How to Reject Diabetes & Metabolic Dysfunction
From 1983 to 2008, the number of people in the world with diabetes increased sevenfold, from 35 to 240 million. In just the three years following (2008-2011), the number jumped to over 350 million. The majority of these diabetes diagnoses are for Type 2 Diabetes (T2D), the dynamics of which we’ll explore below. Because clearly this is a crisis of epidemic proportions and we want you to be informed.
So what happens in T2D? First we must consider insulin and its role. Insulin is like the key that opens the door into the cells to allow glucose to pass through. With T2D, the cells of the body become resistant to insulin – that is, the cells make it increasingly difficult for glucose to enter to avoid being poisoned by excess sugar. (This is called “insulin resistance.”) Therefore, the sugar remains in the bloodstream for longer than intended, causing damage to blood vessels. Meanwhile, the brain senses rising glucose and is alarmed by possible damage, and so raises insulin levels further in an effort to move the sugar out of the bloodstream. Glucose and insulin both continue to rise.
Ultimately the body converts the excess circulating glucose to a type of fat molecule called a triglyceride (yup, you know that marker from your lipid panel) and stashes these triglycerides into the visceral fat surrounding organs, including the liver (“fatty liver”) and pancreas. Over time, if insulin resistance continues, the pancreas will not be able to keep up with the request for greater insulin output and insulin output will eventually plummet, allowing blood sugar to skyrocket.
T2D co-occurs with metabolic dysfunction. “Metabolism” refers to the biochemical processes involved in the body’s normal functioning. The body will prioritize burning carbohydrates/glucose first since these can become toxic when built up, and in a healthy state, is also able to oscillate into fat burning when glucose becomes too low, such as overnight. (Wondering about protein? Protein gets used quickly, and any excess is converted into more glucose.) When the body is no longer able to effectively flip between burning fats and glucose because of the excessive buildup of carbohydrates, metabolic dysfunction arises. When this occurs, not only do we see excessive blood glucose, insulin resistance, and ultimately T2D, but we also see high blood pressure, excess body fat around the waist and obesity, and abnormal cholesterol or triglyceride levels. Metabolic dysfunction leads to an increased risk of heart disease and stroke as well, so it’s important to stay on top of.
Some of the labs used to understand the body’s metabolic state include:
- Fasting glucose: Measures the amount of sugar in your cells and is affected by carbohydrate consumption as well as cortisol. This must ideally be measured by 9:30 am with no more than a 12 hour fast.
- HgA1c: Also referred to as hemoglobin A1c or just A1c, this test reflects your average blood sugar level for the past two to three months. Specifically, A1c measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (“glycated”). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications. Do note that this marker is made inaccurate by iron deficient anemia.
- Fasting insulin: This is the major hormone responsible for blood sugar metabolism and it acts as a storage hormone in the body, causing an increase in body fat. Elevated insulin levels are associated with insulin resistance and chronic inflammation.
- C peptide: C-peptide is a substance made in the pancreas, along with insulin. C-peptide and insulin are released from the pancreas at the same time and in about equal amounts, and when compared with the glucose and HgA1c levels, can tell us if your body is making enough insulin. We typically suggest this lab when we suspect some level of insulin resistance but want to understand if your pancreas is still rockin’ it at producing ample insulin, or if it’s getting tired from a prolonged very high insulin output.
- Homocysteine: An inflammatory compound that is greatly associated with heart disease, diabetes, and neurodengerative conditions. At FWT we also use this marker often to look at the methylation process, so you may have heard us mention it then.
- Liver enzyme ALT: Please refer to the previous blog post about the liver here.
- CRP: C-Reactive Protein is a measure of inflammation. CRP increases whenever there is inflammation in the body and may be telling of a person’s blood sugar stability. This is because rapidly fluctuating blood sugar and elevated insulin tend to be highly inflammatory to the body.
- Triglycerides: Serum triglycerides are composed of fatty acid molecules that enter the bloodstream either from the liver or from the diet. Levels will be elevated when there is excessive serum glucose such as in metabolic syndrome, with fatty liver, in people with an increased risk of cardiovascular disease, and alongside hypothyroidism, and adrenal dysfunction. It can also be elevated with a high-carb diet (remember that excessive glucose will transform into fatty acids to be stored) or if people are rapidly losing weight and clearing out fat.
- Homa IR: This is a key measurement for predicting insulin resistance, using a formula that includes fasting glucose and fasting insulin numbers.
If you find yourself struggling with metabolic dysfunction, the good news is that it is possible to become metabolically healthier in a matter of months, if not weeks, though of course your timeline will vary depending on how entrenched your insulin resistance is (and if you have started insulin replacement) as well as your choices during your work on rebalancing this dynamic.
To rebalance and/or prevent metabolic dysfunction requires lifestyle intervention:
- Choose unrefined, clean whole foods.
- Anchor your diet with vegetables. Build up fiber tolerance gradually.
- Enjoy healthy carbohydrates in your diet based on your body’s unique tolerance.
- Hydrate with clean water. Break the habit of self-medicating with alcohol or caffeine. What do you really want in your life that these are substituting for?
- Eat natural fats liberally (nuts, seeds, olives, avocado, olive oil).
- Eliminate food sensitivities. Start with gluten and dairy.
- Eat enough protein. At least 15 grams in your breakfast.
- Allow greater utilization of stored energy and fats. No food for a full 3 hrs before you go to bed to burn up some calories. Fast at least 12 hours overnight, and more as you can tolerate, to force natural fat burning overnight from metabolic flexibility.
- Move your body in a joyful way at least 3 days per week.
- Prioritize sleeping 7-8 hours/night.
- Support. Surround yourself with people who honor your self-care choices and priority.
- Eliminate what is holding you back! Specifically, this includes all other sugars and sweeteners, any type of flour (yes even the “healthy” ones), all dairy foods, all foods containing gluten, alcohol, and processed foods from boxes, bags, cans, and cartons (though whole food choices e.g. frozen fruit/vegetables/animal proteins, canned beans with no additives are good exceptions). Remember: a moderate reduction vs. elimination may prevent you from making solid progress.
If you would like targeted support for metabolic dysfunction, we would be happy to support you! You can schedule a free info call here.