If you have type 2 diabetes, don’t you think it would make more sense to treat the root cause of the disease rather than trying to fix the damage to your body after it is already happened?
Type 2 diabetes (T2D) is a dietary disease. Therefore, the best treatment is a healthy diet. The root cause of T2D is too much sugar (or carbohydrates).
So what is the most logical treatment? You can treat your T2D by reducing your carbohydrate intake, lowering the amount of processed food with added sugar that you consume and by not drinking your calories (avoiding beverages sweetened with sugar.)
It makes a lot more sense to attack the root cause of type 2 diabetes (high carbohydrate intake) rather than trying to fix the damage that diabetes causes after it has occurred.
That’s why the first and best treatment for diabetes is a low carbohydrate diet. If you can control your diabetes with diet, you may not need to start a medication. That would be the best outcome..
How do you treat insulin resistance and type 2 diabetes with diet?
Answer: a low carbohydrate diet. In practice, this means that you are consuming less than 30% of your daily calories from carbohydrates. I would recommend a low carbohydrate diet for most people with insulin resistance (those diagnosed with prediabetes, diabetes or fatty liver).
How does type 2 diabetes develop?
Type 2 diabetes is a disease characterized by high, toxic levels of glucose (a type of sugar) in the blood. Your pancreas is no longer able to produce enough of the hormone insulin which normally drives glucose out of the blood and pushes it into the cells to be used as fuel.
How is excess carbohydrate intake linked to the development of diabetes?
Over time, if you consume more carbohydrates than your body can use as fuel, these carbs are stored as fat in the liver. Specifically, the carbohydrates that you eat include different sugars and starches which are all broken down by your digestive system into a simple sugar called glucose.
Your liver converts this excess glucose into fat, which is the most convenient way for your body to store it. This process is called “de novo lipogenesis”. Much of this newly created fat is stored in the liver (causing fatty liver) and in the pancreas (causing fatty pancreas). This is the “twin cycle hypothesis” of type 2 diabetes, first described by Roy Taylor in 2008.
Basically, excess carbohydrate intake results in fatty liver which then leads to fatty pancreas which then finally results in T2D.
Over time, the liver keeps processing excess glucose and storing it as fat. At this point the liver becomes resistant to the hormone insulin which is trying to push more glucose into the liver cells which are already full of fat.
Now you have developed fatty liver. This is often a warning sign that type 2 diabetes will develop in the next 10 years or so. Once the fat storage capacity of the liver is exceeded, it will start exporting newly created fat to other organs in the body.
A healthy liver will make new glucose while you are fasting overnight while your blood glucose levels are low. This process is called hepatic gluconeogenesis. Another job of insulin is to turn off this process when your blood glucose levels are already high, like after you eat a meal. But all this excess glucose has made your liver become resistant to insulin. So the insulin coming out of your pancreas will no longer be able to push more glucose into the liver. Insulin will also be unable to stop your liver from making NEW glucose, even as the glucose from the food you have eaten starts to build up in the blood with nowhere to go. In response, the pancreas will pump out more dysfunctional insulin.
As you might imagine, this sets up a vicious cycle of high blood glucose levels and increasing production of dysfunctional insulin.What does your liver do with all this excess glucose that it can’t process? As we discussed, it starts to turn this excess glucose into fat in a process called de novo lipogenesis. After the liver cannot store any more fat, it begins to export these newly created fat cells to the rest of the body, packed inside small particles called VLDL or very low-density lipoproteins.
These new fat cells are deposited in different organs including the pancreas. That’s a problem because the beta cells of the pancreas should be producing insulin. As more fat is deposited around the beta cells, they gradually become dysfunctional and over time, they stop producing insulin.
We don’t know exactly how the excess fat in the pancreas kills off these previously healthy beta cells. It could be that the fat cells are directly toxic to the pancreas, causing the beta cells to undergo programmed cell death or apoptosis. Once you have lost about 50% of your pancreatic beta cells, your pancreas is no longer able to produce enough insulin to drive all that glucose back into the cells so you have chronically elevated blood glucose levels.
Now you have developed type 2 diabetes.
It’s not healthy for your body to store fat in the liver, pancreas, muscle or in other organs. Fat doesn’t belong in these places. Fat cells that are stored in and around organs are more likely to cause inflammation and insulin resistance. WHERE your fat is stored is very important. Fat stored in the right place (subcutaneous fat) is “healthy fat”. Fat stored in the wrong place (inside and around organs) is “unhealthy fat .” If all of your fat is stored in unhealthy places like inside and around your organs, it is possible that you can develop diabetes even if your total body weight is normal.
Your body’s tendency to store unhealthy fat is partially determined by genetics. For example, individuals from South Asia tend to store more fat in their organs which means that they are more likely to develop T2D at a lower overall body weight.
In the next article, we will discuss how to stop the reinforcing cycles of fatty liver and fatty pancreas. By intervening in these destructive processes before it is too late, you can potentially reverse your diabetes, especially if you start early in the disease process.
