Lately insulin regulation is getting a lot of play as the culprit for many diseases beyond diabetes, and rightly so: When insulin levels are not well regulated, you end up with too much glucose in the cells. You need some blood sugar swimming around to provide you with energy, but too much damages arteries and contributes to any disease that relies on the health of blood’s superhighway. We’re talking heart disease, eye disorders, kidney issues, and stroke; perhaps more.
Think you’ve got nothing to worry about? According to the CDC, from 2005-8, 35% of Americans over 20 years of age tested pre-diabetic (65 or older? Make that 50%), making for an estimated 79 million folks with pre-diabetes. Whoa. That means your blood sugar might be a bit out of whack, chief.
So let’s break this all down:
What’s blood sugar? It’s glucose that travels through the blood to cells to provide energy. All carbohydrates that we digest and absorb (in other words, not fiber) end up as glucose. Table sugar is glucose and fructose, lactose in milk is glucose and galactose. Most starch is long chains of glucose molecules. It matters not, because it all goes to the liver, which cleverly converts galactose and fructose to glucose.
Glucose we don’t immediately need is stored in the liver and the muscles as glycogen (long chains of glucose — animal starch!), where it can be used later if blood glucose starts to run low. Once we fill up those storage spaces, we turn the rest into fat (which is akin to when you’ve moved beyond all those stuffed drawers and bins and into full-blown off-site storage for all your stuff). This of course, is when the body is behaving itself.
What is insulin? It’s a very small protein made in the pancreas that directs cells to allow glucose to enter. It’s a hormone because it’s made in one place and works in another place as a chemical messenger (“Let the glucose in!”). When blood glucose runs low, (for example, in between meals or during strenuous exercise), the body uses the hormone glucagon to get glucose back into the bloodstream. Thus insulin lowers blood sugar, glucagon raises it.
So? The more refined the carbohydrate (the less fiber, and literally the more mechanically small it is — for example mashed potatoes rather than whole ones), the faster glucose hits the bloodstream, and the more insulin your body will have to make to get that flood of glucose out of the blood stream. When this occurs, it will cause your body will make more cholesterol, which of course will raise your LDL levels. The higher your LDL, the higher the risk of heart disease, stroke, eye diseases, and well, dementia possibly (see the L.A. Times link below). Diets consistently high in glycemic load foods (those that enter the bloodstream more quickly) contribute to belly fat, which in turn predisposes you to heart disease. Also, you usually end up taking in a whole lot of glucose with that flood of insulin, and before the glucagon can slam on the brakes, you’ve taken in enough to trigger…hunger. Which will encourage overeating. Sigh.
Never despair. Soluble fiber (apples, oatmeal) and fat both slow down how fast glucose enters the blood, so good foods containing these will allow for smaller amounts of insulin to be used over time. The American Diabetes Association has a handy list right here, though it ain’t brain surgery. When you eat this way, it also means quite a few things to the body. When insulin is released more slowly, little cholesterol is made in the process. You tend to stay fuller longer and you may end up eating less as a result. You tend to consume foods that actually help lower your blood cholesterol (soluble fiber, ahem). You lower your chances of wearing out your pancreas and or developing diabetes. You may need to start wearing a satin cape you’re so good!
What is diabetes anyway?
Diabetes comes in two forms, Type 1 and Type 2. Type one occurs when the body attacks cells in the pancreas that make insulin (it’s an autoimmune issue). As a result, people with Type 1 diabetes make very little or no insulin, and must take insulin daily via injection. Insulin is a protein that would be dismantled in the stomach, and this is why it can’t be taken as a pill. Researchers have tried other stuff (snorting?!) but to no avail thus far. The insulin pump has worked wonders. Type 1 diabetes can happen at any age, but it more commonly occurs in younger people. Luckily it’s only about 5% of diabetes cases, and hopefully stem cell research will help eliminate this form as a disease (provided no religious zealots halt research involving stem cells).
Type 2 diabetes is the most common form of diabetes, and there is a genetic link boys and girls. Type 2 diabetes occurs when the cells stop listening to insulin when it comes a’knockin’. When insulin comes along (“Let the glucose in!”) and the cells turns a deaf ear, glucose stays in the bloodstream. The pancreas figures it needs more insulin, so it makes more and sends it along. Sometimes the mob can get the cell to listen a little better, but you end up making loads of cholesterol. Also, the glucose damages the cardiovascular system by causing inflammation. This can cause damage to arteries as well as strain organs, and that’s how it encourages disease.
When a person is diagnosed with Type 2 diabetes, the doctor will immediately ask the patient to lose weight and exercise. The patient will find losing weight to be difficult. The blood is flooded with glucose, but the cells have very little. They are hungry, and they will tell you so all the time. Meanwhile, you will be thirsty all of the time as well because the only way to get rid of all that glucose is to wash it out in your urine. So you will drink and pee and be hungry.
Why the diet and exercise then? Filled up fat cells won’t listen when insulin arrives because they don’t need the glucose. The more you empty out those cells, the more closely the fat cells will be listening when insulin swings by with a little glucose pick-me-up. When you exercise those muscles, they tend to prick up their ears when offered a source of energy, so they start listening too. Non-diabetics, pre-diabetics: I’m talking to you too.
The good news: after a time, the hunger will dissipate and it will become easier to take the weight off and keep it off. You will also, however, have to exercise consistently and work with a doctor or coach to help maintain good glucose levels.
And what if you don’t have diabetes? Follow the above advice to lower the risk that you ever will. Now go eat a vegetable.
The L.A. Times health section today has some great articles on managing diabetes. They look at the possible link between diabetes/blood sugar and dementia, stem cell therapy (the future for Type 1 diabetes), having a diabetes coach to help maintain blood sugar, and a very informative one about little girl’s struggle to manage Type 1 diabetes.