Obesity Does Not Protect Diabetics
By GABE MIRKIN, M.D.
This week, a study showed that people who have normal weight at the time of their diagnosis of diabetes are twice as likely to die over the next 10 to 30 years as those who are overweight at the time of diagnosis (Journal of the American Medical Association. August 8, 2012).
THIS DOES NOT MEAN THAT OBESITY PROTECTS DIABETICS FROM DEATH
It means that if you are thin when you develop diabetes, you have a type of diabetes that is more likely to kill you.
THE MOST COMMON CAUSE OF DIABETES
Type II diabetes is most commonly caused by inability of your cells to respond to insulin. When blood sugar levels rise too high, your pancreas releases large amounts of insulin. Insulin then attaches on insulin receptors, special hooks on the outer membranes of cells. Then it drives sugar into cells.
ANYTHING THAT PREVENTS INSULIN FROM ATTACHING TO ITS RECEPTORS CAN CAUSE DIABETES
If insulin cannot attach to its receptors, it cannot drive sugar into cells. This causes blood sugar levels to rise too high, and sugar attaches to the outer membranes of cells. Sugar attached to cell membranes is eventually converted to sorbitol which destroys the cells. This cell destruction is what causes all of the known side effects of diabetes.
FULL FAT CELLS BLOCK INSULIN RECEPTORS
Fat inside cells prevents insulin from attaching to its receptors, so having extra fat in your body causes diabetes.
STORING FAT PRIMARILY IN YOUR BELLY IS A SIGN OF DIABETES
Insulin causes fat to be stored in the belly, so almost all people with big bellies and small buttocks have high insulin levels because their cells cannot respond to insulin, and the pancreas responds by producing excessive amounts of insulin.
Most people who store a lot of fat in their bellies and have small buttocks already have diabetes or are pre-diabetic.
LACK OF MUSCLES CAN CAUSE DIABETES
Muscles help to prevent blood sugar levels from rising too high and damaging the cells in your body. Resting muscles are inactive and draw no sugar from the bloodstream. On the other hand, contracting muscles actively remove sugar from the bloodstream and don’t even need insulin to do this.
WHY ARE PEOPLE WHO ARE FAT WHEN THEY ARE DIAGNOSED EASY TO CURE?
Virtually all people who are fat when they develop diabetes can cure their diabetes by losing weight. When they empty their muscle, liver and fat cells of fat, these cells can once again respond to insulin. Blood sugar levels drop and the person is no longer diabetic.
WHY ARE PEOPLE WHO ARE NOT FAT WHEN THEY ARE DIAGNOSED WITH DIABETES MORE DIFFICULT TO CURE?
More than 90 percent of diabetics are overweight. Thin people who develop diabetes do not have full fat cells. They are diabetic because:
• Their pancreas does not make enough insulin. We have drugs to make the pancreas put out more insulin, but we do not have drugs to permanently make the pancreas produce normal amounts of insulin.
• Their muscles are so small that they do not remove sugar from the bloodstream adequately. Lifting weights would help, but growing large muscles is beyond the motivation of most people with small muscles. It takes a lot of consistent painful resistance exercise to grow larger muscles.
• They may have other hormone abnormalities that are far more difficult to treat.
WHAT SHOULD YOU DO IF YOU ARE DIAGNOSED WITH DIABETES, STORE FAT PRIMARILY IN YOUR BELLY, HAVE VERY SMALL BUTTOCKS, HAVE A FASTING BLOOD SUGAR LEVEL ABOVE 100, OR HAVE AN HBA1C ABOVE 5.7?
• Immediately try to lose fat by eating less and exercising more
• Start a supervised exercise program and try to exercise every day
• Start a supervised weight lifting program to grow larger muscles
• Avoid all sugared drinks except when you exercise
• Avoid all sugar-added foods
• Avoid red meat (saturated fat from animals blocks insulin receptors)
• Eat large amounts of vegetables and fruits
• Get your blood levels of hydroxy-vitamin D above 75 nmol/L
Dr. Pinna says: