentioned: the pancreatic beta cells.

Pancreatic Beta Cells and Insulin

Insulin is released from the pancreas; more specifically, it is released from the beta cells of the pancreas. When your blood sugar is under control and insulin sensitivity is high, everything functions normally.

You eat a meal or a snack, your blood sugar elevates, your pancreas senses this, the beta cells secrete insulin, insulin does its job by reducing blood sugar and then insulin goes back to normal levels.

This entire relationship can be described with a mathematical function in both normal blood glucose control and type 2 diabetics. This function is known as the disposition index. See figure below.


Source: Bergman et all, Diabetes, 2002, Figure 1, page S213.
Note: Red lines added.

The horizontal axis is insulin sensitivity and the vertical access is insulin secretion. What we can note from this figure is that as insulin sensitivity increases, insulin release decreases. We also note the opposite: As insulin sensitivity decreases, insulin release increases.

Based on research, we know the following: The work required by the pancreatic beta cells changes as insulin sensitivity changes – this can be seen by in the graph above by noting the increase in insulin release as we move left along the horizontal axis (insulin sensitivity).

As noted above (2nd italicized paragraph), at some point the pancreatic beta cells are unable to secrete more insulin in response to elevated blood sugar as insulin sensitivity decreases.

Note the two boxes in the graph above. We have zoomed in on them in the figure below. The two bottom numbers in the figure below in each of the boxes is 800 and represented by DI, which is the disposition index. So both have a disposition index of 800 but occupy different places on the function. How can this be?

The other numbers in the boxes give us the answer. “S” refers to insulin sensitivity and “AIR” refers to insulin release. The insulin release value in the left box is 2,000 pmol/l while it is 400 pmol/l in the right box. This means, for all practical purposes, that to achieve an optimal level of blood sugar control, when insulin sensitivity is 2.0 pmol/l (right box) we have to release 400 pmol/l of insulin. If insulin sensitivity decreases to 0.4 pmol/l, we have to release 2,000 pmol/l of insulin – a fivefold increase in insulin release.

What this means is that as insulin sensitivity decreases, the pancreatic beta cells have to do more work by secreting additional insulin to deal with the elevated blood sugar. The beta cells adapt to this additional work and over time, they reach an “insulin secretion limit.” This results in chronically elevated insulin and blood sugar, also known as type 2 diabetes.

But it is clear the dysfunction in pancreatic beta cells is the first domino to fall in this string of events.

So the main question is, what causes the beta cells to reach their limit? Why and/or how do they reach a point where they can no longer secrete insulin (or enough insulin)?

This is an active area of research, with new answers frequently. While there are answers to many questions, the precise mechanism has not been identified. And it may just be there are several factors that lead to this pancreatic beta cell dysfunction.

In our next post, we will cover some of the more promising areas of research. Included will be things you can do to increase the health of your pancreatic beta calls.

By implementing some of these suggestions, your insulin sensitivity will certainly change. This will also lead to an improvement in insulin release. Overall, this will lead to an improvement in your control of type 2 diabetes.

That’s something all of us want.

Can losing fat from the pancreas reverse type 2 diabetes?

Maybe!

This summary says it can.

The summary comes from this article, which paints a slightly different picture, but important nonetheless.

So what is going on?

Well, it is part truth and part sensational, attention-grabbing headlines.

Gastric Bypass, Insulin sensitivity and Type 2 Diabetes

In the actual study, the authors evaluated both type 2 diabetics and non-diabetics, matched for age, sex and weight, before and 8 weeks after gastric bypass surgery (laproscopic RYGB).

The results were interesting.

Both groups lost weight after surgery (not surprising) and both groups lost a significant amount of body fat (also not surprising). However, the type 2 diabetic group also lost a significant amount of pancreatic fat, which did not happen in the non-diabetic group. See figure below.

This led to significant improvements in all measures of insulin sensitivity for the type 2 diabetic group, which means a significant improvement in controlling type 2 diabetes. In other words, they improved.

It’s also likely why the authors of the summary had such a sensational headline.

Can you spot reduce visceral fat?

So what happened here?

The type 2 diabetic group had a higher level of pancreatic fat before surgery. This is internal fat, known as visceral fat. Subcutaneous fat is the fat right underneath your skin. It’s the fat you can pinch. Studies have repeatedly shown that visceral fat is more detrimental to your health than subcutaneous fat.

If you are type 2 diabetic, you might wonder if you can specifically reduce visceral fat and improve your insulin sensitivity. And based on the questions I’ve had, many of you are wondering this.

The answer is kind of.

You can do this through diet and exercise and probably by sleeping better and managing stress.

We will focus on exercise and diet.

Exercise, Type 2 Diabetics and Visceral Fat

Higher intensity exercise has repeatedly been shown to decrease visceral fat, whether type 2 diabetic or not. And, while both low and high-intensity exercise have been shown to also reduce subcutaneous fat, it is high intensity exercise that can do so more preferentially.

Given that the type 2 diabetics had higher amounts of visceral fat at the beginning of the study, exercise might be a plausible explanation for the significant reduction in pancreatic fat after surgery. It’s unlikely, though, since surgery can be rough and assessment was only 8 weeks after surgery.

Diet, Type 2 Diabetics and Visceral Fat

It is likely the significantly reduced caloric intake after surgery was the main reason for reduction in pancreatic fat. Prior to the surgery, the average weight of the type 2 diabetics was 266 pounds. Eight weeks after surgery it was 230 pounds. This is an average weight loss of 36 pounds or 4.5 pounds per week. And…of those 36 pounds of weight loss, 30 of them were fat, which means they were losing 3.75 pounds of fat per week.

To lose 4.5 pounds per week, you need a daily caloric deficit of 2,250 calories per day (going by the 3,500 calories per pound, which is questionable). That’s a HUGE caloric deficit!

Which brings us back to diet and visceral fat. A caloric deficit this large will lead to significant visceral fat reduction. And without surgery, I’m not sure anyone can subject themselves to a caloric deficit of this magnitude.

Outside of gastric bypass surgery, what can you do, at least nutritionally, to decrease visceral fat? The research is fairly clear on this. A diet that severely limits processed foods – particularly processed carbohydrates will help. A low-carb, high-fat diet (which may be the same thing) will also do the trick.

But it won’t work as fast as surgery.

So what does is all mean?

Well, the diabetes wasn’t reversed in this population but it was significantly improved. And it corresponded to a decrease in pancreatic fat. This most likely happened because of a massive reduction in caloric intake after gastric bypass surgery.

Outside of surgery, are there things you can do to preferentially target pancreatic or visceral fat? Yes!

If you are a type 2 diabetic you should consider two things: 1) a diet lower in processed carbohydrates and 2) work to improve your fitness level. Diets lower in processed carbohydrates (or low-carb, high-fat diets) have repeatedly been shown to reduce visceral fat (and subcutaneous fat too). Improving your fitness level through any means of physical activity so that you can perform higher intensity activity is also important. And at some point, you probably need to make sure you are getting enough sleep and managing stress.

These two things will accomplish the same as the surgery, just not as quickly or severe.